From 2021, the minimum and maximum amounts of benefits for temporary disability and in connection with maternity will change

When is it issued?

A sick leave certificate is issued to an employee by a medical institution as evidence of temporary disability.
This is a strict reporting document that records the employee’s absence from work and ensures payment of sickness benefits. Everything related to sick leave is regulated by Federal Law No. 255-FZ of December 29, 2006 (Articles 6, 7 255-FZ). Sick leave is provided to an employee in the following insurance cases:

• disease;
• injuries;
• pregnancy;
• quarantine;
• forced sanatorium treatment;
• prosthetics or installation of stimulators that ensure vital functions.

The start date of the sick leave is the day and month of the visit to the medical institution.

Legal framework for payment of disability benefits

This issue is regulated by the following regulations:

• Federal Law No. 255 dated December 29, 2006. This federal law speaks about the rights of citizens themselves in this aspect, as well as the rights of the employer.
• Order of the Ministry of Health and Social Development No. 624n dated June 29, 2011. The provisions regulated by this order contain standards for issuing the main documents necessary to receive payments of temporary disability benefits - sick leave. In addition, this normative act regulates other nuances, according to which medical institutions directly establish facts confirming the existence of grounds for payment of periods.
• Order of the Ministry of Health and Social Development No. 347n dated April 26, 2011. This order establishes a uniform form for issuing sick leave for everyone.
• Decree of the Government of the Russian Federation No. 375 of June 15, 2007. This document establishes the amount of disability benefits
• Article 183 of the Labor Code of the Russian Federation. The provisions of this article establish the rights of citizens to receive compensation for disability, guarantees in the event of its occurrence, and the direct responsibilities of employers to ensure the payment of these payments.

These laws are taken as a basis, but every year there is an indexation of all benefits and payments, and the minimum wage also changes, then amendments and additions are issued that must be constantly monitored and studied in order to avoid penalties.

Who is paid the benefit?

According to current labor legislation, sickness benefits are received by:

• employees of institutions signed under employment contracts;
• employees of individual entrepreneurs;
• employees employed in accordance with civil contracts with conditions included in the contract for the provision of a social package;
• citizens who are members of consumer cooperatives;
• citizens of the Russian Federation who voluntarily pay contributions to the Social Insurance Fund.

Payment of amounts on a certificate of incapacity for work is mandatory for working pensioners. The maximum and minimum amount of sick leave in 2021 for this category of citizens are determined according to the general rule.

When an employed pensioner is dismissed, the amount of sickness compensation must be paid to him within one month. The exception is cases where a working pensioner takes sick leave to care for a sick relative. Such sheets are not subject to payment.

For how long is it issued?

A certificate of temporary incapacity for work is issued for a period of ten days, but if the illness becomes more complicated, the doctor has the right to extend it up to one month. The maximum limit of sick days per year per person is 30 days. The following cases are exceptions:

• pregnancy and childbirth without identified complications - 140 days;
• pregnancy and childbirth with complications - 156 days;
• multiple pregnancy - 194 days;
• care for a child due to his illness - 30 - 60 days;
• disability - up to 5 months.

The maximum period of sick leave reaches 12 months if the patient is diagnosed with severe pathologies, complicated fractures and diseases requiring long-term treatment.

Read more: “For how many days is sick leave issued?”

How to calculate

The rules for calculating the amount of sick leave benefits are as follows:

1. The accountant determines the income base and average daily earnings, focusing on the hospital limit in 2021 for insurance premiums for temporary disability and maternity. The basic value is calculated for the 2 years preceding the insured event. Average daily earnings are calculated using the following formula: employee income for the pay period / 730 days.
2. Next, the calculated amount of average daily earnings is multiplied by the number of days missed.
3. The final benefit is calculated using the formula: SDZ × percentage depending on the employee’s length of service. If the experience is less than 5 years, then 60% of the calculated benefit amount is paid, if the experience is from 5 to 8 years, then 80% will be paid. Temporary disability certificate is paid in full (100%) if the employee’s work experience is more than 8 years.

Maternity benefits in 2021 – maximum amount

When calculating benefits in connection with disability caused by pregnancy and childbirth, the accountant should be guided by the following algorithm:

1. Summarize the income of a pregnant employee for the previous two calendar years. If the sick leave is dated 2021, the calculation base will consist of accruals for 2017-2018, subject to social insurance contributions.
2. The average daily earnings are displayed: income 2017-2018. is divided into 730 days.
3. The average daily income is multiplied with the calendar days of incapacity indicated on the sick leave.
4. The maximum amount of maternity leave in 2021 is compared with the calculated benefit received. If accruals are above this limit, an amount equal to the maximum is payable.
5. If the maximum maternity benefit exceeds the accrued benefit, the benefit is compared with the minimum limit. In cases where the minimum is greater than the actual calculated benefit, the minimum amount of the minimum wage is paid. If the calculated value is in the range between the permissible maximum and minimum, the payment is assigned based on actual average income.

The maximum amount of maternity benefits in 2021 is calculated taking into account the maximum bases for insurance contributions from the Social Insurance Fund (for disability and maternity) for the corresponding years:

• In 2021, the upper limit of the base was applied equal to 755,000 rubles, which was obtained as a result of re-indexation according to the coefficient approved by Government Resolution No. 1255 dated November 29, 2016.
• In 2021, the limit was RUB 815,000. (which was the result of an adjustment to the indexation coefficient indicated in Government Decree No. 1378 dated November 15, 2017).

Maximum maternity benefits in 2021 can be assigned in different amounts - the final value of the benefit depends on the duration of maternity leave:

• in standard cases, maximum maternity leave in 2021 is assigned for 140 days of sick leave in calendar terms;
• in case of complicated childbirth in the maternity hospital, sick leave is extended for another 16 days, the total period of incapacity for work is 156 days;
• Pregnant women carrying several children at once are issued a certificate of incapacity for work with a total duration of 194 days.

The maximum maternity payments in 2021 for 1 day of sick leave will be 2150.68 rubles. This value was obtained by dividing by 730 days the values ​​of the maximum bases for contributions to compulsory social insurance in 2017-2018:

(815 thousand + 755 thousand) / 730 = 2150.68 rubles.

As a result, the maximum payment of maternity leave in 2021 for sick leave issued for 140 days will be equal to 301,095.89 rubles. ((815 thousand + 755 thousand) / 730 x 140).

If sick leave is issued for 156 days, the maximum payment in the form of benefits will be at the level of 335,506.85 rubles. ((815 thousand + 755 thousand) / 730 x 156).

In case of multiple pregnancy, a woman can count on a benefit amount not exceeding the limit of 417,232.88 rubles. ((815 thousand + 755 thousand) / 730 x 194).

When maternity benefits are calculated, the 2021 maximum does not take into account the current minimum wage, so the increase in this indicator from January 2021 will not affect the amount of the upper benefit limit.

The allowance paid to an employed woman until the child reaches 1.5 years of age should also increase. Its maximum in 2021 will be RUB 26,152.33. ((755 thousand + 815 thousand) / 730 x 30.4 x 40%).

What are the features of calculation in 2021

Due to the coronavirus pandemic, adjustments have been made to the procedure for paying sick leave. From April 1 to December 31, 2021, when calculating benefits, the accountant is guided by the minimum wage and the maximum amount of daily sick leave benefits in 2021 (Article 1 No. 104-FZ of 04/01/2020). Until December 31, 2020, consider the benefit as follows:

1. Calculate your average daily earnings (ADW).
2. Determine the amount of daily sick pay for SDZ, taking into account the length of service.
3. Withdraw your daily minimum wage. The current minimum wage for calculating sick leave in 2021 is 12,130 rubles. Index daily earnings according to the minimum wage according to the employee’s rates and length of service, and if necessary, apply the regional coefficient.
4. Compare both amounts (from paragraph 2 and paragraph 3). Select the highest value.
5. Calculate the final payment for sick leave by multiplying the selected daily value by the number of sick days.

In what cases is sick leave paid?

The principles for calculating benefits for temporary disability are established by Federal Law No. 255-FZ of December 29, 2006 “On compulsory social insurance in case of temporary disability and in connection with maternity”

.

Payments due to industrial injury are regulated by a separate regulatory act ( Law No. 125-FZ of July 24, 1998

). Before granting benefits, the employer is obliged to investigate the causes of the accident that caused harm to health.

The procedure for paying sick leave in 2021 has not undergone any significant changes. According to Art. 5 FZ-255

Temporary disability benefits are paid if a person:

• is sick or injured;
• quarantined alone, with a child under 7 years of age or an incapacitated person;
• cares for a sick family member;
• undergoes a prosthetic procedure in a hospital;
• is undergoing further treatment in a sanatorium.

Temporary disability benefits are paid on the basis of a bulletin issued by licensed medical organizations. Not all patients can count on receiving benefits. A prerequisite is the payment of fees

in the FSS.

For working citizens, mandatory payments are made by the employer. Self-employed persons pay their own contributions. To do this, they need to enter into a voluntary relationship with the Social Insurance Fund. For students and unemployed persons, payment for temporary sick leave in 2021 is not provided. An exception for the unemployed is illness or injury within the 30-day period after dismissal.

Maternity benefits have their own calculation mechanism and are not discussed in the material. Rules for calculating maternity benefits

can be found in our article.

How much pay

The minimum and maximum amount for calculating sick leave in 2021 is established by law, taking into account the employee’s earnings. The calculation period is the two previous years. In 2021, the years 2021 and 2021 are used to calculate the benefit amount.

The minimum size is determined based on the current minimum wage. From January 1, 2020, the minimum wage is 12,130 rubles. According to the rules, the minimum average daily earnings for calculating sick leave in 2021 is calculated as follows: 12,130 × 24 months / 730 days = 398.79 rubles.

The lower limit is applied in cases where the employee’s calculation base for the previous two reporting periods is unknown or his income is too small. If necessary, the minimum average daily wage is adjusted as a percentage by the employee’s length of service.

The maximum amount of average daily earnings in 2020 is calculated as follows:

The established limit on insurance premiums for VNiM: (865,000 + 815,000) / 730 days = 2,301.37 rubles.

The maximum amount of payment for sick leave in 2020 is 69,041.10 rubles per month. This value is calculated by multiplying the maximum number of days in a month (30) by the maximum possible average daily earnings.

Sample certificate of incapacity for work

The formula for calculating sick leave in 2021 looks like this:

To calculate benefits, you must first determine:

• billing period;
• employee's earnings for the pay period;
• average daily earnings
• insurance experience;
• daily allowance amount;
• the total benefit amount.

The calculation procedure is not affected by either the reason for registering disability or the applied taxation system.

Maternity benefit

Maternity compensation is calculated taking into account a number of features.

SDZ is calculated according to the formula given in Part 3.1 of Art. 14 No. 255-FZ:

SDZ = income of the woman in labor for the billing period / (number of calendar days in the billing period - periods excluded from the calculation).

The number of calendar days, as a general rule, is 730. But how many days to take to calculate sick leave if the year is a leap year: 731 or 732 days. In 2021, the base is 2021 and 2021, they are not leap years, therefore, 730 days are taken as the basis for calculation.

The excluded periods include (Part 3.1 of Article 14 No. 255-FZ):

• illnesses and other cases of temporary disability;
• maternity leave;
• Holiday to care for the child;
• release of an employee with full or partial retention of salary, during which maternity contributions were not accrued.

Maternity compensation is paid in full - 100% of the amount on the temporary disability certificate. The benefit is calculated as follows:

Daily allowance = SDZ × 100%;

Total amount = daily allowance × number of vacation days.

The minimum limit for paying maternity leave in 2020 is:

12,130 rubles × 24 months / 730 days = 398.79.

398.79 × 140 days = 55,830.60.

By analogy, the amount of payments for a complicated pregnancy (156 days) is equal to 62,211.24 rubles, and for a multiple pregnancy (194 days) - 77,365.26 rubles.

Maximum limit on sick leave payment in 2020 (payment in rubles):

(865,000 + 815,000) / 730 days = 2,301.37.

RUB 2,301.37 × 140 days = 322,191.80.

For complicated pregnancy: RUB 2,301.37. × 156 = 359,013.72.

For multiple pregnancy: RUB 2,301.37. × 194 = 446,465.78.

IMPORTANT!
If a woman in labor does not have an insurance base for the two previous financial years (she had no salary), then the employee has the right to write an application to postpone the billing period for calculating maternity benefits, provided that this will lead to an increase in the amount of compensation (Part 1 of Art. 14 No. 255-FZ).

How to calculate temporary disability benefits

To calculate payments, use the following: the amount of the daily benefit must be multiplied by the number of calendar days for which the sick leave was issued. In case of illness, injury, prosthetics for medical reasons, quarantine and follow-up treatment, the following amount is legally established, depending on the insurance period:

• 100% of average earnings if the insured person’s work experience is more than 8 years.
• 80% of average earnings if the insured person’s work experience is from 5 to 8 years.
• 60% of average earnings if the insured person’s work experience is less than 5 years.

Also, the benefit amount is 60% of average earnings in case of illness or injury that occurred within 30 days after dismissal from the last place of work and termination of an employment relationship that was subject to social insurance.

If there was an injury at work, then payment is made in the amount of 100% of average earnings, regardless of the amount of insurance coverage. If an insured citizen is caring for a sick family member, except for children under 15 years of age, then social compensation is assigned depending on the insurance period. If it is necessary to care for a sick child, compensation is:

• For outpatient treatment - the first 10 days of incapacity for work, depending on the insurance period, the subsequent days are already 50% of the average earnings.
• For inpatient treatment, the entire period of incapacity for work is calculated depending on the length of insurance coverage.

When calculating length of service, the duration of the employment contract, civil and municipal services and other types of activities in which a person was subject to social insurance for the likelihood of temporary disability and in connection with maternity are taken into account.

The length of service also takes into account the period of military service. The insurance period is calculated on a calendar basis.

If a person’s insurance experience is less than 6 months, then the amount of compensation is limited to the minimum wage, which is established at the legislative level in the regions of the country. If a coefficient is used in the regions, then this coefficient is also taken into account when calculating the minimum wage.

If a person does not have labor income, or it is less than the established minimum wage, then the average earnings will be equal to the minimum in the region and multiplied by the regional coefficient.