Violation of hospital regulations: norms and rules, consequences of violations

Sick leave with violation of payment regime in 2020

In case of violation of the procedure for treatment and the regime of stay in a hospital, a sheet of temporary incapacity for work (legally established name for sick leave) is paid to the employee in a slightly different amount, different from that if the calculation was carried out for consequences of a valid nature.
The benefit is cut if there is a reason for this, which the doctor must make a note about on the sick leave form. Read about the nuances of applying for sick leave to care for a child

Violation of hospital regime consequences

In case of violation of the sick leave regime, the leave is paid at the main job, but the Social Insurance Fund has the right to reduce the amount of benefits if there is an appropriate mark. How the sick leave is paid for in violation also depends on what situation might have existed at the time the sick leave was issued, causing the employee to become incapacitated. The reasons that cannot be valid for non-compliance with the regime and entail the issuance of a note are the following:

• failure to attend an appointment;
• the employee left the medical institution without permission;
• treatment prescribed during the period of incapacity was rejected by the patient;
• an act of refusal to undergo procedures, examinations or any hospital treatment;
• employee returning to work early;
• organization by the patient of a trip to another region with subsequent treatment by another specialist.

Sick leave is paid from the day on which the violation occurred. The consequences of this are that benefits are calculated not on the average employee’s earnings, but on the minimum wage. The calculated value is multiplied by the time spent at work (experience) and a calculation is made for payment of benefits. Until the moment when a violation occurs, sick leave payment is made in the required amount.

Example: Employee Petrov, having a disability due to illness, was undergoing treatment from August 11 to August 28. Petrov did not attend the reception scheduled for August 21. The reason for absence is not valid. But he comes for examination on August 26th. A note about the violation is placed on the sheet form. The benefit is paid based on this example as follows:

• From August 11 to August 21 - the sheet is paid on a general basis, and payment is based on the value of average earnings (10 calendar days);
• from August 21 to 28 - the sheet is paid based on the minimum wage (7 calendar days), since there is no valid reason for its absence. At the moment it is 7500 rubles.

The example showed us that with Petrov’s average earnings at work being 800 rubles and with more than eight years of experience - before the procedure is not followed, his allowance is: 10x800 = 8000 rubles. Whereas from the same example it is clear that payment for the time elapsed after non-compliance with the treatment conditions will be: 7x(7500:31) = 1693.55 rubles. For the specified period, benefits are paid exclusively in the order given in this example.

Mark on the sick leave about violation of the regime code 24

Missing an appointment prescribed by a doctor for a reason that is not of a valid nature, even if you go to the appointment healthy, will have the consequences of recording a special mark on the form confirming incapacity - code 24. Marking the sheet with code 24 means an untimely exit, no matter whether it is the first This was a truancy, or not the first one.

Code 24 is not the only mark that can be placed on the form in response to a violation.

If the sick leave is marked as a violation of the regime, how to pay for it?

O assumes consequences in which the benefit is paid in a minimum amount. The amount of payment depends on whether the reason for failure to appear was valid. If the nature of the absence was clearly valid and the employee provided an explanation, the payment cannot be reduced. Otherwise, the amount of payment will be calculated from the minimum monthly wage.

When calculating payment for disability, the periods of treatment before and after the violation are taken into account. The first necessary step that must be taken after the employee appears at work is to determine the maximum amount of payment for disability for one day, based on the established minimum wage. Calculate the total amount for all days after the violation was committed. Compare the amounts received and charge the smaller amount. The benefit amount is calculated using the formula: “coefficient of average wages in the region” X minimum wage / number of days in a given month.

If the employee did not show up to see a doctor at all during the period when the incapacity occurred, the benefit is not paid. It is also not paid if the sheet was not closed due to the fault of the employee and there is a reason for this. Showing up at work with an uncovered disability certificate is prohibited by law!

Valid reasons for absenteeism

To do this, it is enough to take written explanations from the employee why he did not show up for an appointment with the doctor on time, and supporting documents, if any. But in order to assess the validity of the reasons for absence, a social insurance commission from among the employees or a social insurance commissioner is needed if there are few employees in the organization (clause 11 of the Regulations, approved by Government Resolution No. 101 of 12.02.94 (hereinafter referred to as the Regulations); clause 1.1, 2.2 of the Standard Regulations, approved by the Federal Tax Service on July 15, 1994 No. 556a).

The decision of the commission (authorized person) is documented in a protocol (clause 4.3 of the Model Regulations). On its basis, the director issues an order on the assignment of benefits and its amount (clauses 1.1–1.3 of the Model Regulations, clause 10 of the Regulations).

However, there is no list of reasons that are considered valid in the legislation. That is, the decision of the commission (authorized person) is made entirely at its own discretion. The FSS cannot simply recognize it as incorrect on its own, but only has the right to go to court (clause 10 of the Regulations; clause 1 of Article 65 of the Arbitration Procedure Code of the Russian Federation; Resolution of the FAS UO dated 04.10.2013 No. F09-9678/13).

Calculation of sick leave with violation of the regime in 2018 example

In 2020, there were some changes to the procedure for calculating non-compliance benefits. Now the calculation period is considered to be 24 months of work preceding the moment when the employee received incapacity for work. The amount of accrued benefits is determined by dividing by 730 days.

Example: a patient was late for his first appointment with the doctor. The reason for the late exit is valid - an error with the doctor entering the date for the appointment, made on the first day of visiting the clinic. After 5 days, the employee was late the same as the first time, but the reason was not valid. The period of stay on sick leave is 10 days. This example shows that when calculating the amount of benefits for the first five days, an adjustment is applied according to the length of service. The next five days are calculated based on the minimum wage.

Read further: Valid reasons for failure to appear in court.

Businessman at work wearing neck brace with crutches

Every employee has the right to issue a certificate of incapacity for work due to illness. In this case, the prescribed treatment by the doctor must be strictly followed by the patient. Only in this case is the sick leave paid by the employer.

What to do if there is a violation of the sick leave regime, whether payment will be made for the period of incapacity for work and what consequences await the employee can be found out based on the provisions of the Labor Code of the Russian Federation (including the question of whether holidays are paid on the sick leave).

To the question: how to calculate the payment of benefits yourself, even if violations are found, you can get the answer in the material.

What to do if an employee goes to work while on sick leave

If an employee returns to work during a period of temporary incapacity, the employer does not have the right to remove him from work on the grounds that he is on sick leave. The possibility of removing workers in such a situation is not provided for in Article 76 of the Labor Code of the Russian Federation.

Before he starts work, it would be better for the employer to explain to him, preferably against signature, what negative financial consequences are possible for him.

For this purpose, an act can be drawn up in any form, and it also records the return to work. In particular, it should be explained to the employee that if he violates the prescribed regime without a good reason, this is grounds for reducing the amount of temporary disability benefits from the date of the violation, and as a result, the employee may receive less for sick leave than expected. It should also be clarified that for days of work on sick leave, payment of both benefits and wages is not provided at the same time, since the benefit is intended to compensate for lost earnings when the employee is unable to work.

Although the employer is not required to do this, he can transfer these documents indicating that the employee worked while on sick leave to his attending physician.

How is sick leave paid in violation of the schedule?

Violations in filling out sick leave notes are a common occurrence at work.

Payment of sick leave in violation of the procedure is done:

1. Until the violation is recorded according to the generally accepted formula.
2. After non-compliance with the rules - taking into account the minimum wage.

The calculation depends on the degree of the offense: accidental and special. In order for the benefit to be paid by the employer, a special commission is invited, which considers the case of violation and makes a conclusion in the form of non-compliance with the rules, for a good or bad reason.

The list of marks that cause the payment of the minimum amount of benefits includes the following factors:

1. Failure to return to work on time without a doctor's permission.
2. Failure to comply with the instructions of a medical specialist means failure to show up for an appointment.
3. Failure to comply with and refusal to take tests and conduct examinations.
4. Transfer to another hospital.

If an employee is injured due to alcohol or drugs, in accordance with paragraphs 1 and 2 of Article 8, the amount of financial support during the period of incapacity for work is reduced.

The calculation will be made taking into account the minimum wage. It is possible to avoid punishment and minimum payment of benefits from the employer only if evidence is provided that the employee did not violate the rules during the period of illness.

There are several situations that constitute offenses for good cause:

• deterioration of health;
• funeral;
• illness of a family member.

If the medical commission, on the basis of an explanatory note, proves the degree of innocence of the patient, the employer pays benefits in the amount required by law.

Notes on violation of the regime on the sick leave code 24

Each type of non-compliance with the regime has its own marks in the form of a code. If one of them is not met, the employer pays the benefit, taking into account the minimum wage.

Violation: being late for an appointment with a doctor, which has code 24, may have the consequences of not paying benefits at all. If an employee ignores a doctor’s examination on the appointed day and comes back healthy after a while, the boss has the right not to pay for government assistance.

If an employee is late for an examination by a medical specialist for a good reason (feeling ill on the road, family circumstances, accident, etc.), compensation is paid by the employer according to the established model. Despite a good reason for being late for an examination, the doctor still makes a note about the violation of the schedule.

Only a doctor can record an offense. The head of the organization cannot draw up an act of non-compliance with the schedule and subsequently not pay the benefit. An employer does not have the right to deprive a sick employee of benefits unless there is evidence from a medical specialist.

Consequences of violating sick leave at work

Failure to comply with hospital regulations has consequences for the employee. Depending on the degree of the violation, during the period of incapacity you may receive a minimum amount of benefits or be left without compensation at all. The doctor’s recording of the offense on the certificate of incapacity for work indicates the peculiarities of payment of benefits.

Calculation of compensation due to non-compliance with the hospital schedule is made on the basis of:

1. Replacing the average wage level with the minimum wage value.
2. Multiplying the result obtained by the length of service.

The formula is valid only if the medical commission proves an act of non-compliance with hospital regulations.

An example of calculating sick leave with violation of the regime in 2020

In order to be able to correctly calculate the level of benefits, you can use a practical example. The total duration of the patient's sick leave starts from the date: September 10 to September 27.

An appointment with the doctor is scheduled for the 20th. The employee, without a good reason, ignores a visit to a specialist and only comes on the 25th. The medical specialist puts a mark with code 24 on the certificate of incapacity for non-compliance with the regime.

In such a situation, payment is made on the basis of replacing the average monthly earnings with the minimum wage value.

The calculation formula includes the following points:

1. The salary level is determined by adding up all salaries for the year and dividing by the sum of 12 (the number of months in a year).
2. The consequences of the final benefit amount depend on the length of service. If the employee has worked for 5 years, the amount of compensation depends on 60% of the salary. If from 5 to 8 years - from 80%. If an employee has more than eight years of experience, he is entitled to compensation of 100% of income. If the work experience is less than six months, the minimum wage is taken as an indicator.

Such an example will prompt employees that it is better to take the rules of the regime seriously and not violate the hospital routine. Because the amount of benefit before non-compliance and after non-compliance is significantly different.

Reasons for violating the regime

The two main reasons for difficulties with payment of compensation include: failure to follow doctor’s recommendations and missing an examination at a medical institution. If there is a lack of substantiated arguments, the above actions are considered violations. Two-digit codes in sheet fields have a specific meaning, which is clearly displayed in the Table.

Table

The current laws do not contain provisions on reasons for non-compliance with medical instructions that can be assessed as valid.

To protect their rights, an employee can refer to document No. 74 of the Ministry of Health and Social Development of Russia dated January 31, 2007.

According to the order described above, non-punishable reasons include:

• natural disasters (hurricane, flood, etc.),
• long-term illness or injury (illnesses lasting longer than six months),
• change of place of residence or family circumstances (death or serious illness of a relative).

If a person, for good reason, was unable to comply with a certain rule of the hospital regime, this does not affect his financial support. When making calculations, the boss and the commission must take into account the fact that there is no legal basis for cutting sick pay.

The head of the company independently assesses the nature of the violated norm; permission from the FSS branch is not required. He is responsible for the accrual and expenditure of compulsory social insurance funds. The opinions of the commission are taken into account only if there are appropriate authorized representatives in the organization. They are usually elected at a meeting of company employees.

To substantiate the reason for the violation, the employee must write a statement.

A valid reason must be documented.

For clarity, we can give a simple example: an employee did not come to see the doctor because her young son was sick. The child's local police officer was called from the medical facility. Data about the therapist's visit serves as a justifiable reason for the violation.

How to pay for sick leave if it was violated for a good reason?

At the place of work, the employee must provide an explanatory note explaining the reasons for non-compliance with the regime. A special commission created by the employer or the social insurance commissioner makes a decision on the payment of benefits.

Important: a note about violation of the hospital regime is not a basis for closing the sick leave.

What are they?

The legislation of the Russian Federation does not have a clear list of valid reasons for non-compliance with the hospital regime. You can focus on the order of the Ministry of Health and Social Development dated January 31, 2007 N 74 “On approval of the list of valid reasons for missing the deadline for applying for benefits for temporary disability, pregnancy and childbirth, monthly child care benefits”, which states that valid reasons include:

• natural disasters;
• moving a person to another locality;
• serious illness or death of a close relative of the patient;
• forced absenteeism due to illegal dismissal or suspension from work;
• other reasons recognized as valid in court.

Often the FSS does not recognize the reasons for the violation as valid and does not agree with the decision of the social insurance commission. The main reasons for refusal are:

• lack of supporting documents to recognize the reason as valid;
• the meeting of the commission was carried out formally;
• errors in papers and documents.

If all documents are filled out correctly and the valid reason is proven, then the FSS cannot refuse payments. If such a situation occurs, then the fund’s decision can be appealed in court or higher authorities of the FSS of Russia.

Calculation of funds on a certificate of incapacity for work

If it is proven that the sick leave regime has been violated for good reason, then the amount of benefits is calculated in the usual way based on the employee’s average salary. To determine it, wages for the previous 24 months are summed up and divided by 730.

Depending on the length of service, the benefit amount is:

• 60% – less than 5 years;
• 80% – from 5 to 8 years;
• 100% – more than 8 years.

Example: Sick leave was opened on February 10. An appointment with the doctor is scheduled for the 15th. For good reason, the employee visited the doctor only on the 16th. The document with a violation mark was extended and closed on February 18. The employee’s monthly salary over the past two years was 25 thousand rubles.

25000*24/730=822 rubles – average daily earnings.

His work experience is more than 10 years, which means that the benefit amount is calculated at 100%.

822*9=7398 rubles – payment to an employee under the BL.

Preparation of documentation and important points in filling it out

There are several types of violation of hospital regulations, which are recorded in the corresponding line of the BC with a specific code:

• code 23 – violation of medical instructions;
• code 24 – untimely visit to the doctor;
• code 25 – early return to work;
• code 26 – refusal to take tests and undergo examination;
• code 27 – missed or late medical examination;
• code 28 – other violations.

After the digital mark, the date of the violation and the doctor’s signature are placed.

The sick leave form must be filled out without errors or corrections. Also, you cannot go beyond the permissible limits - in this case, the document may be declared invalid.

Grounds for reducing the benefit amount

For example, in one of the disputes, by the decision of the social insurance commission, formed from representatives of the employer, the reason for the employee’s failure to appear for a medical examination was recognized as valid (poor health). Based on this decision and the explanatory note of the insured person himself, the employer issued an order to pay temporary disability benefits.

Please note: indicating code 021 on the certificate of incapacity for work does not clearly indicate injury due to alcohol intoxication.

In the first case, opposite code 24 in the line “Note about violation of the regime” will be the date of the missed appointment. The table “Exemption from work” will indicate the period from the date of opening of sick leave to the date of the missed appointment. In the line “Other” - code “36”, meaning “Apparently able to work”, and the date of admission after failure to appear. The “Get Started” line will be empty.

In such cases, the benefit is paid by the employer. The employee only needs to provide an explanatory note, on the basis of which the manager issues an order. The order expresses the employer’s agreement that violations of the sick leave regime will not cause a reduction in the amount of benefits for the period of absence from work.

If employees of the organization visited the patient and drew up such a report, it does not constitute grounds for non-payment of benefits.

But if the period of “absenteeism” is not included in the table “Exemption from work”, and you must pay benefits for these days, then it is better to send the employee to the clinic so that the sheet is corrected - a period of “absenteeism” is added. However, there is no list of reasons that are considered valid in the legislation. That is, the decision of the commission (authorized person) is made entirely at its own discretion. The FSS cannot simply recognize it as incorrect on its own, but only has the right to go to court (clause 10 of the Regulations; clause 1 of Article 65 of the Arbitration Procedure Code of the Russian Federation; Resolution of the FAS UO dated 10/04/2013 No. F/13).

If the regime was violated for a good reason, this will not affect the final payment amount. The employer should be aware of this.

A certificate of incapacity for work is issued to each employee in case of illness and surgery. It is issued for the period prescribed by the doctor. Despite the incapacity for work during illness, an employee may accidentally or deliberately violate the sick schedule. Therefore, if medical instructions are violated, the consequences of further issuing sick leave and issuing benefits can be negative for the patient.

Let’s take a closer look at what this is and what consequences this mark entails for the employee and the employer.

How to calculate benefits in this case depends on several factors. Firstly, on the reason for the “absenteeism”, and secondly, on whether the sick leave was extended after no-show.

Let’s take a closer look at what this is and what consequences this mark entails for the employee and the employer.

How to calculate benefits in this case depends on several factors. Firstly, on the reason for the “absenteeism”, and secondly, on whether the sick leave was extended after no-show.

Sick leave with violation of the regime - we will consider an example of payment in 2020 in the material below - is paid in the minimum amount. How to pay for sick leave if it contains a note about violation of the regime? What codes display this or that violation of the regime and does the amount of benefits depend on these designations?

Is it paid if the doctor’s orders are violated for an unjustifiable reason?

If an employee violates the sick leave regime for an unexcused reason, then the amount of payments is reduced to an amount not exceeding the minimum wage. If the doctor's instructions are continually not followed, the employee may be completely deprived of hospital benefits.

Grounds for reducing the amount of compensation

Depending on the type of violation, the amount of benefit may be reduced in whole or in part from the moment of non-compliance with the regime. Decrease since violation:

• violation of medical regulations;
• being late or not showing up for a doctor's appointment.

Reduction for the entire period of sick leave: if an employee is injured or sick due to alcohol, drug, or toxic intoxication. In order to note in the BC that the employee was drunk, the doctor underlines the word “injury” in the line about the cause of incapacity and then signs “intoxicated.”

Is the regional coefficient considered?

Regional coefficient is an indicator by which the salary of a person working in regions with difficult climatic and environmental conditions is multiplied.

When a sick leave is issued without violations, the regional coefficient is not calculated, since the benefit is calculated from actual earnings, which already take into account additional allowances.

If an employee violates sick leave or receives temporary disability due to intoxication, then the amount of benefits is calculated using the formula:

Days of illness * (minimum wage * 24/730 * regional coefficient) * percentage by length of service = amount of sick leave.

The procedure and example for calculating benefits (subject to a reduction in the amount from the day of non-compliance with the doctor’s instructions)

Benefit payments, subject to a reduction in the amount from the date of violation, are calculated as follows:

1. From the date of opening of the BC until the day of the violation, sick leave is paid in the usual manner.
2. From the moment of the violation until the closure of the certificate of incapacity for work, the amount is calculated based on the minimum wage. From May 1, 2020, this amount is equal to 11,163 rubles.

Example: Sick leave opened on March 10. The employee was supposed to come for an appointment on the 15th, but for an unexcused reason he came a day later. The certificate of incapacity for work was extended and closed on the 18th.

Let's say the average salary per day is 25,000*24/730=822 rubles.

From July 10 to July 14, the employee is credited 822*5=4110 rubles.

From July 15 to 18, the minimum wage (11,163 rubles) *24/730= 367 rubles per day, which means 367*4=1468 rubles from the moment of non-compliance.

1468+4110 = 5578 rubles for the entire sick leave.

The procedure and example of calculating benefits, which requires a reduction of the entire compensation

In cases of severe violation of the disability regime, the employer has the right to reduce the entire amount of payments to the minimum wage.

Typically, the underlying cause is injury or illness sustained while intoxicated. In the BC this is marked with code 21.

Example: An employee was unable to work from July 10 to July 15. The BC has code 21. Work experience – 4 years. Regional coefficient – ​​1.3.

11163 * 24/730 = 367 rubles - the minimum wage per day.

367* (60%/100%)*1.3 = 286 – daily payment to an employee according to the minimum wage.

286 * 10 (sick days) = 2860 the entire amount of sick leave.

Calculation of minimum wage benefits if the period of illness moves to another year and the size of the minimum wage has changed

If the sick leave transfers to the next year and the minimum wage changes, or it changes several times a year, as happened in 2020, then benefit payments are calculated based on the “old” minimum wage at the time of which the sick leave was opened.

Example: An employee’s work experience is 20 years. He was on sick leave from April 25 to May 20, 2020. The certificate of incapacity for work indicates violations, according to which benefits are calculated according to the minimum wage. From January 1 to April 30, the minimum wage was 9,489 rubles. And from May 1, 2020, the amount increased to 11,163 rubles.

When calculating, you should take the amount current at the time of opening the sick leave, that is:

312 (average daily “old” minimum wage) * 26 (sick days) * 100% (according to length of service) = 8111 rubles - the full amount of the benefit.

The employee was very late in going to the doctor for closure (counted as absenteeism/vacation)

If an employee missed an appointment with a doctor and came back later, already healthy, then code 36 is entered in the “other” column - appeared healthy.

The doctor will not determine the moment of onset of working ability and will simply mark the day of absence as the day the sick leave ends.

Thus, the days from the missed appointment to the actual appearance are considered absenteeism and may result in a fine or dismissal from the workplace. In rare cases, the employer may treat missed days as unpaid leave.

Example: BC is open from June 1. The doctor's appointment was scheduled for June 4, but the employee only arrived on the 6th. His work experience is 8 years, the average daily salary is 822 rubles. The daily minimum wage is 367 rubles.

From 1 to 3 payments are accrued as usual: 822 * 3 * 100% = 2466 rubles.

For the 4th day, the employee will receive 367*1*100%=367 rubles.

The 5th and 6th are not subject to payment and are considered absenteeism.

It was a fact, but it was not reflected in the BL

If the employer or social insurance commission has identified violations of the employee’s hospital regime, but this is not indicated in the BC, you can submit an official request to the medical institution with documents or other evidence that confirms the fact of non-compliance with the regime.

Important: the organization does not have the right to independently make changes to the certificate of incapacity for work.

Noted in BC for care or BC

If an employee issues a BC to care for a relative, he is responsible for visiting a doctor and complying with medical instructions. In cases of non-compliance with the regime, the corresponding codes are entered on the certificate of incapacity for work. The amount of payments will be calculated in the same way as for sick leave payments due to the illness of the employee himself.

When registering sick leave for pregnancy and childbirth, the legislation of the Russian Federation does not provide codes for violation of the regime. Problems with receiving payments can only arise if there are errors or inaccuracies when filling out the document.

Payments for temporary disability are due to all officially employed citizens. If you strictly follow the medical requirements and visit the doctor in a timely manner, there will be no problems with the calculation of benefits. In cases where a violation of the regime occurred for a good reason, try to prepare documents confirming this and provide them, along with an explanatory note at the place of work, so that this has less impact on the payment of sick leave.

How to pay for sick leave in 2020 with a violation of the regime

See what to do if an employee brings sick leave in violation of the rules, and how to pay for it in 2020. We explained the consequences of non-compliance with the hospital regime and gave an example of calculating disability benefits. You will be able to download samples of all documents required to pay for sick leave in violation of the regime.

Violation of the hospital regime entails a reduction in the amount of disability benefits, but not in all cases. Two circumstances are taken into account:

1. Type of violation
2. Having a good reason.

File information

Let's figure out in order what an accountant should do if an employee brings a certificate of incapacity for work with a note of violation.

Sample sick leave Information about the file Sample sick leave (benefits from the minimum wage) Information about the file

The procedure for calculating benefits is regulated in two regulations:

• Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of disability and in connection with maternity”,
• Government Decree of June 15, 2007 No. 375.

Keep records of sick leave and check their authenticity in the Simplified 24/7 program. The program has built-in convenient tips that will help you calculate benefits taking into account the new requirements of officials.

Try the program "Simplified 24/7"

Sick leave with violation of the rules is paid in full, reduced amount or not paid at all. First of all, it depends on the code specified by the doctor:

Experts from the magazine “Salary” have prepared step-by-step instructions on how to calculate sick leave benefits in case of violation of the regime. The article contains examples, video instructions and a detailed presentation.

Step-by-step instructions for calculating benefits

We pay for such sick leave in steps:

Step 1. We receive from the employee and study the certificate of incapacity for work, determine the type of violation.

Step 2. Find out the reason for non-compliance with the regime. We receive a statement from the employee explaining the reasons and supporting documents. The employee draws up an application in any form addressed to the head of the enterprise:

Step 3. Create a social insurance commission. The commission will consider the employee’s application and objectively assess the degree of his guilt. If the organization employs less than 100 people, instead of the commission, you can elect a social insurance commissioner:

Step 4. We draw up the minutes of the commission meeting or the decision of the commissioner:

Step 5. The manager, taking into account the opinion of the authorized person, makes a decision on the payment of benefits:

• If the reason is recognized as valid, the benefit for all days is paid in full,
• If the reason is not valid, then look at the violation code:

1. The benefit with codes 23, 25, 26, 27 consists of two parts: from the onset of the illness until the violation - in full, from the date of the violation until recovery - based on the minimum wage,
2. Sick leave with code 24 is paid in a special manner, we will look at it below,
3. Disability with code 021 is paid from the minimum wage.

We issue an order:

Step 6. We inform the employee and pay benefits.

Code 24c indicates that the employee did not show up for examination on the day prescribed by the doctor, but came one or more days later. The doctor records the violation, even if he knows that the patient could not come. For example, due to deterioration in health, the patient was unable to visit the doctor and called him to his home.

The calculation of such sick leave depends on two circumstances:

1. Reason for not visiting a doctor
2. Was the sick leave extended after attendance?

The employer instructs a commission or authorized representative to look into the circumstances of the omission. If they are objective, sick leave is paid in full.

If the commission found the absence unexcused, the next step is to determine whether the employee was discharged after failing to appear or continued treatment. There are two possible options here.

In the first option, the patient missed a day of visiting the doctor, and came to close his sick leave after recovery. In this case, the doctor makes the following notes:

• Opposite code 24 will be the date of the missed appointment,
• In the “Exemption from work” table, the doctor will indicate the period from the onset of the illness to the date of the missed appointment,
• In the “Other” line there will be code 36, opposite it - the date of actual appearance,
• The “Get Started” line will be empty.

In this case, the benefit is calculated as follows:

• The period from the onset of illness to the day preceding the failure to appear is paid in full according to the general rules,
• The day of missed appointment is paid from the minimum wage,
• The period after absence until recovery is considered absenteeism and is not subject to payment.

In the second option, the patient missed an appointment with the doctor, showed up later and continued treatment. In this case, the sick leave will be filled out differently:

• Opposite code 24, the doctor will indicate the date of absence,
• The “Other” line will be empty,
• The “Start work” line will indicate the employee’s discharge date,
• The “Exemption from work” table will indicate the periods: From the onset of illness to the day of absence,
• From the day of admission to the actual appearance,
• From appearance to recovery.

note

Sometimes doctors indicate only two periods:

• From the onset of illness until the day of absence,
• From appearance to recovery.

The period from the day of admission until the appearance falls out. This is incorrect, ask the employee to go to the clinic and complete the “Exemption from work” table.

In this case, the benefit consists of two amounts:

• The period from the onset of illness to the day preceding the absence is paid at the usual rate,
• The period from the date of absence until recovery is paid based on the minimum wage.

Violation of sick leave entails certain consequences for both the employee and the employer.

The employee may receive a reduced benefit or lose sick leave pay altogether. It depends on the violation code indicated by the doctor:

• For violations with codes 23, 24, 25, 26, 27, the benefit is calculated based on the minimum wage from the date of the violation,
• Code 24 sometimes gives the employer a reason not to pay benefits at all,
• If code 021 is specified, the benefit is calculated based on the minimum wage for all days of incapacity for work.

The consequence for the employer will be the need to convene a social insurance commission and decide on the amount of benefits. The mere fact of a violation does not give the employer the right to unconditionally reduce the amount of benefits. The commission must first determine whether the non-compliance was intentional and whether the employee has a valid reason.

Legislative regulation: what is a violation of sick leave

The unified procedure for issuing disability certificates was approved by Order of the Ministry of Health and Social Development of the Russian Federation No. 624n dated June 29, 2011, which is adjusted annually. In accordance with Article 58, a note on a violation of the regime on a sick leave certificate is indicated by two-digit codes:

• 23 – refusal to comply with the routine prescribed by the medical institution, leaving the hospital without permission, unauthorized departure outside the territorial district;
• 24 - failure to undergo medical control within the prescribed period due to failure to appear;
• 25 – unauthorized going to work without discharge or sanction from the clinic;
• 26 – refusal of a medical examination previously prescribed for the purpose of establishing disability;
• 27 – appearance for a medical examination later than the actual appointment date;
• 28 – violation of the sick leave regime that was not taken into account according to previous codes;
• 21 – appearing in a medical facility in a state of intoxication.

According to Article 61 of Order No. 624n, refusal to conduct a medical examination, discharge from the hospital for violating the regime, absence from a scheduled examination are grounds for prematurely closing the sheet and starting work from the next day, about which the appropriate notes are made:

• 35 – not recognized as disabled;
• 36 – recognition of the citizen as ready to begin work duties.

What are the consequences of violating sick leave? What are the consequences other than early termination of actual disability? An explanation is provided by Federal Law No. 255-FZ dated December 29, 2006 and Russian Government Decree No. 375 dated June 15, 2007, according to which:

Sick leave in violation of the regime is paid in full, reduced to the minimum wage or not paid at all. The determining factor is the recognition and documentation of the employee’s guilt or innocence.