Registration of disability sheets of a new sample involves the introduction of information in the form of information in digital form. This type of filling facilitates the processing of documentation. In addition, the time is saved both by health workers and accounting specialists when compiling the form and entering data into other necessary papers. Let us further consider some codes of causes of disability in the new sick leave.
General information
The code instead of the diagnosis in the new sick leave is one of the requirements of the form. Inquiries are provided to the accounting department of the enterprise for calculating benefits. In order to correctly carry out the calculation, it is necessary to identify what the cause of disability is: an accident or occupational disease, domestic injury or normal pathology. The allowance is calculated in accordance with the procedure provided for in Federal Law No. 255, which governs the rules for compulsory social insurance of an employee. Decoding of disease codes on sick leave is provided on the back of the form. This information is used by both the health worker and the accountant when filling out the certificates.
Codes of causes of disability in the new sick leave
Absenteeism may be associated with domestic or industrial situations. According to the Federal Law, several values have been established by which the cause of disability is determined. Code 02 - any pathology not related to production. The worker may also be injured. In the form, it is indicated under the value 01. If disability is associated with an accident at work, then 04 is set, with occupational disease or its exacerbation - 07. The last two values indicate that the benefit will be calculated in a special order.
General calculation rules
As it was said above, the allowance is calculated depending on which code on the disability sheet in the line “Reason” is put down by the health worker. Consider household situations not related to production. If the cause of disability is code 02 or 01, the calculation takes into account earnings for 2 calendar years that precede the incident. The length of service is also taken into account . If the reason for incapacity for work is indicated - code 02 or 01, when calculating the allowance, the right to replace the year (s) of the calculation period if it was maternity leave or to take care of the child if it leads to an increase in payment is taken into account. If the form contains notes on violation of the regime (if recognized by the employer as disrespectful), the compensation should be reduced. If the cause of disability is code 02 or 01, the costs of payment in the first 3 days are reimbursed from the funds of the enterprise, then - at the expense of the FSS of the Russian Federation. If the average employee’s salary for a full month (calendar) is less than the minimum wage or it was not there, the minimum wage at the time the insurance situation occurs is used to calculate the benefit.
Calculation of benefits for work-related injuries: regulatory documents
When calculating compensation related to disability arising from occupational disease or accident, you must be guided by:
- Federal Law No. 125.
- A number of provisions of Law No. 255 of the Federal Law that do not contradict the above Federal Law. These include, in particular, Articles 12-15. In Art. 12 sets the period during which you can apply for the payment of benefits, in Art. 13 - on the purpose of compensation at the place of work and the choice of an enterprise that will compensate for the damage (if a person works in several places). Article 14 establishes the calculation procedure, and Art. 15 - timing of accrual and payment.
- Regulation on the calculation of compensation, which is approved by a government decree.
- The rules of accounting, accrual and expenditure of funds in order to carry out compulsory social insurance against industrial injuries and occupational diseases.
Appointment and payment
If the filled-in form contains codes for the causes of disability 04 and 07, then the procedure for establishing and issuing compensation is similar to that used for domestic injuries or pathologies. There are no restrictions on the amount of earnings. As in the calculation of ordinary benefits, compensation for incapacity for work due to occupational disease or work injury is charged in accordance with the salary of the employee for 2 years that were before the year the accident occurred. The absence of restrictions on the maximum wage is due to the fact that the taxable base for such insurance premiums does not have a maximum size, unlike the one established for maternity leave.
Length of service
According to Art. 9 Federal Law No. 125 the payment of disability benefits related to work-related injuries or occupational diseases is carried out in the amount of 100% of the average salary of an employee. The duration of the insurance period does not matter. This dependence is established in Art. 7 of the Federal Law No. 255. However, this article is not mentioned in Art. 1, part 2 of the Federal Law No. 255. Thus, the insurance experience in the calculations is not taken into account.
Allowance amount
The amount of compensation cannot be reduced, even if the healthcare provider has put a mark in the completed form of the sheet indicating a violation of the regime. The allowance is paid for the entire period of absenteeism until recovery or full restoration of the loss of ability to fulfill one’s duties in 100% of the average salary. Reduce the amount of compensation, even if there are grounds listed in Art. 8 of the Federal Law No. 255, the tenant is not entitled, since this article is not in the list provided in art. 1, part 2 of Federal Law No. 255.
Payout source
The expenses of the enterprise for the payment of compensation in connection with disability due to occupational disease or work-related injury are fully reimbursed at the expense of the Social Insurance Fund, aimed at compulsory social insurance. The authorized body credits the indicated costs against deductions of insurance premiums, in accordance with Art. 15, paragraph 7 of the Federal Law No. 125, as well as paragraph 10 of the Rules for the calculation, accounting and expenditure of funds, which are approved by government decree.
Compensation for part-timers
The allowance due to the employee in connection with disability due to an injury at work or occupational disease is paid in full at the place of business under the conditions of external part-time employment . However, there is a nuance. The employee must be employed for the past 2 years with the same employers as on the date of the insured event. This requirement is established by Art. 13 of the Federal Law No. 255. The allowance is accrued in accordance with the average salary established by art. 14 of the Federal Law No. 255 received during the service, work and other activities of the policyholder appointing and paying compensation. In case specified in Art. 13 the condition is not fulfilled, the employee receives benefits at one place (of his choice), taking into account part-time payment.
Personal income tax
The Tax Code provides a list of non-taxable compensation. Disability benefits are not included in this list. Thus, compensation for absenteeism due to work injury or occupational disease should be subject to personal income tax.
Examples
1. A specialist with an insurance experience of less than five years was temporarily incapacitated due to an industrial injury from January 1 to February 15, 2013. There were 46 days off. In the form of the hospital’s letter, the doctor noted a violation of the regime - the specialist did not come to the appointment on the appointed day. The following amounts are taken into account for calculating benefits:
- 635 000 rub. - for 2012;
613 000 rub. - for 2011.
The amount of benefits is determined as follows. Since the salary for the years of the billing period is not limited to the maximum value, the average earnings per day is (613,000 + 635,000): 730 = 1,709.59 rubles. Since compensation to the employee for disability is accrued in 100% of the average. s / n and will not depend on the length of the insurance period, the daily allowance will also be 1709.59 rubles. Since compensation in this case cannot be reduced under any circumstances, the mark of the health care provider about the violation of the regime is ignored. Thus, the total amount of benefits - 1709.59 X 46 days = 78 641.14 rubles.
2. A specialist with an insurance experience of less than five years was on sick leave due to domestic injury from March 19 to April 5, 2012. The total period is 18 days. In the hospital doctor, a mark was made about the violation of the regime. To calculate the allowance, the following amounts are taken into account:
- 102 000 rub. - for 2010;
US $ 73,573.33 - for 2011
Determine the amount of compensation. According to the decision of the social insurance commission, the reason for the violation of the regime was recognized as disrespectful. This means that the accountant must reduce the amount of benefits from the date indicated by the doctor until the day the employee is discharged. Average salary per day (73,573.33 + 102,000): 730 = 240.51 rubles. The daily allowance will be 60% of the average salary - 144.31 rubles. Until the day of decline, the compensation will be equal to 144.31 X 11 (from March 19 to 29) = 1,587.41 rubles. Now you should calculate the compensation after the violation (from March 30 to April 5 - 7 days). First, the daily minimum wage allowance is calculated for each day in which it is reduced. It should be borne in mind that if a regional coefficient was applied to the area, then wages will increase by him. In addition, it should be added that in case of temporary disability due to motherhood (pregnancy and childbirth), a federal minimum wage is used, and not specifically established for the subject of the Russian Federation. So, the daily allowance will be:
- For March 2012 - 4611: 31 = 148.74 rubles.
For April 2012 - 4611: 30 = 153.7 rubles.
Next, you should compare the amount of benefits calculated on the minimum wage and average actual earnings:
144.31 and 148.74 in March and 144.31 and 153.7 in April.
Here the choice is made in favor of a smaller amount - 144.31 rubles. and the amount of compensation for the time when it should be reduced is determined:
144.31 X 7 = 1010.17 rubles.
The following determines the total amount of compensation:
1010.17 + 1587.41 = 2597.58 rubles.
Of the amount received, the first three days are compensated by the employer. Starting from the 4th day, the benefit is reimbursed from the FSS fund.