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If an employee is injured at work and it brings the employee to the hospital, then the employer is obliged to pay him sick leave.
The definition of work injury is specified in Art. 227 Labor Code of the Russian Federation and in Art. 3 Federal Law dated July 24, 1998 No. 125-FZ “On compulsory social insurance against accidents at work and occupational diseases". This is an injury that an employee received while performing his work functions.
Not every injury can be considered a work-related injury. This category includes:

• bodily injury, including from electric shock;
• overheating or cooling, including heat stroke and frostbite;
• bites of various insects and animals;
• other injuries that are listed in clause 3 art. 227 Labor Code of the Russian Federation.

The injury must have occurred in work time or during a regulated break, as well as while traveling to or from work, if the employee was traveling in the employer’s transport. If he uses his own transport for work, this must be specified in the employment contract.
If an employee is injured during a regulated lunch break, then it will be considered work-related. And an injury during a smoke break most likely will not be considered work-related, unless such breaks are stipulated in the collective agreement.

To pay for sick leave, the employee must have in his hands the sick leave and a certificate stating that this injury recognized as production. Such an act constitutes special commission, which is created to investigate the accident.
The employer is obliged to assign sick leave benefits to the injured employee within 10 days after receiving this document from the employee. And he must make payments for a work injury in 2018 on the next payment days wages.

How is sick leave paid for a work injury? It is paid in accordance with the same standards as if the sick leave was not related to the injury at work. This is stated in paragraph 1 of Art. 15, paragraph 2, art. 1, as well as in Art. 12, 13 and 15 of Law No. 225-FZ.
Sick leave payments for work-related injuries are calculated based on average earnings this employee for the last year. In order to calculate this earnings, it is necessary to add up the entire “labor” income of the employee (that is, all payments that are related to his work duties), with the exception of vacation pay and sick leave, and divide it by the number of days that the employee actually worked. Days of vacation, temporary disability, and absence from work for other reasons are not taken into account. Thus it is calculated average earnings employee per day.
The resulting average earnings must be multiplied by the number of days the employee spent on sick leave. This will be the average income.
The employer is obliged to pay sick leave for an industrial injury in the amount of 100% of the employee’s earnings, regardless of his length of service. If the employee has worked so little that it is not enough to calculate the average daily earnings, then it is necessary to take the salary according to the staffing table.

In addition to sick leave, the employer must also pay for the employee’s rehabilitation, as well as his expenses for purchasing medications.
To determine the severity of harm to the employee’s health, a medical and social examination is collected. The damage is determined as a percentage, according to which the employer will have to reimburse the employee for treatment expenses.

If it is proven that the injury was caused by the employee, this greatly reduces his chances of receiving benefits.

An injury is any injury that results in a person being temporarily disabled. Examples: fractures or bruises of the limbs, sprains, burns, frostbite. If unpleasant situation happened not at work, then she admits domestic injuries. As with other diseases, the doctor must formalize and issue sick leave to the victim. We explain how sick leave is paid if the injury is domestic.

Procedure

If, in the event of a work-related injury, the employer must carry out whole line mandatory procedures(investigation of the situation, drawing up an appropriate act), then in case of a domestic injury, the employer’s actions are limited only to paying sick leave. The benefit must be assigned within 10 days after the employee presents a certificate of incapacity for work. Sick leave is usually paid on the days when salaries are paid.

Calculation of the amount

The FSS Letter No. 02-18/07-1243 states that the amount of payment by employers for sick leave is determined based on the following factors:

• average employee salary;
• the employee's length of service at this enterprise;
• number of days on sick leave.

If a person has been working for an employer for more than a year, then first you need to calculate the amount that this employee earned during the year. This is not only a net salary, but also compensation, bonuses, and travel allowances. But past sick leave and vacation are not taken into account.
The resulting amount is then divided by the number of working days. Exactly workers, the calculation does not take into account days when the employee was absent for any reason. So, dividing these two indicators, we get the average earnings per day. Payment of sick leave for injury depends on it.
Attention! Above we gave an example for those who work at one enterprise for more than a year. If this period is shorter, then there are two options. The first is to calculate the average earnings for the current period of work of this employee. The second option is to ask the employee for a certificate of income from the previous enterprise in order to take these indicators into account.
So, in any case, the amount will be calculated as the number of days spent on treatment multiplied by the average daily salary. The following rules apply:

1. if a person worked for this place more than 8 years, he will receive the entire amount;
2. with an experience of 5 to 8 years, sick leave for a domestic injury is equal to 80% of the mentioned amount;
3. those who have worked for 3-5 years will receive 60%;
4. 1 to 3 years of experience at one enterprise gives the right to receive 50%;
5. newcomers who have worked for less than one year will receive 30% of the amount average salary.

You received domestic injury? The doctor will prescribe special document- sick leave. With this he will document the current disability. A similar official document is issued in case of injury to a household or of a production nature. Simply put a special code in the reason line.

How is sick leave paid for a domestic injury?

At industrial employer must conduct an investigation and then draw up current act and fully reimburse all treatment costs. In this case, the employer must pay only sick leave. Treatment is carried out independently.

Procedure for paying sick leave for a domestic injury

Do you want to calculate sick leave pay for a domestic injury? Calculate the average earnings per day of an employee. Has his experience been more than two years? For the calculation, income for this particular time is taken. Less experience? Calculate based on actual wages.

The total amount of profit is calculated based on the number of days worked. Vacation, illness and absenteeism at your own expense are not taken into account in the formula.

Then you need to divide total income by the number of days worked. The result is the employee's average earnings for one day. After this, we multiply by the appropriate coefficient, taking into account the employee’s insurance experience:

• From 6 to 12 months - multiplied by 30 percent;
• From one to five years - 50 percent;
• From five to eight years - 80 percent;
• More than 8 years - 100 percent.

Features of sick leave payment for a domestic injury

A company employee can provide a certificate of income with previous place work. In this case, past experience will be taken into account. Work for more than eight years to receive 100% sick pay. If the total length of service is lower, receive the cost according to the current coefficient.

How to apply for sick leave for a domestic injury?

As mentioned above, the amount of payment for such a sheet directly depends on the number of days worked by the employee. The legislation does not establish a specific procedure regarding payments and temporary disability due to various injuries. Other causes may be found. Payment is made in the same way as in cases of illness. Does the company use a standard taxation system? Then the insurance company is obliged to pay for the insured event.

List of documents

You don't know what documents are needed to pay for domestic personal injury paperwork? Provide the following:

• Application to be filled out general director organizations according to Form 4 FSS Russian Federation;
• Transfer specific amount Money for payment social tax in the moment official document disability;
• Copies of documents that must be certified by relevant people. This includes sheets as well as medical certificates.

Sample letter of explanation for sick leave for a domestic injury

Explanatory FSS - important legal document. It indicates the wage benefit. This document must contain the following information:

• Last name, first name, patronymic, as well as position of the applicant;
• Full name of the organization's accountant;
• Clear idea of ​​receipt bodily harm, place and time;
• Name medical institution and the names of the doctors who provided first aid and issued the sheet;
• Date of signature and note.

The employer will receive 10 calendar days to accept the sheet. Payment must be made on the nearest payment day after the assignment of this benefit.

However, initially consider part-time total amount income from various jobs. The benefit, as is correct, should be accrued from the place of work where you are currently located. He must bring a certificate of income to the organization or enterprise. Must have worked for at least two years.

It is not always obvious whether and how to properly issue a sick leave certificate for a domestic injury, because it did not occur at the workplace, and it has nothing to do with traditional colds. Which doctor to contact, how to register everything according to the law to the personnel service of the enterprise is not always immediately clear. We will talk about this today.

Definition and rules of law

Labor legislation does not divide injuries into industrial and domestic. To be completely precise, there are two types of injuries: those received as a result of an unfortunate accident at work associated with the performance of labor responsibilities, and other injuries. It is the latter that are considered to be household ones. Relatively precise definition can be found in specialized collections by-laws on labor protection: an injury received outside of production is regarded as domestic - more about the system of labor safety standards, labor protection in gas industry. Basic terms and definitions.

On this moment What is of fundamental importance is not the place of injury, but the cause-and-effect relationship with the circumstances of its receipt. If the injury occurred during work on the territory of the enterprise or outside it, but on behalf of the employer, then the injury will be considered industrial, an investigation will be conducted and payment will be made in accordance with the legislation on social insurance against accidents of the employer, 125-FZ.

The procedure for paying for injuries assessed by the results of the investigation as not related to the performance of work duties or received at home is set out in the Labor Code of the Russian Federation, as well as in the law on insurance in the event of temporary disability, No. 255-FZ.

Will a domestic injury be paid on sick leave?

Before the start date of the modern Labor Code it was important for the insured person whether he would write medical worker on the certificate of incapacity for work, that the injury was of a domestic nature. Then the worker would not receive benefits for the first five days. It is clear that for some workers the question of how a domestic injury is paid for on sick leave causes unpleasant associations with the prospect of losing money. In addition, the previous Labor Code of the Russian Federation gave the employer the right to dismiss an employee who received a domestic, rather than industrial, injury, the treatment of which required more than 4 months without a single return to work. The new Labor Code has excluded this article; now the duration of restoration of working capacity is determined by the doctor or medical commission, and the employer cannot have any adverse effect on the employee.

The current version of the legislation on compulsory social insurance and payment of benefits has eliminated the rule on missing payments for the first days after injury and obliges the employer to calculate average earnings from the date of the onset of the period of incapacity. The first three days after injury are at the expense of the enterprise, the remaining days are at the expense of the Social Insurance Fund (Article 3 255-FZ).

It’s also nice that sick leave opened during the next 30 days after the date of dismissal is also subject to payment, although not in the desired amount. According to Article 13 of the Labor Code of the Russian Federation, in case of illness or injury former employee his previous employer must still accrue benefits for the entire period of disability that occurred within a month after leaving the company, regardless of the reasons and the party initiating the termination of the contract. Law 255-FZ gives the right to present a sick leave even after six months, as long as the date of its opening falls within a 30-day period. Only the new employment of a former employee relieves the policyholder from such obligation.

Due date

After receiving the original certificate of incapacity for work or its installed copy, in case of injury to a part-time worker, the employer must accrue and issue financial allowance within the time limits specified by law. According to Article 15 255-FZ, the HR and accounting department of the employer has a 10-day period for filling out reverse side received document and calculation of benefits. The enterprise is obliged to pay all funds due to the sick employee on the next date of payment of wages at the enterprise. On practice, maximum term will not exceed 26 calendar days, since, according to Article 136 of the Labor Code of the Russian Federation, the issuance of the due employees wages must be carried out at least once every half a month, in other words, the break cannot exceed 16 days.

What does the payment amount depend on?

Article 7 255-FZ tells in detail how sick leave is calculated for a domestic injury and what amount of benefits the victim will ultimately receive.

The amount of benefits for a domestic injury mainly depends on the number of years insurance period injured person:

• got a job not so long ago, but worked for Lately less than six months, the employee cannot expect to be paid more than the minimum wage prevailing in his region on the date of injury;
• a person who has worked for more than 6 months, but less than 5 years, will be paid only 60% of the average earnings for the previous two years;
• those who have worked for more than 5 years, but less than 8, will receive 80% of the average salary;
• 100% will be received by persons officially employed for more than 8 years.

Unfortunately, length of service will not matter if the former employee suffered a domestic injury after being fired. No matter how long he works throughout his life, the benefit amount will be only 60% of the average salary. But if he was injured while still employed, and provided a document about this 6 months later, then the payment will be calculated in full, the amount will depend on the length of service and the amount of income.

What can reduce sick leave payments?

In addition to length of service, the final amount of benefits may also be affected by the circumstances that arise during a domestic injury, and the presence of notes about violation of the regime or state of intoxication while on sick leave. About how sick leave is paid for a domestic injury, which has special doctor’s notes on front side document on incapacity for work, says Article 8 255-FZ.

So, if an employee, while in a hospital or on outpatient treatment, neglected the regime or did not show up for an appointment prescribed by the treating doctor, then the employer is obliged to significantly reduce the amount of benefits to the minimum wage from the date the violation began. But if the cause of a domestic injury was intoxication, no matter what type, then the payment will not exceed the minimum wage from the first day. The presence of special doctor’s notes on sick leave will force the employer to demand from the victim written explanation their behavior, assess the degree of validity of the reasons and events that led to the violation of the regime. It is safer to record a decision to reduce the amount of benefits in an order, having familiarized the employee with its contents.

The employer's right to a reduction arises already when the certificate of incapacity for work is marked with the code of a domestic injury (02), and in the period about the facts of violation of the regime, code 24 is indicated or in the “Other” field there is 34. If there is a conclusion that the employee was injured in a state of alcoholic or toxic intoxication (domestic injury code - 021), then you need to prove a direct connection between these events. This will require an explanatory statement from the victim; without it, the employee will be able to challenge the accrual amount in court and accuse management of non-payment of wages.

A situation may arise where the injury was not the result of drunkenness, it was simply an accompanying circumstance. Alternatively, the person received a traumatic brain injury from a heavy object falling on his head from the roof of a building, past which he was returning home, being slightly drunk. Since the illness would have occurred regardless of the fact of drinking alcohol, the benefit should be accrued at in full. But if he drunkenly climbed onto this roof and fell, then the connection will be direct, and there is reason to assume that he will be paid sick leave according to the average salary, negligent employee simply no.

How to calculate reduced benefits?

The calculation of the reduced benefit is made in proportion to the number of days of sick leave, based on the fact that the minimum wage is calculated for the entire month. This means that the accrued amount for each full month diseases, from first to last number, will be equal to the minimum wage plus regional coefficient. If the injury was not severe and the employee was ill for only a few days, then the minimum wage on the day the injury occurred at home must be multiplied by 24 months and divided by 730/731 calendar days, and then multiplied by the number of calendar days of illness or period of violation. However, the benefit calculated in proportion to the minimum wage may be greater than that calculated on the basis of data on average earnings and length of service, in which case the latter amount will be payable.

Payment order

How sick leave is paid at an enterprise and how benefits are practically calculated is described by the Regulation on the procedure for calculating benefits No. 375.

Everything is quite simple if the injured employee has worked at the company for several years without breaks. Then the calculation will not require additional effort: the sum of all salary income (even in in kind) for the 24 months preceding the year of illness (in 2019 this is 2017 and 2018) must be compared with maximum limit income for social insurance and, if there is no excess, divide the amount by 730 (731 if it is a leap year). This is how the average daily rate is determined; it must be multiplied by the number of calendar days of incapacity to work, and you will get the amount of the benefit before it is subject to income tax.

If the employee started working less than two years ago, then for the calculation you will need a certificate of income from the previous place, fortunately, now they are required to give it to everyone on the day of dismissal. It happens that it is still not there, then you will have to request the data in Pension Fund. But to do this, the employee must write a corresponding statement as consent to the provision of personal data.

In a situation where the injured worker had no earnings for several months of the billing period or his income was below the minimum wage on the day of the domestic injury, the accountant will calculate the average daily rate based on minimum wage. If the calculation period for sick leave includes child care leave, then, according to the employee, you can change the calculation period and take another 24 months.

The resulting amount is multiplied by the coefficient of dependence of the benefit on the insurance period. After this, they determine the amount of the benefit that will be paid at the expense of the enterprise and the balance that will be repaid at the expense of the Social Insurance Fund.

Required documents

List of original documents, without which payment of sick leave for an injured person, issued on permanent basis for one policyholder, will not happen, is small:

1. Original sick leave certificate.
2. Application for changing the billing period, if necessary.

Additional documents will be required if the sick employee combines several jobs:

1. The original certificate of incapacity for work, issued specifically for each current policyholder, if the employee has chosen the payment system at all places of current employment.
2. A copy of the sick leave, if the employee does not apply for part-time benefits, but is still obliged to confirm the validity of the reasons for his absence.
3. Certificates from other places of employment about salaries for the previous 2 years, if a decision has been made to receive benefits from the main employer.

If an employee who has already resigned received a domestic injury, and the date of the accident fell within a 30-day period, then along with the original sick leave same place work must also be provided work book, the absence of admission records in it new job will confirm the sick person’s right to receive benefits.

Where should an employee go?

Where should an employee go to apply for sick leave in case of a domestic injury?

In the hospital

To obtain a certificate of incapacity for work, the employee contacts his attending physician. Moreover, if a person is employed by several employers and intends to receive benefits from each of them, then this must be reported to the hospital in advance. In this case, the patient is issued several sick leaves, with a mark of the main place and part-time places, according to the number of employers.

At the enterprise

After restoration of working capacity, the employee should contact personnel service of your enterprise. Article 12 255-FZ allows that the insured person can present documents confirming the period of illness within 6 months. But it is unlikely that the employer will wait that long for an explanation for absence from work. This deferment is most likely suitable for those who have already been laid off, as well as for those who fell ill on annual leave or have been ill for a long time. different types illnesses, without going to work.

In any case, the person responsible for personnel records management is obliged to accept the certificate of incapacity for work without any objections. To be on the safe side, you can submit the document along with cover letter and ask to sign the acceptance and surname or register as incoming correspondence through the office. If a conflict does arise when accepting documents, then nothing prevents the employee from sending the original sick leave by mail with an inventory of what was included in the shipment.

Grounds for refusal to accept sick leave It can only be filled in incorrectly or incompletely. But even then, they do not have the right to refuse to accrue benefits to the employee; they can only demand that adjustments be made to the document or a duplicate be issued. The procedure for filling out and methods for correcting errors are described in Section IX of Order No. 624n.

In a situation where an employee has billing period there was a change of employer, or maybe there are other reasons to make additions or clarity, it is better to also contact the accounting department. Salary certificates and other documents are provided here.

What should an employer do?

Having received from the insured person all the documents necessary for calculating sickness benefits, the employer must due calculations, as well as determine the amount that can be reimbursed to him by reducing contributions paid for the needs of social insurance for disability.

The amount of benefits issued to an employee may be small, and then it is reimbursed by reducing the amount of contributions paid by the amount of the payment issued during the year. The accountant must then reflect such actions in the 4-FSS report.

The amount of the benefit may exceed the amount annual fees when a domestic injury entails a long period of recovery and rehabilitation. Then you will need to contact the fund authorities with a request to transfer the funds paid to the victim to the account of the enterprise, Article 4.6 255-FZ. First of all, an application is submitted in the form approved in the letter of the Social Insurance Fund dated December 7, 2016 N 02-09-11/04-03-27029. It is accompanied by a calculation indicating the total amount requested and a breakdown of what payments these funds will be used for.

Since contributions are transferred to monetary equivalent, and the amounts of compensation from the Fund also go to the company’s current accounts in the form of non-cash funds, then simple logic suggests that it will not be possible to pay benefits in kind. From the point of view of tax authorities, such a transaction can be regarded as a commodity-money exchange and will be subject to additional income tax.

How can an accountant avoid unnecessary problems?

The Fund's supervisory authorities can immediately approve the application for reimbursement and transfer the money, or they can order a verification of the correctness of the calculations made. Such cases are by no means rare, and the accountant needs to minimize all risks. For security purposes, accounting or personnel officers check not only the completeness and correctness of filling out documents. The employer has the right to verify the authenticity of the issued sick leave if the circumstances of the domestic injury or the duration of treatment raise doubts. The verification can take place in several stages:

1. Visual control of signs of the form’s authenticity, since certificates of incapacity for work are subject to strict recording, they also have appropriate protection (watermarks, multi-colored microfibers, a special texture of yellowish paper).
2. You can use online service on the FSS website and look to see if the issued form is listed among the canceled ones.
3. A simple check of the data entered into the document (name and OKPO of the hospital, names of doctors or other “inaccuracies” in filling).
4. A letter to the medical institution with a request to confirm the fact of issue.
5. Contact the FSS with a request to check the sheet if the employer still has doubts.

All these actions will take time, but will save the policyholder from troubles during the audit. After all, if the fake sick leave is paid for at the expense of the Social Insurance Fund, then fines cannot be avoided, and if the employee has already been fired by the time of the inspection, then it will be extremely difficult to return the money he received illegally.

It is worth recalling that since 2017, the Federal Tax Service has taken over the functions of control over the work of all social insurance funds, so spend time and effort on additional checks still more expedient than waiting for the inspector to arrive.

When can payments be denied?

Legislation in the field of social insurance quite reliably protects workers who have received a domestic injury or general disease, and there are not many reasons for refusing to receive insurance payments, Article 9 255-FZ:

1. If the injury occurs while you are in free vacation, maternity leave, child care leave or suspension from work due to the fault of the employee. Only days of incapacity for work that occur during annual leave, but only if the disease struck the employee personally, and not the young members of his family
2. Illness during arrest, detention or forensic examination.
3. A domestic injury during a period of downtime, when employees are paid 2/3 of their salary, will also not be paid as temporary disability. But, if an injury incident occurred even the day before the start of downtime, then the benefit will be assigned on a general basis.
4. They will refuse to accrue if it is proven that the injury occurred as a result of self-harm or the commission of a deliberate criminal offense.
5. Sick leave provided later than 6 months from the date of its closure, as well as if the former employee’s certificate of incapacity for work was opened 31 days or more after the date of dismissal, will not be accepted for payment. Even if an employee was late in providing sick leave and payment for it will no longer be received, it is still worth giving it to the employer. Indeed, according to paragraph 5 of Order 624n, such a document will help prove that the employee did not miss work, but was released from work for medical reasons.

Whatever the reason for the refusal to provide benefits, it should be formalized by order. It is better to put under it the documents on the basis of which such a decision was made. These may be certificates or expert opinions, responses from medical institutions, copies of other orders sending an employee on leave or downtime, protocols investigative authorities, explanatory notes from the injured person and testimony of witnesses.

Bar lawyer legal protection. Specializes in handling cases related to labor disputes. Defense in court, preparation of claims and others regulatory documents to regulatory authorities.