April 21, 2017
Since January 1, 2017, the inspectorates have been the administrator of insurance contributions, including social insurance in case of temporary disability and in connection with maternity (VNiM) in terms of income; administration of the costs of paying insurance coverage for VNIM is retained by the FSS of Russia. Let's consider the new procedure for applying to social insurance for reimbursement of benefits.
In connection with the transfer of the function of control and administration of insurance premiums to the jurisdiction of the Federal Tax Service of Russia and its territorial inspectorates from January 1, 2017, issues of calculation and payment of insurance premiums for compulsory pension and medical insurance, as well as for insurance in case of temporary disability and in connection with maternity are regulated ((hereinafter referred to as Law No. 243-FZ)).
Documents for reimbursement of benefits from 2017
According to the Federal Tax Service of Russia, the new procedure for administering insurance premiums is aimed at improving conditions for taxpayers. One of the advantages is positioned that “from the point of view of administering insurance premiums, the Funds will not be involved in the process of interaction with taxpayers” ().
At the same time, there is no need to talk about a complete lack of contacts with the funds as bodies monitoring the payment of insurance premiums. In particular, the FSS of Russia (hereinafter referred to as the Fund) has at its disposal:
- powers to administer the costs of paying insurance coverage for temporary disability and in connection with maternity (VNiM) ((hereinafter referred to as Law No. 255-FZ));
- functions for monitoring the implementation of mandatory social insurance from accidents at work and occupational diseases (NS and PZ) (, (hereinafter referred to as Law No. 125-FZ);).
Therefore, despite the fact that policyholders will submit reports on insurance premiums for reporting (calculation) periods starting from the first quarter of 2017 to the tax inspectorates, the Fund will still need to submit documents that serve as the basis for the allocation of funds for the payment of social benefits. insurance.
In addition, starting from 2017, every quarter the Fund will expect from us a “new” calculation with the old name “Form 4-FSS” (approved). It will include information only on contributions from NS and PP. Starting from the report for the first quarter of 2017, the usual 4-FSS calculation, which provided data on two types of insurance (from personal injury and personal insurance and temporary disability), in terms of compulsory social insurance for VNIM, is not submitted to the Fund’s bodies.
So, we will be required to report to the tax authority by sending a calculation of insurance premiums (approved) no later than the 30th day of the month following the billing (reporting) period. It includes, in particular, Appendix 2 " ", as well as Appendix 3 " " (the latter is included in the calculation only if the corresponding expenses have been incurred).
Let us repeat, the calculation form will be used for all insurance premiums, except for contributions from NS and PZ. The Russian Ministry of Finance regards the new document as optimizing reporting on insurance premiums, since it combines the four currently valid forms (RSV-1, RV-3, RSV-2 and 4-FSS) and contains a reduced number of indicators ().
However, the costs of paying insurance coverage for VNiM, which the policyholder will reflect in the calculation submitted to the tax office, will still be checked territorial body FSS of Russia in the manner established, on the basis of information received from the tax authority to the Fund (information from the FSS of Russia dated August 29, 2016 " " (hereinafter - Information)). For these (and other) purposes, an interdepartmental exchange of information is provided between the Fund and the tax authority ().
Reimbursement of benefits and new certificate-calculation
According to the procedure in force in 2016, employers paid insurance coverage to insured persons to pay insurance contributions to the Fund, while the amount of contributions to be transferred was reduced by the amount of expenses incurred for the payment of benefits (,). If the accrued contributions were not enough to pay benefits in full, the policyholder contacted the territorial body of the Fund, which allocated the necessary funds within 10 calendar days from the date of submission of all necessary documents ().
This procedure for interaction between the parties will not change in the current 2017. At the same time, the composition of the documents (approved (hereinafter referred to as the List)), which for these purposes must be submitted by the policyholder to the Fund, will be different. The existing List has been adjusted ().
In 2017, two components of the package (a written application from the policyholder, which indicates the amount of funds required to pay insurance coverage, and copies of supporting documents) will not change, but instead of calculating 4-FSS (which still remains necessary when applying for periods that have expired before 01/01/2017), the policyholder must prepare a statement of calculation, which is required when applying for the allocation of funds for periods starting from January 1, 2017.
Let's take a look at the list of details of the calculation certificate, which includes the following amounts ():
- debt of the policyholder (FSS of Russia) for insurance premiums at the beginning and end of the reporting (calculation) period;
- accrued for payment insurance premiums, including over the last three months;
- additional accrued insurance premiums;
- expenses not accepted for offset;
- funds received from territorial bodies of the Federal Social Insurance Fund of Russia to reimburse expenses incurred;
- returned (offset) overpaid (collected) insurance premiums;
- funds spent for the purposes of compulsory social insurance, including for the last three months;
- paid insurance premiums, including for the last three months;
- written off debt of the policyholder.
So, if the policyholder applies to the Federal Social Insurance Fund of Russia to receive funds to pay benefits, he generates the following package of documents (see table below).
Judging by the list of indicators, filling out the calculation certificate, in the author’s opinion, should not cause any difficulties for policyholders. It is much more difficult to survive the transition period. As the Fund explained (clause III of the Information), it retains certain responsibilities in relation to periods expired before January 1, 2017 (in this case, the Fund operates in the manner in force before that date):
- to monitor the correctness of payment of insurance premiums;
- making a decision on the return of amounts of overpaid (collected) contributions, penalties and fines;
- fulfillment of the obligation to accept settlements (including updated ones) for insurance premiums;
- transferring to the tax authorities information on the amounts of arrears, penalties and fines on contributions that were generated as of January 1, 2017.
One can also hope that the tax department is not lying when it claims that “taxpayers will not feel the change of administrator: neither payment deadlines nor insurance premium rates, including preferential categories, will change” ().
Package of documents for reimbursement of benefits
Elena Melnikova, expert of the Legal Consulting Service GARANT, auditor, member of the RSA
Federal Law of May 19. 1995 No. 81-FZ “On state benefits"for citizens with children" the following types of state benefits are established:
Maternity benefits;
One-time benefit for women registered in medical institutions in early dates pregnancy;
One-time benefit for the birth of a child;
Monthly child care allowance.
Pay the above benefits at the place of work is carried out to persons subject to compulsory social insurance in case of temporary disability and in connection with maternity.
__________________________________________
1. Maternity benefit
Paid to the insured woman in total for the entire period of maternity leave lasting 70 (in case multiple pregnancy- 84) calendar days before childbirth and 70 (in the case of complicated childbirth - 86, for the birth of two or more children - 110) calendar days after childbirth.
If, while the mother is on maternity leave before the child reaches the age of one and a half years, she begins maternity leave, she has the right to choose one of two types of benefits paid during the periods of the corresponding leave.
Maternity benefits are paid to the insured woman in the amount of 100 percent of average earnings.
An insured woman with an insurance period of less than six months is paid maternity benefits in an amount not exceeding the minimum for a full calendar month. size wages established by federal law.
2. One-time benefit for women registered in medical institutions in the early stages of pregnancy
Benefit amount – RUB 613.14
After the birth of a child, the mother has the right to receive:
3. One-time benefit for the birth of a child
Benefit amount – 16 350,33 rub.
The benefit is paid at the place of work of one of the parents. If the parents do not work, the benefit is paid to the authorities social protection population at the place of residence.
In the case of the birth of two or more children, the specified benefit is paid for each child.
4. Monthly child care allowance
4.1. Working citizens, that is, persons subject to compulsory social insurance, are paid benefits in the amount 40% of average earnings, but no less:
RUB 3,065.69- caring for the first child;
6131.37 rub. - for caring for the second child and subsequent children.
4.2. For mothers dismissed during the period of parental leave, during maternity leave in connection with the liquidation of organizations, termination of activities by individuals as individual entrepreneurs, termination of powers by private notaries and termination of the status of a lawyer, benefits are paid to the social protection authority at the place residence.
4.3. Unemployed citizens, that is, persons not subject to compulsory social insurance, must contact the social protection authority at their place of residence for the assignment and payment of benefits.
_________________________________________________________________
Payment for sick leave when caring for a sick child
A certificate of incapacity for caring for a sick child is paid for:
Up to 7 years - no more than 60 calendar days in a calendar year for all cases of caring for this child (no more than 90 calendar days in a calendar year in cases where the disease is included in the List of diseases approved by the Ministry of Health of the Russian Federation);
From 7 to 15 years - up to 15 calendar days for each case of illness, but not more than 45 calendar days in a calendar year for all cases of caring for this child.
If a disabled child under the age of 18 falls ill, up to 120 calendar days per calendar year are paid.
Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity” (Part 5, Article 6)
But the indicators that need to be used have changed. The following indicators have changed since 01/01/2017:
- for normal birth – 266,191.80 rubles. (RUB 1,901.37 x 140 cal days x 100%);
- for multiple pregnancy – RUB 368,865.78. (RUB 1,901.37 x 194 cal days x 100%);
- for complicated births – RUB 296,613.72. (RUB 1,901.37 x 156 cal days x 100%).
calculation period (maternity benefits, monthly child care benefits are calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of maternity leave, child care leave. Thus, if the insured event occurred in 2017, the calculation period will be 2015 and 2016);
maximum payment amount
if temporary disability, maternity or child care leave occurred in 2017, the years 2015 and 2016 will be included in the calculation period. In this regard, the maximum amount of earnings taken into account when calculating the above benefits will be 1,388,000 rubles. (670,000 + 718,000), where:
670,000 rub. – the maximum value of the base for calculating insurance contributions to the Social Insurance Fund in 2015, established by Decree of the Government of the Russian Federation No. 1316;
718,000 rub. – the maximum value of the base for calculating insurance contributions to the Social Insurance Fund in 2016, established by Decree of the Government of the Russian Federation No. 1265;
the number of calendar days in the billing period (it must be taken into account that 2016 was a leap year, i.e. 731 calendar days);
maximum average daily earnings (the maximum average daily earnings for calculating benefits in 2017 will be 1,901.37 rubles (1,388,000 rubles / 730 cal days));
maximum size benefits:
Monthly child care allowance. In accordance with Part 1 of Art. 11.2 Federal Law No. 255-FZ, a monthly child care benefit is paid in the amount of 40% of the average earnings of the insured person, but not less than the minimum amount of this benefit provided for by Federal Law No. 81-FZ. The average earnings for calculating this benefit are determined by multiplying the average daily earnings established in accordance with Parts 3.1 and 3.2 of Art. 14 of Federal Law No. 255-FZ, at 30.4 (part 5.1 of this article). Therefore, the maximum monthly child care benefit in 2017 will be RUB 23,120.66. (RUB 1,901.37 x 30.4 x 40%).
The procedure for determining the amount of benefits in 2016
In 2016 benefits:
-
for pregnancy and childbirth,
monthly child care allowance
are calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of occurrence:
temporary disability,
maternity leave,
maternity leave,
including while working for another policyholder(s).
Average earnings during work for another policyholder are not taken into account in cases where, in accordance with Part 2 of Article 13 of Law No. 255-FZ, benefits:
due to temporary disability,
for pregnancy and childbirth
are assigned and paid to the insured person for all places of work based on the average earnings during the period of work with the insurer assigning and paying benefits.
If in two calendar years immediately preceding the year of occurrence of the specified insured events, or in one of the specified years, the insured person was:
on maternity leave,
on maternity leave,
the corresponding calendar years (year), at the request of the insured person, may be replaced for the purpose of calculating average earnings by previous calendar years (year), provided that this leads to an increase in the amount of the benefit.
Note: the employer has the right to reimburse all types of benefits from the Social Insurance Fund (except for the amount of benefits accrued to the employee for the first three days of incapacity, provided that the employee himself fell ill, and not a member of his family (child)). The Federal Social Insurance Fund of Russia reimburses benefits from the first day if a temporary disability certificate is issued, for example, in connection with caring for a sick family member (including a child) or in connection with an industrial accident or occupational disease. If the employee himself falls ill and the disability is not related to any work injury or occupational disease, then the temporary disability benefit for the first three days of the employee’s illness is paid by the organization at its own expense. From the fourth day of illness, the amount of the organization’s benefit is reimbursed by the FSS of Russia (subclause 1, clause 2, article 3 of Federal Law No. 255-FZ of December 29, 2006, hereinafter referred to as Law No. 255-FZ).
Birth benefit
At the birth of a child, the employer pays the employee:
lump sum allowance women who registered with medical organizations in the early stages of pregnancy;
This is a one-time benefit for the birth of a child.
Child care allowance up to one and a half years old
According to Article 15 of Federal Law No. 81-FZ dated May 19, 1995, the amount of monthly child care benefits for children under 1.5 years old is 40% of average monthly earnings.
The average monthly earnings for calculating child care benefits are determined by multiplying the average daily earnings by the average number of calendar days - 30.4 (clause 5.1 of Article 14 of Law No. 255-FZ).
To calculate benefits in 2016, the calculation period is from January 1, 2014 to December 31, 2015. Accordingly, earnings taken into account when calculating benefits for 2014 cannot exceed 624,000 rubles, for 2015 – 670,000 rubles.
That. maximum average daily earnings, based on which they are calculated child benefit in 2016, equal to 1,772.60 rubles. = (670,000 rub. + 624,000 rub.) : 730 days. This means that the maximum monthly benefit for a child under 1.5 years old in 2016 is 21,554.82 rubles.
Calculation of sick leave in 2016
Maximum average daily earnings, on the basis of which temporary disability benefits are calculated in 2016: (670,000 rubles + 624,000 rubles): 730 days = 1,772.60 rubles.
Minimum average daily earnings for calculation sick leave benefit in 2016 it is equal to 203.97 rubles. (minimum wage (RUB 6,204) × 24 months: 730 days).
Features of calculating benefits at the expense of the Social Insurance Fund in 2013 - 2014
Accountants of organizations are constantly faced with various difficulties associated with calculating benefits for temporary disability of employees.
Calculating maternity benefits and other benefits paid from the Social Insurance Fund is also not always a simple matter. At the same time, legislative bodies are introducing more and more changes to the current legislation, which do not make life easier for practicing accountants.
So, in accordance with the amendments made to Law No. 255-FZ of December 29, 2006. “On compulsory social insurance in case of temporary disability and in connection with maternity” and taking effect from January 1, 2013, the procedure for determining average earnings for calculation will change:
In accordance with this bill, from January 1, 2013 it is established new level minimum wage (minimum wage) in the amount of 5,205 rubles per month.
This change will affect the amount of temporary disability benefits paid, in cases where this benefit is calculated based on the minimum wage, or taking into account the limitation in the amount of the minimum wage.
The maximum amount of sick leave payment will also increase.
In 2013, this amount will be 1,335.62 rubles. (at 100% of average earnings), whereas in 2012 it was 1,202.74 rubles. per day.
The article will discuss some of the features of paying for sick leave,
the current and new procedure for calculating benefits for temporary disability.
The current procedure
1. Calculation of sick leave for temporary disability in 2012
The amount of sick leave benefits in 2012 is calculated by dividing earnings for 2010 and 2011 by 730 and multiplying by the number of days of disability (subject to restrictions on the number of days).
In this case, the amount of earnings for 2010 for calculating benefits is taken to be no higher than 415,000 rubles, and for 2011 - no higher than 463,000 rubles.
2. Calculation of maternity benefits and child care benefits up to 1.5 years in 2012
Maternity benefits are paid in the amount of 100% of average earnings, but not more than 1,202.74 rubles per day.
If the insurance period is less than six months, the benefit is paid in an amount not exceeding the minimum wage for a full calendar month.
Payment of maternity benefits is carried out at the expense of the Social Insurance Fund from the first day of incapacity for work.
The average daily earnings for calculating benefits, starting from 01/01/2011, are determined based on the average earnings calculated for the two calendar years preceding the year of maternity leave.
In accordance with clause 2 of Law No. 343-FZ of December 8, 2010. “On Amendments to the Federal Law “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Maternity”, benefits:
for pregnancy and childbirth,
in the period up to December 31, 2012 inclusive, can be calculated according to the rules in force in 2010.
In this case, the maximum benefit amount is calculated based on the old version of Law No. 212-FZ in the amount of 415,000 rubles.
Those. the benefit is limited to the amount of 1,136.99 rubles. per day, despite the fact that the maximum benefit amount calculated according to the new rules is 1,202.74 rubles. in one day.
Average daily earnings before 01/01/2011 were determined based on earnings for the last 12 calendar months preceding the month of the insured event.
In accordance with paragraph 2 of Article 3 of Law 343-FZ of December 8, 2010, the employee herself can choose the method of calculating maternity benefits during the period from January 1, 2011 to December 31, 2012 (inclusive).
To calculate benefits “as before,” you must write an application in any form.
The amount of the accrued benefit at the expense of the Social Insurance Fund cannot exceed its maximum amount.
If during the billing periods the employee had no earnings, or the calculated average earnings (for the month) are below the minimum wage, then the benefit is calculated based on the minimum wage.
Formulas for calculating maternity benefits in 2012
1. According to the rules in force from 01/01/2011, the benefit is calculated based on earnings for the 2 calendar years preceding maternity leave.
The amount of the benefit in 2012 is calculated by dividing the amount of earnings for 2010 and 2011 by 730 and multiplying by the number of days of disability (at least 140 days).
In this case, the amount of earnings for calculating benefits is taken no higher than the maximum value of the base for calculating insurance contributions:
- for 2010 - 415,000 rubles,
- for 2011 - no more than 463,000 rubles.
(415,000 + 463,000)/730 = 1,202.74 rubles.
2. According to the rules in force in 2010, the benefit is calculated based on earnings for the 12 months preceding the month of maternity leave.
The amount of the benefit according to the 2010 rules is calculated by multiplying the average daily earnings by the number of days of incapacity for work (at least 140 days).
Average daily earnings are calculated based on the amount of accrued wages for 12 months.
The resulting amount is divided by the number of calendar days worked, including weekends.
The calculation does not take into account periods when the employee maintained average earnings (business trips, sick leave, vacations, etc.).
Those. if in the month worked the employee received a salary of 10,000 rubles. and he was paid sick leave in the amount of 2,000 for 5 days, then the amount of earnings for calculating benefits will be 10,000, and the number of calendar days of the month will decrease by 5 days.
The amount of earnings for calculating benefits is accepted no higher than the maximum base for calculating insurance premiums established in 2010 - 415,000 rubles.
New order. What will change in 2013
1. Calculation of sick leave for temporary disability in 2013
In 2013, the amount of sick leave benefits is calculated in the same way as in 2012.
Only the minimum wage will change (5,205 rubles from 01/01/2013) and the maximum amount of sick leave payment.
This amount has increased due to a change in the base for calculating insurance premiums for 2 years: the base amount for 2010 will no longer be taken into account in the calculations; the base for 2011 will be added to the base for 2012 in the amount of 512,000 rubles.
The amount of earnings for 2011 and 2012 is still divided by 730 (days) and multiplied by the number of days of disability (subject to restrictions on the number of days).
In this case, the amount of earnings for 2011 for calculating benefits is taken to be no higher than 463,000 rubles, and for 2012 - no higher than 512,000 rubles.
(463,000 + 512,000)/730 = 1,335.62 rubles.
2. Calculation of maternity benefits and child care benefits up to 1.5 years in 2013
On January 1, 2013, amendments made to Law No. 255-FZ by Federal Law of February 25, 2011 come into force. No. 21-FZ “On Amendments to Article 14 of the Federal Law “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Maternity” and Articles 2 and 3 of the Federal Law “On Amendments to the Federal Law “On Compulsory Social Insurance in Case of Temporary Disability” disability and in connection with maternity.”
In accordance with Article 1 of Law No. 21-FZ, Part 3.1, Clause 3, Art. 14 “The procedure for calculating benefits for temporary disability, pregnancy and childbirth, monthly child care benefits” of Law No. 255-FZ is stated as follows:
Average daily earnings for calculation:
maternity benefits,
monthly child care allowance
is determined by dividing the amount of accrued earnings for a two-year period (specified in paragraph 1 of Article 14 of Law No. 255-FZ) by the number of calendar days in this period, with the exception of calendar days falling on the following periods:
periods of temporary disability, maternity leave, parental leave;
additional paid days off to care for a disabled child;
the period of release of the employee from work with full or partial retention of wages in accordance with the legislation of the Russian Federation, if insurance contributions to the Social Insurance Fund are paid for the retained wages for this period in accordance with the Federal Law “On Insurance Contributions to Pension fund RF, Social Insurance Fund of the Russian Federation, Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds” were not accrued.
In addition, starting from 01/01/2013, in accordance with clause 2 of Law No. 343-FZ, benefits:
for pregnancy and childbirth,
monthly allowance for child care up to 1.5 years,
can no longer be calculated according to the rules in force in 2010, which was allowed until December 31, 2012 inclusive (average daily earnings could be calculated based on earnings for the last 12 calendar months preceding the month the insured event occurred).
But the procedure for determining the number of calendar days worked for the 2 previous years taken into account will be similar to the “old” rules.
Indeed, in accordance with them, the calculation did not take into account periods when the employee retained his average earnings (business trips, sick leave, vacations, etc.).
Accordingly, until new clarifications are released, it seems quite logical to use the methodology already known to us for determining “calculation” days.
An example of calculating benefits in 2013
Employee of Romashka LLC Petrova N.M. submitted to the accounting department sick leave, confirming maternity leave. The vacation period is 140 calendar days (from January 14 to June 2, 2013 inclusive). Ivanova’s insurance experience is more than six months. Previously, Ivanova had not been on “children’s” vacations.
The billing period will be the time from January 1, 2011 to December 31, 2012 (731 calendar days)
During this time, Petrova received a salary in the amount of 710,000 rubles, including:
for 2011 - 330,000 rubles;
for 2012 - 380,000 rubles.
Petrova’s earnings for 2011 and 2012 did not exceed the maximum values (463,000 rubles and 512,000 rubles, respectively). Therefore, when calculating benefits, all these payments will be taken into account in their entirety.
In 2012, from November 19 to December 9 (21 calendar days), Petrova received temporary disability benefits. This means that the duration of the billing period will be 710 calendar days (731 - 21)
Average daily earnings are: RUB 710,000. : 710 days = 1000 rub./day.
Ivanova is entitled to maternity benefits: 1000 rubles/day. × 140 days = 140,000 rub.
From June 3, Petrova is taking maternity leave for up to one and a half years. Billing period will be the same - from January 1, 2011 to December 31, 2012, 710 calendar days (the period of temporary disability at the end of 2012 is not taken into account). Accountable earnings - 710,000 rubles.
Thus, the monthly child care allowance will be: 710,000 rubles. / 710 days x 30.4 days x 40% = 12,160 rubles.
Deadlines for applying for benefits
Deadlines for applying for benefits:
due to temporary disability,
for pregnancy and childbirth,
monthly allowance child care,
established by Article 12 of Law No. 255-FZ.
In accordance with the provisions of this article, benefits are assigned no later than six months:
From the date of restoration of working capacity (establishment of disability), as well as the end of the period of release from work in cases of caring for a sick family member, quarantine, prosthetics and after-care - for temporary disability benefits.
From the date of termination of maternity leave - for maternity benefits.
From the day the child reaches the age of one and a half years - for a monthly allowance for child care up to 1.5 years.
In accordance with paragraph 3 of Art. 12, when applying for benefits:
due to temporary disability,
for pregnancy and childbirth,
monthly child care allowance
after the expiration of the six-month period, the decision to assign benefits is made by the territorial body of the Social Insurance Fund if there are good reasons for missing the deadline for applying for benefits.
The list of valid reasons for missing the deadline for applying for benefits was approved by Order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2007 No. 74 “On approval of the List of valid reasons for missing the deadline for applying for temporary disability benefits, maternity benefits, and monthly child care benefits.”
In accordance with this List, the following circumstances are recognized as valid reasons:
Force majeure, that is, extraordinary, unpreventable circumstances (earthquake, hurricane, flood, fire, etc.).
Long-term temporary disability of the insured person due to illness or injury lasting more than six months.
Moving to a place of residence in another locality, change of location.
Forced absenteeism due to illegal dismissal or suspension from work.
Damage to health or death of a close relative.
Other reasons recognized as valid in judicial procedure, when the insured persons go to court.
Cases of reducing the amount of temporary disability benefits
Article 8 of Law No. 255-FZ provides grounds for reducing the amount of temporary disability benefits:
Violation by the insured person without good reason during a period of temporary disability of the regime prescribed by the attending physician.
Failure of the insured person to appear without good reason at the appointed time for a medical examination or for a medical and social examination.
In this case, the following situation is possible:
The employee presented several sick leave certificates.
In the first of them, for example, from August 3 to August 10, 2012, a note was made about a violation of the regime - on the 7th the employee did not show up for an appointment with the doctor.
In subsequent sick leave x, which are continuations of the first, do not have such marks.
In this case, in the absence of valid reasons for violating the regime, temporary disability benefits are paid to the insured person in an amount not exceeding the minimum wage for a full calendar month - from the day the violation was committed until the restoration of working capacity.
That is, starting from August 7 and until the day from which the employee must begin work, indicated on the last sick leave.
In this case, from August 3 to August 6, sick leave is paid in the usual manner.
In accordance with the Order of the Ministry of Health and Social Development dated June 29, 2011 No. 624n “On approval of the Procedure for issuing certificates of incapacity for work,” the following two-digit code is indicated in the line “Notes on violation of the regime,” depending on the type of violation:
23 - failure to comply with the prescribed regimen, unauthorized leaving the hospital, traveling for treatment to another administrative region without the permission of the attending physician;
24 - late attendance at a doctor’s appointment;
25 - going to work without being discharged;
26 - refusal to refer to a medical and social examination institution;
27 - late appearance at the medical and social examination institution;
28 - other violations.
The date of the violation is indicated in the “Date” line, and the signature of the attending physician is placed in the “Doctor’s signature” field.
3. Illness or injury resulting from:
alcoholic,
narcotic,
toxic
intoxication or actions related to such intoxication.
In this case, in the line “cause of disability” on the sick leave, after the two-digit code, a three-digit additional code “021” is entered.
If there are one or more of the above grounds for reducing the temporary disability benefit, the benefit is paid to the insured person in an amount not exceeding the minimum wage established by federal law for a full calendar month.
In districts and localities in which regional coefficients are applied to wages in accordance with the established procedure - in an amount not exceeding minimum size wages taking into account these coefficients.
These sanctions apply:
If the rules are violated and the employee fails to appear for inspection:
from the day the violation was committed.
If the disease or injury is caused by alcohol (etc.) intoxication:
for the entire period of incapacity.
At the same time, the employer should remember that the notes made on the sick leave:
about alcohol intoxication,
violation of the regime and failure to appear,
by themselves are not sufficient to reduce the benefit amount.
The organization needs to obtain a written explanation from the employee, conduct an investigation, and obtain a medical report.
Otherwise, the employee can go to court and appeal against the reduction in benefits.
When temporary disability benefits are not awarded
The grounds for refusal to grant temporary disability benefits are provided for in Art. 9 of Law No. 255-FZ.
In accordance with this article, temporary disability benefits are not assigned to insured persons for the following periods:
for the period of release of the employee from work with full or partial retention of wages or without payment in accordance with the legislation of the Russian Federation, with the exception of cases of loss of ability by the employee due to illness or injury during the period of annual paid leave;
for the period of suspension from work in accordance with the legislation of the Russian Federation, if wages are not accrued for this period;
during the period of detention or administrative arrest;
during the period of the forensic medical examination;
during the period of downtime, except for the cases provided for in Part 7 of Article 7 of Law No. 255-FZ.
In accordance with paragraph 2 of Art. 9 of Law No. 255-FZ, the grounds for refusal to grant temporary disability benefits are:
The onset of temporary disability as a result of a court-established intentional infliction of harm to one’s health by the insured person or an attempted suicide.
The onset of temporary disability as a result of the commission of an intentional crime by the insured person.
The article was posted in 2012. Added 01/14/2016, 02/16/2017
IN FSS check sick leave by number online available on the official website of the department. About how to check the authenticity of a sick leave certificate by number and what the consequences of paying for an invalid document are, read further in the material.
How to check the authenticity of a sick leave certificate
Any employee who is absent from work due to illness is required to provide the employer with a certificate of incapacity for work. Within 10 calendar days, the accounting department calculates the benefits due to the employee and pays them on the next payday.
But there are situations when the authenticity of the sick leave is in doubt. After all, if the employer pays benefits, and the sick leave turns out to be fake, then the Social Insurance Fund will not reimburse the company for the expenses incurred. Which will entail additional charges, penalties and fines.
To avoid such trouble, the employer should check the authenticity of the document independently. The original document form contains several degrees of protection:
- watermarks with the “FSS of Russia” logo, which are easy to see by shining a light on the document;
- microtext “Certificate of Incapacity for Work”, written on the line under the column “Doctor’s signature”;
- microfibers in paper;
- in the upper right corner on back side the document contains the name of the manufacturing company LLC "SpetsBlank - Moscow";
- luminous words that are visible when the specimen is illuminated with ultraviolet light;
- check sick leave by number, because it is embossed in a typographical way and has irregularities that can be easily felt if you run your finger over them.
For other features of visual verification of the sick leave form, see the material.
In addition, you can check the authenticity of the sick leave certificate on the FSS website.
Official website of the FSS for checking certificates of incapacity for work
The FSS portal can be found at: portal.fss.ru. However, this site will only help calculate the amount of benefits payable to the employee, but will not allow check sick leave online.
To FSS check sick leave by number online, you need to go to the official website of the department via the link fss.ru and download the database of invalid forms (for example, stolen or lost).
Where to download the database of invalid certificates of incapacity for work in 2016
Social insurance regularly updates base sick leave, that have been lost or stolen.
Check your sick leave number on the FSS website and you can download the database in the section “Information for employers (forms, reporting, forms)” and find the line “Invalid forms of certificates of incapacity for work.” The database is laid out in Excel format. To find the number you are looking for, you can use the “Find” service and enter the first 9 digits of the code designation of the number of the certificate of incapacity for work.
Checking sick leave by number online it is not provided in any other way on the department’s website.
At the territorial office FSS checking sick leave by number is also possible (this is provided for in paragraph 7 of Article 59 “On the Protection of Citizens’ Health” No. 323-FZ). To do this, you can contact the branch at the place of registration with a request to check the suspicious document by number, attaching a copy of the document. The FSS records the numbers of the forms that were received by each medical institution. Consequently, branch employees can determine whether the copy number belongs to the organization that issued it.
Letter to the Social Insurance Fund about checking sick leave if the check on the portal did not produce results (sample)
Request to FSS O checking sick leave is drawn up in any order and must contain the following information:
- about the policyholder: company name, INN/KPP/registration number in the Social Insurance Fund, legal address and telephone number;
- to whom, by whom and when issued, as well as the number of the certificate of incapacity for work;
- where and how the fund should send the response;
- about applications;
- signature of the head of the company and date of preparation.
The original sick leave certificate must be attached to the application. After verification, the department will return it.
You can download a sample application on our website.
Results
Checking sick leave V FSS is possible on the official social insurance website, using a regularly updated database of lost forms, or at the territorial authority at the employer’s place of registration by sending an official request. Other ways online sick leave checks are not provided for by the department.
