How is sickness code 09, family connection 42 paid?

Classification of sick leave codes and their decoding

The structure of a sick leave certificate (certificate of incapacity for work, approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2011 No. 347n) provides for the use of such types of codes as:
1. Codes of the cause of incapacity for work.

There are 15 codes in total for the cause of disability on the sick leave (their decoding is also given in Order No. 347n).

These 2-digit codes are entered in the “Code” cell directly opposite the line “Cause of disability.”

If the original disability code on the sick leave certificate needs to be changed, the new one must be entered in the “Change code” cell, which is located next to it.

2. Additional codes.

They are recorded next to the disability code in certain cases. Namely if:

• the person is undergoing treatment in a sanatorium (in this case, an additional code 017 is entered on the sick leave);
• the employee is undergoing treatment in a sanatorium due to an incident at work (code 018);
• the person is being treated in a clinic belonging to a research organization (code 019);
• the employee is granted additional maternity leave (code 020);
• the employee fell ill due to intoxication or actions related to it (code 021).

3. Codes reflecting family relationships.

They are indicated above the line “Family relationship” if the sick leave is issued for an employee who does not go to work due to caring for a sick family member. In this case, the code must correlate with the one that reflects the cause of disability. If this is code 38, indicating that the employee is a mother and is caring for a child, then code 09 is entered in the line “Cause of disability.”

4. Code reflecting the employee’s violation of the treatment regimen.

Fixed opposite the line “Note about violation of the regime”, if a corresponding violation has taken place. For example, code 24 indicates that a sick employee did not show up for an appointment with a doctor at the appointed time.

5. Other codes.

Indicated opposite the line “Other”. May reflect other significant information about the employee’s health status. For example, if this is code 31, it will mean that the employee has not recovered and is going on new sick leave.

6. Code reflecting the conditions for calculating compensation for sick leave.

Fixed in the line “Accrual conditions”. For example, if a person has already left the company, but fell ill within 30 days after dismissal, code 47 is entered. If necessary, several codes can be indicated in the corresponding line.

Among other significant elements of the document on which compensation for temporary disability is calculated is the subordination code on the sick leave. It, unlike the codes discussed above, is not unified and is set depending on the region of registration of the company in the Social Insurance Fund. You can find out this code from the notice of registration of the employer with this department or by contacting them.

Cause of disability codes on sick leave: decoding

The cause of disability code on the sick leave is indicated in a special field consisting of two cells. Their values ​​range from 01 to 15. The form has three cells for specifying an additional code. It is intended to clarify the causes of injury or illness and some other details. Their values ​​range from 017 to 021.

Let's look at the most common values, and the remaining codes for the reasons for disability on the new sick leave can be seen on the sample back of this form.

Causes of illness and legal consequences for the employer (codes 01, 02, 04)

What is the impact of recording certain codes on the certificate of incapacity in practice? What does sick leave code 01 or 02 mean?

Let's study these issues in the context of the possible legal consequences of indicating certain codes on the certificate of incapacity for work for the employer.

First of all, what specific cause of the employee’s illness is reflected in the sick leave (code “Cause of disability”) may be important:

• One of the most common disease codes on sick leave is 01. It reflects the fact that the employee has contracted a common illness, such as ARVI. If this code is indicated on the sick leave, the employer calculates sick leave compensation in the usual manner established in paragraph 1 of Art. 14 of Law No. 255-FZ.
• In turn, what does sick leave code 02 mean? The fact that the employee suffered an injury not related to work. The presence of sick leave code 02 implies that the employer has the same obligation to calculate the amount of compensation according to the general rules (in particular, taking into account the employee’s length of service).
• The fact of injury at work is reflected on the sick leave using code 04. In this case, the enterprise must pay the employee compensation for sick leave in the amount of 100% of his average earnings (Clause 1, Article 9 of the Law “On Compulsory Social Insurance...” dated July 24, 1998 No. 125-FZ). This is a fundamental difference between the employer’s responsibilities compared to when the cause of incapacity 01 is indicated on the sick leave and the amount of compensation depends on the length of service.

Among the other responsibilities of the employer in the event of an employee’s work-related injury is an investigation of the incident in accordance with the requirements of the Labor Code of the Russian Federation, as well as the rules adopted in local documents. Actually, the presence of code 04 on an employee’s sick leave should not be a surprise to the employer, since it is unlikely that he will not be aware of what happened (and will not take the measures prescribed by the provisions of Articles 228–231 of the Labor Code of the Russian Federation even before the employee returns from sick leave).

But if the company really, for some reason, did not know that the employee was injured as a result of an incident at work, this relieves the employer of responsibility for its investigation, unless the employee applies for an investigation (Article 229.1 of the Labor Code of the Russian Federation).

You will learn more about the rules for calculating sick leave compensation in certain cases from the selection of materials in this section.

Common questions and errors

Is it allowed to renew a disability certificate in another locality?

In accordance with the Procedure for issuing a certificate of incapacity for work, approved by Order of the Ministry of Health and Social Development No. 624n, issuing a sick leave certificate in another medical organization, including in another city, is possible.

However, it is worth considering that a trip to another city may be one of the reasons that violates the regime (code 23). Such a mark may result in a reduction in compensation payment.

What is not considered a basis for extending the BC through this coding?

In the event that the patient complains of poor health, but it is not confirmed by a doctor’s examination, the sick leave will not be extended. Accordingly, code 31 should not be indicated, but some doctors mistakenly write it on the sick leave.

It is necessary to contact the clinic where you were treated to correct this error and set the end date of the sick leave.

In what cases is it not paid?

There may be several situations with non-payment:

• sick leave is extended without a medical examination confirming the continuation of the illness;
• it was discharged retroactively;
• the bulletin was issued by a medical institution operating without an appropriate license.

Code 11 on sick leave: employer's responsibilities

Other responsibilities may arise for the employer if the disease code on the sick leave certificate is 11. It reflects the fact that the employee suffered the disease specified in clause 1 of the list of socially significant ones, approved. by Decree of the Government of the Russian Federation dated December 1, 2003 No. 715, - tuberculosis.

In this case, the duration of treatment can be up to 12 months (Clause 4, Article 59 of the Law “On the Fundamentals of Health Protection...” dated November 21, 2011 No. 323-FZ), and the employer must be prepared to compensate for it. The maximum duration of treatment in the general case is 10 months (clause 13 of the procedure approved by order of the Ministry of Health and Social Development of the Russian Federation dated June 29, 2011 No. 624n).

In addition, if an employee, along with a sick leave certificate, brings a medical order according to which he will need to be transferred to another position for health reasons, the employer will be obliged to provide such a position or remove the employee from work and pay him temporary disability benefits (Article 73 of the Labor Code of the Russian Federation , paragraph 3 of article 14 of the law “On preventing the spread of tuberculosis” dated June 18, 2001 No. 77-FZ).

How is sickness code 09, family connection 42 paid?

Sick leave during maternity leave is issued only in certain cases. At the same time, there are different types of maternity leave: for pregnancy and childbirth and for caring for a newborn child until his third birthday.

Grounds for applying for sick leave on maternity leave.

Is sick time paid during maternity leave?

To find out whether sick leave is needed on maternity leave, you must first separate the concepts that are understood by this term. After all, maternity leave, as a rule, also means maternity leave (hereinafter referred to as Bir), provided for in Art. 255 of the Labor Code of the Russian Federation, and parental leave until their third birthday, provided for in Art. 256 Labor Code of the Russian Federation.

In the first case, a certificate of incapacity for work (in other words, sick leave) is simply necessary, since it is this that serves as the basis for going on Bir leave. It is issued at the 30th (for multiple births - at the 28th) week of pregnancy for 140 days (for the birth of 2 or more children - 194), in accordance with clause 46 of the Procedure for issuing certificates of incapacity for work, approved by order of the Ministry of Health and Social Development dated June 29, 2011 No. 624 n . However, you can go on maternity leave later - in this case, sick leave is taken not at 30 (28) weeks, but when the need arises for the pregnant employee.

To go on leave to care for a young child, sick leave is not needed, since the basis for registration of such leave is the application of the young mother. You can go on maternity leave, return to work full time, and then go on leave again to care for your child as many times as you like until the child reaches the age of three. At the same time, the employee retains her position and workplace throughout her maternity leave (Part 4 of Article 256 of the Labor Code of the Russian Federation.

Reasons for applying for sick leave on maternity leave

Sick leave during maternity leave to care for children is issued only in two situations:

At the end of the vacation, if the painful condition of the maternity leaver persists (clause 22 of order No. 624 n).

If a maternity leaver, while on vacation, works at home or in the workplace, subject to part-time employment (clause 23 of order No. 624 n).

Sick leave for caring for a sick child is not issued, according to paragraph 40 of Order No. 624 n, if the employee is on vacation at that time:

to care for your child under three years of age;

according to Bir. Do I need sick leave during maternity leave?

If while an employee is on maternity leave, her child falls ill, a certificate of incapacity for work is issued only when the mother plans to go to work (that is, at the end of her vacation), in accordance with clause 41 of Order No. 624 n. In the event that the employee is already on maternity leave (to care for a child) and the time is right to take Bir leave, the corresponding sick leave is issued on the basis common to all cases (clause 52 of order No. 624 n).

Is sick time paid during maternity leave?

Sick leave on maternity leave is paid if the mother, caring for the child until his third birthday, continues to work part-time or works at home (clause 23 of Order No. 624 n and clause 1 of Article 6 of the Law “On Compulsory Social Insurance...” dated December 29, 2006 No. 255-FZ).

Is sick leave paid during maternity leave to care for a minor child in all other cases? The answer here will be clearly negative, since there is simply nothing to pay (after all, a certificate of incapacity for work is not issued). There are no sick pay payments during these periods, since the woman on maternity leave already receives social benefits due to insured persons:

a benefit in the amount of 100% of the salary (Clause 1, Article 11 of Law No. 255-FZ) - paid to those who have taken Bir leave;

a benefit in the amount of 40% of the employee’s average earnings (Clause 1, Article 11.2 of Law No. 255-FZ) - paid to those on leave to look after a child until he reaches 1.5 years of age.

If, at the same time, an employee who has taken leave to care for a child under 1.5 years of age, the time comes to go on Bir leave (i.e., when another pregnancy occurs), she can choose the benefit that is larger by size (clause 3 of article 10 of law No. 255-FZ).

A young mother who has taken leave to care for her young child cannot take out sick leave either to look after him during illness or in connection with her own illness. The exception is situations when a woman, while on maternity leave, continues to work from home or goes to work part-time: in these cases, a certificate of incapacity for work is issued and paid on a general basis.

The amount of temporary disability (sickness) benefit for the insured person depends on the insurance length of such employee and ranges from 60 to 100% of average earnings for the last 2 years (clause 1, article 7 of law No. 255-FZ). My answer to your question is comprehensive.

What do violation codes mean (23, 24)

Knowing what code 01 means on a sick leave certificate is not enough. It is also necessary to check whether the medical institution has identified other circumstances characterizing the employee’s state of health. Which for example?

Thus, the commonly used sick leave code 01 can be supplemented with a code that gives the employer a basis for reducing the amount of compensation for sick leave. These may be codes that reflect (Clause 1, Article 8 of the Law “On Compulsory Social Insurance...” dated December 29, 2006 No. 255-FZ):

• non-compliance with the prescribed treatment regimen (code 23 in the line “Note about violation of the regimen”);
• failure to appear for a medical examination on time (code 24 in the line “Note about violation of the regime”);
• illness due to intoxication (code 021 in the “Additional code” line).

Sick leave compensation in this case is reduced to the level of the minimum monthly wage:

• from the moment of violation under codes 23 and 24;
• for the entire period of illness using code 021.

Read more about paying sick leave for alcohol intoxication here.

Thus, deciphering the disease code on the sick leave sheet 01, 02, 04 must necessarily be done taking into account the possible presence of the 3 considered codes in the document. Their presence directly affects the size of the company’s obligations for sick leave compensation.

How to pay for a newsletter with code “31”

The assignment and payment of social benefits is carried out to insured citizens upon presentation of a sick leave certificate. The procedure for social payments is regulated by the Federal Law of the Russian Federation No. 255 of December 29, 2006. Thus, Art. 6 of the Federal Law of the Russian Federation No. 255 prescribes sick leave (in case of injury) to be paid for the entire period of temporary incapacity until returning to work (until full recovery) or until disability is established.

Social benefits in 2021 are calculated based on the total number of sick days. As is customary, the first 3 days are paid by the employer, and the subsequent days by the Federal Social Insurance Fund of the Russian Federation. The counting begins from the first day of illness. This takes into account:

• all full calendar days, including holidays, weekends, non-working days (total number of sick days according to the bulletin);
• the insurance period of the sick employee (periods of payment of contributions);
• his earnings for the last two years;
• SDZ of the employee;
• the actual minimum wage for 2021 (if there is little or no experience, when there is no income, etc.).

With 8 years of experience or more, 100% of sick leave is paid. An employee with 5 to 8 years of experience will be paid 80% of the ballot. With up to 5 years of experience, this percentage decreases to 60. The actual calculation of the amount of social benefits is made according to the usual formula: SDZ * number of days of illness.

Line “Other” (using code 31 as an example)

In some cases, along with disease codes, information on the line “Other” is recorded on sick leave. For example, code 31, reflecting the fact that the employee did not have time to recover and cannot go to work (the consequence may be the opening of another certificate of incapacity for work).

The fact that the employer received this sheet with code 31 obliges him to pay compensation for it, calculated in the prescribed manner, despite the fact that the employee has not yet returned to work. A sick leave with code 31 is considered closed one way or another. The total number of sheets does not matter: the employer is obliged to pay for each one brought by the employee.

These are the features of deciphering sick leave in cases where the employee himself falls ill. But situations are possible in which it is not he who is sick, but his relative. In this case, a special code is entered on the certificate of incapacity - 09. Let us study what legal consequences its presence on sick leave can create for the employer.

How is it paid?

Regardless of whether the employee continues to remain on sick leave or has begun to perform his duties, the employer undertakes to pay sick leave compensation by submitting the relevant information to the Social Insurance Fund .

The employee has the right to present one such sheet, while continuing to be treated under the second bulletin, and simultaneously all sick leave sheets. In the latter case, the calculation will be made based on the sum of days missed due to illness.

To determine the amount of compensation, the following data is taken into account:

• insurance experience;
• earnings of a disabled employee for a two-year period;
• average daily earnings;
• for less than six months of experience – the current minimum wage;
• the total number of days on the certificate(s) of incapacity for work, including weekends and holidays.

What does code 09 mean on sick leave: legal consequences for the employer

If an employee’s sick leave is coded 09, this means that he was absent from work due to caring for a child who was sick. Indication of this code in the document implies payment of sick leave in an amount determined in the general manner, as if code 01 or 02 were on the sick leave. As for the number of paid days an employee is on sick leave, it is established taking into account certain provisions of the law.

The duration of paid sick leave for an employee who was absent from work to care for a child is (Article 6 of Law No. 255-FZ):

1. If the child is under 7 years old:

• 90 days a year if the child’s illness is reflected in the list approved by order of the Ministry of Health and Social Development of the Russian Federation dated February 20, 2008 No. 84n;
• 60 days in other cases.

2. If the child is from 7 to 15 years old - up to 45 days a year for all cases of illness (no more than 15 days for each individual case).

3. If the child is under 18 years old:

• up to 120 days if the parent is caring for a child with disabilities;
• without restrictions, if a parent is caring for a child with HIV;
• without restrictions, if a parent is caring for a child who has suffered from vaccination complications or is undergoing treatment for malignant neoplasms.

These rules are the same for employees, regardless of whether their child is a son or daughter, grandson or granddaughter.

IMPORTANT! The specified time restrictions relate specifically to the payment of sick leave, and not to the duration of stay. Read more here.

Application of a new sick leave (by order of the Ministry of Health and Social Development of Russia No. 347n): nuances

It will be useful to consider a number of other nuances that characterize the use of sick leave certificates of the new type by employers (of course, relatively new - they were approved in 2011, but nevertheless they have specifics that should be paid attention to).

First of all, there are a number of formal requirements for filling out a certificate of incapacity for work. So:

• it must be filled with ink, gel, capillary or fountain pen, but not ballpoint;
• characters are not allowed to go beyond the boundaries of document cells;
• characters must be recorded in the document starting from the very first cell.

The sick leave must be certified with a seal that does not appear on certain cells of the document. The fact that, for example, code 02 and not any other is indicated on the sick leave certificate should be obvious to the inspector. In this case, the check can be carried out using a scanner, which will not be able to recognize the code if the seal is layered on the sick leave information field.

The seal of the medical institution must be clear - so that its name is readable (which must coincide with that indicated in the document).

If there are errors in the sick leave certificate or it is filled out incorrectly, the employer must ask the employee to bring a duplicate of the document, filled out taking into account all the requirements (their full list is given in the order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n).

Results

A sick leave certificate is a document on the basis of which the employer determines, firstly, the amount of compensation for the employee’s temporary disability, and secondly, the duration of paid sick leave. To do this, the various codes recorded on the certificate of incapacity for work are deciphered. When applying sick leave, the employer needs to take into account their correlation.

You will learn more about the peculiarities of using sick leave by employers from the articles:

• “Is sick leave (sick leave) subject to personal income tax?”;
• “Payment for sick leave to care for a sick relative”.

You can find more complete information on the topic in ConsultantPlus. Free trial access to the system for 2 days.

How is the cause of disability determined?

Recommendations for filling out the document were given by the Social Insurance Fund in Letters No. 140311/15-8605 of September 14, 2011, No. 14-03-11/05-8545 of August 5, 2011 and No. 14-03-18/15-12956 of October 28, 2011 . In particular, it indicates how to make entries in the document, how and where to put stamps, in what situations the sheet will be considered invalid, provides recommendations for filling out both for employees of medical institutions and for employers, and specifies requirements for affixing certain codes. Their main values ​​are presented in the table below.

Table - Code values ​​of the certificate of incapacity for work and their interpretation

Source: Form of certificate of incapacity for work

The values ​​given in the table are entered in the column “Cause of disability” in the first 2 cells. The important point is that codes “14” and “15” are entered into the document only with the consent of the patient himself or (more likely) his official representative. If the mother or father (including guardians) do not want to reveal the secret of the illness, then the medical institution will put code “02” in the required column. If during the preparation of the document the cause of disability was changed, then in the corresponding column “change code.” the doctor will enter the correct value. The three-digit codes presented at the bottom of the table also fit into the “Cause of Disability” section, in the columns following the two-digit code.