Sick leave for a domestic injury. When can payments be denied? What is the difference between a domestic injury and an industrial injury?

21.09.2019

Payment for temporary disability certificate, better known as, has undergone some changes since 2013.

If previously the employer himself handled the payment, then since 2013 the Social Insurance Fund has been paying for the citizen’s temporary disability certificate. Russian Federation.

To become more familiar with this issue, we recommend that our readers pay attention to the following laws and codes:

Law “On the fundamentals of protecting the health of citizens in the Russian Federation” No. 323 of November 21, 2011;
Resolution “On approval of the Regulations on the specifics of the procedure for calculating benefits for temporary disability during pregnancy and childbirth, monthly child care benefits for citizens subject to compulsory social insurance in case of temporary disability and in connection with maternity” No. 375 of June 15, 2007;
Order of the Ministry of Health of the Russian Federation “On approval of the procedure for issuing certificates of incapacity for work” No. 624 dated June 29, 2011.

Changes with the payment of sick leave affected the relationship between the Social Insurance Fund of the Russian Federation (hereinafter referred to as the Social Insurance Fund of the Russian Federation) and the employer, but not much has changed for the employee.

As before, the certificate of temporary incapacity for work must be submitted directly to the accounting department at the place of work, but now it is not the employer himself who will pay for sick leave, but the Social Insurance Fund of the Russian Federation.

Will a domestic injury be paid on sick leave?

Many people ask important issue will it be paid? domestic injury after receiving sick leave? Based on the legislation of the country, an employer or entrepreneur whose employee was injured and issued a sick leave, is obliged to pay its employee disability benefits in connection with his injury or illness. It is important to know that payment for a domestic injury occurs at the expense of the Social Insurance Fund of the Russian Federation, and not at the expense of the employer himself, as was the case before.

In the event of a domestic injury, payment is made for the entire period of stay while the employee was unable to perform his duties due to unsatisfactory health.

It is important to know that in certain cases, payment may not be made or may stop if the patient receives due to injury.

Payment does not occur if the patient’s domestic injury does not interfere with his direct duties at work.

For example, a broken finger of a watchman does not prevent him from doing his job efficiently, while a broken arm of a welder will not allow him to weld metals efficiently and therefore he will receive a temporary disability payment.

Due date

After the employee receives a temporary disability certificate, he needs to submit it to the Federal Social Insurance Fund of the Russian Federation. Payment calculation in this case will be made within 10 days, in accordance with the law. The employee receives the payment itself from the Fund in his next payment.

It is important to remember that if it was submitted a few days before salary, the payment will most likely be made in the next salary, due to the fact that the Fund does not have time to process the data and transfer the funds.

What determines the amount of payments?

If the employee’s insurance period is less than 6 months, then the amount of sick leave payment will be no more than one per month. In 2017, this amount is equal to 7,500 rubles (7,800 rubles from July 1, 2017).

Payment procedure

Required documents

Add to list necessary documents The following documents are included in the payment process:

A statement written by an employer or entrepreneur.
A special statement form (according to Form 4-FSS of the Russian Federation).
A receipt that confirms the transfer of the required amount to pay the unified social tax during the period of official confirmation of the employee’s disability.
Copies of documents certified by a notary that confirm the need for payments from the Federal Social Insurance Fund of the Russian Federation: medical sheets and certificates, as well as other related documents.

Where should an employee go?

After registration of all necessary documents, they must be submitted to the Social Insurance Fund of the Russian Federation. The Foundation's employees will do the rest for you.

What should an employer do?

If your employee cannot independently provide a certificate of the amount of earnings from his previous place of work, upon receipt of his application you need to send a request to the territorial body of the Pension Fund of the Russian Federation to provide the necessary information.

In 2017, the payment of benefits for temporary disability of an employee occurs together with wages or in advance. Depending on which payment is made first.

If your employee gets sick or injured while under arrest or on leave at his own expense, no payments will be made.

If the employee submitted a certificate of the amount of his salary after the benefit was calculated, in this case it is necessary to recalculate the benefit, but no more than for the last 3 years.

When can payments be denied?

An employee may be denied payment for temporary disability due to a domestic injury in several cases:

In the event that a person worked under a contract (including if he was injured at work).
Violation of the treatment regimen prescribed by the doctor.
If the sick leave was issued or extended by an institution without a license or that has lost its license.
There is no record of the employee's health status in the outpatient card.
Without the conclusion of the VKK, the sick leave was extended for more than 30 days.
In case the document was issued, but treatment was not prescribed.
Sick leave that was issued is also not paid.
If an employee is under arrest (including administrative arrest).
The employee was suspended from duties without pay.
If at the time of work at the enterprise there was a period of downtime.
The illness or injury was received in connection with a criminal violation committed by the employee.
In the case of a forensic medical examination.

As stated in Law No. 255-FZ, every employer is obliged to pay sick leave to its employees if the cause of temporary disability is injury or illness. Payment is made at the expense of the Social Insurance Fund, since the employee is an insured person in the social insurance system, and an injury or illness is an insured event.

A domestic injury is an injury that does not occur at work or during working hours. The employer is obliged to pay sick leave on this basis in the general manner.

That is, the amount of payments will depend on:

The employee's insurance length;
His average earnings;
From the duration of sick leave in days.

As stated in the FSS Letter No. 02-18/07-1243, sick leave for a domestic injury from the first day of the onset of disability is paid as it should be for a specific employee.

First of all, it is necessary to calculate the average salary of an employee for 1 day of work. If an employee has worked for more than 2 years, then the income for this period is taken for calculation. If the work experience is this enterprise less, then you need to calculate based on actual experience.

To determine total income, all payments that are related to work are taken into account - wages, bonuses and other payments. Social payments, for example, for the birth of a child, are not taken into account.

Dividing income by the number of days, we get the average earnings of a specific employee for 1 day. Then we multiply this value by the length of service coefficient and by the number of days of sick leave.

The length of service coefficient depends on the insurance experience of a particular employee:

More than 8 years - 100%;
From 5 to 8 years - 80%;
From 1 to 5 years - 50%;
From six months to 1 year - 30%.

Only the first 3 days of illness are paid at the expense of the employer. The remaining days are paid for at the expense of the Social Insurance Fund.

The employee must present the sick leave certificate to the employer within six months from the date of closure. The employer, in turn, must accrue temporary disability benefits to the employee within 10 days after the employee has taken sick leave. The employer must pay the benefit on the next payday. This procedure is established by Law No. 255-FZ and Labor legislation.

How sick leave is paid in 2016: domestic injury

How is sick leave paid in 2016 if the cause of the sick leave was a domestic injury?

The concept of “domestic injury” means temporary loss of ability to work due to injury received outside of work. What to do if injuries result in you receiving sick leave. How is it paid in 2016?

Payment procedure

The main difference between a domestic injury and an industrial injury is the absence of the need to conduct an investigation into the causes that led to the injury. In this case, an act is drawn up and the employer is obliged to pay 100% of the employee’s sick leave, regardless of the length of service at this enterprise. Also, if serious injuries occur, the employee has the right to demand compensation. In the event of a domestic injury, the employee is paid sick leave, taking into account the coefficient of length of service.

Please note that the employee is required to notify the employer of temporary disability and provide proof this fact in the form of sick leave. After which the company calculates and transfers the corresponding benefit to the employee within a period not exceeding 10 days. In this case, the payment for temporary disability is added to the next salary.

Payout calculation

It should be borne in mind that to calculate the amount due on a certificate of incapacity for work, you need to take into account:

Average annual income of the employee for the last year.
Work experience at this company.
All additional payments, including bonuses, compensations and allowances for the period under consideration, directly related to the labor process.

Attention! When making calculations, payments received for sick leave are not taken into account. Also, payment for vacations is not taken into account, including those taken for valid reasons (for study, for caring for the sick, etc.).

To calculate the amount of payment under a certificate of incapacity for work, it is necessary to calculate the total number of days worked during the accounting period. This number does not include days when the employee was actually absent from work, even if there were good reasons for this: sick leave, vacation, etc.

This data is necessary to calculate the average daily earnings of an employee. In this case, the total income is divided by the previously calculated number of days. The final value will be the required amount. It is multiplied by the number of days of incapacity.

In practice, there are situations in which a person who has suffered a domestic injury works at a given enterprise for less than 12 months. In this case, the average daily earnings are calculated based on the time he worked on it.

Attention! In this case, the patient has the right to provide a certificate from his previous place of work and proof of income for the missing period; these data are taken into account when calculating the final amount of sick leave benefits.

Another important factor that should be taken into account is the payout ratio. It affects the amount of benefits based on the total length of service at the enterprise. Taking this into account, you will receive:

100% of the total benefit amount if the employee has worked for more than 8 years;
80% - if the experience is less than 8, but more than 5 years;
60% will be received by those who work in one place of work for more than 3 but less than 5 years;
50% of average earnings are transferred to those whose experience is less than 3 years, but more than a year;
If an employee suffered a domestic injury but worked for less than a year, he will receive 30% of his average earnings.

In practice, a domestic injury and sick leave for it differ little from an ordinary certificate of incapacity for work received for other reasons. The benefit is calculated in the same way as in other cases.

How to calculate sick leave: video

Payment of sick leave for a domestic injury in 2016-2017

Domestic injury - sick pay in 2016-2017 does not differ from the standard calculation of benefits and may be the basis for declaring an employee temporarily unable to perform work duties. Let's study the features of accruing sick leave for a domestic injury.

Features of assigning sick leave for injury at home

From the point of view of labor law, a domestic injury is an injury received by a person outside his place of work. In turn, if it is received at work, it is considered as production. That, How is sick leave paid for an injury?. received at work, differs significantly from the standard payment for temporary disability.

Read also: Reduction of staff according to the Labor Code of the Russian Federation 2019, who cannot be reduced

It is worth noting that this or that injury received by an employee may not always give him the right not to go to work. The fact of temporary disability is determined by the doctor.

It is quite possible that the doctor will consider that the person, despite the injury, can continue to work, and sick leave for a domestic injury in this case it will not be issued. In this case, the doctor can issue a certificate that will allow, if necessary, to certify the employee’s absence from work. good reason: due to the fact that he was at an appointment at a medical institution.

But How is sick leave paid for a domestic injury?. if it is still issued?

How is sick leave paid for a domestic injury?

The algorithm for calculating and paying sick leave for a domestic injury by the employer company generally does not differ from the procedure for providing benefits for temporary disability that arose due to other reasons (with the exception of an industrial incident). Payment of sick leave for a domestic injury carried out in the same way as if a person has a cold.

At the same time, the circumstances in which the citizen was injured, as well as the specifics of the employee’s treatment, may be important. They largely determine the extent to which the sick pay for injury. Thus, there are a number of reasons for reducing temporary disability benefits.

In what cases is sick leave pay reduced in case of injury?

Paymentsick leave for injury at home V 2016 -2017 decreases if:

1. The employee was injured due to alcohol intoxication.

This fact must be noted directly on the sick leave: on it the doctor enters additional code 021.

Temporary disability benefits in this case are paid based on the minimum wage.

2. The employee violated the treatment regimen.

This circumstance is also recorded on the certificate of incapacity for work: code 24 is entered in it in the column “Notation of violation of the regime.”

Likewise sick leave for a domestic injury in this case it is calculated based on the minimum wage.

In what other cases can a reduced disability benefit be paid?

Other grounds for reduction sick leave payment By domestic injury in 2016 and 2017 should be considered in the context of general legal norms governing the assignment of temporary disability benefits. The reasons for this decrease may be:

short employee experience;
small employee salary.

But, one way or another, sick leave for a domestic injury cannot be less than the payment calculated on the basis of the minimum wage. And if the experience is less than 6 months, there cannot be more than the minimum wage for 1 calendar month, regardless of actual earnings.

Sick leave for a domestic injury in 2016. and also in 2017, it is calculated in the general case in the same way as for any other cause of disability - if it did not arise as a result of a work injury. At the same time great value there may be circumstances in which a person was injured. For example, sick leave for injury, received as a result of intoxication is paid based on the minimum wage. The same applies to the case of violation of the treatment regimen by an employee.

Sick leave for a domestic injury - payment and terms

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 compensation. 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, read more in the material.

How is sick leave paid for a domestic injury in 2017?

Injury at home is included in the list of valid reasons for which an employee may be temporarily absent from work. 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.

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 head, and the subsequent days the Citizens Temporary Disability Fund takes responsibility for paying compensation.

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 the last year. Labor earnings include all compensation, bonuses, and additional cash accruals that were made during the year. Only money received from past 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.

Read also: Certificate of arrears of wages

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 bill, 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 differs in minimum size too.

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.

Payment of sick leave for a domestic injury

Domestic injuries are considered the most common; they include all types of injuries that a person can receive outside the workplace.

The issue of sick pay due to domestic injuries is relevant for victims and employers:

the nature of the injury determines how many days the doctor will issue a sick leave for;
The amount of compensation due will depend on the length of service.

In any case, payment can only be made if there is a certificate of temporary incapacity for work, which must be issued in accordance with the standards legislative framework and presented to the victims.

Sick leave gives you the right to be absent from work and receive compensation.

Any medical institution that has a license to provide medical services and the right to issue such documents.

In case of a domestic injury, paying sick leave in 2016 to the injured employee has its own characteristics.

Disability benefits

Temporary disability due to a domestic injury and sick leave is now paid by the Social Insurance Fund in accordance with Federal Law No. 255.

The employer only needs to make necessary calculations and submit them to the FSS. The sick leave is submitted, as before, to the accounting department of the enterprise. These changes have been in effect since 2013.

To receive sick leave and benefits, the victim must first go to the emergency room or traumatology department of any hospital, where the fact of injury will be established.

When the doctor makes a diagnosis and issues a sick leave, the victim must undergo treatment for a certain time, after which the sick leave will be closed.

Sick leave must be issued from the first day of the victim’s application, and benefits will be calculated from the same day.

The accounting department will accrue benefits within 10 days after the certificate of temporary incapacity for work is submitted. In order for the FSS to pay for it, the document must be drawn up accordingly, this is verified by the fund itself.

The following factors influence the amount of benefits:

The average monthly salary, which is calculated based on the last 2 years.
The amount of additional payments that the employee received over the last 2 years: bonuses, allowances, compensations, etc.
How well the patient complied with the treatment regimen, did the doctor determine any violations, which is recorded on the sick leave with a special mark.
Duration of the employee's insurance period.
The number of days registered on sick leave.
The amount of the benefit, according to established standards, should not exceed the upper limit of payments for a temporary disability certificate.
The condition of the victim if he was injured while under the influence of intoxicants or alcohol. In this case, the benefit is paid according to the minimum wage.

If an employee works on the basis of employment contracts at several enterprises, then according to the law he receives separate sick leave for them. But on the condition that he present certificates from his place of work stating that he is actually registered there.

In this case, the law allows the victim to receive benefits from each employer.

For how long?

Sick leave for a domestic injury is issued on a general basis, i.e., as for other diseases. Its duration is determined by the doctor.

First, it is discharged for 3-10 days, then extended until the patient has fully recovered.

If the duration of the temporary disability certificate is more than 30 days, its extension will be decided not by the attending physician, but by a medical commission.

Often patients after severe injuries you have to spend more than one month in the inpatient department. The commission has the right to issue sick leave to the victim for 12 months.

How is sick leave paid for a domestic injury?

In case of a domestic injury, the Social Insurance Fund will pay for all days of sick leave. There are certain cases when payment of benefits may not be accrued, although sick leave has been issued.

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.
IN employment contract 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 there are no signs of an industrial 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 the 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, 2 are taken into account last year labor activity employee. 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 a civil law rather than an 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.

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 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 end. 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.

It is necessary 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 hospital document, then it must be taken equal to 24 times minimum size wages 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 a domestic injury was sustained by an employee during work leave, 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 with the next salary. In case of delay in disability payments, the employee must receive compensation.

From the point of view of labor law, a domestic injury is an injury received by a person outside his place of work. In turn, if it is received at work, it is considered as production. The way sick leave is paid for a work-related injury differs significantly from standard temporary disability pay.

It is worth noting that this or that injury received by an employee may not always give him the right not to go to work. The fact of temporary disability is determined by the doctor.

It is quite possible that the doctor will consider that the person, despite the injury, can continue to work, and a sick leave certificate for a domestic injury will not be issued in this case. In this case, the doctor can issue a certificate that will allow, if necessary, to certify the employee’s absence from work for a good reason: due to the fact that he was at an appointment at a medical institution.

But how is sick leave paid for a domestic injury if it is issued?

How is sick leave paid for a domestic injury?

The algorithm for calculating and paying sick leave for a domestic injury by an employer generally does not differ from the procedure for providing benefits for temporary disability that arose due to other reasons (with the exception of an industrial injury). Payment for sick leave for a domestic injury is carried out in the same way as if a person received a certificate of incapacity for work due to a cold.

Read more about the stages of the procedure for calculating sick leave payments.

At the same time, the circumstances under which the citizen received a domestic injury, as well as the characteristics of the employee’s treatment, may be important. They largely determine the amount of sick leave paid for an injury. Thus, there are a number of reasons for reducing temporary disability benefits.

In what cases is sick leave pay reduced in case of injury?

Sick leave pay for a domestic injury in 2019 is reduced if:

1. The employee was injured due to alcohol intoxication.

This fact must be noted directly on the sick leave: on it the doctor enters additional code 021.

Temporary disability benefits in this case are paid based on the minimum wage.

2. The employee violated the treatment regimen.

This circumstance is also recorded on the certificate of incapacity for work: code 24 is entered in it in the column “Notation of violation of the regime.”

Similarly, sick leave for a domestic injury in this case is calculated based on the minimum wage.

Read about the codes reflected in the certificate of incapacity for work in the article “What do disability codes mean on a sick leave certificate?” .

In what other cases can a reduced disability benefit be paid?

Other grounds for reducing sick pay for a domestic injury in 2019 should be considered in the context of the general legal rules governing the assignment of temporary disability benefits. The reasons for the decrease may be:

short employee experience;
small employee salary.

But, one way or another, sick leave for a domestic injury cannot be paid in an amount less than the payment calculated on the basis of the minimum wage. And with less than 6 months of experience, sick leave accruals cannot be calculated from an amount exceeding the minimum wage for 1 calendar month, regardless of actual earnings.

How to calculate benefits based on the minimum wage, find out in the material “The size of the minimum wage for calculating sick leave in 2018-2019 .

Results

Sick leave for a domestic injury in 2019 is calculated in the same way as for any other cause of disability (except for that arising as a result of a work injury). In this case, the circumstances of a person’s injury may be of great importance. For example, sick leave for an injury caused by intoxication is paid based on the minimum wage. The same applies to the case of violation of the treatment regimen by an employee.