When does the Social Insurance Fund pay benefits under the direct payment system?

What benefits will the FSS transfer?

The Social Insurance Fund will pay the following benefits:

for temporary disability (including due to an accident at work and (or) occupational disease);
for pregnancy and childbirth;
a one-time benefit for women who registered in the early stages of pregnancy;
lump sum benefit for the birth of a child;
monthly child care allowance.

Under the direct payment system, additional leave will be paid to an employee injured at work.

Deadlines for preparation and transmission of documents, payment of benefits

The accounting department of the organization, in accordance with Resolution No. 294, must receive an application and supporting documents from the employee no later than 5 calendar days

from the date of receipt, send them to the territorial body of the Fund with information for the appointment and payment of the appropriate benefit. That is, documents are sent to the fund in the form of an electronic register.

If the accounting department does not transfer all documents to the Fund or the information is incomplete, the territorial body of the Fund will send a notice within 5 working days about the need to provide the missing information.

Missing documents or information must be transferred to the fund within 5 working days from the date of receipt of the notice.

Payment of benefits to employees is carried out by the territorial branch of the Social Insurance Fund within 10 calendar days

from the date of receipt of the application and documents necessary for the assignment and payment of benefits.

Payment of benefits to employees is made:

by transferring benefits to the bank account specified in the application or in the information register,
through the federal postal service organization,
through another organization at the request of the employee (his authorized representative).

What are the requirements for filling out and general appearance of a sick leave certificate?

In accordance with the existing legislation of Russia, a document on a citizen’s incapacity for work must be drawn up in accordance with existing rules, such rules include:

The format of the sheet on which the necessary fillings are made must correspond to A4 dimensions.
Availability of FSS watermarks confirming the authenticity of the document.
Presence of yellow and blue colors.
The sheet contains a special barcode containing the number of the document being issued.
There are requirements that also apply to the handwriting used to fill out a sick leave form. It must be in printed form and must be readable.
In addition, according to business standards, any kind of corrections in the certificate are not allowed.

Note!
All payment calculations in accordance with the law are made using the 1C electronic system, as well as on the official website of the Federal Insurance Service.

Further, after filling out the sheet, it is sent to the place of demand. According to the legislation of the Russian Federation, the employer has the right to verify the authenticity of the document provided.

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Transferable benefits for child care up to 1.5 years

If the company, as of January 1, 2021, has female employees on maternity leave and receiving benefits, the last time they need to pay benefits is for December 2020. In fact, this payment is made on the day of payment of wages to employees for December.

Then, you need to get an application and documents about the birth of the child from the employee. All documents must be submitted to the FSS. The fund will pay benefits for an employee on maternity leave for January.

The accountant’s task is to receive the child’s application and birth certificate on time, so as not to leave the employee without money.

The period of payment for sick leave in accordance with the law of the Russian Federation

There were no significant changes in the legislation, but amendments were made.

Who pays for sick leave?

Here is a list of those who can pay compensation for sick leave:

Employing organization. During the first three days, sick leave is accrued and paid by her (clause 2, article 53 of law number 255).
Social Insurance Fund. According to the law, the fund must pay sick leave from the fourth day of the employee’s illness until its end. There are times when this organization fully compensates for sick leave: caring for a sick family member; company quarantine; installation of prostheses for an employee; treatment in a sanatorium; Holiday to care for the child.
Employment Center. This case applies to persons who are officially unemployed and are registered. Here, compensation will be paid according to the amount of unemployment benefits.

Sick leave payment

The payment period is specified in Federal Law No. 255, Article No. 15.

Compensation payment period

As already mentioned, the amount is calculated within ten days after the employee provides a certificate of incapacity for work to the employer. Payment occurs on the nearest salary date from the date of accrual of funds.

If the payment is made by the social insurance fund, then compensation is calculated within ten days after the citizen submits an application and relevant documents.

List of required documents:

Sick leave issued by a medical institution.
Employee salary certificate.
A work book, which must be certified by the employer, and which indicates the total length of work experience.
An application filled out according to a single accepted form.

What if sick pay is delayed?

Payment may be delayed if a citizen, due to various circumstances, does not provide a certificate of incapacity for work on time. According to the law, in this case he can receive compensation within six months after he has fully recovered his health.

Important! After a citizen has overstayed this period, he will NOT receive funds in the form of compensation! There can only be exceptions to the general rule. You can find a list of valid reasons in paragraph 3 of Article 12 of Law No. 255.

Measures for delayed payment of a certificate of incapacity for work

If an employee provides sick leave on time, but payment is not scheduled within ten days, then he has every right to demand compensation from the employer for interest on the delay. To protect their rights and interests, a citizen can contact the following institutions:

Federal Labor Inspectorate.
The prosecutor's office.
Court.

If a delay in payment occurred and this was proven by the relevant authorities, the employer will be held administratively liable and paid a fine. If the law is violated again, the employer can be removed from office for up to three years.

When do you need to transfer sick leave to your employer and when will compensation be transferred?

The employing company must submit the certificate of incapacity for work to the social insurance fund on time. Now let’s look at what the employee himself must do to ensure that the amount is accrued and transferred on time.

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Deadlines for transferring sick leave to the employer

Let us remind you once again that the legal period for providing a certificate of incapacity for work is six months. The same period is provided for those persons who, after undergoing treatment, are recognized as disabled.

Accrual deadlines and calculations based on certificates of incapacity for work

Calculation of monetary compensation occurs within ten days from the date of provision of sick leave to the accounting department. The payment itself is made on the nearest salary date.

Minimum period

There is no minimum number of sick days in the legislation of the Russian Federation. The treatment period can only be determined by the attending physician based on the severity of the person’s illness. Only a specialist determines how many days he needs for treatment and rehabilitation.

Conditions for recovery and rehabilitation:

Outpatient.
Day hospital.
Hospital.

As a rule, doctors determine the minimum duration of treatment - three days. If a person is on sick leave in an outpatient setting, a certificate of incapacity for work is issued for 15 days. If there are additional reasons or the citizen cannot recover during this period, then the sick leave may be extended for some more time.

Maximum duration of sick leave

If a citizen is undergoing treatment on an outpatient basis (at home), then the maximum period of sick leave should not be more than fifteen days. In this case, only a special medical commission can increase the number of days of incapacity for work.

Note! There are special periods of sick leave for paramedics and dentists: their sick leave should not be more than 10 days!

If the patient was treated in a hospital (in a medical institution), then everything will depend on his condition and the recovery process. The maximum period of sick leave in this case is not provided for by law. A certificate of incapacity for work is issued for the period during which the citizen is in a medical institution.

Expert opinion

Alexandrov Dmitry Petrovich

Practicing lawyer with 15 years of experience. Specializes in family law

It can be extended after the citizen has been discharged from the hospital (usually 10 days). If an employee has undergone surgery, sick leave is issued for the period during which postoperative procedures are prescribed. All of the above also applies to persons undergoing treatment in a day hospital. The maximum number of days here is also determined only by the attending physician.

Who transfers disability benefits?

If an employee falls ill, the first three days of his illness are paid directly by the employing company itself. Starting from the fourth day, this is done by the social insurance fund. If an accident occurs, an employee develops an occupational disease, or he is caring for a sick family member, and also installs prosthetics in a hospital setting, then the social insurance fund accrues sick leave from the very first day.

If an employee brings two certificates of incapacity for work to the accounting department at once, they will be counted as a single insured event. If two or more sheets are considered primary documents, then the company must pay for the first three days for each document.

All cash payments are made by the employer, but then she compensates for all her expenses from the social insurance fund. At the moment, there are already regions where disability benefits are paid directly from the social insurance fund to the citizen.

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When will the sick leave funds arrive?

This is probably the most common question among citizens. According to the law, wages are transferred twice a month. The interval between transfers of salary parts should not be more than fifteen days. It turns out that the maximum period for accrual and payment of disability benefits is 25 days. It can't be bigger!

Those regions in which the social insurance fund directly pays benefits to employees are luckier. Here, the period for calculating compensation for sick leave has been reduced to five days. The period for transferring funds has also been shortened, now it is fifteen days.

The minimum accrual period in all cases is one day.

If the benefit was transferred later than the period specified in the law?

Not everything depends on the employer here. There are cases when an employee brought sick leave at the wrong time (even overstayed the six-month period). Valid reasons for a later accrual of monetary compensation on a certificate of incapacity for work:

Force majeure situations (hurricanes, floods, fires, etc.).
If a citizen is on sick leave due to a long-term and complex illness (more than six months).
Moving to another place of residence (change of region/district of residence).
Absenteeism due to his illegal dismissal.
Serious illness of a close relative or his death.
Other reasons that are recognized as valid by the court.

What if the funds have not been received?

What to do if an employee submits sick leave to the accounting department on time, but the organization for some reason does not transfer disability benefits? In this case, the citizen has every right to apply to a judicial institution or the Labor Inspectorate.

If these authorized bodies indeed discover violations, then the employer must pay the sick leave in full, as well as pay a percentage for each day of delay.

How does the organization submit information: electronically or on paper?

Companies whose average number of employees for the previous billing period exceeds 25 people submit to the Social Insurance Fund at the place of registration the information necessary for the appointment and payment of benefits in electronic form in the formats established by the Fund.

Companies with an average number of employees of 25 people or less have the right to provide information on paper to the Social Insurance Fund.