The duty of the state is to support citizens in the event of illness or caring for a sick relative. This task is assigned to the Social Insurance Fund (SIF). His responsibilities include collecting payments and determining the amount of payments. Contributions are required to be made by private entrepreneurs, companies and, in rare situations, the insured persons themselves. We will tell you how sick leave is paid and under what circumstances money may be denied.
How is sick leave paid?
Concept of sick leave
This is a document confirming the temporary inability to carry out work assignments. It is made in the form of an A4 sheet with columns in which information about the employee and the reasons for the occurrence of the insured event are entered. It is issued by a clinic, hospital or other medical organization. The basis for issuing a sheet is considered to be the occurrence of a temporary loss of ability to work associated with:
- illness or work injury;
- caring for a small child;
- maternity leave;
- caring for a child or other family member in case of illness.
The document is provided at the place of employment to determine the start date and end date of forced absence. It indicates the applicant's details, the reason for receiving payments, as well as the start and end times of sickness or nursing leave.
A document confirming the temporary inability to carry out work assignments
What the law says
General provisions and requirements, as well as methods for calculating compensation for temporary loss of ability to work fully, are described in Law No. 255-FZ of December 29, 2006. A citizen can count on compensation if he is unwell, after receiving damage or injury, as well as when he goes on forced leave due to the illness of a family member.
The insurer is an organization, individual entrepreneur or the citizen himself, depending on the type of employment. These include lawyers, members of peasant farms, notaries, members of communities in the Far North, as well as payers who have independently entered the insurance system. In case of maternity, the Social Insurance Fund is recognized as the insurer.
The maximum period of treatment in the event of an illness or work-related injury is not legally defined; however, the maximum duration of child care is indicated. It is no more than 15 days per sick leave, but no more than 45 days per year. Sick leave issued above this figure will not be paid.
Federal Law N 255-FZ “On compulsory social insurance in case of temporary disability...”. Article 5
What determines the amount of compensation?
The amount of the benefit depends on the length of work. In this case, the duration of the entire activity is taken as a basis. It doesn’t matter how long an employee has been working for the organization. The total number of working years is important. This rule applies to both sickness compensation and benefits when a relative or child goes on forced leave due to illness.
If the length of service is less than 6 full months, the payment cannot exceed the minimum salary established for 12 months. The minimum wage is set by regional authorities independently, taking into account the cost of essential products, the price of a square meter of housing and other socio-economic aspects.
What percentage of salary is included in compensation?
Amount of benefits for temporary disability. Article 7 Federal Law N 255-FZ
Article 7 of Law No. 255-FZ determines the amount of sick leave payments. It depends on the length of experience. The base is the amount of insurance payments for the last two years. The amount of the benefit is determined according to the following principle:
- up to 5 years – 60% of average earnings;
- from 6 to 8 years – 80%;
- more than 8 years – 100%.
In 2021, the maximum average earnings for determining the amount of benefits is 1,570,000 rubles. It consists of the maximum indicator for 2021 (755,000 rubles) and 2018 (815,000 rubles). Thus, if the official salary is exceeded, only the maximum indicators will be included in the calculation.
The benefit amount is determined by the average earnings
Reference! This restriction was introduced in 2017 after news appeared in the media that the St. Petersburg Social Protection Fund directed most of the payments to the players of the Zenit football club. The peculiarity of the situation is that each team player, when injured, has the right to count on benefits due to temporary disability. Considering the fact that football players’ salaries are much higher than the market average, payments made up a significant portion of the FSS budget.
The duration of work activity is determined by the work book. If it is lost or destroyed, the amount of length of service can be determined using employment contracts or other supporting documents. Verbal agreement is not accepted as evidence of employment
The duration of work activity is determined by the work book
Find out how to open a sick leave certificate on a day off from our new article.
Deadlines for assigning payment for sick leave
Chapter 4 of the Federal Law describes the procedure for assigning benefits, including the timing of application and provision of payments. In both cases, 10 calendar days are allotted for these events. In this case, registration of sick leave takes place within the specified period, starting from the date of application, and payment is made on the nearest date of payment of wages.
As a rule, the employer is responsible for issuing sick leave. However, if the insured person does not have a permanent place of work at the time of application, the applicant must independently contact the social insurance authorities. In the absence of a certificate of income of the applicant, specialists of the Social Insurance Fund make a decision on the amount of the benefit based on the data on earnings available to him. If a citizen has no previous work experience, the minimum wage is taken as a basis.
Duration of sick leave
Deadlines for receiving benefits
The legislation does not have a clear limit on the number of days allotted for receiving medical care. This means that it will not be possible to stop payments only on the basis of long-term sick leave. However, for child care or sick leave due to pregnancy, a threshold event has been defined, after which the amount of payment will either decrease or stop altogether.
| Duration of payments | |
| Disease | No formal restrictions |
| Sick leave for childbirth and pregnancy | 70 days before birth and 70 days after. The period increases with multiple pregnancies and is 84 days before and 110 days after birth |
| Caring for a child when sick | No more than 15 days at a time and no more than 45 days in a calendar year |
Refusals to pay sick leave
The applicant may be denied sick pay. According to the same law No. 255-FZ, payment is not made in the following periods:
- partial or complete release from work in accordance with the law;
- time spent in custody or spent conducting a medical examination;
- downtime;
- other periods of time during which payments were not made in favor of the citizen to the Social Insurance Fund.
Federal Law N 255-FZ “On compulsory social insurance in case of temporary disability...”. Article 9
If there are reasons to doubt the legality of the refusal, you should go to court. At the initial stage, it is recommended to consult with a lawyer. With its help, you will be able to reduce the time spent on paperwork.
The applicant may independently refuse sick leave. In this case, he takes on the risk associated with a possible deterioration in health. In this case, due to the lack of sick leave, payments cannot be made.
Who pays for sick leave?
Who pays for sick leave?
Compensation payments are borne by the state and the employer, depending on the length of sick leave. The company or entrepreneur pays only for the first three days of forced leave from work. Starting from the fourth day of incapacity for work, the obligation to pay benefits falls on the Social Insurance Fund. However, it is worth noting that the Fund’s budget is filled thanks to contributions from organizations and entrepreneurs, so one way or another, the employer is responsible for paying for sick leave. If the benefit is paid for another reason, then the FSS bears all expenses.
Regulated payment terms
Knowing how sick leave is paid, you can plan treatment costs in advance. It is important to remember that financial assistance will be provided only after a certificate of incapacity for work is provided. It is also necessary to find out whether sick leave is paid and in what amount if violations by the employee have been recorded.
Payment procedure:
- Provide a medical certificate to the employer.
- Check the accrued amount with your own calculations.
- Payment is made in accordance with the current regulations - on the day of salary or advance payment.
The last point is important - money will not be issued in advance. Therefore, you need to prepare for treatment costs yourself. The employer can assign financial assistance, but only on its own initiative.
What to do if a person is employed by several employers
When working part-time, a citizen has the right to both receive benefits for his main job and sick pay from his part-time employer. Of course, provided that both employers make payments to the Social Security Fund on time. In this case, the number of places of employment does not matter. What is important is the length of service, the volume of payments to the Social Insurance Fund and the amount of average annual earnings.
When working part-time, a citizen has the right to both receive benefits for his main job and sick pay from his part-time employer
Important! To receive compensation for temporary disability, an employee must be officially registered. If the total length of service is less than 6 months, the minimum wage is taken as the basis for calculating the amount of compensation. Its value depends on the region of residence.
How to calculate the amount of compensation yourself
Registration of an application for benefits is usually handled by the accounting department. To independently calculate the amount of compensation, you need to know the employee’s length of service and his average earnings over the last 2 years. There are enough online calculators on the Internet to determine the correctness of payment calculations. The calculation procedure itself is easier to consider using an example.
Procedure and purpose of payment of temporary disability benefits
Example of sick leave calculation
Ivanov Ivan Ivanovich has a sick leave certificate for the period from March 1 to March 14. The total period of work is 6 years. Over the past two years, the employee has an average salary of 660,000 rubles per year. This indicator is lower than the limit in 2021 and 2021, which means it can be used in calculations.
Next, you need to calculate your average daily earnings. To do this, the total income in the amount of 1,320,000 rubles (660,000 rubles per year) is divided by the number of days for two years - 730.
1,320,000/730=1,808 rub. 22 kopecks
Due to the fact that Ivan Ivanovich worked for a total of less than 8 years, the benefit amount is 80% of his average daily income.
1808.22*0.8=1,446 rub. 58 kopecks
All that remains is to multiply the resulting value by the number of days of sick leave.
1446.58*15=21,698 rub. 70 kopecks
In the same way, you can independently calculate the amount of compensation in other situations. The main parameters are the number of days on the sheet, total length of service and the corresponding percentage of average earnings.
Sick leave calculation scheme
If the employee had less than 6 months of experience, the minimum wage would be taken into account. The all-Russian minimum wage in 2019 is 11,280 rubles. For example, in Moscow its value is 18,781 rubles, and in St. Petersburg – 18,000 rubles. Subjects of the Russian Federation independently determine the amount of the “minimum wage”.
Sick leave payment calculator
Go to calculations
How to submit documents on direct payments to the Social Insurance Fund
The method of transmitting data to the Social Insurance Fund depends on the average number of employees of the employer:
- 25 people or more - documents, including the register of information, are sent to the FSS in electronic form;
- 24 people or less - documents, including an inventory, can be sent to the FSS both electronically and on paper.
Let's consider each of the methods.
Direct payments: electronic register
The register can be filled out in relation to one or more employees who applied for various types of social benefits during the last 5 calendar days. Data for each employee must be indicated in a separate line of the register. If there is no data to fill out any columns, dashes are placed in them.
Fill out the register taking into account the following features:
- If the employee will receive benefits on the Mir card, the address of residence in column 7 does not need to be filled in.
A number of benefits from the Social Insurance Fund are paid only to the Mir card. You can find out more about this here.
- In column 19 “Cause of disability”, transfer the code from the sick leave certificate.
- When replacing years in the billing period, in column 37 “Calculation period”, indicate the date of the employee’s application on the basis of which the replacement is made.
- In columns 39 and 40 “Amount of average earnings for the billing period,” indicate the larger of the values: the base for calculating benefits or 24 times the minimum wage.
- In column 42 “Other information affecting the right to receive benefits or the calculation of its amount,” indicate the details of certificates in Form 182n from previous employers or the size of the coefficient if the employee works in an area where the regional coefficient is applied.
Within 5 calendar days, submit the originals of the above documents to Social Security. The FSS will return them after checking and assigning benefits (refusal to pay).
Inventory of documents in the Social Insurance Fund: pilot project
If the average number of employees is 24 or less, fill out a list of applications and documents instead of a register. The inventory form is given in Appendix No. 2 to Order No. 578 of the Federal Social Insurance Fund of the Russian Federation dated November 24, 2017.
FAQ
From what amount is the amount of payment for sick leave calculated? – The employee’s average earnings over the last 2 calendar years are taken as the basis. In 2021, this figure is equal to 865,000 rubles per month.
What to do if sick leave to care for a child lasts longer than the established period? – In this case, the parent has the right to extend sick leave, but days forcedly spent without work will not be paid.
Can an employer fire an employee while on sick leave? - No. An entrepreneur or organization does not have the right to dismiss an employee, even if his sick leave lasts longer than usual. This right is enshrined in Article 81 of the Labor Code. However, an employee can leave his place of work at his own request.
An employer cannot fire an employee while on sick leave
Special situations
Having figured out how many sick days are paid per year, it is worth familiarizing yourself with the situations when an exception to the rule is made. Disabled people or those caring for them can count on no restrictions on the payment of sick leave per year.
It is important to know! The period increases from 2 weeks to a year in case of such serious diseases as tuberculosis or postoperative complications. If the doctor gives an unfavorable prognosis, then after 4 months the person is sent for a medical and social examination, where he is assigned a disability.
The legislation of the Russian Federation today does not introduce restrictions on how many times you can take sick leave per year if we are talking about an insured person. While the certificate of incapacity for work is valid, the employer does not have the right to dismiss a citizen, even if his illness is prolonged.
But there are certain nuances in this matter that are worth knowing in order to be able to protect your rights if the company violates them.
There is no benefit for an employer to keep such an employee who “stamps” sick leave certificates like a copy machine.
Law No. 255-FZ, in its sixth article, took this circumstance into account and limited the length of stay on sick leave.
This is important to know: Benefits for pensioners: social benefits for older people in 2021
Let's sum it up
A citizen of the Russian Federation has the right to payment of compensation in connection with temporary loss of disability. Reasons for losing the ability to work may include illness, work injury, pregnancy and childbirth, or caring for a sick child. Depending on the case, the maximum duration of sick leave is established.
The responsibility for calculating and paying benefits falls on the Social Insurance Fund. Its budget is formed from contributions from entrepreneurs and organizations that transfer payments to employees. Depending on the length of work experience, the amount of payment may vary. For example, citizens with more than 8 years of experience can count on full payment.
Depending on the length of work experience, the amount of payment may vary
Sick leave for child care is limited in time to 15 calendar days, but no more than 45 days for the entire year. As a rule, this time is enough to treat the child on your own or to decide on a medical institution where treatment will continue.
140 days are allocated for sick leave for pregnancy and childbirth (70 each before and after the birth of the child). When several children are born, its value increases to 194 days (84 days before and 110 after). If you refuse to issue a sick leave, no payments will be made, however, the employee assumes the risk of possible deterioration in health. It is illegal to fire an employee who is on sick leave.
Project “Direct Social Insurance Payments” in 2020
The FSS pilot project has currently been introduced in 69 regions of the Russian Federation. The full list of participating entities can be found in this article. From January 2021, it is planned to extend the direct payments project to the entire territory of Russia.
The mechanism of the pilot project is as follows:
- The employee provides the employer with sick leave and all related documents confirming the insured event. The deadline for submitting a certificate of incapacity for work and other documents confirming the occurrence of an insured event is 6 months after the end of the sick leave.
- The employer submits a package of documents to the Social Insurance Fund within 5 days.
- Within 10 days, the Social Insurance Fund checks the papers provided by the employer and issues a decision on the appointment or refusal to pay benefits.
- The benefit is transferred to the employee’s current account or transferred by post. If any documents are missing or are drawn up incorrectly, the FSS will send a notice to the employer. Within 5 days, the policyholder is obliged to replace them or provide the missing documents.
This approach allows you to avoid errors in the assignment and payment of benefits, protect the policyholder from paying benefits on a fake sick leave, and guarantee the insured person timely payment of funds.
The following types of benefits are paid in the “direct payments” system:
The algorithm for calculating benefits has not changed: benefits for the first 3 days of an employee’s illness are also paid from the employer’s funds. In addition, the employer pays a funeral benefit and 4 additional days of caring for disabled children. The FSS reimburses the employer for the costs of the last two insured events.
Participation in the Direct Payments pilot project is mandatory for all policyholders registered in this region. The exception is separate divisions that do not have a current account and do not pay wages to employees. Provided that the parent organization is located in a region where the pilot project has not yet been introduced.
