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Filling a sick leave: sample. Rules for filling out sick leave

In July 2011, the form of disability (sick leave) sheets changed in the country. Their characteristic feature at the moment is a fairly large amount of encoded information. Next, we analyze in more detail the rules for filling out a sick leave. A sample form will also be presented in the article.

sick leave

General information

The sample sick leave form presented below illustrates a new way to fill out a document. When compiling it is necessary to apply codes. They are located on the back of the form. It should be said that the new sample of filling the sick leave caused the first time of difficulty not only among medical workers. It was quite difficult to get used to the adopted option for both the personnel department and the accountants.

Today, a prerequisite is the completion of the sick leave by the employer. The sample contains special graphs. The information must be entered by the employer. At first glance, indeed, the new rules for filling out sick leave by the employer seem complicated. However, in practice, everything is much simpler. Nevertheless, it is necessary to pay attention to this procedure with all, since the sick leave is not only a justification document for employees who were absent from work. It is also the basis for receiving monetary compensation.

Old and new form: problem and solution

Before you consider in detail the example of filling out a sick leave, you should find out what is the reason for the introduction of new forms. According to most experts, the replacement is more than justified. First of all, I must say that the old forms were often falsified. This, in turn, meant that the state suffered some moral damage. In addition, the old forms have long ceased to meet modern requirements. Not only was the information that was entered into the document insufficient, the forms were filled in by hand, which greatly complicated their processing by the FSS. Filling out sick leave is now much faster and easier.

The new forms provide more serious protection against counterfeiting. Documents are now subject to automatic processing. Reading all information is carried out using special equipment. Remained, of course, are the graphs into which the data is entered by hand. However, now it is much more convenient to do this, since the information fits into special cells. This is far from all the innovations that a new model for filling out a sick leave provides. FSS, doctors, accountants, having figured out the accepted way of filling out the form, have already managed to feel all the advantages of such a design. In the left corner (top) there is a binary code. It contains some of the information. The series and number, which were on the previous forms, today replaces the 12-digit barcode.

Checking the information entered by the medical institution

Filling out sick leave today is in accordance with fairly stringent requirements. In this regard, it is necessary to pay more attention to directly entering data, and to checking the graph, which are compiled by specialists of medical institutions. Upon delivery of the sick leave by an employee, the responsible employee accepting it must make sure that the form is completed by the doctor.

First requirements

Today, unfortunately, not everyone has completely dealt with them.So, for example, earlier filling out a sick leave could be carried out with corrections. Today, new forms do not allow blots or other defects. If the doctor made a mistake when filling out the sick leave, the medical institution must issue a new form to the patient. If an employee brings a revised document to the company, it will be returned. To prevent this situation from happening, you should check the absence of blots in the form directly at the medical institution and replace it if necessary.

Primary or Duplicate

Many doctors start filling out a sick leave with this column. The doctor must check the box next to the word "primary" or "duplicate." In the second case, this must be done if the sick leave was lost for some reason. If errors were identified in the form and replaced, the doctor ticks the "primary" box.

Name of organizations

This, in particular, is about the medical institution, and about the enterprise, where then the document will be handed over by the employee. The rules for filling out sick leave do not provide for the use of quotation marks, dashes, periods, brackets, number signs in these columns. Only alphabetic and numerical designations are allowed. The rules for filling out sick leave allow the use of both abbreviated and full names of organizations. However, if the length of the column is not enough even for an abbreviated name, the company needs to choose an abbreviation or word (phrase) for which there will be enough space. This name can be used exclusively for sick leave. For this, an appropriate order is issued by the head of the enterprise. The organization must notify the FSS employees about the choice of an additional official name. Along with this, medical specialists should be warned about how to enter the name of the company on the form.

sick leave procedure

PSRN and the address of the clinic (hospital)

These graphs need special attention. According to the information in the OGRN column, the medical institution is identified in the existing common database. There should be absolutely no discrepancies. Reading of this data is carried out automatically. Accurate information must be conveyed to the employee who is filling out the sick leave for inclusion in the “PSRN” and “Name” columns. The address of the medical institution is entered in a certain sequence. So, the procedure for filling out a sick leave requires first writing the city, then the streets, then the house number. Such words as "street", "avenue", "boulevard" and so on are not written. A building can have a complex number. For example, the clinic can be in an additional building or structure. In this case, the number is written through a fraction. You do not need to put a space.

Primary Patient Data

Date of birth, as well as F. I. O. of the patient are entered into the document in accordance with his identification card. To enter this information, the form has 28 cells. If the patient has a double or very long last name, then the first 28 letters from it are entered. Initials are not indicated. It is not allowed to go beyond the provided fields.

Codes

They are necessary to indicate the cause of the patient's disability. The form has three fields. They fit in:

  • Code. In this column, the doctor indicates the reason for the initial appeal of the employee.
  • Additional code. The reason for additional incapacity for work is entered in this field.
  • Change code. This column is filled in if necessary. For example, changes in the cause of disability may occur.

filling in the sick leave by the employer sample

Place of employment

Entering information about whether the enterprise where the patient works is his main place or additional is carried out solely from his words. For this, there is no need to provide any certificates and other documents.If a person works at several enterprises at once, then sheets are given to him in all places of the requirement. In the form that will be provided by the employee to the enterprise where he works part-time, you must also enter the number of the document issued for the main place of professional activity.

"Special" graphs

They are not filled in all cases. In particular, this applies to the column "Date 1". It is filled in case of a change in the cause of disability. So, when preparing a document on the basis of pregnancy, the estimated date of birth is entered in the column. After treatment, the patient can also be referred to a sanatorium to restore strength. In this case, the "special" columns indicate the number of his permit, the date of the beginning of rehabilitation, the PSR dispensary.

Patient care

If the sheet is issued due not to personal disability, but in connection with the illness of a child or other close person, then the degree of relationship must be indicated in special columns. This information also fits in encoded form (codes are on the back of the form). In addition, the age of the person to be taken care of is indicated. The age of children who are not a year old fits in months. If care is provided for several family members, several sick leave are issued in accordance with the number. All forms are issued the same way, except for the data of relatives.

Hospital stay

This information is also indicated on the form. There is a special graph for this. It also bears the date of arrival and discharge. If after that the person was sent to ambulatory treatment, the time spent in the hospital and the release from work will be different.

An example of filling out a sick leave certificate by an employer

Incapacity for work

As a rule, it does not exceed ten days. If there is a need, the doctor can extend this period. Information about this is entered in the column "Exemption from work". Due to the fact that it provides only 9 cells, reductions are allowed. For example, instead of "attending physician" you can write "lay down. Doctor." If the duration of incapacity for work exceeds 30 days, the decision on the further extension of this period is made by a special commission. Its chairman is indicated on the form as "chairman of the VK". At his discretion, the initials and surname may be entered in abbreviated form or in full. Below is the number at which the person will go to work. If the patient continues treatment, then the information is entered in the column "Other". The next sick leave number and the corresponding code are entered in it.

Additional Information

The sick leave includes the column "Violation of the regime." It is filled, respectively, if this circumstance has occurred. In the new form, this information is also encoded. Without fail, this information must be certified by the signature of the doctor. It is also necessary to indicate the date of violation. The completed form must have seals and stamps. At the bottom of the sick leave, the doctor puts his signature. The document should have a clear print of the seal, which indicates the name of the medical institution. It can be round, triangular or special for this document.

Filling the sick leave by the employer

After verification, the form is sent to the accountant and the personnel department for processing. They continue to fill it. In accordance with the requirements, the necessary information is entered in the form (an example of filling out a sick leave by the employer is presented in the article). In particular, the name of the organization and its identification number are indicated. In this case, the name fits exactly that which is adopted in accordance with the order. Ideally, the data entered by the doctor, filling out a column about the employee’s enterprise, and the information that is entered by the accountant or human resources officer should be identical.However, some discrepancies are allowed. In this case, the most important thing is the correct indication of the identification number.

employer sick leave rules

Disabled Employee Information

For its correct identification, columns are mandatory filled out, in which its TIN and SNILS are indicated. If a document is issued due to an occupational disease or its incapacity for work has occurred as a result of an industrial injury, an Act shall be drawn up in the form of N-1. The column “Contingent accruals" is mandatory if it is a term contract employee, beneficiaries, people with disabilities and those who have been absent from the enterprise for more than 30 days. Information is entered according to the encoding given on the back of the form. She, in turn, will affect the amount of compensation for disability.

Start of activity

The column "Start of work" records the date from which, in accordance with the agreement, the employee began to work at the enterprise. The employee has the right to rely on compensation even if the contract was concluded, but he has not yet had time to begin to perform his duties. If provided disability sheet he receives an allowance, and in the column "Start of work" the date from which he should begin activities is indicated (in case of cancellation of the contract).

Compensation calculation

Special attention should be paid to filling out a sick leave from the minimum wage. It is performed in almost the same way as in general cases. The settlement form, in accordance with which payments are formed, must be attached to the document on disability. The form for this form is free. When calculating the minimum wage, it is necessary to take into account the number of days in the month in which the employee went on sick leave. At the same time, the "minimum salary" is divided by the number of working days of the month and multiplied by the duration of the absence of the employee. If the duration of incapacity for work is two or more months, then for each of them the amount of the benefit is set separately.

Insurance and non-insurance periods

In the column "length of service" you must accurately indicate the number of months and years. This is important for the subsequent calculation of compensation. Non-insurance periods include military service, temporary unemployment, a period of being registered with an employment center, and studies. They cannot be taken into account when calculating disability compensation. The line “due for the period” shall indicate the same information as in the column “exemption from work”, which shall be filled in by the doctor.

FSS sick leave sheet

Pay

It is carried out at the expense of the FSS and the employer. The employer pays only the first three days. The rest of the period, including prosthetics, aftercare, quarantine and so on, is compensated by the FSS fund. In the form, the amount of benefits should be indicated in two parts. The first is the one paid by the employer, the second is the FSS. Both amounts must be indicated taking into account personal income tax. In the line “accrued total” the value is deducted, minus it.

Important points

In addition to the fact that all the information on the form of the disability sheet must be readable and reliable, there are several important nuances that should be remembered when filling out a sick leave. In particular, it is not allowed to crumple and fold the document. When entering information, records should not go beyond the boundaries of the fields reserved for them. This also applies to signatures and seals. However, if such defects are present, the disability certificate cannot be declared invalid. Compensation payment in this case must be made. The seal (stamp) of a medical institution may go beyond the boundaries of its designated field. However, it should not overlap other information columns and information in them.


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