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Disability sheet: fill pattern. When is a disability certificate issued and how is it paid?

This article details the list of reasons for which you can get a disability bulletin, highlights the main features of its filling. The categories of medical workers with and without the right to apply for it are indicated. The terms for which a “sick leave” is possible are described, and the rules for calculating the size of the disability benefit are indicated. A sample of a disability sheet with an example of filling in some columns and lines is given.

The list of persons entitled to apply for a disability certificate

disability certificate

Citizens of Russia, stateless persons or citizenship of another country, insured in the system of compulsory social insurance, engaged in labor activities and making contributions to the Social Insurance Fund can receive a sick leave certificate confirming incapacity for work.

The main groups of people who, in accordance with the law, are granted the right to receive a disability certificate and make payments on it include:

  • Citizens working under an employment contract, managers who are the only employees of the organization.
  • Priests and church workers.
  • Persons in prisons sentenced to restriction of liberty and the performance of paid work.
  • State and municipal employees.
  • Members of cooperatives.
  • Individual entrepreneurs, members of law firms and lawyers, persons who do not have individual IP status, other persons who voluntarily conclude a compulsory social insurance agreement and pay contributions to the Pension Fund of the Russian Federation.

Grounds for issuing a document confirming the impossibility of labor

A sick leave certificate shall be issued for the following reasons:

  • for general disease;
  • for a disease resulting from the performance of professional duties;
  • due to injury;
  • quarantine;
  • on caring for a family member (child, spouse, parents and other relatives of the first degree of kinship);
  • maternity;
  • with prosthetics;
  • when passing ITU;
  • when on a spa treatment.

Persons entitled to issue a disability bulletin

Issuance of certificates of incapacity for work is carried out by persons empowered by the legislation of the Russian Federation with the right to issue documents confirming temporary disability. These include:

  • doctors of medical organizations with a license to conduct medical activities;
  • paramedics and medical workers with secondary specialized education, who are employees of licensed medical organizations;
  • private practitioners, with a permit (license) for medical activities;
  • Doctors of sanatorium-resort institutions with the indicated license.

Persons not entitled to a disability certificate

These include:

  • doctors of NSR and blood transfusion stations;
  • employees of reception departments of medical organizations;
  • doctors of water and mud baths;
  • other persons specified by law.

sick leave certificate

Grounds for refusing to provide a disability certificate

Not in all cases the insured person may receive a temporary disability certificate. The grounds on which a representative of a medical organization has the right to refuse to issue this document:

  • lack of signs confirming the impossibility of carrying out activities (the so-called request to issue a “sick leave” to a healthy person without any reason);
  • issuance of sick leave by a different number (i.e., paperwork by the number preceding the citizen's request for medical care);
  • when passing medical commissions, examinations and other examinations in the areas of military commissariats;
  • persons in custody or in custody;
  • students (if they do not carry out paid labor activity);
  • patients with chronic diseases in remission.

Features of the issuance of sick leave due to the occurrence of a disease, injury or poisoning

Disability certificate for a citizen on outpatient treatment issued no more than 15 days. If it is necessary to extend this period, the decision is made by a special commission of the medical institution providing treatment or rehabilitation of the patient. The paramedic or dentist can issue this document for up to 10 days.

temporary disability certificate

Also, in the case of a favorable prognosis for the person to fulfill his professional duties, the medical commission is issued a “sick leave” for a period of up to ten months, and in some cases up to twelve months with the possibility of extension every twelve days.

If a person is sent from one medical institution to another, a sheet of temporary disability is opened by the date of receipt of the person at the sent institution.

If incapacity for work has arisen during the holiday period, “sick leave” begins on the day the holiday ends, if further treatment or rehabilitation is necessary.

Making a "sick" during pregnancy and childbirth

Persons entitled to issue the indicated disability certificate include:

 disability sheet filling

  • obstetrician-gynecologists;
  • family doctors (general practitioners);
  • paramedics

This "hospital" is issued for:

  • 140 days during pregnancy with one child, drawn up and given on hand with a gestational age of 30 weeks;
  • 194 days with multiple pregnancy (2 or more fetuses). Issued on hand with a gestation period not earlier than 28 weeks;
  • 154 days at delivery from the 22nd to the 30th week of pregnancy.

In some cases, a pregnancy disability sheet can be extended by:

  • 54 days, in the event of the establishment of a multiple pregnancy directly during childbirth;
  • 16 days in case of complications during childbirth.

During abortion (termination of pregnancy), “sick leave” is issued for the entire time of disability, but cannot be less than three calendar days.

In the case of adoption by a woman of an infant (up to three months of age), she is entitled to a sick leave from the date of adoption for up to 70 days (if one child is adopted) and 110 (two or more) from the date of birth of the child.

It should be noted that “sick leave” is issued to both working and unemployed women. The only condition for representing a sick leave in this case is registration with the employment authorities as unemployed. In other cases, a pregnant woman will not be able to get a “sick leave”.

Disability sick leave when sent to ITU, quarantine and prosthetics

In case of persistent disabilities, a citizen can be sent to the ITU upon expiration from the moment of the onset of disability:

  • 4 months in the event of an unfavorable prognosis of further treatment and, accordingly, the implementation of labor activity;
  • 10 months with a favorable prognosis.

If a person is recognized as disabled, the bulletin issuing temporary disability ends on the day preceding the date of submission of documents to ITU (recall that the date of disability commencement is the date of submission of documents to ITU).

With quarantine, a disability sheet covers the entire quarantine period.

With prosthetics, a "sick leave" is issued for the duration of the prosthetics work and travel to the place of treatment.

All the terms for which sick leave is issued are calendar.

Disability certificate

disability sheet fill pattern

To order filling out sick leave The legislation imposes a number of special requirements, the violation of which may entail the invalidity of this document. Thus, a certificate of incapacity for work can be filled out either in print or in manuscript. Filling the disability sheet with a handwritten method involves the use of black ink only in a gel or fountain pen. Using a ballpoint pen when filling out this document is not permitted.

Going beyond the cells is also prohibited. An exception is allowed for the press of the organization, but it should not occupy the main fields of the information form. Letters must be Russian, printed, capital.

Any corrections, typos and errors in the document are not allowed. If they have a place to be, it is necessary to make a duplicate of the document. Also, a duplicate is drawn up in case of loss of the disability bulletin. In case of loss, a citizen must come to the organization, where he was issued with a lost sick leave with a statement on the issuance of a new one, as well as with a certificate of absence of this document from the employer.

Filling out a disability sheet, in particular its column and cells, must also meet the requirements established by legislative acts in the field of healthcare. Indeed, in the event of an error, the relevant authority may refuse to issue benefits for the submitted sick leave. And you will have to draw up a duplicate of the document, which will require additional time, as well as strength and nerves.

Features of filling in the graph and cells of the disability sheet

A disability certificate, the sample of which is briefly reviewed in this article, is drawn up by the doctor of the organization that provides medical services and provides appropriate assistance, and the employee of the employer. Each side fills in its part of the form.

We will not dwell on each line of the sick-list in detail; we will only cover those whose filling may cause certain difficulties.

In the columns in which it is necessary to indicate the place of work and the name of the institution providing medical care, the full name of the organization's data should be reflected. The use of the abbreviated name is allowed, however, it should be spelled out in the constituent documents of the organization. If the employer is an individual entrepreneur, the abbreviation IP is indicated in this column.

Disability sheet sample

In the line “Last name, initials of the doctor”, the surname and initials of the medical worker are displayed, respectively, without separation by punctuation marks. The gap between the surname and the initials should be one cell.

Folding, and even more so wrinkling, a disability sheet should not be. In this case, problems may arise with the delivery of this document to the employer.

The columns “Get started” and “Start date” are not identical. The first column is filled in by the attending physician, it indicates the date from which the patient should begin work. The column “Date of commencement of work” is filled in only if the employee was dismissed from work.

Making a "sick leave" is allowed for the main job and part-time work. The type of work must be indicated in the appropriate columns.

On the part of the employer, the document is certified by the chief accountant and general director (in case of work in the organization).

Particular attention should be paid to such an innovation as disability codes on the sick leave. Now the disease is not prescribed in the "sick leave", but only the code of the reason for the occurrence of temporary disability is indicated.Also, a medical institution may use a seal without specifying an organization profile. This applies to organizations of a psychiatric and narcological profile, centers for the prevention and treatment of HIV infections, AIDS, etc.

Disability periods paid on sick leave

The size of disability benefit payments varies depending on the cause of the disability.

Disability benefits, the basis of which is a general illness, occupational disease or injury, are paid to the patient for the entire time during which he was incapable of work, until recovery or until he is recognized as disabled.

If, by the conclusion of ITU, a citizen is recognized as disabled, the benefit is paid to him for incapacity for work for four or five months in a row in a year.

disability certificate

A disability certificate for caring for a child up to seven years of age is given for the entire time of the illness and appropriate treatment, but in a period not exceeding 2 months.

When caring for a child aged from seven to fifteen years, "sick leave" is issued for a period of not more than one and a half months in total for all episodes of the disease or for 15 days for one episode of the disease.

In the case of being on sick leave to care for a minor child with a disability, the deadline for submitting a disability certificate is up to 120 days.

For the care of other close relatives (spouse, parents and other relatives of the first degree of kinship), the maximum term for providing sick leave is seven days for one episode of the disease and not more than 30 days in general for all episodes of the disease.

Disability benefits in case of quarantine, as well as prosthetics are issued for the entire period of quarantine and dental prosthetics.

The payment of cash benefits during pregnancy and childbirth is carried out for the entire maternity leave.

Temporary incapacity for work, the sick leave of which is executed in accordance with the requirements of the relevant regulatory acts, is subject to payment in the amount established by law.

Payments on temporary disability certificates

Depending on the type of incapacity for work, the amount of the sick leave payment is calculated.

The amount of disability benefits resulting from illness, trauma, prosthetics, quarantine and sanatorium-type institutions is calculated on the basis of the employee's total length of service:

  • If the total length of service exceeds eight years, the size of the payment will be calculated on the basis of full average earnings.
  • With the experience of continuous work from five to eight years - in the amount of 80% of earnings.
  • With an experience of six months to five years - 60% of earnings.

When calculating a person’s earnings, all payments made for a period equal to two years preceding the onset of temporary incapacity for work, deductions from which went to the Social Insurance Fund, are taken into account.

Further, the sum of all payments for the above two years is divided by 730 (coefficient established by the Federal Law No. 255-FZ of December 26, 2006).

The payment of a disability certificate for caring for a child being treated in a hospital for the first 10 days of treatment is carried out at an interest rate calculated from the total length of service, further - at a rate of 50% of earnings.

If there is a work experience of not more than 6 months, the calculation of the disability sheet is based on the minimum wage for one month.

In some cases, the established amount of benefits may be reduced, or even canceled. Consider the main reasons that may lead to a reduction or cancellation of disability benefits.

sick leave codes

Grounds for reducing and refusing to pay disability benefits

Among the reasons that entail a reduction in the amount of temporary disability benefits include:

  • Violation of the instructions of the attending physician, as well as the regimen prescribed by him.
  • Late or missed turnout for examination by the medical commission to confirm incapacity for work and during the examination of ITU.
  • Disease or injury caused by the use of alcoholic, narcotic and other psychotropic substances.

The grounds for a complete refusal to pay benefits are the onset of incapacity for work when committing suicide, other violent actions aimed at causing harm to one's own body, as well as when committing a crime.

It should be specially noted that in the case of submitting a false sick leave, it is possible to bring the person who submitted such a document to criminal liability.

We hope that the sample of the certificate of incapacity for work given by us, the procedure and particularities of filling it out, as well as the reasons for the appointment, the time and amount of payment will help you in case of questions related to the preparation of a document confirming the fact of short-term incapacity for work.


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