The amount of sick leave benefits for child care is calculated based on the employee’s average earnings for the two calendar years preceding the date of issue of sick leave, the same as in the case of illness of the employee himself. However, there are differences when paying sick leave for care and for illness of the employee himself.
Firstly, all days of sick leave for child care that are subject to payment are paid in full from the Social Insurance Fund.
Secondly, when an employee is dismissed, sick leave for child care must be paid if the child falls ill no later than the date of the employee’s dismissal.
Thirdly, if a child falls ill during an employee’s annual paid leave, days of incapacity for work falling during the vacation are not paid, and the employee’s vacation itself is not extended or postponed (Clause 1, Part 1, Article 9 of the Federal Law of December 29, 2006 No. 255-FZ; clauses 40, 41 of the Procedure for issuing sick leave, approved by order of the Ministry of Health and Social Development of Russia No. 624n; letter of Rostrud dated June 1, 2012 No. PG/4629-6-1).
Cause of disability codes on sick leave: decoding
The cause of disability code on the sick leave is indicated in a special field consisting of two cells. Their values range from 01 to 15. The form has three cells for specifying an additional code. It is intended to clarify the causes of injury or illness and some other details. Their values range from 017 to 021.
Let's look at the most common values, and the remaining codes for the reasons for disability on the new sick leave can be seen on the sample back of this form.
Violation codes
The line “Record of violation of the regime” is filled in only if a violation is detected. Codes apply:
- 23 – in case of non-compliance with the prescribed regimen, unauthorized departure from the hospital;
- 24 – when you miss an appointment with a doctor;
- 25 – when reporting to work without an extract;
- 26 – upon refusal to be referred to an ITU institution;
- 27 – in case of untimely attendance at the ITU institution;
- 28 – for other violations.
If the reasons for the violation are found to be unjustified, the benefit is reduced from the date of the violation. Together with these codes, code “36” can be used in the “Other” line, indicating that the employee was able to work at the last doctor’s appointment.
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Labor law establishes the payment of compensation to workers injured at work. The employer reimburses:
- unearned income of a citizen due to sick leave;
- additional expenses for medical, professional or social rehabilitation.
In the event that the employer pays all insurance contributions to the Social Insurance Fund, the authorities reimburse all payments. The calculation of payments is regulated by the Federal Law “On Compulsory Social Insurance against Accidents” . Unearned income is reimbursed to the victim in the amount of the average salary for the entire period of incapacity for work.
The one-time insurance payment is calculated based on his average earnings, regional coefficients and premiums established in the given area. The maximum amount, according to Art. 11 of this law is 94,018 rubles. This amount is compensation for medical, social and professional rehabilitation.
The maximum monthly payment is calculated based on the share of average monthly earnings and the degree of disability. Average monthly earnings are calculated as follows:
ZPsr = ZPtot / 12 , where ZPtot is the total amount of earnings for 12 months (salary itself, bonuses) before the accident occurred.
Sick leave for care with codes 13, 14 and 15
The maximum number of days for caring for a sick disabled child (code 13), which must be paid during the year, is 120 calendar days. Moreover, the number of paid days for each case of illness within this limit is not limited (clause 3, part 5, article 6 of Law No. 255-FZ).
The maximum number of paid days on sick leave for child care with code 14 or 15 is not limited.
In each case, the employee must be paid benefits in the same amounts as when caring for a child under 7 or 15 years old (clause 1, 2, part 3, article 7 of Law No. 255-FZ).
Taking turns caring for a sick child
If necessary, sick leave can be issued to different family members alternately (clause 36 of the Procedure for issuing certificates of incapacity for work, approved by order of the Ministry of Health and Social Development of Russia No. 624n).
The insured event is the temporary disability of the insured person (family member) due to the need to care for a sick child (and not the illness of the child or another family member who needs care). Therefore, a certificate of incapacity for work for each family member must be issued as a primary one. Certificates of incapacity for work issued to each family member who cared for a sick child are subject to closure. Accordingly, benefits for temporary disability are calculated as for individual insured events. This is stated in the letter of the FSS of Russia dated July 28, 2021 No. 02-09-14/15-0.
If the completed ballot contains errors in the codes
The presence of incorrect codes in the bulletin is a significant error. It cannot be ignored, since the FSS accepts for consideration only ballots with minor errors.
As evidenced by the example from the FSS letter No. 14-03-18/15-12956 dated October 28, 2011, these include only isolated technical flaws, such as spaces when writing the doctor’s initials. The key point, the FSS draws attention to, is the readability of the text and the absence of distortions in content.
A. P. Kaminsky.
If the code “04” or any other code indicated by the doctor is incorrect, then the sick leave form is considered damaged and must be replaced. Only the employer has the right to make corrections in the bulletin, but only in his own section and no more than 2 times.
Important! If, during an inspection, the FSS of the Russian Federation reveals serious errors that distort the meaning, or 3 or more corrections to the text made by the employer, it will recognize such a ballot as invalid.
Accordingly, the FSS will refuse to assign and pay social benefits for the above reasons. A justified written refusal, sick leave with errors in this situation is sent to the employer.
If the amount of social benefits was paid on an illegally issued ballot, then it must be returned. The onset of liability for the above violations is stated in paragraph 4 of paragraph 1 of Art. 4. 2 Federal Law of the Russian Federation No. 255 of December 29, 2006, as well as clause 18 of Resolution No. 101 of February 12, 1994.
Conclusion of the Presidium of the Supreme Arbitration Court of the Russian Federation in 2012
The judges considered a situation in which a company employee had been ill for almost eight months. In the third month of treatment, she once mixed up the appointment dates and came to her next appointment with the doctor a week later.
According to experts from the Federal Social Insurance Fund of the Russian Federation, the benefit should be reduced from the day the deadline for reporting to the doctor is violated until the end of the period of incapacity for work. In this situation, this period was almost five months.
The judges of the Presidium of the Supreme Arbitration Court of the Russian Federation did not agree with this approach. They noted that the FSS of the Russian Federation must take into account the principle of fairness and proportionality of the violation and punishment. In Resolution No. 14379/11 dated February 14, 2012, they indicated that in this situation the fund has no grounds for reducing the amount of benefits for the entire period of incapacity.
Example 2. Calculation of sick leave for a domestic injury
While doing repair work at home, an employee of Sluchai LLC injured his hand. He was given a ballot for 13 days. The victim’s work experience is 6 years, which means that he is entitled to a payment in the amount of 80% of the SDZ. SDZ size for the last 2 years: RUB 2,000.
This injury is a domestic injury. Accordingly, the first 2 days are paid by the employer, and the rest - by the Social Insurance Fund. The actual calculation of social benefits is made according to the formula: SDZ * 80% * number of days of illness (2,000 rubles * 80% * 13 = 20,800 rubles).
New procedure for calculating sick leave in 2021
From April 1, sick leave for a full month of incapacity must be no lower than the federal minimum wage, taking into account regional coefficients, regardless of the employee’s insurance coverage and actual earnings. This is established by Federal Law No. 104-FZ of 04/01/2020. This procedure is valid until the end of 2021. In 2021, the federal minimum wage is 12,130 rubles.
This is how you now need to calculate temporary disability benefits.
- Calculate how many calendar days are due for payment. To do this, look at what date and date there was a release from work. If there are non-working days during this period, they are also paid. Pay attention to the codes in the “Reason of disability” cells - this determines how many days of sick leave you need to pay. For example, “01” means illness; the employee must be paid benefits for all days of illness. “09” is caring for a sick family member, and here, depending on the additional information on the sheet, there will be restrictions on the number of days. Decoding of the codes can be found on the back of the sick leave.
- Calculate your average daily earnings as usual. To do this, divide the employee’s earnings for the billing period (in general, these are the two previous calendar years) by 730 and adjust them taking into account the length of service: less than 5 years - 60% of average earnings; 5-8 years -80%; 8 or more years - 100%. If the employee’s insurance coverage is less than 6 months, the benefit is calculated based on the minimum wage.
- Calculate the daily allowance based on the minimum wage, taking into account the regional coefficient (if there is one) - divide the minimum wage by the number of calendar days in the month in which the sick leave falls. So, if the sick leave is in July, then divide by 31. If the sick leave falls on more than one month, you need to calculate it separately for each month.
- Compare the daily allowance from the average salary and from the minimum wage and choose the highest value. Multiply it by the number of calendar days of illness.
Let's look at examples of how to calculate temporary disability benefits.
Full time employee
The employee was on sick leave from 06/22/2020 to 06/26/2020. His insurance experience is 7 years. Over the previous two years, he earned 344,560 rubles.
Average daily earnings are 344,560 / 730 = 472 rubles.
Taking into account the length of service, the daily benefit amount is 472 * 80% = 377.60 rubles.
Now let’s calculate the daily allowance based on the minimum wage. Let's assume the company is located in an area that applies a regional salary coefficient of 1.2. Then you need to calculate based on the increased federal minimum wage. That is, 12,130 * 1.2 = 14,556 rubles. Let's divide it by the number of calendar days in June.
Daily allowance from the minimum wage = 14,556 / 30 = 485.20 rubles. Let's compare: 485.20 is more than 377.60 - which means that to calculate the benefit we take the amount calculated from the minimum wage.
For five days of illness, the employee will receive:
485.20 * 5 = 2,426 rubles.
Part-timer
An external part-time worker hired at 0.5 rates was ill from June 15 to 24, 2021. On the date of issue of the certificate of incapacity for work, he worked part-time for six months. Insurance experience - 4 years and 7 months. I did not provide a certificate of earnings from previous places of work, since I had not worked in the previous 2 years. In the locality, a regional salary coefficient of 1.3 is applied.
An employee can receive temporary disability benefits at one of the last places of work of his choice.
If he wants to receive it where he works part-time, he needs to bring a certificate from the main employer stating that the benefit was not assigned.
Since information about salaries for 2018-2019. no, then the average daily earnings are calculated from the minimum wage:
RUB 15,769* 24 months / 730 days = RUB 518.43
Since the part-time worker has a part-time job, we calculate the daily allowance based on a rate of 0.5:
518.43 * 0.5 = 259.22 rubles.
Until April 1, 2020, due to the employee’s short length of service, the benefit would have further decreased to 60% and amounted to 259.22 * 0.6 = 155.53 rubles, but according to the new law No. 104-FZ, sick leave cannot be lower than the federal minimum wage, taking into account regional coefficient. If the insured person works part-time, then the minimum wage benefit is calculated in proportion to the length of working time.
For 10 days of incapacity, the employee will receive:
259.22 * 10 = 2,592.2 rubles.
Sick leave for March-April
The certificate of incapacity for work was opened on March 27, and closed on April 5, 2020. The employee’s insurance experience is 10 years, place of work is primary, full-time, coefficients are not applied. Earnings for the previous two years - 275,600 rubles.
The benefit is calculated in two stages:
- Until 04/01/2020 - according to the old rules (No. 255-FZ).
- After 04/01/2020 - taking into account the new law No. 104-FZ.
Average daily earnings = 275,600 / 730 = 377.53 rubles.
Daily benefit amount for April = 12,130 / 30 = 404.33 rubles.
Let's compare: 377.53 is less than 404.33. This means that the amount calculated from the minimum wage will be included in the calculations. But only for part of the benefit for April, since the new rules were not yet in effect in March.
Benefit for March = 377.53 rubles. * 5 days = 1,887.65 rubles.
Benefit for April = 404.33 rubles. * 5 days = 2021.65 rubles.
For 10 days of illness, the employee will receive 3,909.30 rubles.
