Sick leave for a domestic injury. Which incidents require payment? How is sick leave paid if there is a domestic injury?

21.09.2019

How is sick leave paid for a domestic injury? This question worries many people. A sick leave certificate (temporary disability certificate) is issued to a worker in a medical institution in the event of an injury, illness, or necessary care for a seriously ill child or adult. According to this document, the organization is obliged to pay for the temporary disability of its employee.

How sick leave is issued and payment is made in case of a domestic injury

Payment for sick leave for a work-related injury is made only after the bulletin is submitted, no later than 180 days from the date of its completion. The ballot must reflect the following positions:

Filling out the “Get Started” column (a precisely recorded date is required).
In the “Other” cell the code “36” is written, it means the day that follows the number recorded in the “By what date” column of the “Work Release” table.

If an employee provides a ballot after 180 days from the end of sick leave, payment for these days is not made.

You need to assign a settlement phase. To do this, take 2 consecutive years (from January 1 to December 31 inclusive) preceding the current one. If there was maternity leave or maternity leave in one of these years, then it must be replaced with any previous one. Here you need to take into account that this is only possible if the calculated compensation increases. Then you need to add up the paid cash for the selected years. This will be the basic basis for calculating the amount of compensation. It usually includes all funds paid to the employee, for which payments and vacation were accrued over a period of 2 years.

Payments made by the previous employer must be included in the basis for calculations when calculating benefits after providing a salary certificate from the previous place of work (it must be certified by the employer or a notary).

The amount of payments required when calculating the amount of disability compensation for the months of the calculation period cannot be higher than the maximum base for crediting payments to the Social Insurance Fund in the selected period. This year the maximum amount was 718,000 rubles.

If the calculated amount of payments does not reach the minimum wage for 24 months, determined on the starting date according to the sick leave document, then it must be taken equal to 24 times the minimum wage when calculating the base. This year it is equal to 148,896 rubles. (RUB 6,204 for 24 months). Now you need to calculate your average daily earnings. It is equal to the quotient of dividing the total payments taken into account when determining the amount of compensation for sick leave by 730 days.

Payment of sick leave for an injury depends not only on the average daily earnings, but also on the worker’s insurance record. It must include periods (must be documented):

activities under a civil contract in production, as well as work in municipal or civil services;
work in fire services, military, law enforcement and other supervisory organizations;
any other periods when payments were made to the Social Insurance Fund for an employee in cases of short-term disability (for example, the activities of an individual entrepreneur, which involves independent payment of contributions to the Social Insurance Fund).

The length of insurance premiums must be taken into account in full for the year or month.

The percentage of average daily earnings depends on the length of insurance payments and the reasons for visiting a medical institution.

If sick leave must be paid for a domestic injury, then in the following cases:

If an employee has been making insurance contributions for more than 8 years, 100% of the average daily earnings is taken;
80% of insurance premium experience from 5 to 8 years is taken into account;
less than 5 years of insurance coverage, only 60% of average daily earnings are taken into account.

In the event of a domestic injury to an employee, the payment must be calculated for all days falling on temporary absence from work, noted in the bulletin, not excluding weekends and non-working holidays.

Exceptions are the following cases:

vacation time issued at the expense of the employee;
sessional leave time;
maternity leave for children up to 3 years old.

If domestic injury was received by an employee during a vacation, which is paid annually, then it is extended by the number of days recorded in the bulletin, payment is made for all days counted as vacation pay.

The maximum duration of incapacity for work is not prescribed by law. Exceptions are temporary hired employees and workers with disabilities.

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Calculation of sick leave by day

The amount of the sick leave payment for the entire period should be calculated based on the average daily earnings, increased by the calculated percentage according to the following scheme: the amount of the sick leave payment is equal to the average earnings per day, multiplied by the percentage of average earnings per day and the number of paid days of sick leave.

The initial 3 days of absence from work on a certificate of incapacity for work must be paid by the employer, the rest are paid from the Social Insurance Fund.

Payment for short-term disability must be assigned within 10 calendar days from the date of submission of sick leave. The benefit must be paid from the nearest wages. In case of delay in disability payments, the employee must receive compensation.

On at the moment The legislation defines two types of injuries: industrial and domestic. The first case includes any injury received in working hours, when driving to work on official or personal transport used for official purposes, as well as when carrying out instructions from the manager by car or on foot.

As for domestic injuries, they are given a clear definition: this is an accident that occurred due to negligence during non-working hours and caused temporary loss of ability to work. Such an incident can happen anywhere: on the street, in public transport, while walking, etc. The main criterion is the absence of signs of an industrial accident:

The injury did not occur on the territory of the employer’s organization and not during working hours.
The injury occurred during a corporate event.
An employee used a company car for personal purposes and got into an accident.
The employee left work without permission and was injured.
The injury was caused during working hours as a result of a fight.
The employment contract does not provide for the possibility of using personal vehicle for official purposes, and the employee committed an accident while driving it.
The company's rules prohibit smoking, but the employee neglected this and was injured during a break.

A complete list of accidents subject to investigation is indicated in Art. 227 of the Labor Code of the Russian Federation, and domestic injuries do not apply to them.

Below we will consider specific situations when injuries are considered work-related, and when - domestic:

Ivanova E.I. works as a secretary at Pyramida LLC. While delivering documents to the manager, she was going down the stairs, tripped and seriously hurt her knee. Subsequently, Ivanova E.I. She called an ambulance and was taken to the emergency room, where she was given an x-ray and the image showed damage to the meniscus. She was given sick leave and 2 weeks later she returned to work. The case is considered domestic, because it has no signs work injury and it occurred through the fault of the employee herself.

Manager Pavlov I.A. has a company car in use, all documents for it are properly prepared. While getting to work, he got into an accident through no fault of his own, which he notified his employer about. He, in turn, notified about this Labor inspection and the Social Insurance Fund, the relevant acts were drawn up. The case was considered industrial, even though the employee was traveling during non-working hours, because here the main criterion is the use of a company car in in the prescribed manner and with the permission of the manager.

The seller Sazonova O.N., returning home from work, fell into an open well. After a medical examination, she was diagnosed with a closed fracture of the right leg and was sent on sick leave, notifying the manager. The certificate of incapacity for work was paid in full. In addition, she managed to obtain through the court compensation for moral and physical harm from the organization that owns the well into which she fell, because if it is impossible to repair or install a cover in a timely manner, it must be fenced. The situation is domestic.

Head of the Marketing Department of Irbis LLC Kapitonova A.A. During a sudden power outage at production, she called an electrician, but before his arrival she decided to look into the electrical panel to make sure what the problem was. Because of this, she received a mild electric shock, which led to temporary disability. An ambulance was called for her, and subsequently she went to the doctor to get a sick leave certificate. The case was considered industrial because occurred on the territory of the organization during working hours, despite the fact that Kapitonova A.A. safety regulations were violated.

Thus, domestic incidents include all injuries received not in connection with the performance of official duties: lightning strike, animal or insect bite, fracture, bruise, poisoning, drowning, frostbite, injury electric shock etc.

Another important issue that worries the working population is how a domestic injury is paid for. Everything is very simple here:

Within 10 days after submitting the sick leave, the accountant calculates the benefits.
Next, the entire package of documents is transferred by the accountant to the Social Insurance Fund.
Payments are made in advance or salary.

How is sick leave issued in case of injury?

Having a sick leave certificate is a necessary condition in order to receive the payments due; otherwise, absence from work without this document will be considered absenteeism and the employee, of course, will not receive compensation. It is formalized in the same way as for a simple illness:

You need to see a doctor who will conduct an examination and choose a treatment option: in a hospital, outpatient or at home. In addition, he must determine whether the employee will be able to perform job duties or whether he needs bed rest for a quick recovery.
If temporary suspension from work is necessary for treatment, the doctor opens a certificate of incapacity for work and enters the corresponding code “02” as the reason: domestic injury.
After some time, the patient must come for examination, and then the doctor determines whether treatment needs to be extended or the sick leave can be closed.
Finally, the sick leave is closed. It must indicate the exact period and reason for the disability.

For how long is sick leave issued for a domestic injury?

The period for which sick leave is issued depends on the severity of the injury: if it is mild, then it is issued for 3 days, but if necessary and in especially severe cases, it can be extended for several months.

Even if it takes the employee 1 year to fully recover, the manager does not have the right to dismiss him during sick leave, otherwise such an action will be declared illegal by the court, and the employee will be able to be restored to his previous place. The best option is to wait for recovery, and while the subordinate is sick, the performance of his duties can be assigned to other employees and they can be given appropriate allowances.

Sick leave payments for injury: how are they calculated?

To calculate sick leave, the last 2 years of the employee’s work are taken into account. All days on which the employee was not employed or was absent from the workplace are excluded from this period. The accountant then performs the following actions:

Sums up income for 2 years and divides the resulting figure by the number of days worked.
The resulting amount is multiplied by the number of days of incapacity indicated on the sick leave, and as a result, the amount of the benefit is received.

The final amount of payments also depends on the length of service at the enterprise:

100% is paid for work experience of 8 years or more.
80% – if a citizen works for 5 to 8 years.
60% - 3-5 years.
50% – from 1 to 3 years.
30% – less than 1 year.

It is worth considering that if an employee works in an organization for less than six months, then the amount of the benefit cannot be more than 1 minimum wage. In general, how a domestic injury is paid for on sick leave is no different from calculating compensation for a viral or any other disease.

Payment of sick leave for injury: what can affect the amount of payments?

The key factors influencing the amount of compensation are the length of insurance, the amount of salary and the number of days of incapacity for work.

The benefit is calculated within 10 days after the certificate of incapacity for work is provided, and it is paid along with the advance payment or salary.

What documents must the employer provide to the Social Insurance Fund to process payments:

Statement.
A receipt confirming the transfer of payments to the Social Insurance Fund during the period of the employee’s incapacity for work.
A copy of the sick leave certificate and other certificates (if any).

Previously, payments were calculated from the 6th day of disability, but now the entire period from the moment the sick leave was opened is taken into account.

Possible reasons for refusal of payments

Cases of FSS refusal to pay are quite rare, but it is still worth considering the circumstances under which this could happen:

If a citizen worked on the basis of civil law, and not employment contract.
If the sick leave was extended for more than 30 days without a medical commission.
If the medical institution that issued the sick leave does not have a license.
If the employee violated the treatment regimen, and this was recorded on the certificate of incapacity for work.
If there is no record of the patient's injury in the outpatient card.
If at the time of the employee’s injury the enterprise was not operating (idle).
If the injury occurred while on unpaid leave.
The employee was not prescribed treatment, but sick leave was open.
The sick leave was issued retroactively.

The important point is that in order to open a certificate of incapacity for work, the injury must cause the inability to perform work duties. If the injury has been sustained and does not pose a health hazard and the person can move without inconvenience, there are no grounds for filing a sick leave. If the injury resulted in the death of an employee, a special commission should be appointed that will determine the type of injury (domestic or industrial), because the possibility of receiving payments by the relatives of the deceased citizen directly depends on its conclusion.

The law provides for 2 types of injuries - domestic and industrial. In both cases, benefits are paid to the victims, but the amount of payments and the conditions for their assignment differ. Let's look at how sick leave is paid for injuries at home and at work, what documents are required and what affects the amount of payments in both cases.

What is a domestic injury and how does it differ from an industrial injury?

A domestic injury is an injury that occurs outside of work. This is how it differs from a work-related injury related to the performance of official duties. A domestic injury does not require an internal investigation. She is recorded in the emergency room, after which a regular sick leave is issued.

How is a domestic injury paid?

Payment for sick leave for a domestic injury in 2019 is made by the employer within 10 days after receiving sick leave from the employee. There is no need to conduct an investigation or draw up a report. The employer's obligation to in this case- just accept documents from the employee and apply for temporary disability benefits. Sick leave is paid for at the expense of the Social Insurance Fund.

The FSS Letter No. 02-18/07-1243 states that to calculate benefits for a domestic injury, the following data will be needed:

average employee earnings;
length of service in the organization where the person is currently employed;
duration of sick leave.

When calculating average earnings, all payments received by the employee during the last working year are taken into account. This is a salary, as well as bonuses and compensation related to the labor process. Payments for previous sick leave and vacation pay are not taken into account.

Interesting information

The sequence of calculation and payment by an organization of sick leave for a domestic injury is basically no different from the rules for providing benefits for temporary disability that arose due to other circumstances (an exception is an industrial injury). Sick leave for a domestic injury is paid exactly the same as for a cold.

The next step for calculating sick leave payment for a domestic injury is calculating the number of days actually worked over the past working year. Days of vacation, sick leave and absence of an employee from the workplace for other reasons, including valid and disrespectful ones, are not taken into account.

Average daily earnings are calculated using the following formula:

total employee income / number of days actually worked.

The resulting amount should be multiplied by the number of days of sick leave. This is the maximum allowance. In fact, the amount of payments will depend on the length of service:

if the victim’s work experience is more than 8 years, the benefit will be 100% of average earnings;
if the experience is 5-8 years - 80%;
if the experience is 3-5 years - 60%;
if the experience is 1-3 years - 50%;
if less than 1 year - 30%.

With less than 6 months of experience, the amount of sick leave payments is limited to the minimum wage, which is now 7,800 rubles.

In what cases can payment be refused?

Sometimes workers are denied benefits. Payment of sick leave for a domestic injury in 2019 is not possible under the following circumstances:

work under a contract;
violation of treatment regimen;
onset of disability due to injury;
absence of a record of the employee’s health status in the outpatient card;
the sick leave certificate was issued or extended by an institution that did not have or lost a license;
sick leave was issued, but no treatment was prescribed;
sick leave extended for a period of more than 30 days without the conclusion of the commission;
sick leave was issued “retroactively”;
being injured while the employee was suspended from work without pay;
the employee is under arrest, including administrative arrest;
receiving a domestic injury in connection with the commission of a crime;
receiving a domestic injury during a period of downtime at the enterprise;
conclusion of a forensic medical examination that the injury does not interfere with the performance of work duties.

If an employee independently collects payments for an injury, then he must first complete all the listed documents and then submit them to the Social Insurance Fund Russian Federation. Next steps will be carried out by Foundation employees.

What documents need to be provided for payment?

To receive sick leave benefits due to a domestic injury, the following documents are required:

statement from the employer;
a special statement form according to Form 4-FSS of the Russian Federation;
a receipt confirming payment of the unified social tax during the period of officially confirmed incapacity for work of the employee;
notarized copies of documents confirming the need for payments from the Social Insurance Fund: medical sheets, certificates.

What is a work injury

According to Art. 227 of the Labor Code of the Russian Federation, an industrial injury is an injury received by an employee during the performance of labor function. These are bodily injuries, animal bites, overheating, hypothermia and other emergencies that occurred directly during working hours on the territory of the organization. Occupational injuries can also occur when an employee is on a business trip or in official transport in connection with the execution of instructions from a manager.

Procedure for payment for work-related injuries

Let us now understand how sick leave is paid for an injury at work. In this case, the employer is obliged to assemble a special commission to conduct an investigation. Based on its results, an act is drawn up. If the fact of a work-related injury is confirmed, then within 10 days after receiving sick leave from the employee, the employer must assign him benefits.

What factors are taken into account when calculating the amount

Curious facts

It must be taken into account that at the legislative level there are restrictions on the maximum amount of monthly benefit payments in connection with an injury at work. In 2019, this amount is 72,290 rubles. 40 kopecks, multiplied by 4 (Subclause 2, Clause 1, Article 6 of the Law “On the Social Insurance Fund Budget” dated December 19, 2016 No. 417-FZ). In fact, the monthly disability benefit cannot exceed RUB 289,161. 60 kop.

The amount of benefits for a work injury is calculated taking into account the employee’s average earnings for last year. To calculate it, you need to add up all the payments that the employee received in connection with his labor activity. Vacation and sick pay are not taken into account. Annual income is divided by the number of days actually worked over the past year. Days of vacation, sick leave and absence from work for any reason are excluded. The total amount is the average daily earnings.

Average earnings are calculated using the formula: average daily earnings x number of sick days.

The amount of benefits for work injuries is 100% of average earnings, length of service is not taken into account. If an employee has worked in the organization for such a short time that the average daily earnings cannot be calculated, the salary should be taken according to the staffing table.

The employer not only pays the injured employee temporary disability benefits, but also bears the costs of rehabilitation and the purchase of medicines. To establish the severity of harm to an employee’s health, medical and social examination. It establishes harm as a percentage. In accordance with it, the employer must reimburse treatment costs.

An employee was injured at work. How to pay sick leave

Cases when payment is refused

Under certain circumstances, sick leave for an injury at work in 2019 may not be paid. This occurs in the following situations:

work under a contract;
at the time of injury, the employee was engaged in other activities that were not part of his job duties;
the employee was intoxicated;
the employee walked or rode his own or public transport on personal business, and not carrying out instructions from management;
the injury led to disability.

Documents required to receive payment

To assign sick leave payments in connection with a work injury, the following documents will be required:

certificate of incapacity for work indicating its cause - industrial injury (code 4);
act N-1, information from which contains a sick leave certificate.

If you have questions, write in the comments

The list of unforeseen situations that may arise during the period of work includes domestic injury. Damage means that the worker will be temporarily unable to work and has the right to claim payment of compensation (although it is important to prevent violation of the sick leave regime by deliberately extending it). How to obtain a certificate of incapacity for work and what is the difference in payment for a domestic injury that occurs under different circumstances, more details in the material.

How is sick leave paid for a domestic injury in 2018?

Injuries at home are included in the list good reasons, in connection with which the employee may be temporarily absent from work (although here there are restrictions on the maximum period of stay on sick leave, described). Unlike in a work-related incident, where the employer conducts an investigation of the location of the injury, there is no need to find out the causes of the domestic injury. Upon provision of a written document, the manager is obliged to calculate the amount of state support for the employee’s period of incapacity for work within 10 days. Accrual is made on the day the salary is paid. The calculation procedure includes the amount of earnings and length of service.

More details about how many days a year sick leave is paid to an employee in 2018 if he was absent from the workplace, including due to a domestic injury, can be found in the article at the link.

Based on the provisions of the Laws of the Russian Federation, payment for a domestic injury is valid on the first day of sick leave. The first three days of financial support are paid by the manager, and the following days the Temporary Disability Fund for Citizens takes responsibility for paying compensation (although in the case of a combination of “sick leave and alimony” some difficulties may arise, as described).

The amount and how temporary disability benefits are issued in 2018 are described at the link.

For how long is sick leave issued for a domestic injury?

An employer does not have the right to refuse to issue a certificate of incapacity for work for an employee. According to Article 59, Part 3 of the Labor Code of the Russian Federation, the period within which you can receive payment for sick leave is an unlimited number of days. Depending on the doctor’s instructions and the characteristics of the domestic injury, the duration of the certificate of incapacity for work can be extended either by a month or by one year. If after thirty days the employee has not recovered, a special medical commission is appointed, which determines the degree of illness and the duration of vacation pay. It is worth noting that sick leave is paid even in this case.

What documents are needed?

In order for sick leave to be paid, it must be brought to the employer no later than six months from the first day of recovery. No other documents are needed to confirm payment. If the six-month period passes, payment of sick leave for a domestic injury may not be assigned. A certificate of incapacity for work is paid if the document is drawn up with errors - the answer to the question is clear: in this case, the employee will not be able to receive compensation payments based on the Legislation of the Russian Federation.

Calculation of benefits and procedure for receiving them

The procedure for determining the benefit amount is as follows:

It is necessary to calculate the salary level for last year. Labor earnings include all compensation, bonuses, and additional cash accruals that were made during the year. Only money received from previous sick leave does not count towards earnings.
Next, you need to establish the actual number of days that the employee spent at work. Periods of sick leave and vacation pay are not taken into account.
To find out the average income, you need to divide the amount for the last year by the length of time worked. Multiply the resulting number by the number of sick days.

An employee who has worked at the same job for more than 8 years will receive compensation in the amount of 100%. If the work experience varies between 5-8 years - size financial support becomes 80% of average salary. If an employee has less than five years of experience, he is entitled to 60% of his working income. If the duration of work is less than six months, the amount of the benefit can be calculated taking into account 30% of the salary, if there is a certificate of income from the previous job. If there is no document, the employee will receive benefits based on the minimum wage.

Disability benefits

Based on Article 13 of the Labor Code of the Russian Federation, insured persons can receive state benefits during a period of temporary disability. Compensation is paid if:

The employee will be temporarily unable to go to work due to a domestic injury or illness.
Cared for an incapacitated family member.
Due to quarantine.
If the employee is prescribed a prosthetic procedure.
The course of treatment ends at the sanatorium.

In all cases, the employee is paid sick leave for the entire period of incapacity.

What factors influence the amount of benefits?

The benefit is calculated taking into account that the amount does not exceed the maximum amount of funds for sick leave, which is established by the State of the Russian Federation. If a worker is seriously injured and this is recorded in the personal statement, he has the right to receive payments that will cover his treatment costs. In the event of an injury while intoxicated, an employee can only count on the minimum amount of benefits, regardless of how long he or she has worked. When the medical regime is violated, the amount state support different minimum size Same.

What compensation is due for a domestic injury - calculation procedure

In addition to benefits for temporary inability to work, according to the provisions of the Labor Code of the Russian Federation, the employee does not receive any other payments. According to the Law, compensation for domestic injury is not awarded. And this is regardless of the severity of the employee’s injury.

In what cases can you receive a refusal to pay benefits?

Sick leave is not paid if:

The worker was on vacation at the time of injury.
Receiving bodily and internal injuries occurred during the arrest.

If you know the procedure for paying compensation, an injury to an employee will not seem such a serious incident. During the period of incapacity for work, he will be able to legally receive the amount of financial support assigned to him.