Cause of disability 02 on sick leave – what does it mean to pay in 2021

Have you ever been given a sick leave certificate at a medical facility? If not, then you are probably a lucky person. If yes, then you most likely noticed that instead of a text description, all sorts of uniform codes were used. For example, very often this document indicates code 02 as the cause of disability, the decoding of which remains a mystery to many ordinary people. Let's try to figure out what information may be hidden behind the numbers. Moreover, it is not at all difficult. We will also find out how sick leave is issued (cause of incapacity for work - code 02).

What is written on a sick leave sheet

The following data is entered into a document such as a certificate of incapacity for work:

• Full name of the sick patient (the basis is an identity card, namely a passport).
• The date, month and year of his birth.
• Floor.
• Name of the organization (factory) where the patient works (based on the patient’s words). If the patient works for an individual entrepreneur or is one himself, then the full name of the employer is indicated in this column.
• Information about where the sick leave was issued: at the place of work or residence.
• Patient Taxpayer Identification Number.
• Reason for disability.
• Date of opening and filling out sick leave.
• The period during which a person was unable to work.
• All kinds of violations of the regime.
• Other information.
• Conditions for calculating cash benefits.

All codes in the document, starting from the first to the penultimate one, are entered by the doctor who opens the sick leave. But the conditions for calculating disability benefits (in coded form) are entered by the employer, namely the employee dealing with these issues.

Calculation of benefits for industrial injuries: regulatory documents

When calculating compensation related to disability resulting from an occupational disease or accident, you must be guided by:

• Federal Law No. 125.
• A number of provisions of Law No. 255 Federal Law that do not contradict the above Federal Law. These, in particular, include articles 12-15. In Art. 12 establishes the period during which you can apply for payment of benefits; Art. 13 – on the appointment of compensation at the place of work and the choice of the company that will compensate for the damage (if a person works in several places). Article 14 establishes the calculation procedure, and Art. 15 – terms of accrual and payment.
• Regulations on the calculation of compensation, which is approved by government decree.
• Rules for accounting, accrual and expenditure of funds for the purpose of implementing compulsory social insurance against industrial injuries and occupational diseases.

Why do you need to encode information?

What is the purpose of coding? And it is as follows:

• fully preserve confidential information about the patient’s illness;
• minimize the likelihood of any counterfeit;
• desire to use medical forms economically and compactly;
• have the opportunity to cooperate with various medical institutions abroad;
• significantly simplify (sometimes a doctor’s handwriting is very difficult to read) and optimize the activities of HR workers.

On a note! Not only the personnel officer, but also the patient himself can familiarize himself with the decoding of these codes: it is presented on the back of the sick leave. Just turn it over and read it.

Who needs these codes

The most important part of the certificate of incapacity for work is the columns in which codes are entered indicating certain reasons why patients cannot be at work and carry out their professional activities as usual. Several cells are allocated for this encoded information:

• the first two are the main code (numbers from 01 to 15);
• the next three are an additional code (numbers from 017 to 021);
• the final two are a clarifying code (fixed if the diagnosis has been clarified).

Why do you need to use so many codes? Who needs them? And they are needed both by medical workers and by management (that is, the employer).

Basic codes

So, let's take a look at the list of basic codes that the doctor writes in the first two cells of the medical document:

• 01 – the presence of any disease that does not require the patient to be at work.
• 02 is a sick leave code indicating a person’s incapacity for work as a result of being injured.
• 03 – quarantine is declared, preventing a person from being at work.
• 04 – the patient received an injury (or consequences after it) directly at the workplace.
• 05 – leave was granted for the period of pregnancy and childbirth.
• 06 – the need for prosthetics in a medical hospital.
• 07 – exacerbation of a previously identified disease or detection of an illness associated with professional activity.
• 08 – rehabilitation period in a sanatorium after an illness.
• 09 – exemption from work, which is issued in case of caring for a sick close relative.
• 10 – other circumstances entailing the release of a person from the need to be at the workplace.
• 11 – a disease specified in a special list (for example, mental disorder, hepatitis, diabetes mellitus or other similar ones) approved by the government.
• 12 – the need to care for a child (under 7 years of age) who has one of the ailments listed in the list of diseases approved by the Ministry of Health and Social Development.
• 13 – presence of disability in a child who needs care.
• 14 – a case when a child is diagnosed with a malignant disease or certain complications arise after vaccination.
• 15 – caring for a child with HIV infection.

Ciphers and what they mean

The sick leave form has special cells. The doctor puts codes in them. All codes are approved by the Russian Ministry of Health.

Basic codes for different fields of a temporary disability document:

• reason for disability: 01-15;
• violation of the therapeutic process: 23-28;
• other: 31-37;
• coding of family ties: 38-42;
• additional codes: 017-021;
• information for the employer: 43-51.

Under each of these numbers certain information is encrypted.

01-15: cause of disability

The column “Cause of disability” consists of two fields.
The first and second cells indicate the main diagnosis, and the next three provide clarifications and the circumstances of treatment. There is also an additional field “change code”. Often, in the column about the cause of the pathology, the doctor puts the mark 01. This set of numbers is incomprehensible to most ordinary workers, so many people wonder, the reason for the disability is 01 on the sick leave: what does this mean? The numbers 01 indicate all simple pathologies.

Standard decoding of disease code 01 on a sick leave certificate: flu, colds, acute respiratory viral infections, etc. A description of other codes in this column is given in the table below.

Expert opinion

Irina Vasilyeva

Civil law expert

There are cases when during the examination another pathology is revealed. Then a clarification is made in the column “change code”.

23-28: disruption of the healing process

There are cases when a patient violates the requirements of the attending physician.

This fact is displayed on the certificate of incapacity for work in a special column located just below the block of information about caring for relatives.

The valid codes are shown in the table below.

31-37: other

In the middle of the temporary disability form there is a field called “Other”. It consists of two cells. Additional information is displayed here. The interpretation of the “Other” codes is given in the table below.

38-42: coding of family ties

In the main part of the sick leave sheet there is a field that is filled in if it is necessary to be released from work to care for loved ones. It is coded by numbers 38-42.

Here the name, surname and patronymic of the person in need of care is indicated, and the type of relationship is also specified. The table below shows a breakdown of the current codes.

017-021: additional codes

Numbers 017-021 indicate additional information regarding the main cause of human illness. The decoding of these codes is given in the table below.

Additional codes

Now let’s find out what additional codes are put down in the next three cells of the disability sheet:

• 017 – the need for treatment in a special-purpose medical institution.
• 018 – staying in a sanatorium (or resort) after undergoing treatment for an injury received as a result of an accident at work.
• 019 – therapeutic activities carried out in rehabilitation clinics.
• 020 – maternity leave provided in addition to the main one.
• 021 – release due to illness or injury resulting from intoxication (drugs, alcohol or toxic).

Important! If the reason for the employee’s absence from his place is fully reflected in the first two cells of the sick leave sheet, then the next three do not need to be filled out. But if such a need exists, then the medical worker enters both the main code and the additional one.

Payment of sick leave for a domestic injury

What is sick leave? This is a medical document that indicates the reasons for a person’s temporary disability and on the basis of which he can receive (for the entire period of absence from work) a certain amount of money.

How is sick leave paid? That is, what factors are fundamental in determining the amount intended to be paid to the employee?

• The insurance record of the person presenting sick leave for payment. Moreover, if this length of service is up to 5 years, then the amount of the benefit will be equal to 60% of the average salary; if from 5 to 8 years, then the employee receives 80% of the PPP; and if more than 8 years, then he has a chance to get 100%.
• Average annual earnings.

Important! Keep in mind that there are significant limitations in determining average earnings per year. So, in 2021, its largest amount was 670,000 rubles. That is, even if, during the actual calculation, your average annual income significantly exceeds this figure, the value that is officially determined to be the highest will be taken into account in the calculation of hospital compensation.

• Average daily earnings.
• The number of days during which the employee may be absent from work.

Important! If the reason for the employee’s absence is illness (for example, the flu) or a domestic injury, then payment for the first three days is the responsibility of the employer directly, and the subsequent days are paid exclusively from the Social Insurance Fund (SIF) - see Law No. 255-FZ (clause 1, part 2, article 3).

What is indicated on the sick leave?

A certificate of temporary incapacity for work is considered a document of strict accountability. It is important to fill it out correctly. All entries are made in Russian. It is customary to enter all information in block letters using a gel pen with black, purple or blue ink.

Blots, cross-outs, and corrections when filling out are prohibited. The document can be drawn up on a computer and then printed on a printer. The form consists of a spine, front and back sides. Each of these parts contains specific data.

The sick leave certificate contains the following information:

• cause of disability;
• date of onset and end of the disease;
• where the document is provided (name of the organization in which the person is studying or working, its location address);
• Full name, age, gender;
• type of work (main, part-time);
• the name of the medical institution that issues the certificate of incapacity for work;
• type of treatment (outpatient, inpatient).

A sick leave certificate issued in accordance with all the rules is certified by the seal and stamp of the medical institution.

Example of calculating hospital compensation

Theoretically, of course, everything is extremely clear. Let's see how in practice you can independently determine the amount due to you.

Let's say citizen Ivan Ivanovich Ivanov was absent from work due to a domestic injury (or due to the flu) for 10 days (note, calendar days). Ivan Ivanovich’s average daily earnings is 1,600 rubles, and his insurance experience is 7 years. The benefit amount will be 12,800 rubles (1,600 x 10 x 80%). Of these, 3840 rubles (1600 x 3 x 80%) will be paid by the employer, and the remaining amount will be 8960 rubles from the Social Insurance Fund.

What does code 02 mean on a sick leave certificate, and how is it paid?

Code 02 identifies a domestic injury that occurred to an employee. Payment for absence from work is carried out in accordance with the procedure relevant for general diseases. The first three days are compensated by the employer, and the remaining amount is paid from the Fund. In this case, the regulated limit values ​​of the payment are taken into account, the calculation of which is carried out taking into account the amount of previously received income, the insurance period and the number of days of illness.

An employee’s absence will be paid only if a document justifying and confirming the reason is provided.

It must be transferred to the organization’s accounting department no later than six months after the date of closing the certificate of incapacity for work. Compensation is calculated within ten days after presentation of the document, and payment is made on the next day of payment of wages. An employee has the right to claim compensation in accordance with the law if the employer violates the terms of a financial transaction.

All days of absence from work are paid. There are no restrictions in legal acts regarding the duration of the period of release of an employee from performing official duties for the reason for which sick leave is issued. They apply only to workers who have temporary or disabled status.

Deadlines for submitting sick leave to guarantee receipt of benefits

A sick leave certificate issued due to illness, disability - code 02 (deciphering is presented above) - or for other circumstances, the employee must present before six months (or rather, 6 months) have passed from the date indicated in the medical document (and exactly in the column “by what date”).

Remember! In case of delay, sick leave benefits are not paid. For example, if the last day on sick leave is May 15, then the latest date for presenting the document is November 15. If you do this even a day later, you will not receive benefits.

Causes of disability codes on the new sick leave certificate

Absenteeism from work may be due to domestic or work-related situations. According to the Federal Law, several values ​​are established by which the cause of disability is determined. Code 02 – any pathology not related to production. The worker may also suffer a domestic injury. On the form it is indicated under the value 01. If the disability is associated with an accident at work, then it is entered as 04, in case of an occupational disease or its exacerbation - 07. The last two values ​​indicate that the calculation of benefits will be carried out in a special manner.

Number of days for which benefits will be paid

There are certain deadlines for assigning and paying sick leave:

• The period for consideration and assignment of benefits is 10 calendar days. The countdown begins from the day the sick leave is presented. This is stated in Law No. 255-FZ (Part 5, Article 13, Part 1, Article 15).
• Payment of benefits is made at the earliest (after it is assigned) date of payment of the next salary in accordance with the same Law (Part 8, Article 13, Part 1, Article 15).

On a note! For each day of delay, you have the right to demand compensation in accordance with the Labor Code of the Russian Federation (Article 236).

Number of paid days on sick leave

If an employee is sick or absent from work due to disability - code 02 (explained above), then the benefit must be guaranteed to be paid for the entire period of exemption from performing his professional activities (or more precisely, for all calendar days indicated in the medical document) . This is clearly stated in Law No. 255-FZ (Part 1, Article 9). Moreover, there are no restrictions on the maximum duration of the paid period. The only exceptions are sick leave benefits for employees hired for temporary work or with disabilities.

Important! If an employee falls ill or is absent from the workplace due to incapacity for work - code 02 (explained above) during the next paid leave, then benefits are paid for the entire period of incapacity for work. The vacation (by agreement) is either extended or postponed to another convenient time. This seems very fair.