For what length of service is sick leave paid 100%?

If a working citizen wishes to take sick leave, then he is entitled to temporary disability benefits. The provision of such a “service” is carried out from the “treasury” of a specialized insurance fund, which assumes the absence of any damage to the enterprise where the sick person works. Which groups of people are entitled to payments during illness, and how is the amount of financial support calculated?

Concept and types of temporary disability benefits

Loss of ability to work in the context of labor relations is a person’s condition in which he is unable to perform his professional functions.

Temporary disability benefits are monetary compensation for wages for the period of treatment, rehabilitation or care for a patient. This compensation is assigned to everyone who participates in the compulsory insurance system.

There are several types of payments:

• in case of illness, damage, insertion of a prosthesis;
• quarantine;
• treatment in a medical institution;
• rehabilitation after injuries and illnesses;
• patient care.

Sick leave funds for the first three days are provided by the company where the person works, and the rest of the time they are accrued from the Social Insurance Fund.

How to determine the number of complete years and months

Paragraph 23 of the Rules states that the periods included in the insurance period should be calculated in calendar order based on full months (30 days) and a full year (12 months). In this case, every 30 days must be converted into full months, and every 12 months - into full years.

In practice, different translation techniques are used. One of the most common is as follows. Each calendar month is considered a full month, regardless of the number of days. So, a full month is considered to be the period from January 1 to January 31, from February 1 to February 28 (if the year is not a leap year), etc.

The number of days in incomplete months is added, and the result is divided by 30. For example, in the first month of the period 28 days were worked, and in the last month - 17 days. A total of 45 days were worked in the period (28 days + 17 days). It is believed that 45 days is one full month and 15 days (45 days: 30 days = 1 month + 15 days).

The legislative framework

The right to compensation is prescribed in the Labor Code, Art. 183 “Guarantees for employees in case of temporary disability.” The main law regulating the rules for its provision is Federal Law No. 255 “On compulsory social insurance in case of temporary disability and in connection with maternity.”

The law answers all questions regarding compensation:

• rights of the insured person;
• who can receive funds;
• period of provision;
• benefit amount;
• rules for calculating the amount;
• conditions for reducing or terminating compensation.

Based on this regulatory act, let us consider in more detail the procedure for calculating compensation, conditions and its amount.

Who should

Material support is provided to persons working on the basis of an employment contract, and only if the institution makes contributions to the Social Insurance Fund for its employees. However, citizens who are not employed by enterprises can also become recipients of funds:

• persons engaged in legal practice, notaries and individual entrepreneurs;
• persons working on their own farms;
• representatives of communities of endangered northern peoples.

The main condition is the payment of contributions to the Fund from the income received. Moreover, it does not matter how exactly the contributions were paid - by the enterprise’s accounting department or by the person himself. Also, in order to receive financial compensation, the employee must confirm the inability to work.

Confirmation of incapacity for work is a doctor's conclusion.

Payments under a certificate of incapacity for work are not due or stop being transferred if:

• the person violated the treatment regimen;
• the sick leave was issued by an institution without a license;
• if the employee was suspended without pay;
• if the loss of health occurred as a result of an offense.

Compensation is also not provided to unemployed citizens who do not receive unemployment benefits. But if a person quits his job, but within a month after leaving he loses the opportunity to work, then he is entitled to compensation.

Formula for calculating sick leave payments and maximum benefit amount

How to calculate sick leave in 2021? The formula for calculating sick leave payments in 2021 is still the number of days of sick leave to be paid, multiplied by the SDZ determined for the billing period, and by a reducing factor, if its application is necessary (clauses 4, 5 of Article 14 of Law No. 255-FZ).

For each of the above four groups, the two full calendar years preceding the year of sick leave are taken as the calculation period for which the SDZ will be calculated. In general, the number of days in them is considered to be 730 (Clause 3, Article 14 of Law No. 255-FZ).

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To calculate sick leave according to BiR, days will have to be counted according to the fact, i.e., taking into account the increase in their number in leap years (clause 3.1 of Article 14 of Law No. 255-FZ). And since this calculation allows (due to the lack or insufficiency of income) the replacement of one or two years from the period with the years preceding them, the duration of the calculation period for leave under the BiR may be equal to 731 or 732 days (FSS letter dated 03/03/2017 No. 02 -08-01/22-04-1049l).

To determine the value of SDZ, the income received during the billing period must be divided by the total number of days in it. But neither the income nor the number of days can include values ​​related to payments that are not subject to insurance contributions to the Social Insurance Fund (i.e., for example, days on sick leave and payments for it will not be included in the calculation).

It should be borne in mind that payment for sick leave for an industrial injury is made at the expense of “accident” contributions, calculated according to the rules reflected in Law No. 125-FZ. That is, the list of income covered by these contributions may differ from that given in the Tax Code of the Russian Federation for contributions to insurance for disability and maternity.

The maximum amount of income taken into account in all calculations, except for that made in connection with an industrial injury, for each year is limited to the amount with which the Social Insurance Fund was required to pay contributions for disability and maternity insurance. For 2021, we will be interested in the following values:

• 2020 — 912,000 rub. (Resolution of the Government of the Russian Federation dated November 6, 2019 No. 1407);
• 2019 — RUB 865,000. (Resolution of the Government of the Russian Federation dated November 28, 2018 No. 1426).

Knowing the value of the maximum income makes it possible to determine the amount above which the SDZ cannot be used to calculate sick leave issued not in connection with a work-related injury. For 2021 it will be:

(865,000 + 912,000) / 730 = 2434.25 rubles.

The number of days for the billing period in this formula is always equal to 730, even if we are talking about vacation according to the BiR (Clause 3.3 of Article 14 of Law No. 255-FZ).

The income subject to “unfortunate” contributions is not limited. But the maximum possible amount is also established for benefits accrued in the event of a work injury. True, it is defined differently: as four times the maximum monthly insurance payment (Clause 2, Article 9 of Law No. 125-FZ). The value of the latter from 02/01/2021 is 83,502.90 rubles, and its fourfold value is 334,011.59 rubles. (in 2021 it was 79,602.38 rubles and 318,409.52 rubles, respectively).

Calculation of temporary disability benefits

The amount is affected by:

• cause of loss of health;
• insurance experience;
• salary amount;
• number of calendar days of incapacity.

Sick leave is calculated using the formula:

SD x PTS x D = Amount of monthly benefit.

• SD – average daily earnings;
• PTS – percentage of experience;
• D – number of days spent on sick leave.

To calculate the average daily salary, you need to calculate the total amount of income received and divide it by 730 days.

The next required indicator - the percentage of work experience - is defined by Federal Law No. 255.
It depends on the length of service and the reason for losing the opportunity to work. Table of dependence of length of service and percentage of sick leave payments

The numbers in the third column are the percentage of average earnings that is taken into account when calculating material compensation.

If a person has had several jobs over the last two calendar years, the amount will be calculated taking into account all income that was subject to insurance premiums.

Filling out a sick leave certificate

The sick leave form was approved by order of the Ministry of Health and Social Development dated April 26, 2011 No. 347n. It consists of two sections.

The first section is filled out by the doctor. If he made a mistake on a paper ballot, corrections cannot be made. Instead, you need to issue another copy by checking the “duplicate” box.

The accountant needs to carefully check the certificate of incapacity for work for violations committed by doctors: filling it out in blue ink, missing the doctor’s name, etc. Most often, such flaws serve as a reason for FSS employees to refuse reimbursement of benefits costs. True, arbitration practice is positive for policyholders. Judges usually decide that the fund is obliged to reimburse benefits for shortcomings in the ballot.

REFERENCE. In the electronic LN, the place of work and type of employment (main or part-time) are not indicated. This follows from paragraph 65 of Order No. 925n.

You should also make sure that the paper sick leave certificate is genuine. This can be done using the FSS website, where the list of stolen and lost forms of certificates of incapacity for work is regularly updated.

The second section is filled out by the employer. If he makes a mistake, there is no need to write out a duplicate. It is enough to cross out the incorrect entry and make the correct one on the back, confirming it with the words “Believe the Corrected”, signature and seal. The use of corrective agents is prohibited.

Calculation of average earnings for sick leave in 2021

The rules for calculating sick leave are set out in the Regulations on the specifics of the procedure for calculating benefits for temporary disability and pregnancy and childbirth (approved by Decree of the Government of the Russian Federation dated June 15, 2007 No. 375). To correctly calculate benefits, you first need to calculate the employee's average earnings. To do this you will need to perform a number of actions.

Determine the billing period

As a general rule, the calculation period includes two calendar years preceding the year in which the illness occurred or maternity leave began. For a ballot opened in 2021, the calculation period is 2021 and 2021.

An exception is provided for women who were on maternity leave or maternity leave during the billing period. They are allowed to carry forward one or two years. The basis is a written statement from the employee.

Example 1.

Let's say an employee gets sick in February 2021. The calculation period for it is the period of time from January 1, 2021 to December 31, 2021 inclusive. But since the woman was on maternity leave in 2021, and on maternity leave in 2021, she wrote a request for a transfer. As a result, the new calculation period included the years 2021 and 2021.

Calculate average earnings

It consists of the amounts that the employee received in the billing period and from which contributions to compulsory social insurance were transferred.

Calculate your salary and benefits taking into account the increase in the minimum wage from 2021 Calculate for free

Compare with the maximum permissible base value

The average earnings for calculating benefits cannot be as large as desired. It can be taken into account only in the part that does not exceed the maximum value of the base for contributions in case of temporary disability and in connection with maternity. This value is approved by the Government of the Russian Federation every year.

IMPORTANT. It is necessary to compare the average earnings in the billing period with the base limits in force at that time. It is necessary to compare not the total figure, but data for each year separately (example in Table 1).

Table 1

An example of comparing average earnings with the base limits

Compare with minimum wage

Average earnings must be greater than or equal to the minimum wage that was in effect on the date of the onset of illness or maternity leave. Otherwise, the benefit should be calculated based on the minimum wage.

The FSS, in letter dated 03/01/11 No. 14-03-18/05-2129, recommends comparing two values ​​of average daily earnings: actual and based on the minimum wage. You need to do the following:

1. Divide actual average earnings by 730 days.
2. The minimum wage on the date of onset of illness or maternity leave is multiplied by 24 months and divided by 730 days.
3. If the first value is greater than or equal to the second, calculate sick leave based on the first value. If the first value is less than the second, calculate the benefit based on the second value (example in Table 2).

table 2

An example of comparing two values ​​of average daily earnings (actual and based on the minimum wage)

REFERENCE. In some cases, the benefit cannot exceed the minimum wage for a full calendar month, multiplied by the regional coefficient (if any), even if the actual average earnings exceed the minimum wage. This rule applies in the following situations: the employee’s insurance period is less than 6 months; the patient violated the regime prescribed by the doctor, or did not show up for examination, etc.

Find average daily earnings

For temporary disability benefits, in the general case, it is equal to the average earnings for the billing period (taking into account the maximum value of the base), divided by 730 days.

For maternity benefit (BIR) it is generally a fraction. The numerator is the average earnings for the billing period (taking into account the maximum value of the base). The denominator is the number of calendar days in the billing period minus the number of calendar days falling within the excluded period.

The excluded period includes days of illness, maternity leave, maternity leave for children up to one and a half years old, and days when a woman was released from work according to Russian laws with full or partial retention of wages (if contributions were not paid from the payments in case of temporary disability and in connection with motherhood).

Example 2 . The average salary of an employee in the billing period is 950,000 rubles, the base limit has not been exceeded. The number of calendar days of the billing period is 730. Of these, the employee was on sick leave for 20 calendar days (excluded period). The average daily earnings is 1,338.03 rubles (950,000 rubles: (730 days - 20 days)).

If the benefit is calculated based on the minimum wage, then the average daily earnings are equal to the minimum wage (as of the start date of the bulletin), multiplied by 24 months and divided by 730 days. For part-time work, a coefficient corresponding to the length of working time is added to the formula.

Do I need to write an application for temporary disability benefits?

To apply for work benefits, you must present a sick leave certificate indicating your release from work. The application is only necessary when applying for benefits from the Social Insurance Fund. You only need to go to this body for payments in three cases:

• the organization in which the employee is registered is at the stage of bankruptcy;
• the organization was liquidated;
• the person has been on sick leave for more than 1 month.

In these cases, when contacting the FSS, an application will be required. When applying for benefits at your place of work, you only need to present a sick leave certificate.

Form of certificate of incapacity for work

The document is issued at the medical institution. It states:

• Address and name of the medical organization.
• Full name of the patient.
• Cause of disability.
• Type of employment.
• Data on average income, information about employer, length of service.
• Period of release from work.

The sheet is filled out by the medical professional, then by the employer.

Sample certificate of incapacity for work

Payment terms and duration

How long can an employee receive compensation:

Temporary disability benefits in 2021 are paid from the Social Insurance Fund budget, but the first 3 days of sick leave are paid by the employer.

Such accrual rules apply only if the cause of disability is illness or injury of the employee himself. In other cases, compensation is calculated by the FSS.

Rules and procedure for calculating sick leave in 2021

The amount of the benefit is equal to the average daily earnings (taking into account the percentage of length of service) multiplied by the number of calendar days of illness according to the certificate of incapacity for work. If the bulletin was issued in connection with pregnancy and childbirth, then the number of calendar days of sick leave is generally 140.

From April 2021, an additional restriction applies. It applies to a situation where temporary disability benefits, calculated on the basis of average daily earnings and work experience, calculated for a full calendar month do not reach the minimum wage (in 2021 it is equal to 12,792 rubles). Then sick leave should be paid in the amount of the minimum wage for a full calendar month. In this case, the amount of the daily benefit is equal to the minimum wage divided by the number of calendar days of the month in which the illness occurs. The total benefit is the daily benefit multiplied by the number of calendar days of sickness in each calendar month. If a regional coefficient is introduced, then the minimum wage is determined taking into account this coefficient (for more details, see: “Sick leave in 2021: the temporary procedure for calculating benefits was made permanent”).

By law, the employer is obliged to independently calculate the full amount of benefits and reflect it in the second section of the sick leave.

Then you need to divide the benefit into two parts: at the expense of the employer and at the expense of the Social Insurance Fund. The following rule applies here: in case of illness or injury, the organization pays for the first three days of the newsletter, the remaining days are paid for by the fund. In case of BIR, quarantine and in a number of other cases, the FSS pays for all days (Article 3 of the Federal Law of December 29, 2006 No. 255-FZ).

Both parts of the benefit are reflected in the newsletter.

IMPORTANT. Both parts of the benefit should be entered on the sick leave in full, that is, before deduction of personal income tax. In the same way, you need to fill out the line “TOTAL accrued”.

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