1. Temporary disability benefits for loss of ability to work due to illness or injury, except for the cases specified in part 2 of this article, during quarantine, prosthetics for medical reasons and after-care in sanatorium-resort organizations immediately after the provision of medical care in an inpatient setting, are paid as follows: size:

1) to an insured person with 8 or more years of insurance experience - 100 percent of average earnings;

2) to an insured person with an insurance period of 5 to 8 years - 80 percent of average earnings;

3) to an insured person with up to 5 years of insurance experience - 60 percent of average earnings.

2. Temporary disability benefits for loss of ability to work due to illness or injury are paid to insured persons in the amount of 60 percent of average earnings in the event of illness or injury occurring within 30 calendar days after termination of work under an employment contract, official or other activity during which they are subject to compulsory social insurance in case of temporary disability and in connection with maternity.

3. Temporary disability benefits when it is necessary to care for a sick child are paid:

1) when treating a child on an outpatient basis - for the first 10 calendar days in the amount determined depending on the length of the insurance period of the insured person in accordance with Part 1 of this article, for subsequent days in the amount of 50 percent of average earnings;

2) when treating a child in an inpatient setting - in an amount determined depending on the length of the insurance period of the insured person in accordance with Part 1 of this article.

4. Temporary disability benefits if it is necessary to care for a sick family member during his treatment on an outpatient basis, with the exception of cases of caring for a sick child, is paid in an amount determined depending on the length of the insurance period of the insured person in accordance with “Part 1” of this articles.

(as amended by Federal Laws dated November 25, 2013 “N 317-FZ”, dated December 31, 2014 “N 495-FZ”)

5. Lost power.

6. An insured person who has an insurance period of less than six months is paid a temporary disability benefit in an amount not exceeding for a full calendar month the minimum wage established by federal law, and in regions and localities in which regional coefficients are applied to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.

7. In the case of temporary disability that occurred before the downtime period and continues during the downtime period, temporary disability benefits for the downtime period are paid in the same amount as wages are maintained during this time, but not higher than the amount of temporary disability benefits that the insured the person would receive according to the general rules.

1. Benefits for temporary disability, pregnancy and childbirth, monthly child care benefits are calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of temporary disability, maternity leave, parental leave, including during work (service, other activities) with another policyholder (other policyholders). Average earnings during work (service, other activities) with another insurer (other insurers) are not taken into account in cases where, in accordance with Part 2 of Article 13 of this Federal Law, benefits for temporary disability, pregnancy and childbirth are assigned and paid to the insured person for all places of work (service, other activity) based on the average earnings during work (service, other activity) with the insurer assigning and paying benefits. If in two calendar years immediately preceding the year of occurrence of the specified insured events, or in one of the specified years, the insured person was on maternity leave and (or) child care leave, the corresponding calendar years (calendar year) at the request of the insured person, they can be replaced for the purpose of calculating average earnings by previous calendar years (calendar year), provided that this leads to an increase in the amount of benefits.

Judicial practice under Article 14 of the Federal Law of December 29, 2006 No. 255-FZ

Decision of October 10, 2019 in case No. A51-16333/2019

Arbitration Court of Primorsky Krai (AC of Primorsky Krai)

The insured was assigned and paid maternity benefits and benefits for caring for a second child in an inflated amount. In violation of Part 3.1. Art. 14 of the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity” LLC “Inopt No. 1” unreasonably underestimated the number...

Resolution of September 25, 2019 in case No. A24-2568/2019

Arbitration Court of the Kamchatka Territory (AC of the Kamchatka Territory)

When calculating the maternity benefit for Safronova E.Yu., it was established that the calculation of the amount of this benefit was made in violation of Part 1.1 of Article 14 of the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and connections with motherhood" (hereinafter referred to as Law No. 255-FZ), since Safonova...

Decision of September 11, 2019 in case No. A69-1493/2019

Arbitration Court of the Republic of Tuva (AC of the Republic of Tuva)

Child care is carried out simultaneously by several persons, the right to receive a monthly child care allowance is granted to one of these persons. Articles 11.2, 13, 14 of Federal Law No. 255-FZ establish the amount, procedure for assigning, paying and calculating monthly child care benefits. By virtue of Article 256 of the Labor Code of the Russian Federation, upon application...

Decision of September 6, 2019 in case No. A72-8932/2019

Arbitration Court of the Ulyanovsk Region (AC of the Ulyanovsk Region)

2016 - RUB 145,002.81). As the fund indicated, the monthly child care allowance is calculated in accordance with Parts 3.1 and 3.2 of Art. 14, h.h. 5.1, 5.2 art. 14, part 1 art. 11.2 of Law No. 255-FZ. Amount of monthly child care allowance for Bashaeva A.A. V...

The main law that regulates the procedure for payments for sick leave is Law No. 255-FZ.

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In order to correctly make all calculations and make the necessary payments, you need to carefully monitor changes that may be accepted.

What the law says

This was specifically developed to ensure that there was regulatory regulation and a legal framework for making payments on sick leave.

The latter is issued in the event of illness of the employee himself, his relatives who require care, and in connection with upcoming motherhood.

The main points of this Law are as follows:

1. The procedure for issuing a certificate of incapacity for work.
2. How to correctly calculate benefits for the period of temporary disability of an employee.
3. For what reasons should compensation be made?
4. What is the basis for issuing the document?
5. Some benefits provided to employees.
6. Provisions regarding the provision of maternity leave and payment for this period.

It is precisely the period of pregnancy and childbirth, as well as the subsequent period, that many provisions of this Law are devoted to.

This Law states that a woman has the right to:

In addition, a woman has the right to issue a sick leave certificate if her child falls ill.

The period of absence from work will also be paid, but when calculating, slightly different rules will be applied than when calculating maternity benefits.

When came into effect

This law was developed and finalized throughout 2006. The main reasons for constant discussions are women's rights related to motherhood and their protection.

But, on December 20, 2006, Federal Law No. 255 was adopted by the State Duma, and a week later it was approved by the Federation Council.

The new Federal Law No. 255-FZ came into force on December 29, 2006.

Changes made to the Federal Law

Since then, many changes have been made to the document. So in 2020, some nuances and improvements came into force. In just 12 years of the law, about 25 changes were made to it.

The document has never changed fundamentally; only some adjustments have been made to it regarding the introduction of modern technologies.

The last changes were made on 03/07/2020. They touched upon the new rules for issuing sick leave and making payments to women during pregnancy and childbirth, and for child care.

The procedure for providing a certificate of temporary incapacity for work

Now you can receive a certificate of incapacity for work not only on paper, but also in electronic form.

This innovation has greatly simplified the lives of workers and employers.

The employee no longer has to worry that the document may become wrinkled, lost, or destroyed due to insurmountable circumstances, since it is quite difficult to obtain a duplicate.

The scheme of operation of electronic certificates of incapacity for work is as follows:

An insured event occurs	All grounds for registration of sick leave are specified in Art. 5 of Law No. 255-FZ
The employee notifies his employer about the occurrence of an insured event	If the employer has the opportunity to accept sick leave electronically, he must inform his employee about this. The employee gives / does not give permission to receive the document in electronic format
If he gave a positive answer	The doctor who will deal with the registration must inform about this. The doctor draws up an electronic sick leave and signs it with his electronic signature
The document enters a single database	Where the employer can find him
After the management makes sure that the employee was really sick and sick leave is issued in his name	It must fill in the appropriate lines and indicate the relevant information in them
In a single database of electronic sick leave certificates	They are available for inspection by the FSS inspector

This unified database linked together the employee - employer - FSS inspector. Now the interaction between these parties has become much more transparent and understandable.

Calculation criteria

Temporary disability benefits are calculated using the following formula:

Benefit = average earnings for 1 day of work * duration of the period.

To calculate the average earnings for 1 day of work for a specific employee, it is necessary to take into account all of his labor income for the last 2 years.

If the period of incapacity for work fell in 2020, then for the calculation you need to use data for 2017 and 2016, respectively.

All periods during which the employee officially received labor income and the employer made contributions to the Social Insurance Fund for him are taken into account.

This value must be divided by 730 (this is the number of days in 2 years) or 731 (if one of the previous years was a leap year).

The resulting quotient will be the average daily earnings of a particular employee.

To know how much the employee will receive, it is necessary to multiply the average daily earnings by the number of days of temporary absence from work.

Benefit payment procedure

The amount of benefits an employee will receive depends on the reason for absence from work and the employee’s length of service.

If the situation is standard, that is, the employee himself gets sick, then he will receive:

In some cases, sick leave is paid based on the minimum wage. These are cases such as:

From 01.01.2020, the federal minimum wage was set at 9,489 rubles, but from 01.05.2020 there was another increase to the subsistence level. Now the minimum wage is 11,163 rubles.

Regardless of length of service, sick leave is paid:

Payment period

The faster an employee submits a sick leave certificate to the employer’s accounting department, the faster he will receive his temporary disability benefit. But, he has six months from the moment the sick leave ends to provide it.

As soon as the certificate of incapacity for work is submitted to the accounting department, employees of this service begin calculating benefits.

It must be assigned within 10 days from the moment the document was received by the employee. The same period is required for the Social Insurance Fund to consider the situation regarding payments.

If an electronic sick leave certificate has been issued, then even fewer disputes arise. It immediately appears in a single database, and calculations can be made.

The employee must receive the entire amount in the coming days of salary payment at the enterprise.

List of reasons for reducing the amount of compensation

In Art. 8 of Law No. 255-FZ provides the grounds on which the amount of temporary disability benefits may be reduced.

Such circumstances include:

If these circumstances exist, payment for the period of incapacity for work occurs based on the minimum wage, which is established at the federal level at the time of the occurrence of these circumstances.

1. Benefits for temporary disability, pregnancy and childbirth, monthly child care benefits are calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of temporary disability, maternity leave, parental leave, including during work (service, other activities) with another policyholder (other policyholders). Average earnings during work (service, other activities) with another insurer (other insurers) are not taken into account in cases where, in accordance with Part 2 of Article 13 of this Federal Law, benefits for temporary disability, pregnancy and childbirth are assigned and paid to the insured person for all places of work (service, other activity) based on the average earnings during work (service, other activity) with the insurer assigning and paying benefits. If in two calendar years immediately preceding the year of occurrence of the specified insured events, or in one of the specified years, the insured person was on maternity leave and (or) child care leave, the corresponding calendar years (calendar year) at the request of the insured person, they can be replaced for the purpose of calculating average earnings by previous calendar years (calendar year), provided that this leads to an increase in the amount of benefits.

(see text in the previous edition)

1.1. If the insured person did not have earnings during the periods specified in Part 1 of this article, as well as if the average earnings calculated for these periods, calculated for a full calendar month, are lower than the minimum wage established by federal law for the day of the occurrence of the insured event, the average earnings, on the basis of which benefits for temporary disability, maternity, and monthly child care benefits are calculated, are taken equal to the minimum wage established by federal law on the day of the occurrence of the insured event. If the insured person, at the time of the occurrence of the insured event, works part-time (part-time, part-time), the average earnings, on the basis of which benefits are calculated in these cases, are determined in proportion to the duration of the insured person’s working hours. Moreover, in all cases, the calculated monthly child care benefit cannot be less than the minimum monthly child care benefit established by Federal Law

2. The average earnings, on the basis of which benefits for temporary disability, maternity, and monthly child care benefits are calculated, include all types of payments and other remuneration in favor of the insured person, for which insurance contributions to the Social Insurance Fund of the Russian Federation are calculated. in accordance with the Federal Law of July 24, 2009 N 212-FZ "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" (for the period up to December 31, 2016 inclusive) and (or) in accordance with the law

(see text in the previous edition)

2.1. For the insured persons specified in Part 3 of Article 2 of this Federal Law, the average earnings, on the basis of which benefits for temporary disability, maternity, and monthly child care benefits are calculated, are taken equal to the minimum wage established by federal law on the day of insured event. At the same time, the calculated monthly child care benefit cannot be less than the minimum amount of the monthly child care benefit established by the Federal Law “On State Benefits for Citizens with Children.”

2.2. For insured persons who worked under employment contracts concluded with organizations and individual entrepreneurs, for whom a reduced rate of insurance contributions to the Social Insurance Fund of the Russian Federation was applied in the amount of 0 percent, in the average earnings, on the basis of which benefits for temporary disability and pregnancy are calculated and maternity benefits, monthly child care benefits, includes all types of payments and other remuneration in favor of the insured person, which were included in the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation in accordance with Federal Law of July 24, 2009 N 212-FZ "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" (for the period up to December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (starting from 1 January 2017) in the corresponding calendar year and do not exceed the maximum value of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation established in this calendar year. Information on the specified payments and remuneration in favor of the insured person for the corresponding period is indicated in the certificate of the amount of earnings issued by the policyholder in accordance with clause 3 of part 2 of article 4.1 of this Federal Law.

(see text in the previous edition)

3. The average daily earnings for calculating temporary disability benefits are determined by dividing the amount of accrued earnings for the period specified in part 1 of this article by 730.

(see text in the previous edition)

3.1. Average daily earnings for calculating maternity benefits and monthly child care benefits are determined by dividing the amount of accrued earnings for the period specified in Part 1 of this article by the number of calendar days in this period, with the exception of calendar days falling in the following periods :

1) periods of temporary disability, maternity leave, parental leave;

2) the period of release of the employee from work with full or partial retention of wages in accordance with the legislation of the Russian Federation, if insurance contributions to the Social Insurance Fund of the Russian Federation were not accrued for the retained wages for this period in accordance with Federal Law of July 24, 2009 N 212-FZ "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" (for the period up to December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees ( starting January 1, 2017).

(see text in the previous edition)

(see text in the previous edition)

3.2. Average earnings, on the basis of which temporary disability benefits, maternity benefits and monthly child care benefits are calculated, is taken into account for each calendar year in an amount not exceeding that established in accordance with Federal Law of July 24, 2009 N 212-FZ " On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" (for the period up to December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (starting from January 1 2017) for the corresponding calendar year, the maximum value of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation. If the appointment and payment of benefits for temporary disability, pregnancy and childbirth to the insured person are carried out by the territorial bodies of the insurer at the place of registration of several policyholders in accordance with parts 2 and 4 of Article 13 of this Federal Law, the average earnings on the basis of which these benefits are calculated, is taken into account for each calendar year in an amount not exceeding the specified limit when calculating these benefits for each of these policyholders.

(see text in the previous edition)

3.3. The average daily earnings for calculating maternity benefits, monthly child care benefits, determined in accordance with Part 3.1 of this article, cannot exceed the value determined by dividing by 730 the sum of the maximum values ​​of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation. Federation established in accordance with the Federal Law of July 24, 2009 N 212-FZ “On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund” (for the period up to December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (starting from January 1, 2017) for two calendar years preceding the year of maternity leave and child care leave.

Compulsory social insurance is the responsibility of the state to provide social protection to the population.

All employees employed on an official basis are subject to compulsory social insurance. The reason for compulsory social insurance is changes in social and material security, even if the changes occurred due to circumstances beyond their control.

Social insurance is a system for protecting working citizens and dependent family members in the event of loss of earnings due to disability due to:

• Unemployment;
• Diseases;
• Disability;
• Old age.

The essence of the federal law

255 of the Federal Law “On compulsory social insurance” in case of disability regulates relations that arise when a citizen is incapacitated or in connection with the onset of motherhood. The legislation of the Russian Federation lists groups of persons who are subject to compulsory social insurance in case of temporary disability and in connection with maternity.

Additionally, the law regulates the conditions, amount and procedure for providing benefits due to disability.

Federal Law 255 does not apply to relations arising in connection with the provision of benefits due to temporary disability or an accident.

The Federal Law “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Maternity” was adopted by the State Duma on December 20, 2006, and approved 7 days later of the same year. The latest changes to the law were made and approved on May 1, 2017.

• Chapter 1 describes the general provisions of this law;
• Chapter 2 describes how to determine temporary disability benefits;
• Chapter 3 describes how to determine maternity benefits;
• Chapter 4 determines the procedure for assigning, calculating and paying benefits for pregnancy and childbirth, temporary disability and child care;
• Chapter 5 describes the procedure for the entry into force of this Federal Law.

Conditions for calculating benefits under Federal Law 255

The conditions for calculating benefits under Federal Law 255 are in Article 13. It describes the procedure for assigning and paying maternity benefits, temporary disability or monthly child care benefits.

The payment is determined by the policyholder in the place where the citizen works. If a citizen is registered with several insurers at the same time and the insurers have not changed over the past two years, then benefits are assigned to all places of work with the exception of a monthly child care benefit. It is accrued from the place of work of the citizen’s choice.

If within 30 days after dismissal an employee loses his ability to work, then the payment of benefits in accordance with Federal Law 255 on compulsory social insurance is paid from his last place of work.

The need to issue a sick leave certificate

To obtain sick leave and issue it, a sick leave form is used. The form is approved by order of the Ministry of Health and Social Development under number 347n. The procedure for issuing certificates of incapacity for work is carried out on the basis of the order of the Ministry of Health and Social Development of the Russian Federation under number 624n.

A genuine sick leave certificate is issued by an organization that has a license to carry out medical activities. Other companies that do not have a similar document are prohibited from issuing forms.

A sick leave certificate is issued based on the employee’s request. You can draw it up either on the day of the doctor’s visit, or on the last day (the day the sick leave is closed). In the line - date of issue, the date of registration of the certificate of incapacity for work is indicated. If a citizen goes to see a doctor after work, he must ask for a sick leave certificate from the next day. Otherwise, circumstances may arise as a result of which an employee working full time opens sick leave on the same day. An employer does not have the right to pay an employee both sick leave and wages for the same day. The procedure for providing sick leave according to the law is discussed in more detail in Article 13 of Federal Law 255.

Latest amendments

The latest changes to this Federal Law “On Compulsory Social Insurance in Case of Disability” were made on May 1, 2017. In particular, the changes affected the following article:

Article 5 states that the benefit is assigned by the employer. The basis is a certificate of incapacity for work due to pregnancy and childbirth. In order for the benefit to be assigned and paid within the specified time frame, the insured person will need to provide information about the amount of wages.

Below are a number of articles that were not affected by the changes, but are important to consider:

Article 3 describes the financial support for the costs of paying insurance coverage. To provide employees with benefits, funds are allocated from the Social Insurance Fund of the Russian Federation. Payments are assigned only to insured persons.

Article 7 describes the amount of temporary disability benefits. The benefit is paid in connection with an injury or illness. The benefit amount is 60 percent of average earnings. Even if an employee quit his last job, he has the right to receive cash payments in the first 30 calendar days.

However, the percentage of payment from average earnings increases depending on the length of insurance coverage. So, if an employee works for 8 or more years in a row, the insurance payment will be 100 percent of average earnings.

Article 8 lists the grounds for reducing the amount of benefits due to temporary disability.

Reasons:

• The patient, after receiving injury or treatment, violated the conditions of the attending physician;
• The patient forgot to come at the time appointed by the doctor for an examination and relevant tests, on the basis of which conclusions will be made about extending or closing the sick leave;
• The patient suffered injuries or illness as a result of drug, alcohol or toxic intoxication.

If there are the above/mentioned grounds for reducing the benefit, the patient is paid funds equal to the minimum wage for one calendar month.

Article 9 describes the time during which temporary disability benefits are not paid. There are several periods for refusing to pay money due to temporary disability:

• During the release of an employee from activities with partial or full retention of wages or without payment on the basis of the legislation of the Russian Federation. An exception is situations in which the employee became unable to work due to injury or illness during annual paid leave;
• During the period of removal from office, if no salary is transferred during this time;
• During the administrative arrest or detention of an employee;
• At the time of the forensic medical examination;
• During the downtime period. The exception is the cases provided for in Article 7 of this Federal Law.

The grounds for refusal to pay benefits are:

• The onset of temporary disability due to a suicide attempt or a court finding of intentional harm to one’s health;
• The onset of temporary disability as a result of the commission of an intentional crime by the insured person.

Article 11 describes the conditions and duration of payment of child care benefits. A similar payment is awarded to persons who care for a child and who are currently on maternity leave. Payments stop when the child reaches the age of one and a half years.

Article 12 describes the deadlines for applying for benefits, including maternity benefits, temporary disability, and monthly child care benefits.

In case of temporary disability, benefits are assigned within 6 months after restoration of working capacity (immediately after application). In order to receive cash payments for pregnancy and childbirth, a citizen can apply after the end of the relevant leave for six months. To contact policyholders after the above deadline, the employee must indicate a valid reason in the completed application.

Article 13 describes the procedure for assigning and paying benefits for temporary disability, monthly child care and maternity benefits. The payment is determined by the insurance company at the employee’s place of work.

If at the time of temporary disability and pregnancy and childbirth the employee worked in several places officially, then the payment is summed up by the insured based on all specified jobs. If child care benefits are paid, the amount is usually paid for one place of work (at the employee’s choice).

Article 14 describes how maternity benefits, temporary disability, and monthly child care benefits are calculated.

To correctly calculate benefits, the average earnings of the insured person are taken as a basis. Namely, the last two calendar years before the occurrence of one of the cases for payment of benefits. The amount of the monthly child care benefit is determined as the average earnings figure, which is multiplied by the amount of the benefit established by Federal Law. If child care is not provided for a full month, then cash benefits are paid according to the number of days of child care.

Article 17 describes the possibility of preserving rights to payment of benefits based on the duration of the insurance period and temporary disability. Employees who entered into an employment or service contract before January 1, 2007 are entitled to receive cash payments for temporary disability at an increased percentage. However, not higher than the maximum size established in accordance with Federal Law.

Download the current version of the law

The Federal Law additionally includes other cases in which benefits are also paid. These are cases such as:

• Baby care;
• Pregnancy and childbirth (paid maternity leave)

To familiarize yourself with this law and recent changes, download Federal Law 255 on compulsory social insurance in case of disability.