Disability Allowance. The amount of temporary disability benefits

Temporary disability allowance very often allows Russian families to keep their financial condition afloat, especially if the situation is such that one or more family members are unable, for certain circumstances, to support their family. This is a very delicate issue in Russian law, the solution of which depends on the correct combination of many factors and nuances.

Who is eligible for disability benefits?

In our country, the following categories of citizens have the right to receive financial support for temporary disability:

• Former military personnel who left the location of the armed forces of the Russian Federation upon the onset of a disability, but provided that their appeal for benefits will be no later than 30 calendar days from the date of dismissal.

• Russian citizens, citizens of foreign states, citizens with dual citizenship and stateless persons (stateless persons) who officially work at enterprises, organizations and commercial structures of Russia; however, the form of ownership is not important, the enterprise can be both public and private.

• Those citizens who officially have the status of unemployed and are registered with regional, federal and local employment agencies.

• Those citizens who have received limited working capacity no later than 30 days from the date of dismissal from a permanent job for good reason.

Who regulates the rights of working citizens to benefits

Virtually all working citizens of our country are entitled to temporary disability benefits. The FSS regulates this with the help of regulatory documents.

The structure of Russian social protection is structured in such a way that benefits are the main tool for supporting socially unprotected categories of citizens. The most common financial support tool is temporary disability benefits. A definition of this phenomenon can be found in the legislative framework.

A special place in the hierarchy of social protection of the population is occupied by benefits for temporary disability. It is worth noting that very often financial assistance from the state for disability is identified with disability benefits. This is not entirely true, since temporary disability benefits are granted only in cases where the process of ill health implies a reversible nature.

That is, if a citizen is seriously ill, and as a result of his illness, his ability to work completely or partially decreased, then he can count on financial support from social protection authorities, but provided that the disease can be completely cured.

Types of material disability benefits

The types of temporary disability benefits directly depend on the definition of insured events. To obtain temporary disability benefits at the legislative level, the following insured events are determined:

1. General improvement of the body in resorts and sanatoriums.

Benefits for this insured event are provided on the condition that the leave is not enough to visit the sanatorium in order to improve overall health. Periodically, such situations arise when the employee has already used vacation, but over time he needed treatment.Then the voucher notes the period that the employee was on treatment. It is worth noting that for unused, according to the package, benefits days are not accrued.

2. Quarantine.

Temporary disability benefits for this type of insurance are accrued in the event that the sanitary authorities exclude the employee from fulfilling his labor obligations, if someone from his family gets an infectious disease. The incubation period of time and sick leave are determined by epidemiologists.

3. Diseases or injuries resulting in disability.

When calculating benefits for this type of insured event, differentiated rules apply that depend on the type: personal injury, work injury, general illness or occupational disease. At the same time, in case of labor injury or with an occupational disease, the allowance is accrued from the moment of the onset of the disease until the restoration of working activity, or the establishment of disability otherwise. The state guarantees the accrual of temporary disability benefits as soon as possible.

Situations in which disability manifests itself on vacation are allowed. In such cases, the employee needs to receive a sick leave, and his leave will be extended by the total number of days of disability. If a person was on vacation without saving his salary, or if he continued to be ill at the time of going to work, then the accrual and subsequent payment of disability benefits occurs from the moment he had to begin to implement the terms of his employment contract.

If this case coincides with the period of idle production capacity, then the size of the benefit corresponds to the full wage, thus, the company will repay part of the benefit for its money. If the employee’s disability continues after the resumption of production activities, then he, on the basis of general rules and accrual principles, will receive temporary disability benefits. An example of this is manifested in occupational diseases at enterprises of an increased hazard class (chemical, radiation, etc.).

Benefits for involuntary abortion are accrued only for the first 3 days of disability, and starting from the 4th day of this period, payment of financial assistance will continue only if the operation was forcedly performed according to medical indications or as a result of a miscarriage. If the disability continues, then the payment of benefits resumes from the 11th day. The accounting for temporary disability benefits in this case is determined by the Social Insurance Fund.

For certain categories of citizens, the Russian legislative framework establishes a limited period for providing disability benefits. For example, temporary and seasonal workers can receive disability benefits for a period of 75 calendar days, but provided that this period is not interrupted without good reason.

Disabled workers (in particular WWII invalids and those injured as a result of the explosion at the Chernobyl nuclear power plant) have the full right to receive a certain amount of benefits, but not more than 4 consecutive months. Such restrictions are not introduced if a work injury or occupational disease is established as the cause of disability. Previously, such a restriction also existed for persons without official work in the amount of 30 calendar days, but as of today this restriction has been lifted.

4. Transfer to another place of work due to occupational disease or tuberculosis.

The legislation allows such situations in which a sick worker is incapable of professional activity, but can perform other duties.In such cases, he can be transferred to another place of work, if the level of salary is lower, he will receive benefits. The company has a so-called surcharge sheet, according to which salary will be paid.

The allowance is calculated on a common basis, but at the same time, its totality with a new salary should not exceed earnings from previous work. It is worth noting that for different occupational diseases there are different rules for calculating this allowance. This can be found out in more detail in the Law on Compulsory Insurance from the National Assembly for Production and Occupational Diseases.

5. Financial payments for caring for a family member who, due to illness, has lost the ability to serve himself.

If an employee has a sick child who requires care, then one of the parents has the right to stay in the hospital for the entire period of treatment. In this example, he will receive a sick leave certificate.

If other family members require care, then the following conditions must be met in order to receive benefits:

• there are no other relatives in the family who are able to provide care;
• lack of care is a danger to the general health and life of the patient;
• if the patient cannot be hospitalized.

6. Prosthetics.

The temporary disability benefit for this insured event is paid only in the situation when the prosthetics process is carried out in an inpatient setting. This allowance is paid for the entire period of time that a person spent in a hospital.

A package of documents that confirms the onset of temporary disability and the amount of benefits

The main reason for receiving partial disability benefits is a temporary disability certificate or a similar certificate of the established form, which is issued in some cases.

A sheet of temporary disability is issued to all working citizens, unemployed who have been registered with the employment authorities, persons whose loss of working ability has occurred within a period of not more than 30 days from the date of dismissal from their previous work for valid reasons, as well as to former military personnel who were dismissed in stock within 30 calendar days from the termination of employment.

Sheets of temporary disability are issued by doctors of medical institutions of any form of ownership, in particular state, private and municipal. However, a license is required for an expert assessment of disability. Those medical specialists who practice private practice may acquire the right to issue sick leave after further training.

How to get sick leave

To obtain a sick leave, you must present a document that identifies you (passport, military ID). According to general rules, the attending physician can issue the sick leave in person if the disability lasts up to 30 days, and he has the right to issue the sick leave for no more than 10 days.

In fact, during the first full calendar month, the doctor will issue 3 sick leave. If disability lasts more than 30 days, then the issue of temporary disability is decided by an expert commission on the basis of a medical institution. The procedure for issuing sheets must comply with the canons of the legislation of the Russian Federation, and for its violation, doctors may be subject to both disciplinary and criminal liability. Actually, everything is decided by the law. The temporary disability allowance must be lawfully motivated, otherwise the doctor may lose the license.

Accrual of material assistance in the USSR

For a long time, the size of sick leave benefits and the procedure for their issuance was calculated on the basis of rules approved by the USSR Council of Ministers. In accordance with this set of rules, the amount of benefits was determined based on continuous work experience activities.In a resolution of April 13, 1973, the Rules for accruing continuous work experience for the purpose of state insurance benefits stipulate that continuous work experience is the duration of the last continuous work in a particular enterprise subject to all conditions established by law.

Such a definition contradicts the Constitution of the Russian Federation, which gives its citizens the right to use and use their labor in a free manner. Therefore, the calculation of benefits for temporary disability in some cases may occur without taking into account the total length of service, but in those cases stipulated by law.

Frequency of termination of employment in accordance with Soviet legal standards

However, the interruption of work was recorded in documentary form, taking into account the frequency. To date, there are the following clear types of periods that can interrupt general labor activity:

• Periods of time that do not count towards seniority, however, do not violate it. An example is the training in higher educational institutions, graduate school and vocational schools.

• The period of residence of family members of military personnel who serve on a contract basis is far from their main place of work. In this case, the rules are differentiated into two parts: military service until 1992, regardless of the place of deployment, and starting from the same year, depending on the location of the military unit, provided that the family members of the soldier did not have the opportunity to find a job in their specialty and received official unemployed status.

• Periods that count towards general work experience (military service).

• The period of maternity leave until the child reaches 3 years of age.

• The period from the moment of dismissal of a woman in demolition or a woman who has a young child who is under 3 years old. According to the law, they cannot be dismissed from their posts at the initiative of administrative employees. Dismissal can occur only on their own or in the event of liquidation of the enterprise.

• Upon termination of the contract by women who have children under 14 years old.

• Upon voluntary dismissal of pregnant women and women who have a disabled child or an HIV-infected child under 18 years of age.

If the employee wants to change the place of work, then the generalized rule for maintaining continuous service is valid. The experience is considered continuous if the break in work was not more than 30 days from the date of termination of the employment contract. However, there are some reasons why the allowable break can reach 1 year.

At the same time, there was the following dependence of the length of service and the amount of temporary disability benefits. The allowance was assigned accordingly in the amount of the full average salary (100%), but provided that the total work experience was not less than 8 years. If the experience ranged from 5 to 8 years, then the size of the benefit was equal to 80% of the average annual earnings, if less than 5 years, then 60%.

It is worth noting that some categories of citizens claimed 100% replacement of benefits regarding wages without taking into account seniority. These included citizens affected by the Chernobyl disaster, workers in the Far North, invalids of the Second World War who did not stop working, citizens who live in resettlement zones, workers who are exempted from fulfilling labor obligations due to the need to care for children under 14 years old, and also members of large families.

Similar rules when calculating disability benefits remained until 2004, then some changes were introduced into the Russian legislative system. However, this change in accrual principles was insignificant; nevertheless, most of the rules were guided precisely by the Soviet version.Since that time, every year some changes are made to the legislative base, which must be independently monitored.

So, for example, now when calculating a hospital allowance, it is not the average annual salary that is taken into account, but the earnings for 2 calendar years, and the experience is taken into account only for those that were accompanied by compulsory insurance payments to the Social Insurance Fund. But nevertheless, the main document according to which the calculation of disability benefits is now calculated is Order No. 21n of the Ministry of Health and Social Development of the Russian Federation dated January 24, 2011. It is not practical to consider changes for each year, especially since the main stages are a copy of the Soviet past. Therefore, let us consider how the calculation of material support goes, and on what the size of the temporary disability benefit depends.

The procedure for calculating unemployment benefits (sick leave) in 2014

According to the current regulatory legal acts (Article 14 of the Law of the Russian Federation No. 255-F3 dated December 29, 2006 and Decree of the Government of the Russian Federation No. 375 of July 15, 2007), in 2014 the hospital material allowance is calculated with some changes to the 2013 base.

Despite the cause of the employee’s disability (occupational illness, injury, pregnancy and maternity leave, caring for a child or another family member), the same procedure for calculating benefits is applied. Our state guarantees the provision of temporary disability benefits to all those in need. In order to accrue it in accordance with the recommendations of the legislative system, it is necessary to take into account the following points:

1. the period for which the employee will receive sickness benefit;
2. a person’s income for a specific period;
3. maximum allowance established by law;
4. the average person’s full-time salary;
5. interest rate on average full-time earnings, which will be taken into account when calculating benefits;
6. final size of the hospital allowance.

It is worth noting that, since 2004, the maximum limit for the amount of temporary disability benefit has been established. Federal Law No. 255 regulates this issue. Also, the size of the benefit may be affected by some other factors (hazardous production, work in the Far North, and more).

Time period for calculating hospital benefits

When calculating the amount of benefits, the time period during which the employee was unable to fulfill his labor obligations for one reason or another, but provided that it relates to the loss of an able-bodied state, is taken into account. In this case, it is necessary to consider 2 main divisions when calculating benefits.

1. The temporary disability allowance can be calculated taking into account the average earnings of an employee for 2 working years (730 calendar days), while no temporary periods (illness, additional day off, business trip, vacation, etc.) are taken into account.

2. A completely different situation is clarified when accruing benefits for the loss of the ability to work during pregnancy, maternity leave or caring for a sick child (another family member). Here also taken in calculation of average earnings for 730 calendar days, however, it is necessary to take into account the actual number of days in a year. So, for example, in a leap year it is necessary to take into account 366 days, and not 365, as in other years. In addition, according to the explanations of the legislative framework, when determining the size of the hospital allowance, it is necessary to exclude some time intervals from the general calculation, in particular:

• the period of the disease (if the disease is not occupational);

• recovery of the body from the effects of trauma (if the trauma was not received while performing work duties);

• time of additional maternity leave;

• period of care for a young child;

• those periods of time during which the employee was relieved of the performance of her labor duties, however, at the same time, earnings were retained in full or in part, provided that the FSS insurance contributions were not accrued on him, in all cases the payment of temporary disability benefits will be made in in accordance with the wishes of the regulatory documents governing this issue.

Calculation of benefits taking into account the insurance experience and the reasons for the loss of ability to work

In order to calculate the maximum amount of the allowance for the loss of working activity, it is necessary to take into account 2 main factors: the cause of disability and the general insurance experience of the employee. In fact, the determination of the amount of benefits in 2014 is similar to the Soviet era, but with some changes.

So, for example, the USSR took into account the total length of service, now they take into account the period of time that was accompanied by compulsory insurance payments to the Social Insurance Fund, in addition, some causes of disability have lost their original meaning. Let us consider in more detail the effect of insurance experience and the causes of disability on the total amount of benefits.

• Any employee who has become incapable of work due to illness, injury, quarantine or prosthetics (except for cases of injury or illness due to professional activity), but who has a total insurance experience of more than 8 years, will receive a full benefit allowance (100%) average earnings for 730 days (Law No. 255-F3).

• If you have an insurance experience of 5 to 8 years, the employee is entitled to receive benefits in the amount of 80% of the average daily earnings for the past 730 working days for each day of sick leave.

• An insurance certificate experience of less than 5 years will be paid at the rate of 60% of earnings for 2 full years of work, provided that the employee has not changed his job more than 1 time. At the same time, the calculation of temporary disability benefits will be carried out within 3 days.

• If the employee lost his labor skills due to his professional activities (work injury, occupational disease), then the allowance will be awarded to him at 100% of the amount of average daily earnings for 730 days for each day of sick leave. Moreover, the length of service will not be taken into account at all.

• If an employee resigned from his post, but within 30 days partially lost the opportunity to realize his labor skills, then he is entitled to a benefit of 60% of the amount of his average earnings from a previous job for 2 calendar years. The length of service will not be considered. However, there is one exception. A person who suffered as a result of the Chernobyl accident will receive a full (100%) material benefit for temporary disability. The experience of the insurance certificate will not be taken into account either.

The size of the allowance for the loss of working capacity due to the care of a child or other family member

When determining the amount of benefits for people who lose the opportunity to work due to caring for a sick family member, the insurance period is also taken into account, and in addition, how a sick family member is treated (inpatient or at home).

1. The amount of the allowance for caring for a child under the age of 14, provided that he is being treated at home, but under the supervision of a doctor:

• If you have a total insurance period of more than 8 years, the benefit amount will correspond to 100% of the average earnings for 730 days (but only during the first 10 days, then the benefit will be calculated in half (50%). At the same time, temporary disability benefit is paid in within 5 calendar days.

• If you have experience supported by regular insurance payments at the Social Insurance Fund for at least 5 full years and no more than 8 years, the benefit amount will be 80% of the average income for 2 years in the first 10 days, starting from day 11, the benefit will be charged at half the average earnings.

• with a total insurance period of less than 5 years, the benefit amount will be 60% of the average two-year earnings in the first 10 days, then for each day half (50%) of the employee’s earnings for 1 working day will be charged.

2. The amount of temporary disability benefits for caring for a child under 14 years old if he is being treated in a hospital setting:

• If the experience exceeds 8 years, then the allowance will be accrued in full of the average two-year earnings for the entire period the child is in the hospital.

• If the experience is from 5 to 8 years, then the amount of the benefit will be 80% of the average salary for 2 years of work.

• If a length of service less than 5 years, the size of the benefit will be 60% of the average employee income for 730 calendar days.

When caring for an adult family member, the amount of the benefit will be 100% (if the experience is more than 8 years), 80% (if the insurance experience is from 5 to 8 years), 60% (if the insurance experience is less than 5 years). This does not take into account exactly how the patient is treated, at home under the supervision of doctors or in a hospital.

Payment of temporary disability benefits is carried out to a bank account or to hands through the cash register of the enterprise or institution in which the person works.