What does code 05 mean on a sick leave certificate? Disability codes on sick leave

Every insured citizen of the Russian Federation, upon the occurrence of an insured event, has the right to contact a medical organization and receive the appropriate benefit from the employer. To process the above payment, the employee must be given a certificate of incapacity for work issued by an institution that has the appropriate license to his permanent workplace.

General information and procedure for registration according to the Labor Code of the Russian Federation

The issuance of sick leave is regulated by Order of the Ministry of Health and Social Development of the Russian Federation No. 624n dated June 29, 2011. The day of applying for medical care will be date of issue of sick leave.

After examining the patient and determining the diagnosis, the doctor sets the period for which the employee is released from work. Currently, during outpatient treatment, according to clause 11 of Order No. 624n, the doctor can decide and issue sick leave for 15 calendar days.

If it is necessary to release the patient from work beyond the established restrictions, the chairman of the medical commission signs the certificate of incapacity for work.

• women caring for young children under 3 years of age;
• employees working under a GPC agreement;
• employees on leave without pay;
• women on maternity leave.

A sick leave certificate is drawn up on a universal form, which is filled out by the medical institution, as well as by the employer. When issuing a sick leave certificate, the health worker does not indicate the diagnosis, but puts a numeric code on the form in the corresponding cell in the line "Cause of disability".

Decoding the causes of disability

A closed list of possible codes is given in paragraph 58 of Order No. 624n dated June 29, 2011. They have following values:

Please note that codes 14 and 15 can be indicated by a doctor only with the consent of the patient.

Following the above two-digit codes, the form has the opportunity to put three-digit codes, which help to detail the reasons for an employee’s absence from work:

• 017 – inpatient treatment at a sanatorium;
• 018 – to undergo sanatorium-resort treatment after an accident at work during illness;
• 019 – during treatment at the Research Institute of Rehabilitation and Balneology;
• 020 – extension of maternity sick leave;
• 021 – in case of illness caused by alcohol or drug intoxication.

The decoding of each of these codes is given on the form of the certificate of incapacity for work; also, if necessary, you can use regulatory documents (Order No. 624n dated June 29, 2011).

Code 01 on the certificate of incapacity for work is the most common. It is usually used to refer to infectious diseases, acute respiratory viral infections, influenza or colds.

After the employee provides a supporting document the employer accepts it for payment. To do this, he determines the basis for calculation and the average daily earnings.

Calculation of benefits for sick leave

According to paragraphs. 1 item 2 art. 3 of Federal Law No. 255-FZ of December 29, 2006, the accountant is obliged to pay for the first three days of illness from the company’s funds, all subsequent days of sick leave are subject to payment by the Federal Social Insurance Fund of the Russian Federation.

But there are also exceptions. The employee was absent from his main place of work because he took sick leave to care for (a close relative or son/daughter), payment from the Social Insurance Fund is made from the first day of illness, and the employer no longer participates in the payment of benefits.

The amount of the benefit is related to the patient’s insurance experience:

1. If an employee has been employed for less than 5 years, then sick leave is calculated taking into account 60% average earnings.
2. Total experience from 5 to 8 years - payment of benefits comes from 80% average earnings.
3. Working for more than 8 years, the insured can count on receiving benefits from 100% average earnings.

When an employee is on sick leave to care for a child, the first 10 days are paid based on the insurance period, and the subsequent days are paid for no more than 50% of the employee’s earnings.

The salary for the two years preceding the occurrence of the insured event is taken as earnings for calculating the certificate of incapacity for work. In the event that an employee did not work in his last place for the required number of years, he can contact his previous employer and request certificate in form 182-n(approved by the Order of the Ministry of Labor and Social Protection of the Russian Federation dated April 30, 2013), where his salary will be indicated for the years and excluded days required for calculating sick leave.

For an insured person with work experience less than 6 months payment for a certificate of incapacity for work may not be higher than the minimum wage for a calendar month.

Only those payments that, according to the law, are considered taxable for calculating insurance premiums are taken into account. Wherein legally established the maximum permissible base for calculating benefits, which is indexed annually. These restrictions are established by clause 3 of Art. 421 of the Tax Code of the Russian Federation.

The accountant divides the base value derived from the calculation results by 730 (the number of calendar days for two years). Thus it is calculated average daily earnings of an employee.

Next, the corresponding percentage, determined using the duration of the insurance period, is applied to the amount received. The total amount is multiplied by the number of days of incapacity. This is what will happen final payment for sick leave.

Often in practice there are situations that differ from the standard ones.

For example, an employee, when visiting a doctor, could miss the date of appearance for a medical examination, as a result of which the doctor will put a note on the sick leave in the appropriate field. This will have impact on subsequent benefit calculations:

• if the failure to show up to the doctor was due to disrespectful reason, the amount of benefits due from the date of violation of the regime is calculated based on the minimum wage;
• however, if there was a reason respectful(for example, the employee was busy caring for a sick child), the accountant has the right to pay for such sick leave according to the general rules, without reducing the amount of benefits.

When calculating maternity sick leave, there are also some nuances:

• the benefit amount is paid from the first day of maternity leave at the expense of the Social Insurance Fund;
• When calculating the average daily payment, excluded periods are subtracted from the total number of calendar days for the previous two years, i.e. days of illness of the insured person.

According to clause 5 of Art. 6 Federal Law No. 255-FZ dated December 29, 2006 exist restrictions on the number of paid sick days for care, which depend on the age of the child and the cause of disability. For example, an employee has already cared for a minor between seven and fifteen years of age for 40 days in the current year.

And again provides sick leave for a period of time for 8 days. It is legally established that an employee can use 45 days a year while on sick leave with such a child. In this case, only 5 calendar days, since the limit has already been exceeded.

What to do if there is an error in the instructions

When making entries on the sick leave certificate, mistakes can be made by both the doctor and the employer. The main difference is that if any data is incorrectly indicated on the certificate of incapacity for work by an employee of a medical institution, the form must be replaced, and the patient is given a duplicate.

If the employer made a mistake on the sick leave, he has the right to make a correction by crossing out the incorrect entry and indicating the correct data on the back of the sheet, followed by their certification by the organization’s chief accountant.

How is sick leave paid? Details are in the video.

Since 2011 all information about the causes of disability is contained in the disease codes on the sick leave certificate. With their help, the amount of compensation due is determined. The ability to read codes will help the recipient of the certificate of incapacity to eliminate errors when filling out the document and receive money on time.

Code names

In total, there are 5 types of encoded information on the sick leave. The fields for codes are marked in red in the illustration of the document form.

The medical institution enters the following encrypted information:

Reason for disability - this field must be filled in.

Family connection - this column is filled in if the employee takes out a certificate of incapacity for work (LS) to care for a sick relative.

Notes on violation of the regime - codes in this category can significantly reduce sick leave payments.

Other - the encoding in this field reflects the reasons for continuing or closing the LN.

The employer codes the column “Calculation conditions” on the sick leave sheet. It contains information about benefits or reasons for reducing payments to a sick employee. Based on encrypted data, accounting calculates the amount of compensation due. Control over the payment of the certificate of incapacity for work is carried out by the Social Insurance Fund (FSS) - it may not pay for the certificate if there are errors in it.

Decoding

Calculation of compensation on a general basis has the following algorithm: average daily earnings (ADE) is multiplied by the length of service coefficient, and then by the number of days of illness. The length of service coefficient means that if an employee has been working at the company for more than 8 years, his compensation according to the bulletin is 100% of the SDZ. With 5 to 8 years of experience, he will receive 80% of earnings; from 1 year to 5 years - 50%, and if the length of service is less than 1 year, sick leave payment will be 30% of the average daily earnings.

Disease codes on sick leave certificates affect the calculation of compensation: in one case, instead of SDZ, the minimum wage (minimum wage) is taken as the basis for the calculation, in another, length of service is not taken into account, in the third, the number of paid days is limited.

Table

Column "Other"

The coding of the column “Other” reflects the change in the patient’s condition during his stay on sick leave:

code 31 means that the employee needs a new sick leave, and the previous one is closed and must be paid;

symbol 32 is associated with recognition of disability - the period of payment for sick leave increases;

code 34 means the closure of the bulletin due to the death of the patient;

code 36 indicates restoration of ability to work; on this basis, the LN is closed and the employee can begin work.

The decoding of all codes is given on the back of the document and is available to the owner of the certificate of incapacity for work who wants to check the correctness of its completion.

The employer needs to know what the employee’s illness is - because this affects the payment of disability benefits. Read our article about which codes affect sick leave payment, download a useful table with their decoding

From this article you will learn:

Why are codes written on sick leave?

The diagnosis established for the patient is indicated on the temporary disability certificate not by its full name, but by a digital code. This significantly saves time on filling out and processing sick leave, and also allows you to reduce the volume of the document itself. A verbal description of the disease and the circumstances associated with it can take up a lot of space. In addition, the codes help maintain medical confidentiality - they provide only general information about the cause of disability, which is important for calculating benefits, and not a specific diagnosis.

There are 3 cells for codes, the first of which must be filled in. This is actually the disease code. The other 2 cells are intended to indicate an additional, explanatory code or a code for a changed diagnosis if it was initially established incorrectly.

What codes affect sick leave payment?

Why does an employer even need to know what an employee’s illness is? First of all, this affects the payment of disability benefits.

Thus, code 01 (illness) is paid in full for the entire period, and code 09 (care for a relative) has some time restrictions. The source of payments is also important. For example, time for treatment after a work injury (code 04) is paid from the Social Insurance Fund, and a domestic injury (02) is paid for three days by the employer himself, and then by the Social Insurance Fund.

Additionally, the additional code, if applied, matters. For example, the corresponding cell contains “021”, this means: an injury or illness occurred due to the fact that the employee was intoxicated or under the influence of drugs. Consequently, sick leave is not fully paid. And if code 023 (violation of the treatment regimen) is used, then the reduction in the amount of payments will not occur for the entire period, but only from the moment the violation is detected.

note

To ensure that you do not have to pay sick leave payments out of your own pocket, carefully check the document. If it turns out to be fake, the FSS will not reimburse the expenses. How to identify a fake sick leave and what to do with it,

Sick leave codes and their interpretation

The codes used are the same for the entire country and are indicated in accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2011 No. 347n. Thus, the code system is unified.

Some codes can only be used with the employee's consent. These are 14 and 15 – child diseases associated with HIV infection, vaccination or cancer.

Cause of disability 01

The most common reason for absenteeism is marked with code 01. This means a common illness, such as influenza or an acute viral respiratory infection. In this case, no additional code is installed. Sick leave will be paid in full and depends on the length of the employee’s insurance period.

Reason for disability 02

The next most common reason for sick leave is injury. For payment of time for treatment, it will matter under what circumstances it is received. Code 02 marks household injuries. Their payment is carried out as follows: the first three days are financed by the employer, the subsequent ones - by the Social Insurance Fund.

Code 04 on sick leave

If a work-related injury is detected, code 04 is assigned. The benefit will be paid by the Social Insurance Fund.

Cause of disability 05 additional code 020

Code 05 means that sick leave was issued for pregnancy and childbirth. If the field for the explanatory code is “020”, it means that the employee receives additional leave. For example, if a family is expecting twins.

Cause of disability 09

Sick leave is issued not only in case of illness of the employee himself, but also if there is a need to care for a family member. This is encrypted with code 09. Relationships will be marked with an additional code.

Code 11 on sick leave

Code 11 is used to mark socially significant diseases that the employer needs to know about - for example, tuberculosis, hepatitis, etc. Their full list is given in Government Decree No. 715 of December 1, 2004.

What other codes are there?

Above we have given examples of the most commonly used codes. The general list of codes is extensive. The procedure for calculating and the amount of disability payments will depend on them. For your convenience, we have prepared a table of codes that indicates their effect on payments.

Other codes on the hospital form

In addition to information about the disease itself, other circumstances of significance are coded on the certificate of incapacity for work. They are not indicated in the first three cells - the main code, additional and modified. They have their own place on the certificate of incapacity for work. There are also three of them - codes for family ties, regime violations and “other”. For example, another - the sick leave extension code is “31”. If an employee died while on sick leave, code 34 is entered.

A relationship code is often used - if, for example, code 09 is used, and then 38, this means that sick leave was issued to the mother to care for the child. Code 41 means trustee. Violations of the regime are also marked if they were committed. Code 24 means failure to show up for an appointment with a doctor, and code 25 means going to work without being discharged.

What codes should an employer provide?

Filling out sick leave is not only done by a health worker. Information at the place of work is also indicated, including codes of calculation conditions and subordination. Depending on the structure of the organization, the employer may entrust the responsibility of filling out sick leave to an accountant or HR specialist.

The sick leave carefully includes information about the organization, the employee, his average earnings, insurance coverage, etc. The “Calculation Conditions” code can be filled in - for example, if an employee has an established disability, “045” is entered. For persons who have benefits due to work in the Far North, code 044 is used, for victims of radiation - 043. In this case, there may be several calculation codes.

In the first two cells, codes are written that reflect: Code What does it mean 01 The presence of an illness due to which the patient is released from work 02 The patient is incapacitated due to injury 03 The establishment of quarantine - its presence prevents visiting the workplace 04 The patient had an accident directly at the enterprise, or painful results have manifested themselves 05 Appointment of leave under the BiR 06 A patient undergoes prosthetics in an inpatient setting 07 An employee is diagnosed with an occupational illness or an exacerbation of a previously identified one occurs 08 The patient is treating residual manifestations of the illness in a sanatorium 09 Exemption from attending work due to caring for the sick a loved one (child, parents) 10 Other condition, including intoxication of the patient, manipulation measures 11 Illness from a special List.

Decoding the codes of the reasons for disability on the sick leave certificate

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

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

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

Deciphering disease codes on a sick leave certificate Each code has its own decoding, and they can and should be entered by the attending physician.

Disability codes on sick leave

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

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

Important! If the reason for the employee’s absence from his place is fully reflected in the first two cells of the sick leave sheet, then the next three do not need to be filled out.

What does code 01 mean on a sick leave certificate?

The date, month and year of his birth.

• Name of the organization (factory) where the patient works (based on the patient’s words). If the patient works for an individual entrepreneur or is one himself, then F is indicated in this column.

  Acting employer.

• Information about where the sick leave was issued: at the place of work or residence.
• Patient Taxpayer Identification Number.
• Reason for disability.
• Date of opening and filling out sick leave.
• The period during which a person was unable to work.
• All kinds of violations of the regime.
• Other information.
• Conditions for calculating cash benefits.

All codes in the document, starting from the first to the penultimate one, are entered by the doctor who opens the sick leave.

Decoding diagnoses on sick leave: what does code 01 mean?

Other codes on the sick leave certificate You can also see encoded information in the following cells on the sick leave certificate:

Sick leave codes and their interpretation

Other features are:

• optimization of the work of the personnel and accounting departments (funds are accrued using two-digit or three-digit codes for periods of absence from work);
• saving space on the form (some names of diseases are too long);
• opportunity to work internationally.

All ciphers are developed in accordance with international standards. If a person was undergoing treatment abroad, the code for the cause of disability will be the same for countries participating in international cooperation.
This significantly simplifies the work of medical institutions, as well as the HR department in the organization. Decoding the codes Each disability code corresponds to a specific reason.
It is by these two-digit codes that accountants and the HR department recognize exactly how the employee’s sick leave should be paid, and in what amount.

How to pay for two sick days if the first one is closed and the second one is its continuation

This means that employers who pay their employees at the minimum wage must raise their wages from May 1.< … Неявка на работу – не всегда прогул Работник заболел, но не предупредил об этом работодателя и не выходит на связь.

You cannot use a corrector or cover up incorrectly written codes. If a medical institution employee makes a mistake, he will have to issue a duplicate certificate of incapacity for work.