Decoding the codes of the reasons for disability on the sick leave certificate

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Published: 06/10/2016

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The sick leave certificate provides for the inclusion of many types of codes, and both health workers and accountants or personnel officers of organizations must enter the codes.

Understanding the codes is not as difficult as it seems at first , you just need to know where to find the necessary information.

• Why is coding needed?
• How to read codes?
• Codes of dangerous diseases Socially significant
• Dangerous
• String "other"

Registration of a newsletter with code “05”

The hospital bulletin is issued at the antenatal clinic at the place of registration by an obstetrician-gynecologist (paramedic or family doctor) to a woman at 30 weeks of pregnancy. Its standard duration is 140 days. Of these, half is provided before childbirth, and the rest after it. Thus, it turns out that 70 days of rest are provided and paid to the woman before childbirth and the same amount after.

In case of early labor (22-30 weeks), as an exception, a bulletin is issued from the first day of birth for the entire vacation period. If, for example, a multiple pregnancy is detected, it is possible to issue sick leave at the 28th week of pregnancy for a period of 194 days. Social benefits are assigned under these circumstances based on the documents submitted, namely:

1. A woman's application for leave.
2. Bulletin with code "05".
3. Certificates of early registration.

If necessary, the above list is accompanied by information from the previous place of work about earnings, etc. All maternity leave dates are specified in detail in the sick leave bulletin.

A woman has the right to go on maternity leave later than required by law. Please note that if you go on maternity leave later, the established deadlines will not be moved. The basic information that must be included in the sick leave is:

• personal information of the woman (full name, date of birth, place of work);
• early registration mark;
• date of issue of the bulletin, its validity period (start and end);
• doctor's signature and seal.

At the request of the woman and if there is such an opportunity, the medical institution can issue her an electronic bulletin or issue a regular sick leave on paper.

An electronic bulletin and a paper sick note are equivalent.

FSS RF.

Sick leave code 05 020 What does it mean?

Additional codes allow you to supplement information on disability. For example, if the code “05 020” is on the sick leave certificate, then the employer automatically increases the amount of maternity benefits . In this case, the basis for this is the legislative norm.

There are two types of codes: main two-digit and additional three-digit . The latter is not always indicated. So, if a citizen comes with a disease that does not require staying in a special sanatorium or hospital, then only a two-digit code will be entered on the sick leave. The employer does not have the right to demand explanations from the employee regarding the issued certificate of incapacity for work.

What does the employer fill out (read more...)

Assignment of social benefits using a ballot with code “05”

Maternity sick leave is generally calculated based on the provisions of the Federal Law of the Russian Federation No. 81 of May 19, 1995 (on state benefits for citizens with children), as well as guided by the norms of the Federal Law of the Russian Federation No. 255 of December 29, 2006 (on social benefits for illness). To receive the required social payment on the ballot, you must first register it.

Thus, a sick leave certificate with code “05” is the main document that provides a woman with the right to maternity leave.

Disease codes on sick leave with explanations

Why does an accountant need to know what the codes on the sick leave mean? To correctly calculate benefits. There are situations when the correct decoding determines which days of the ballot need to be paid based on average earnings, and which days based on the minimum wage. Sometimes the codes tell you what percentage of length of service should be used when calculating benefits. These and other subtleties are discussed in this article.

It shows in encrypted form on what basis the person was given a ballot. This code is entered on the sick leave certificate in the “Cause of disability” field. It consists of three blocks:

1. Two cells labeled “code”. They indicate the code of the reason why the employee went to the doctor on the first visit and received a certificate of incapacity for work.
2. Three cells with the signature “additional code”. They are filled out only in certain cases (see table).
3. Two cells labeled “change code.” They are filled out in a situation where the cause of disability has changed (for example, when the original diagnosis is corrected).

All values ​​with explanations are given in the order in which certificates of incapacity are issued (approved by order of the Ministry of Health and Social Development dated June 29, 2011 No. 624n) and on the reverse side of the ballot form.

Work with electronic sick leave and submit reports through “Kontur.Extern”

Table with decoding of disability codes on sick leave

Create a register of sick leave and submit it online

Sick leave codes 01, 02

Code 01 on the sick leave means that the employee was absent from work due to illness (flu, pneumonia, sinusitis, etc.).

Code 02 means that the person missed work due to injury.

Having received a bulletin with one of these codes, the personnel officer must reflect the information in the work time sheet (usually they use forms No. T-12 or No. T-13, approved by Resolution of the State Statistics Committee dated 01/05/04 No. 1). The corresponding days are marked with the symbols “B” or “19”.

Next, the accountant calculates temporary disability benefits (for more details, see: “Payment of sick leave in 2019”). In this case, the employer pays for the first three days at his own expense.

The remaining days, starting from the fourth, are financed by the FSS. This is stated in paragraph 1 of part 2 of article 3 of the Federal Law of December 29.

Calculate your salary and benefits for free in the web service

Sick leave code 04

Code 04 on the certificate of incapacity for work means that the person missed work due to an accident at work or its consequences.

In the report card in form No. T-12 or No. T-13, days of absence are marked with the symbols “B” or “19”.

Benefits under such a bulletin must be issued for the entire period up to the date of recovery or until the fact of permanent disability is established.

The payment amount is calculated based on 100% of average earnings, regardless of length of service, but for a full calendar month cannot exceed the maximum amount.

It is equal to the maximum monthly insurance payment approved by law, multiplied by four (Article 9 of Federal Law No. 125-FZ of July 24, 1998).

IMPORTANT. First, the organization or individual entrepreneur pays the benefit from its own money, and then can reimburse it from the Social Insurance Fund.

To do this, it is necessary that the incident be investigated by a special commission, which recognized it as an accident (Article 229 of the Labor Code).

Next, the accountant must reflect the costs of the benefit in Table 3 of the calculation in Form 4-FSS (approved by Order of the FSS dated September 26, 2016 No. 381).

Fill out and submit 4‑FSS online for free using the current form

Mode violation codes 23, 24

Significant information is contained in the field of the sick leave sheet, which is called “Notes on violation of the regime.” A two-digit code and the date of violation are entered here. The following marks are most often used.

Code 23 indicates non-compliance with the prescribed regimen, unauthorized leaving the hospital, traveling for treatment to another administrative region without the permission of the attending physician.

Code 24 indicates late attendance at a doctor's appointment.

If these values ​​are present, then starting from the date specified in this field, the benefit must be calculated in an amount that does not exceed for a full calendar month the minimum wage established for the current year and multiplied by the regional coefficient (if any). This rule applies even if the employee’s actual average earnings exceed the minimum wage.

Example

From February 10 to February 17, 2021, he was treated in a hospital. On February 14, the employee violated the regime, and the doctor made a note on the bulletin.

The accountant calculated the allowance:

• for the period from February 10 to February 13 - based on the actual average earnings multiplied by 100%;
• for the period from February 14 to 17 - according to the formula: minimum wage for 2021, divided by 29 (the number of days in February) and multiplied by 4 (the number of days of sick leave, starting from the date when the regime was violated).

Line “Other” (code 31, 36)

It contains additional information in encrypted form. Here are some of them.

Code 31 means that a person needs long-term treatment, and although he was given a certificate of incapacity for work, he continues to be ill. In this case, he submits the primary sheet to the accounting department and receives benefits for the first part of the illness. In this document, the “Get Started” field is not filled in. And in the “Other” field there is code 31, which stands for “continues to hurt.”

Code 36 indicates the following situation. The employee, while on sick leave, missed his next doctor's appointment. And when he showed up (later than the appointed date), he was recognized as able to work. The ballot fields are filled in as follows:

• “Notes on violation of the regime” - worth 24 and the date of the missed appointment;
• “Exemption from work” - the period from the onset of illness to the date of the missed appointment is indicated;
• “Other” - costs 36;
• “Get Started” remains blank.

ATTENTION. The benefit for the ballot, in which code 36 is indicated in the “Other” field, is calculated as follows. From the onset of illness to the date preceding the absence - based on actual average earnings. For a day of failure to appear - in an amount not exceeding for a full calendar month the minimum wage established for the current year and multiplied by the regional coefficient (if any).

Calculate a “complex” salary with coefficients and bonuses for a large number of employees Try for free

Subordination code on sick leave

This field is located in the section of the certificate of incapacity for work that employers fill out.

Here you need to enter the five numbers assigned to the company or entrepreneur when registering with the Social Insurance Fund. You can view them in the registration notice received at the FSS office.

What codes should an employer provide?

The employer should put the subordination code in the bulletin and fill out the “Calculation conditions” field (the codes are given on the back of the sick leave form).

Doctors indicate all other codes, in particular: reasons for disability, notes on violation of the regime and the corresponding values ​​in the “Other” field.

IMPORTANT. If doctors filled out a sick leave certificate with errors (including incorrect disease codes), and the accounting department paid for it, the Social Insurance Fund will most likely refuse to reimburse the benefit. But the courts support policyholders in such situations.

Source: https://www.Buhonline.ru/pub/beginner/2019/11/15226

Example 1. Application for maternity leave and social benefits

The application is written by the woman in any form. As is customary, it states:

• Full name of the head of the organization;
• the applicant's initials, as well as her position and the department in which she is registered;
• a request for maternity leave from a specific date and for the assignment of social benefits;
• link to the hospital bulletin indicating its details.

The following form can be considered as a sample.

Decoding codes

• 31 – extension of the previous sick leave,
• 32 – establishment of disability group,
• 33 – change of previously assigned disability group,
• 34 – death,
• 35 – refusal to participate in ITU.
• 36 – ability to work,
• 37 – referral for follow-up treatment after hospitalization.

Disability codes are a designation of the reason due to which a citizen lost the opportunity to work in his specialty. Encryption is carried out by putting down a number responsible for a particular reason. This is required to maintain medical confidentiality, the dissemination of which is a criminal offense. The certificate of incapacity for work does not indicate the diagnosis given to the citizen when applying to a medical institution.

Amount and payment of social benefits for sick leave with code “05” for 2021

The right to pay maternity leave by ballot is enshrined in Art. 255 and t. 256 of the Labor Code of the Russian Federation and applies to all working and studying women. This norm also applies to the unemployed who are listed in the employment center.

Payment for maternity leave (letter with code “05”) is made from the funds of the Federal Social Insurance Fund of the Russian Federation in the amount of 100% of the SDZ for 140 days (for the general case). The payment is calculated for each pregnant woman individually. For calculation purposes, the following factors are taken into account.

Formula for calculation: average daily earnings * number of days of maternity leave according to the ballot (140, 156 or 194 days, respectively). You can calculate the amount of social benefits yourself using the calculator on the website of the Federal Social Insurance Fund of the Russian Federation. If a woman works for more than 2 years for several employers, then each of them must pay maternity leave.

Sick leave code 05 020 What does it mean?

Code 04 on the certificate of incapacity for work means that the person missed work due to an accident at work or its consequences.

Next, the accountant calculates temporary disability benefits (for more details, see: “Payment of sick leave in 2019”). In this case, the employer pays for the first three days at his own expense. The remaining days, starting from the fourth, are financed by the FSS. This is stated in paragraph 1 of part 2 of article 3 of the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity.”

Sick leave codes 01, 02 (read more...)

Common mistakes when issuing a ballot with code “05”

Error 1. Only a woman who is preparing to give birth to a child can receive a hospital bulletin with code “05” (for pregnancy and childbirth). Accordingly, only she is assigned and paid social benefits according to such a ballot, which replaces her salary.

At the same time, a father, grandmother or other relative can apply for leave to care for a newborn child. To apply for it, the potential vacationer will need to present a certificate from his mother’s place of work stating that she did not take such a vacation, i.e., it remained unclaimed.

Error 2. Social benefits, which are due during maternity leave, are not paid for those days when salaries were calculated. Social benefits and salary are also not assigned at the same time.

So, for example, if a pregnant woman went on maternity leave later than she was supposed to, then social benefits will be assigned and paid from the first day of leave, but not earlier than that.

Code options

Codes are divided into three types:

• Double digit. It must be marked by the doctor when issuing a certificate of incapacity for work and is most often indicated for the standard duration of sick leave. This code reveals the cause of disability (for example, a domestic injury - 02, a separate injury received at the workplace - 04, pregnancy and childbirth - 05, caring for a family member - 09). Usually it is placed in cases where hospital stay and further more detailed explanation of the cause of the disease to the employer are not required. This code is called the main code.
• Clarifying code. This may be followed by two more numbers, which are intended to clarify the diagnosis made by the attending physician. This happens in cases where the patient is recognized as disabled due to illness (32) or an additional period is necessary for further treatment of the patient (37). Also, moments of non-compliance with medical orders and violation of hospital regulations may be indicated here, which may affect how and in what amount the time an employee is absent from the workplace is paid.

All possible codes and their nature that may appear on this document are indicated there. For example, reason for disability 01 is a designation of a general illness, that is, the employee could have been suffering from the flu or another illness at that time, which did not require more complex additional examinations or further treatment in a hospital.

The indicated reason 11 speaks of a so-called special disease (the full list is approved by the government of the Russian Federation), for example, a mental personality disorder or diabetes mellitus.

Answers to frequently asked questions

Question No. 1: Is maternity leave paid for a non-working woman?

No, because maternity leave is provided and paid for by those who work or study. Unemployed women, in fact, have nowhere to apply for it. Therefore, they are deprived of this social benefit.

Exception: if a woman is fired due to layoffs or bankruptcy of the organization and no more than a year has passed since that moment. Then the unemployed mother is paid social benefits according to the ballot. For your information, an unemployed woman can receive the social benefits that are due in her situation only by registering with the employment center.

Sick leave code 04

Care for a child under 7 years of age, if his illness is included in a special list (approved by order of the Ministry of Health and Social Development dated February 20, 2008 No. 84n)

1. Two cells labeled “code”. They indicate the code of the reason why the employee went to the doctor on the first visit and received a certificate of incapacity for work.
2. Three cells with the signature “additional code”. They are filled out only in certain cases (see table).
3. Two cells labeled “change code.” They are filled out in a situation where the cause of disability has changed (for example, when the original diagnosis is corrected).

Functions of disability codes

This digital form of indicating the cause of disability has a number of advantages over conventional handwritten certificates and carries the following functions:

Additional days to care for a disabled child

• Protection of medical confidentiality. Not all employees want to share their health problems with accounting or their manager. This type of indication of the cause of disability for the most part allows the employee to keep this secret. For example, the number 9 means that the employee is not sick himself, but a minor child requires his care. The baby’s illness does not play a role in this and is not indicated.
• Convenience. Such a short designation helps optimize the work process of both the attending physician, the accounting or human resources department, and then the Social Insurance Fund employees. Calculation of necessary payments to an employee is also simplified with the help of this designation.
• Save space and time. Now the doctor does not need to write the full long name of the disease, which the accountant will then not be able to understand.
• Going international. All disease codes are developed by the government in accordance with international requirements and standards. This is a way to bring medicine to a new level and the possibility of convenient processing of sick leave in those companies where the organization’s management and accounting department are located outside the territory of the Russian Federation. Also, if the patient was treated outside of Russia, the codes assigned by foreign doctors will match ours. For example, code 10 everywhere will mean special research, poisoning or another condition that is different from a general disease, but makes the employee temporarily disabled.