A certificate of incapacity for work (sick leave, LN) is a document confirming the temporary incapacity for work of a citizen and is the basis for the appointment and payment of benefits for temporary incapacity for work.
Sick leave certificates are issued by doctors of hospital and sanatorium institutions of the system of the Ministry of Health of Ukraine.
The front side of the LN form is completed in accordance with the "Instruction on the procedure for filling out the LN dated November 17, 2004 No. 1456/10055" by the attending physician or junior medical worker with medical education.
The employer, having received from the LN employee, carefully checks all the filled in data.
If an employee is sick and brings the first sick leave, and then the second sick leave, then the first thing that is paid attention to is either the primary or extended LN.
If it is extended by LN, then it must contain the series and number of the previous one.
The filling is checked: the name and location of the health care institution (in full), which is confirmed by the stamp and seal of the health care institution "For certificates of incapacity for work"; date of issue of POP, surname, name, patronymic of the disabled person (in full); number of full years (in numbers); gender is emphasized; place of work: name and location of the enterprise, institution, organization (in full).
The primary diagnosis, the final diagnosis and the ICD-10 code are indicated exclusively with the written consent of the patient.
Attention is drawn to the exact reason for the incapacity for work, that is: if the general illness is number 1, then the enterprise pays for the first 5 days of incapacity for work, and the rest of the days are paid by the Social Insurance Fund for temporary disability (hereinafter referred to as the FSS for VTP) if care (age) is number 10 , where the full age of the child is indicated (for example, 5 years and 6 months), then the FSS pays in full for the VTP; if pregnancy and childbirth is number 8, then it is fully paid by the FSS for VTP; if isolation from COVID-19 is at number 11, then the enterprise pays for the first 5 days of incapacity for work, and the rest of the days are farther than the FSS according to VHT
Further, the regime is stationary, outpatient, sanatorium and the like. The notes about the violation of the regime should contain the entry "was not", the signature of the doctor, the seal.
Regarding the column "Forwarded to MSEC", the date of sending documents to MSEC is recorded, which is confirmed by the signature of the chairman of the medical advisory commission.
In the column "Examined in MSEC" the date of examination of the patient is noted.
In the column "Withdrawal of the MSEC", a corresponding entry is made, which is certified by the signature of the chairman of the MSEC and the seal of the MSEC: recognized as a disabled person of a certain group and category; not recognized as disabled, requires treatment; not recognized as disabled, efficient.
If the patient is recognized as a disabled person, the date of establishment of disability must coincide with the day of receipt (registration) of documents in MSEC.
If the patient is recognized as able-bodied, the date following the date of examination in MSEC is indicated in the column "start work".
In the column "I allow the issuance of a certificate of incapacity for work" is a mandatory entry with the signature of the head physician and the seal of the health care institution for those patients who have temporary disability outside their place of residence, work, that is, in another district or region (the name and location of the health care institution is indicated at the top of the LN ).
A sample of filling the front side of the LN is given below.
The next step is to check the "Exemption from work" column.
It is here that the period of the employee's illness is displayed, from which to what date inclusive and is checked against the time sheet.
A seal must be affixed for the certificates of incapacity for work, the seal of the attending physicians and their signatures.
There should be a date in the "get started" column.
If the employee continues to be ill, this is noted in the corresponding column with the new number of the certificate of incapacity for work.
It is important that the doctor can make no more than two corrections on the form of the certificate of incapacity for work.
If the LN is issued with violations or incorrectly filled out, the commission (authorized) for social insurance of the employer does not have the right to appoint, and the accountant does not have the right to calculate payments.
The decision of the commission (authorized) for social insurance of the enterprise on the appointment or refusal to appoint material security to the insured persons must be drawn up in the minutes of the meeting of the commission on social insurance (by the decision of the authorized person) on the day of their adoption.
If the decision on granting benefits was positive, Section I is filled in the protocol (for assigning benefits for temporary disability, pregnancy and childbirth, funeral benefits).
If the commission decides to refuse to grant benefits (to terminate payments), Section II is filled out in the minutes with the obligatory indication of the reasons for the refusal in the appropriate column.
The completed protocol is certified by the signatures of the chairman of the commission (authorized), deputy chairman and signatures of the members of the commission.
A sample of filling out the minutes of the meeting of the social insurance commission (decisions of the commissioner) are given below.
After the front side of the LN form has been checked, then the company (place of work of the insured person) is filled in by the company (the place of work of the insured person) the reverse side of the LN form.
The reverse side of LN is divided into four sections, so each of them is filled in by the corresponding responsible department of the enterprise.
And so, the first section is filled in by a timekeeper or an authorized person: the name of the enterprise, institution, organization; structural unit, position; personnel number; work permanent, temporary, seasonal (underline the necessary) did not work with "___" _____ 20__. until "___" _____ 20__; non-working days for the period of incapacity for work; began to work with "__" _____ 20__; signature and surname of the timekeeper or authorized person, date.
The second section is filled in by the personnel department or an authorized person: it emphasizes the insurance experience on the day of the onset of incapacity for work giving the right to benefits in the amount of 50% (insurance experience up to three years), 60% (insurance experience from three to five years), 70% (insurance experience from five to eight years), or 100% (insurance experience over eight years), of the average salary.
Insurance experience for 12 months is a kind of tool for saving insurance funds by the FSS.
So, if an employee earned less than 6 months of insurance experience within 12 months before the insured event, then he has the right to sick leave, calculated on the basis of the accrued salary from which ERUs were paid, but not more than the amount of assistance calculated from the minimum wage.
For privileged categories of workers, sick leave is calculated regardless of the insurance experience at the rate of 100% of the average daily salary.
But at the present time, another reason for disability has come into play.
This is "isolation from COVID-19-11".
Here, the general insurance experience is also not important if you are counting on sick leave for an employee.
For such an LN, sick leave is paid at the rate of 50% of the average salary.
If sick medical workers, they are paid 100% of the average salary.
But even in such cases, it is still necessary to determine this total insurance experience in order to be reflected in the application-calculation for obtaining funding.
The insurance experience, including for 12 months, is determined as of the date of the insured event.
Here you need to be extremely careful, since the size of the sick leave will depend on this.
And also the position, signature and name of the personnel department or authorized person are indicated.
The third section is completed by the Social Insurance Commission (Commissioner).
If assistance for temporary incapacity for work has been assigned, then the amount of payment is indicated in percentage depending on the length of service and the number of working days.
If maternity leave is assigned, then only the number of calendar days of maternity leave is entered.
The allowance is paid at the rate of 100% of the average salary (does not depend on the length of service).
If assistance is not provided for reasons, the reason for refusal is indicated.
Also indicate the position, signature and name of the authorized person.
The fourth section is completed by the accountant.
Here everything begins with the calculation of the average daily salary (WA) in the subsection "Certificate of salary".
And the following formula comes in handy:
ЗПср = ЗПрп: КДрп,
where ЗПрп - the amount of salary accrued in the billing period and entered the base for calculating ERUs;
КДрп - the number of calendar days in the billing period.
The "sick leave" billing period is divided into:
1. The period of being in an employment relationship with the employer is more than 12 calendar months (billing period - 12 full calendar months (from the 1st to the 1st day) preceding the month of the occurrence of the insured event);
2. The period of being in an employment relationship with an employer is less than 12 calendar months (billing period is the actual number of full calendar months in an employment relationship (from the 1st to the 1st day) preceding the month in which the insured event occurred)
3. The period of stay in an employment relationship with the employer is less than one calendar month (billing period - the actual time spent in an employment relationship (calendar days) before the occurrence of the insured event).
If the employee worked at the enterprise before the occurrence of the insured event for less than 6 months and may have more experience, then here the sick leave is calculated using the formula:
ZPmin / 30.44 = OP,
where ЗПmin is the minimum wage;
OP is an intermeshing indicator.
In the subsection "Belongs to payment" all data for determining the amount of sick leave (maternity benefits) and the amount of these payments are indicated. The period of temporary incapacity for work is given according to the data of the first section, which was filled in by the timekeeper. The number of days to be paid according to the third chapter, which is filled in by the social security commission (authorized), is affixed.
The size of the benefit is noted as a percentage of the average salary for the third section, which is filled by the commission (commissioner) for social insurance.
The size of the average daily salary is indicated, calculated in the "Certificate of salary" section.
The amount of sick leave (maternity benefits) is given.
Sick leave is determined by the formula:
L = ZPsr x C x K,
where ЗПср - the size of the average daily wages;
С - the percentage of payment of the certificate of incapacity for work, is established depending on the insurance record;
K - the number of work days missed due to illness, payable.
We calculate the maternity allowance using the formula:
P = ЗПср х Kpd (in),
where ЗПср - the sum of the average daily wages;
Kpd (v) - the number of calendar days falling on maternity leave (indicated in the certificate of incapacity for work).
The amount of assistance is indicated in hryvnia, words, kopecks - in numbers.
The month and year are entered when it is included in the payroll, the head, the chief accountant is signed, the company is stamped.
A sample of filling the back of the LN is given below.
If mistakes are made, the entry "to believe corrected" is entered and a seal is affixed.
The number of amendments on the back of the sick leave is not limited.
On the basis of the certificate of incapacity for work, in accordance with the decision of the Commission (authorized) for social insurance of the enterprise (the decision is made within 10 calendar days), the employer draws up and submits to the Fund an application-calculation for the payment of material security to the employee - up to 5 working days are allotted for this.
It is from the date of submission of the application-calculation by the employer that the date of financing of hospital and maternity payments depends. The fund transfers funds to pay benefits to employees to the employer's account, which must make the payment as soon as possible after receiving funds from the FSS.
The deadline for submitting an application-calculation was approved by the resolution of the Board of the FSS of Ukraine dated 07.19.2018 No. 12 "On approval of the Procedure for financing policyholders to provide material support to insured persons in connection with temporary disability and individual payments to victims at work at the expense of the FSS"
So, if an employee is sick, the employer can only sympathize with him and support him, but also document it correctly to carry out the calculations of his hospital payments either at the expense of the enterprise or at the expense of the Fund. Carefulness and accuracy in calculations must be present here.
Galina Konyk • partner of InBridge Consulting