Have you ever been given a sick leave certificate at a medical facility? If not, then you are probably a happy person. If yes, then you most likely noticed that instead of a textual description all sorts of common codes were used in it. For example, very often in this document code 02 is indicated as the cause of disability, the decoding of which remains a mystery to many ordinary people. Let's try to figure out what information may be hidden behind the numbers. Moreover, it is not at all difficult. And also find out how to draw up a sick leave (reason for disability - code 02).
What is written on the sick leave
The following data is entered in a document such as a disability certificate:
- F. I. O. of a sick patient (the basis is an identity card, namely a passport).
- Date, month and year of his birth.
- Floor.
- The name of the organization (factory) where the patient works (base - according to the patient). If the patient works for an individual entrepreneur or is one himself, then this column indicates the full name of the employer.
- Information about where the sick leave was issued: at the place of work or residence.
- TIN of the patient.
- Reason for disability.
- The date of opening and filling out the sick leave.
- The period during which a person was disabled.
- All kinds of violations of the regime.
- Other information.
- Conditions for calculating cash benefits.
All codes in the document, from the first to the penultimate, are entered by the doctor who opens the sick leave. But the conditions for calculating disability benefits (in coded form) are entered by the employer, namely the employee dealing with these issues.
Why do you need to encode information
What is the purpose of coding? And it consists in the following:
- fully preserve confidential information about the patient’s illness;
- minimize the likelihood of any fake;
- desire to use medical forms economically and compactly;
- have the opportunity to cooperate with a variety of medical institutions abroad;
- significantly simplify (sometimes the doctor’s handwriting is very difficult to read) and optimize the activities of personnel workers.
On a note! Not only the personnel officer, but also the patient himself can get acquainted with the decoding of these codes: it is presented on the back of the sick leave. Just flip it over and read it.
Who needs these codes?
The most important part of the disability sheet is the columns in which they enter codes indicating certain reasons why patients cannot be at work and carry out their professional activities in the usual way. Several cells have been allocated for this encoded information:
- the first two are the main code (numbers 01 to 15);
- the next three are an additional code (numbers 017 to 021);
- the final two are the qualifying code (fixed in the event that the diagnosis is clarified).
Why use so many codes? Who needs them? And they are needed both by medical workers and the authorities (that is, the employer).
Deciphering sickness codes
Each code has its own decoding, and they can and should be affixed by the attending physician.
An exception is only the basic codes numbered 14 and 15, which are affixed in the event that the consent of the patient is obtained. In addition, the column on the cause of temporary disability may be amended (if necessary).
Key Codes
So, let's get acquainted with the list of basic codes that the doctor writes in the first two cells of a medical document:
- 01 - the presence of any disease that does not imply the patient is at work.
- 02 - sick leave code indicating the person's incapacity for work as a result of injury.
- 03 - quarantine is announced that prevents a person from finding work.
- 04 - the patient received an injury (or consequences after it) directly at the workplace.
- 05 - leave is granted for the period of R&D (pregnancy and childbirth).
- 06 - the need for prosthetics in a hospital.
- 07 - exacerbation of a previously identified disease or the detection of an ailment associated with professional activity.
- 08 - the rehabilitation period in the sanatorium after the disease.
- 09 - exemption from work, which is issued in case of care for a sick close relative.
- 10 - other circumstances entailing the release of a person from the need to be at the workplace.
- 11 - a disease indicated on a special list (for example, mental illness, hepatitis, diabetes mellitus or the like), approved by the government.
- 12 - the need to care for a child (under 7 years old) who has one of the ailments listed in the list of diseases approved by the Ministry of Health and Social Development.
- 13 - the presence of disability in a child who needs care.
- 14 - a case when a child has a malignant disease or there are certain complications after vaccination.
- 15 - care for a child with HIV infection.
Additional codes
Now let's find out what additional codes are put down in the next three cells of the disability sheet:
- 017 - the need for treatment in a medical institution for special purposes.
- 018 - being in a sanatorium (or resort) after undergoing treatment for an injury received as a result of an accident at a workplace.
- 019 - therapeutic measures carried out in rehabilitation clinics.
- 020 - maternity leave granted in addition to the main one.
- 021 - exemption due to illness or injury resulting from intoxication (drug, alcohol or toxic).
Important! If the reason for the absence of an employee in his place was fully reflected in the first two cells of the sick leave, then the next three need not be filled out. But if such a need exists, then the medical professional enters both the main code and the additional one.
Sick pay for household injuries
What is sick leave? This is a medical document that indicates the reasons for the person’s temporary incapacity for work and on the basis of which he can receive (for the entire time he is absent from the workplace) a certain amount of money.
How is sick leave paid? That is, what factors are fundamental in determining the amount intended for payment to the employee?
- Insurance experience of a person presenting sick leave for payment. Moreover, if this length of service is up to 5 years, the amount of the benefit will be 60% of the average wage; if from 5 to 8 years, then the employee receives 80% of the plant protection; and if more than 8 years old, then he has a chance to get all 100%.
- Average annual earnings.
Important! Keep in mind that there are significant limitations in determining the average earnings for the year. So, in 2016, its largest amount was 670,000 rubles. That is, even if, in the actual calculation, your average annual income significantly exceeds this figure, the value that is determined to be officially the largest will be taken into account in the calculation of hospital compensation.
- The average daily earnings.
- The number of days during which an employee may be absent from work.
Important! If the reason for the absence of the employee is illness (for example, flu) or personal injury, then the payment of the first three days is the responsibility of the employer, and the subsequent days are paid exclusively from the Social Insurance Fund (FSS) - see Law No. 255-FZ (paragraph 1, part 2, article 3).
Example of calculating hospital compensation
Theoretically, of course, everything is extremely clear. Let's see how, in practice, you can independently determine the amount due to you.
Suppose, citizen Ivanov Ivan Ivanovich was absent from work due to an injury in everyday life (or due to flu) for 10 days (note calendar). The average daily wage of Ivan Ivanovich is 1600 rubles, and the insurance experience is 7 years. The amount of the benefit will be 12,800 rubles (1,600 x 10 x 80%). Of these, 3840 rubles (1600 x 3 x 80%) will be paid by the employer, and the remaining amount - 8960 rubles from the FSS.
Duration of presentation of sick leave guarantee benefits
A sick leave issued due to illness, due to incapacity for work - code 02 (the decoding is presented above) - or for other reasons, the employee must present before the expiration of six months (or rather, 6 months) from the date indicated in the medical document (a in the column “by what number”).
Remember! In case of delay, the hospital allowance is not paid. For example, if the last day on the sick leave is May 15, the latest deadline for presenting the document is November 15. If you do this even a day later, then you will not see benefits.
The number of days for which the allowance will be paid
There are certain deadlines for appointing and paying sick leave:
- The term for consideration and assignment of benefits is 10 calendar days. The countdown begins on the day the sick leave is presented. This is stated in the Law No. 255-FZ (part 5, article 13, part 1, article 15).
- Allowances are paid as soon as possible (after they are assigned) the next salary according to the same Law (part 8, article 13, part 1, article 15).
On a note! For each expired day, you have the right to demand compensation in accordance with the RF Labor Code (Article 236).
The number of paid days on sick leave
If the employee fell ill or was absent in his place due to incapacity for work - code 02 (the decoding is presented above), then the allowance must be guaranteed to be paid for the entire period of exemption from the performance of his professional activity (or, more precisely, for all calendar days indicated in the medical document) . This is clearly stated in the Law under the number 255-ФЗ (part 1, article 9). Moreover, there are no restrictions on the maximum duration of the paid period. The only exceptions are hospital benefits for employees hired for temporary work or having a disability.
Important! If the employee became ill or was absent at the workplace due to incapacity for work - code 02 (the decoding is presented above) during the next paid vacation, then the benefit is paid for the entire period of incapacity for work. Holidays (by agreement) are either extended or rescheduled to another convenient time. This seems to be very fair.
Finally
Now you know what the decoding of the cause of disability means (code 02). Everything is very simple. The code no longer scares and does not alarm anyone. It’s just a sign of household injury. Additional information on the number of days paid on sick leave, as well as on the timing of its presentation and the time during which payment must be made, is useful to any citizen.
You can even preliminarily make an approximate calculation of hospital compensation. Moreover, you already know how sick leave is paid and what indicators are used in its calculation.