Who pays for sick leave – the state or the employer?

Who pays sick leave in 2021 and when?

From 01/01/2021, temporary disability benefits throughout the country are paid according to the rules of the “pilot” project. So, in case of illness or injury:

• the employer issues benefits for the first 3 days of illness;
• The employee receives the rest from the Social Insurance Fund.

In cases of sick leave:

• caring for a sick family member;
• for quarantine of an employee, his child under 7 years old attending kindergarten, or an incapacitated family member of the employee;
• for prosthetics for medical reasons in a hospital;
• when providing follow-up treatment to an employee in a sanatorium-resort organization on the territory of the Russian Federation immediately after providing him with medical care in a hospital,

benefits The FSS pays benefits in full starting from the first day.

See our memo for accountants on the new procedure for paying benefits from 2021.

The benefit is accrued no later than 10 calendar days from the date of receipt of sick leave from the employee. The employer issues the money on the next day after the settlement date established for the payment of wages. Social insurance pays funds within 10 calendar days from the date of receipt of documents (information) or a register of information from the employer.

For example, if an employee submitted sick leave on January 15, and the salary payment deadlines are on the 5th and 20th of each month, then the benefit must be paid no later than February 5.

Important! Recommendations from ConsultantPlus To pay an employee benefits due to illness or domestic injury, obtain from him the following documents (information): certificate of incapacity for work... See the full list of documents in K+, having received a free trial access.

General information about calculating sick leave and possible changes

In 2021, no major changes are expected in the calculation of sick leave. A certificate of temporary incapacity for work does not have a fixed meaning; it depends, first of all, on length of service and earnings.

General rules for paying sick leave:

• if the work experience is 8 years or more, a benefit is paid in the amount of 100% of the salary;
• from 5 to 8 years - 80%;
• less than 5 years - 60%.

If the average earnings for each year exceed the required limit (815 thousand in 2021, 865 thousand in 2021, 912 rubles in 2021), then the specified maximum amount must be taken into account to pay for sick leave!

In order to correctly calculate sick leave in 2021, you must complete the following sequence of actions:

1. Determine the average earnings for the billing period.
2. Calculate average daily earnings.
3. Calculate the amount of daily allowance.
4. Set the amount of benefits to be paid.

First you need to determine your earnings for the previous 2 calendar years. If an employee has recently joined a company, a certificate of the amount of salary and other payments that each employer is required to issue upon dismissal will help in the calculations.

To determine the average daily earnings, the amount received must be divided by 730. Next, you need to calculate the amount of the daily benefit, taking into account the insurance period.

If the employee’s insurance experience is less than 6 months, no more than one minimum wage is paid for each month; from January 1, 2021, the minimum wage is 12,792 rubles.

The final step is to determine the total amount of the temporary disability certificate. You need to multiply the amount of the daily benefit by the number of days in accordance with the sick leave provided.

Please note: starting from 2021, it has become possible to issue electronic sick leave certificates instead of the paper version.

Law on calculation and payment of sick leave

Payment of sick leave is regulated by federal legislation, namely 255-FZ of December 29, 2006 “On compulsory social insurance in case of temporary disability and in connection with maternity”, taking into account all changes and additions.

To pay for temporary disability certificate, the employee must experience one of the following insured events:

1. illness or injury of the employee himself;
2. caring for a family member who is sick;
3. quarantine of an employee, his child under 7 years of age or an incapacitated relative;
4. prosthetics, the basis for which is medical indications;
5. follow-up treatment in a sanatorium immediately after inpatient medical care.

A mandatory requirement for all of the above situations is the insurance of the employee by his employer by transferring insurance contributions to the Social Insurance Fund of the Russian Federation in the amounts established by law. In practice, every officially registered employee is insured.

How sick leave is paid to an employee who is injured at work or “earns” an occupational disease is established by federal law.

In these situations, the main regulatory document is Law No. 125-FZ “On compulsory social insurance against industrial accidents and occupational diseases” dated July 24, 1998.

Accidents and compensation for occupational diseases are paid from the Social Insurance Fund in the usual manner and are identical to how sick leave is paid in 2021 for other insurance cases.

Funds to pay for sick leave

If an employee took sick leave in 2021, how this sick leave is paid for and from what sources is regulated by regulations.

Any insured event that occurs with the employee himself is paid as follows:

• the first three days – at the expense of the enterprise’s profit;
• the remaining period is subject to compensation from the Social Insurance Fund of the Russian Federation.

Such sick leave payment is established by Article 3, paragraph 2. 1 of the federal law on insurance premiums (No. 255-FZ).

Payment for sick leave for caring for a child or for an incapacitated relative is carried out entirely from the Social Insurance Fund budget. Payment of sick leave after dismissal is carried out in the amount of 60%, regardless of the length of the employee’s insurance period.

Important! A former employee may qualify for such sick leave if he fulfills a number of requirements specified in Article 7, paragraph 2 of Federal Law No. 255-FZ.

Sick leave calculator

How was sick leave paid until 2021?

Until 2021, payment of temporary disability benefits within the statutory sick leave payment period was carried out by:

1. The employer - upon subsequent reimbursement of expenses from the Social Insurance Fund (starting from the 4th day of illness, in case of a work injury - for all days).

This scenario was implemented in the most general case. It was assumed that at the time of payment of sick leave, the employee was an active full-time employee of the employer.

Read about filling out an application for reimbursement of expenses that exceeded the amount of accrued OSS contributions here.

2. FSS as a subject of legal relations regulated by the provisions of the Law “On Compulsory Insurance” dated December 29, 2006 No. 255-FZ.

The Social Insurance Fund was obliged to make payments for sick leave (starting from the 4th day of illness, in case of a work injury - for all days), if (clause 4 of Article 13 of Law No. 255-FZ):

• the employer from whom the employee has the right to receive benefits was liquidated at the time of registration of sick leave;
• the employer cannot pay sick leave due to insufficient funds in the account, based on the priority of fulfilling other financial requirements;
• the employer is in bankruptcy, and there is no way to recover sick pay from its existing assets.

3. FSS as a subject of legal relations regulated by Decree of the Government of Russia dated April 21, 2011 No. 294.

Here we are talking about a “pilot project”, within the framework of which the calculation and payment of benefits is carried out only by the Social Insurance Fund (from the 4th day of illness, except for sick leave for an industrial injury).

Let’s consider how long it takes for employers and the Social Insurance Fund to pay for sick leave under each of the above scenarios.

Review of legislation

The main document guaranteeing employees the opportunity to be absent from work due to illness and receive compensation for this is the Labor Code (namely Article 183). All citizens know about this right. But who pays sick leave - the state or the employer? Most people have a completely wrong idea about the nature and procedure of compensation for a period of temporary disability. To figure this out, you need to refer to other regulations:

• Federal Law No. 255-FZ of December 29, 2006;
• Government Decree No. 375 of June 15, 2007.

However, many workers do not like to read laws: their language is too complex and the wording is cumbersome. Therefore, next we will look at whose money is spent on sick leave and how the amount of benefits is calculated.

Sick leave payment is shared between the employer and the Social Insurance Fund

Payout Features

Who pays sick leave - the budget or the employing organization? The costs of paying for the period of incapacity are shared by both parties in the following proportion: 3 days by the employer, the rest of the period by the state. But here we need to be clear:

• the transfer of funds for the entire period is carried out by the employer (except for the constituent entities of the federation where the “Direct Payments” project has been implemented);
• for paying the benefit he receives compensation from the Social Insurance Fund;
• All employers make monthly contributions to the Social Insurance Fund to the Compulsory Medical Insurance Fund in the amount of 2.9% and 5.1% of the employee’s salary, respectively.

Thus, the main part of the sick leave is paid by the citizen himself - the social insurance fund compensates the money to the employer through the employee’s monthly contributions. It is for this reason that the amount of the benefit is tied to length of service: the more contributions a citizen has made, the more complete compensation he has the right to count on.

For example, an employee officially receives 17,000 rubles. This means that every month his employer pays 17,000 x 2.9% = 493 rubles to the Social Insurance Fund for him. For the year it comes out to 493 x 12 = 5,916 rubles.

Payments from the employer

Basically, the timely payment of sick leave is the responsibility of the employer: it is he who will determine the amount of compensation and transfer the funds to the account of the sick citizen after presenting the sick leave. But for all payments, starting from the 4th day of absence, the organization will receive compensation from the Social Insurance Fund (to which money was deposited monthly for each employee). That is, the first 3 days are paid by the employer, all the rest - by the social insurance fund, or rather by the employee himself.

It is important to know that in most regions there is now a “Direct Payments” project, according to which, from the 4th day of illness, payments to the citizen are made directly by the FSS. That is, the intermediary function of the employer and subsequent compensation are canceled. In general, the introduction of this approach will help reduce the bureaucratic burden on the organization and eliminate the confusing procedure for paying for temporary disability. The downside is the shift in the payment deadline (more details in the section “What to do if there are no payments”).

Employers monthly contribute 2.9% of each employee’s salary to the Social Insurance Fund: these contributions make up sick leave compensation

Payments from the Social Insurance Fund

The Social Insurance Fund receives 2.9% of the earnings of each officially employed citizen monthly. By accumulating these payments, funds are collected for sick leave. Therefore, it is fundamentally wrong to say that the state spends budget funds on sick leave. In fact, the citizen gets his own money back.

Previously, there was a system in place where the Social Insurance Fund compensated the employer for sick leave. But now in most regions a scheme has already come into force, according to which payments from the 4th day of incapacity are directly made by the fund itself. The employer transmits information that the employee will need to pay benefits to the Social Insurance Fund - within 5 calendar days.

A citizen’s obligation to receive benefits is limited only to providing a certificate of incapacity for work. All calculations and payments are made by the employer and the Social Insurance Fund.

Role of the Job Center

How is sick leave paid for unemployed citizens who are registered with the Employment Center? Unfortunately, no way. Payments to the unemployed are limited to benefits only. They need a certificate of incapacity for work solely to confirm the legality of missing a mark or a regular meeting.

It is believed that since during this period a citizen does not make contributions to the Social Insurance Fund (since the employer pays them from his salary), then no one should pay him sick leave. In this case, contributions from the previous place of work do not matter, even if the employee never took sick leave there. It’s unfair, but that’s the order for now.

How long did employers have to pay for sick leave in 2021?

The obligation to pay sick leave for Russian employers arose from the moment an employee who is on or has returned from sick leave presents a certificate of incapacity for work, which is issued by a medical institution. Within 10 days after receiving such a certificate, the employer was obliged to accrue temporary disability benefits to the employee.

On the nearest (relative to the date of accrual of benefits) salary transfer day, the employer is obliged to pay the corresponding benefit. As a rule, this payment is made simultaneously with the salary and in the same way (cash or by transfer to a card).

For information on the specifics of withholding personal income tax from sick leave payments, read the article “Is sick leave (sick leave) subject to personal income tax?”

How long does it take for an employer to pay disability benefits if an employee takes sick leave on the day of dismissal? The answer to this question is considered step by step by ConsultantPlus experts. Get trial access to the system and study the material for free.

Formulas for calculation

There is a formula that helps calculate the minimum sick leave in 2021. It looks like this:

On the date of illness of the employee in 2021, we take the current minimum wage, which we multiply by 24 months, and then divide it all by 730 days

The final result is the minimum average daily earnings. If, based on the results of the calculation, it turns out that it is less than calculated according to the minimum wage, then a larger amount is accepted for the calculation.

When sick leave is calculated on the basis of the minimum average daily earnings, it is necessary to calculate disability benefits for a period of 1 day. The following method is used for calculation:

They take the minimum average daily wage according to the minimum wage and multiply it by a percentage depending on the length of service that the employee has accumulated

To determine the percentage depending on the length of service, the following rule is used:

• the calculated percentage is 100 if the employee’s insurance experience is more than 8 years;
• the calculated percentage for sick leave is 80 if the employee’s work experience is 5-8 years;
• 60% is used for calculation if the employee’s length of service is less than 5 years.

When the length of service is less than six months, the amount of sick leave should be no more than the minimum wage in 2021 for a calendar month.

During the first 3 days of an employee’s illness, sick leave money comes from the employer’s budget. After this, payment for the sheet occurs at the expense of funds allocated by the Social Insurance Fund of Russia - FSS. And for those cases where sick leave is issued because the employee needs to care for a sick relative, the benefit is paid in full using Social Insurance Fund funds from the first day.

For cases where an employee works part-time, a general formula is used with the minimum wage indicator for sick leave in 2020. Then the resulting value is multiplied by a special coefficient. It represents the proportion of hours actually worked over the entire working period.

Deadlines for payment (payment) of sick leave from the Social Insurance Fund until 2021

If the employer was located in a constituent entity of the Russian Federation in which the FSS pilot project was not in effect, then in cases provided for by law, the fund pays sick leave funds to the employee within 10 days from the date of receipt directly from him or through the MFC of the necessary documents:

• statements (according to Appendix No. 1 to the regulations, approved by order of the Ministry of Labor and Social Protection of Russia dated May 6, 2014 No. 290n);
• sick leave;
• certificates of earnings (according to Appendix No. 1 to the order of the Ministry of Labor of the Russian Federation dated April 30, 2013 No. 182n);
• documents certifying insurance experience (according to the rules approved by order of the Ministry of Health and Social Development of the Russian Federation dated February 6, 2007 No. 91):
• other documents listed in clause 13 of the regulations approved by order No. 290n.

If the employing company was located in the region in which the Social Insurance Fund pilot project is being implemented, then sick leave payment - the timing of benefit payment - will consist of the following periods:

1. The period during which the employer is obliged to transfer to the local Social Insurance Fund the necessary data about the employee who went on sick leave is 5 days.

2. The period of verification of documents by the Social Insurance Fund and payment of sick leave is 10 days.

Thus, the total period for paying sick leave in 2021 in the regions of the FSS pilot project may have a longer duration (up to 15 days).

Reasons why an employer refuses to pay sick leave

The only reason for refusal to pay sick leave by an employer may be

be a fake sick leave certificate.

No other argument can serve as a reason for refusal. If the money has already been paid by the time the fact of forgery is established, the money is withdrawn by the employer from the employee’s future salary.

It is illegal to force people to take unpaid leave when sick. When the employer insists on this, you should still give the sick leave certificate to the accounting department, having first made a copy of it and asked the employee who accepted it to sign it.

Payment for sick leave is made within 10 days from the date of transfer of sick leave to the work organization. Payment occurs on the payroll day closest to the date of the benefit.

If this does not happen, you can submit an application to the labor inspectorate, where you will describe the entire situation. You can also contact the prosecutor's office or court to appeal the employer's position. Article 145.1 of the Criminal Code of the Russian Federation talks about liability for the insurer’s failure to pay wages, benefits and other mandatory payments.

You should know that you cannot fire an employee because he is often sick.

If you regularly and on time submit your sick leave to the accounting department, this is a guarantee that you missed work for a good reason.

This means that dismissal due to illness can be easily challenged in any court.

Each employment contract may contain special clauses related to absenteeism due to illness. For example, it may talk about the need to warn the director about absence from work due to illness. In such cases, such a clause of the employment contract will still have to be fulfilled, otherwise the dismissal will hardly be able to be challenged in court or the prosecutor’s office.

Results

Starting from 2021, sick leave is paid according to new rules: the employer calculates and issues benefits for the first 3 days of illness, the second part of the amount is paid to the Social Insurance Fund employee. To accrue benefits, the employer is given 10 days from the date of receipt of sick leave from the employee. Money is issued along with the next salary. The Social Insurance Fund pays benefits within 10 days after receiving the relevant documents from the employer.

Sources:

• Federal Law of December 29, 2006 No. 255-FZ
• Decree of the Government of the Russian Federation of April 21, 2011 No. 294
• Order of the Ministry of Labor of Russia dated April 30, 2013 No. 182n
• Order of the Ministry of Health and Social Development of Russia dated February 6, 2007 No. 91

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Changes due to coronavirus

Due to the pandemic, the rules for calculating and paying sick leave have changed. Since social contacts must be limited as much as possible, issuing sick leave has become easier (they are compiled electronically). Employees forced to comply with quarantine receive sick leave. Pensioners who are prohibited or advised not to leave their homes should also not appear at the workplace in order to reduce the risk of their illness. They are also given sick leave for the period of self-isolation.

Who pays for quarantine sick leave in 2021?

In accordance with current legislation, quarantine is indicated by the code “03” and is paid in full by the Social Insurance Fund. This follows from the Temporary Rules approved by Government Decree dated March 18, 2020. They are valid from March 20, 2020. until 07/01/2020

There are also temporary rules for assigning benefits in the event of quarantine for citizens over 65 years of age, approved by the Decree of the Government of the Russian Federation dated April 1, 2020. No. 402. A working pensioner does not need to apply anywhere; it is enough to inform the employer about self-isolation.

The Social Insurance Fund must work very quickly, benefits are paid throughout the day (first for the first 7 days, then for the remaining time). But the employer must send the Fund all the necessary data on the employee.