Order of the Ministry of Health of the Russian Federation No. 624 on approval of the procedure for issuing certificates of incapacity for work

Receiving certificates of incapacity for work is the legal right of any insured citizen.
But in order for the hospital bulletin to be valid and have legal force, it must be drawn up in accordance with all the rules prescribed by law. Dear readers! To solve your specific problem, call the hotline or visit the website. It's free.
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For this purpose, on June 29, 2011, Order No. 624n of the Ministry of Health and Social Development of Russia “On approval of the Procedure for issuing certificates of incapacity for work” was issued.

This order regulates the procedure for issuing sheets in various cases of taking sick leave, the persons who can draw up a ballot and who can issue it, the rules for filling out the ballot, as well as sanctions for those responsible for violating the algorithm for issuing sick leave.

However, since the order was issued, it has undergone many changes, the most recent of which was on November 28, 2021.

General provisions

The general provisions section contains information about the categories of citizens who have the right to receive a certificate of incapacity for work in the Russian Federation. Sick leave is issued to all insured persons residing in the Russian Federation:

• citizens of the Russian Federation;
• Foreign citizens;
• stateless persons.

The condition for issuing a certificate of incapacity for work is official employment:

• all persons working under an employment contract;
• civil servants;
• members of production cooperatives and farms;
• clergy;
• lawyers;
• individual entrepreneurs.

All of these categories must have a medical insurance policy valid in Russia.

Important! Sick leave is issued to people who have an insured event (injury or illness), even after dismissal. The valid period is 30 days from the date of termination of the employment contract.

LVN is also issued to women who become pregnant within a year before the termination of the employment contract. People who are registered with the employment service have the right to receive sick leave.

Certificates of incapacity for work can be issued by persons who have a medical license and have completed training in the examination of incapacity for work:

• attending physicians;
• paramedics and midwives;
• dentists.

They are not issued to hospital ambulance workers, blood transfusion stations, hospital emergency departments, or sanatorium-resort institutions.

Important! Sick leave can only be issued if you have a passport.

If a person works for several employers for two years or more, he is issued certificates of incapacity for work for each place of work. If a person works in several places for less than two years, he is given one sick leave for the place of work of his choice.

A medical professional issues a medical device after examining the patient and establishing the fact of his illness. This is an examination of temporary disability. The examination must be recorded in the outpatient card or medical history. LVN forms are also registered there. Sick leave is issued on the day of application or upon completion of treatment. If long-term treatment is necessary, the medical organization conducts a commission at which the patient’s condition is determined and a decision is made to extend the LVN.

Useful article on the topic: Calculation of temporary disability benefits

Acts regulating work with sick leave

Currently, there is a procedure for issuing certificates of incapacity for work, approved by order of the Ministry of Health and Social Development dated June 29, 2011 No. 624n (hereinafter referred to as Procedure No. 624n).
On December 14, 2021, another document comes into force - the procedure for issuing and processing certificates of incapacity for work, approved by Order of the Ministry of Health dated September 1, 2020 No. 925n (hereinafter referred to as Procedure No. 925n). From the same date, order No. 624n will cease to be in force.

ATTENTION

Now the sick leave form is used, which was approved by order of the Ministry of Health and Social Development dated April 26, 2011 No. 347n. But there is reason to believe that the form will soon be adjusted. So, in the current form, one of the sections is called “TO BE COMPLETED BY THE EMPLOYER.” And in the new Procedure it has a different name - “TO BE COMPLETED BY THE INSURED.”

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The procedure for issuing a certificate of incapacity for work when sending citizens for a medical and social examination

People with persistent and irreversible disabilities and self-care are referred to MSE. The examination is indicated for people when:

• unfavorable labor and clinical prognosis;
• favorable prognosis in case of injuries, reconstructive operations, and tuberculosis;
• the need to strengthen the disability group for working disabled people.

If a person is assigned a disability, the temporary disability ends the day before this fact.

Important! If the patient refuses to appear for medical examination, temporary disability ends on the day of refusal. The sick leave is closed, making a note about the violation of the regime.

The procedure for issuing a certificate of incapacity for caring for a sick family member

If one of the family members temporarily loses the ability to self-care, a relative or guardian is given sick leave for care. LVN is issued for the care of:

• a child under 7 years of age for the entire period of his treatment;
• a child from 7 to 15 years old for a period of 15 days;
• a disabled child under 18 years of age for the entire period of treatment;
• a child with HIV infection for the entire period of inpatient treatment.

If two children fall ill at the same time, one LVN is issued. If more than two children are ill at the same time, two LVNs are issued. If the second child gets sick later than the first, LVN is extended until the second one recovers.

They do not issue LVN for the care of:

• adult patients undergoing inpatient treatment;
• chronic patients without exacerbation;
• during the period of leave - annual, maternity, maternity leave.

LVN for caring for an adult patient is issued for a period of no more than 3 days.

Electronic sick leave certificates

General points

Very important innovations are devoted to electronic certificates of incapacity for work (ELN).

Let us remind you that the electronic newsletter is generated and stored in the unified integration information system “Sotsstrakh”. Doctors tell the patient the ELN number, and he passes it on to the employer. Using the specified number, the employer finds the sick leave certificate in the UIIS “Sotsstrakh” database, fills out its section, saves it and certifies it with an electronic signature. After this, the ELN is automatically sent to the Social Insurance Fund. There is no need to print or store paper copies (see “Electronic Sick Leave in 2021” and “Transition to Direct Benefit Payments in 2021: What an Accountant Needs to Know”).

Work with electronic sick leave with a “complicated” salary with bonuses and coefficients

In the current Order No. 624n there are no clauses dedicated to electronic sick leave. And Order No. 925n describes in detail how to draw up an electronic tax record and work with it.

IMPORTANT

It follows from paragraph 74 of the new Procedure that the electronic signature must be sealed with two enhanced qualified electronic signatures (UKES): the manager and the chief accountant. Instead of the chief accountant's UKEP, it is permissible to use the electronic signature of another person authorized to keep accounting records. And only if the functions of the chief accountant are assigned to the director, one UKEP belonging to the director can be placed on the ballot. In practice, many policyholders, when signing an ELN, use one UKEP: either the manager or the chief accountant. As far as we know, the FSS is loyal to this. However, it is worth remembering that this option does not comply with the Order and is therefore risky. If the policyholder’s relationship with the Social Insurance Fund is “tense”, signing a sick leave note with one signature may serve as the basis for formal claims from the Fund. The only option to protect yourself when using one signature is to adopt a local act of the organization, which would entrust record keeping to the director.

Receive an enhanced qualified electronic signature certificate in an hour

How to correct employer errors in ENL

What should an employer do if he made a mistake when filling out his section on the electronic sick leave form? Now he can only recalculate on paper and keep it for himself. It will not be possible to make adjustments to the ENL, since there are no corresponding regulations.

The new Procedure provides for such regulations. Paragraph 72 says: if an error is found in the section “TO BE COMPLETED BY THE INSURER”, changes must be made to the electronic newsletter. Then put the UKEP of the chief accountant and the manager and re-send the information to the Social Insurance Fund.

Other details of working with ELN

We list the most important rules for working with electronic newsletters provided for by the new Procedure. Among other things, it installed:

• unemployed people can only receive a paper ballot. The rule also applies to women dismissed due to the liquidation of a company (termination of individual entrepreneur status), whose pregnancy occurred within 12 months before they were recognized as unemployed (clause 1 and clause 2 of Order No. 925n);
• if a person works for several policyholders, and in the two previous years he worked for them, then instead of several paper ballots, he may be issued one ENL. The employee must provide the number of this document to each employer. This rule can also be applied in a situation where in the two previous years the employee was employed by both the same and other insurers (clause 6 and clause 8 of Procedure No. 925n);
• within the framework of one insured event, two bulletins can be issued: the initial one on paper, the continuation in electronic form. And vice versa, it is permissible to draw up the initial one in the form of an ELN, and the continuation on paper (clause 14 of Order No. 925n);
• in the electronic newsletter, the place of work and type of employment (main or part-time) are not indicated (clause 65 of Order No. 925n);
• in the electronic health record, in the “Diagnosis” field (in the sick leave certificate for care, in the “Diagnosis of a family member” field), a code according to the international classification of diseases is automatically entered. This information is not provided to the employer (clause 72 of Order No. 925n). For a number of diseases (HIV, tuberculosis, etc.) the code is not indicated;
• the ENL for caring for a family member indicates the SNILS and date of birth of the sick person, as well as the code for the reason for his disability. In addition, the conditions for providing medical care are noted: outpatient, shared hospital stay. There are no such fields on a paper ballot.

ATTENTION

All actions necessary to work with ENL can be performed in the system for preparing and sending reports “Kontur.Extern”.

Work with electronic sick leave and submit all related reporting through Kontur.Extern

The procedure for issuing a certificate of incapacity for work during quarantine

Quarantine is established for persons who have been in contact with infectious patients, as well as for bacteria carriers. The LVN is issued by an infectious disease specialist or therapist. The period of disability depends on the incubation period of the disease.

If a child or an incapacitated family member is in quarantine, the relative is issued a LVN to care for the latter in accordance with the order on certificates of incapacity for work.

People with diagnosed helminthiasis who work in the food industry are given LVN for the entire period of deworming.

What's new

The circle of persons receiving a certificate of incapacity for work has been increased. Now the following are also entitled to receive sick leave:

• heads of enterprises who are the only participants (founders, property owners);
• persons convicted and involved in paid labor.

Any organization licensed for medical activities, including services for the examination of temporary disability, has the right to issue a certificate of incapacity for work.

But not all employees can issue a certificate of incapacity for work.

Scheme 1. Employees issuing a certificate of incapacity for work

Recommendations for issuing electronic sick leave certificates are also described. In the electronic sick leave certificate for each sick family member, along with the full name, relationship and period of care, you now also need to indicate SNILS and the ICD code. This code is automatically assigned when creating an electronic sick leave. Please note that if medical care was provided for diseases such as tuberculosis, oncology, pediatric oncology, dermatovenereology, psychiatry-narcology, HIV infection, mental disorders and behavioral disorders, in this case the ICD code is not indicated (clause 45 of Procedure No. 925n).

The procedure for issuing a certificate of incapacity for work during pregnancy and childbirth

Working pregnant women receive LVN for pregnancy and childbirth from the 30th week. Sick leave is issued at a time, its duration is 140 days. An obstetrician-gynecologist or therapist draws up a certificate of incapacity for work.

If a woman has a multiple pregnancy, she is given sick leave at 28 weeks. The duration of incapacity for work is 194 days.

The woman’s refusal to register for medical treatment is recorded in the medical documentation. If she applies again with a request for sick leave later than 30 weeks of pregnancy, she is issued a LVN from the day of the 30th week.

Important! If a multiple pregnancy was discovered only during childbirth, an additional LVN for a period of 54 days is issued by the maternity hospital.

In case of complications of childbirth, an additional LVN is issued for a period of 16 days. For premature birth before the 30th week, the maternity hospital issues sick leave for 156 days.

If a woman adopts a child under 3 months old, she is given sick leave for 70 days from the date of birth of the child.

Explanation of changes according to Order No. 953H

Before amendments were made to the legislative framework, employees had the right to be absent from the workplace on children's sick leave:

• no more than 60 days if the certificate of incapacity for work was issued for a child under 7 years of age;
• no more than 90 days if the sick leave was issued for a child under 7 years old suffering from a special disease;
• no more than 120 days, if a certificate of incapacity for work was issued for a disabled child.

Now employees have the right to return to the workplace after the child recovers, even if the period of illness is significantly longer than the above deadlines. At the same time, the employer does not have the right to apply penalties to the employee or initiate dismissal proceedings.

The table provides details of all changes that came into force from April 2021.

Important! Please note that all innovations relate only to increasing the duration of sick leave. This means that if a child is ill, a parent has the right to be absent from work for longer than before the changes in legislation came into force. However, the number of days due remains unchanged.

Example

A child under 7 years of age is treated on an outpatient basis, and the parent provides care while staying with him in a medical facility. In accordance with paragraph 1 of paragraph 5 of Article Federal Law No. 255 of December 29, 2006, the employee will be paid compensation for a certificate of incapacity for work for a period of no more than 60 days. However, an employee can be absent from the workplace for exactly as long as the sick leave lasts, regardless of the established payment period.

Filling out a certificate of incapacity for work

The rules for registering LVN are prescribed in Order 624 of 2011. The 2021 edition makes minor amendments.

1. All entries are made with a black gel or fountain pen. The use of blue paste or ballpoint pen is unacceptable. Letters are in capital letters. The use of printing devices is allowed.
2. Special cells are provided for records. You need to fill it out from the first cell.
3. Stamps should not fall on the cells, affecting the readability of the entered text.
4. The seal of a medical organization must correspond to its name. Some organizations dealing with socially significant diseases have the right not to indicate their name.

If errors were made when filling out the form, it is considered damaged. Instead of such a form, a duplicate is issued.

Errors when filling out the form are:

• using a blue ballpoint pen;
• making entries in capital letters;
• making extraneous entries;
• changing the name of the medical institution, specialty and surname of the doctor, patient data, dates of incapacity for work;
• blots, correction with a proofreader.

When a new form is issued, a note is made in it that it is a duplicate. At the top of the form indicate the number of the damaged sick leave.

Continuation of LVN is issued if the patient is incapacitated for work after 15 days. The number of the previous sick leave is written down on the form and the note “continues to be ill” is made.

Instructions for filling out the form include the following points:

• put o or “duplicate”;
• the number of the previous form is indicated;
• the date of issue of the LVN is indicated;
• indicate the patient's last name, first name and patronymic;
• indicate the specialty, surname and initials of the doctor;
• write the name of the place of work;
• indicate the type of LVN - main or part-time.

The patient signs in a special column at the bottom of the form.

According to the order of the Ministry of Health, each medical organization where a person is treated issues its own certificate of incapacity for work.

The form has a section for the employer to fill out. Here, too, only a black gel or fountain pen is used, but corrections are allowed. If an accounting employee makes a mistake, the entry is crossed out, and the correct entry is entered on the back of the form. The correction is confirmed by the entry “corrected to believe”, the signature and seal of the employer.

Rules for filling out sick leave forms

The basic rules for filling out disability forms are regulated in the ninth paragraph of the order. These include:

1. The disability certificate must be filled out in capital block letters in Russian using a black gel, fountain or capillary pen.
2. It is forbidden to go beyond the established place ; in this case, printing may extend beyond the margins of the designated cell if it does not overlap the sheet information.
3. The seal impression must correspond to the real name of the medical institution ; in some cases, its profile may not be on the seal.
4. If errors or blots are made, the original sheet becomes damaged , and a duplicate is issued in its place.
5. The calculation of benefits is carried out independently by the insurance person on a separate form and attached to the hospital bulletin.

The paragraph of the order on the rules for filling out the ballot contains a lot of information, in particular, special codes and designations. They are often entered incorrectly, which entails re-issuing the ballot. Therefore, the Social Insurance Fund provided clarification on this issue.

According to FSS letter No. 14-03-11/15-1157 dated September 30, 2011, the Foundation has developed a special program that simplifies the process of filling out sick leave forms and allows you to simply type in data. This program has been freely and freely available since 09/01/2011 on the FSS website. Download link here.