How is sick leave paid in case of an occupational injury? The calculation of the amount of payment in case of an injury at work is carried out in a special order, different from that used for regular sick leave. What documents do I need to issue in case of an industrial injury? How to calculate the allowance correctly? Will the social insurance reimburse the costs of paying for the hospital? The answers to these and other questions are in the material below.
How is sick leave issued in case of an industrial injury?
Payment of sick leave in case of an injury at work is carried out only with proper documentary confirmation of the fact of the accident.
The employee’s receipt of an industrial injury is certified:
- A disability certificate in which:
- the code 02 is present in the column “Reason for disability”.
IMPORTANT! Previously, the code 04 was used for an industrial injury, but since 09/01/2022 this code has been abolished and will use the same code as for a domestic injury – 02. For more information, see the ConsultantPlus article
- the date of drawing up the accident report in the form H-1 is reflected.
- Act N-1, the form of which was approved by the decree of the Ministry of Labor of the Russian Federation dated 04/20/2022 No. 223n.
From 2021, the employer does not need to calculate and pay sick leave for an industrial injury. He only has to send the necessary information and documents to the SFR (from 2023). We wrote more about the unification of the FIU and the FSS in the SFR here.
The SFR will already calculate everything and pay the money to the employee directly.
You can find out more about the direct payment of benefits in our memo.
Until 2021, the calculation and payment of benefits were made by the employer, and the then functioning FSS compensated him for these amounts (for injury contributions account) in full from the 1st day of sick leave. This was the difference between the procedure for paying benefits in case of an industrial injury and a sick leave in case of a common illness (when the FSS reimbursed the employer’s expenses only from the 4th day of the employee’s disability).
Readabout the timing of payment of sick leave to an employee.
How is work injury sick leave paid?
When calculating sick leave in the general case, for example, in case of a household injury, the average daily earnings of an employee is calculated taking into account the coefficient, the value of which is influenced by the length of service of the employee:
- 0.60 — if the experience is less than 5 years;
- 0.80— if the experience is 5–8 years;
- 1— if the experience is more than 8 years.
In case of an occupational injury, the corresponding coefficient is not applied, that is, the benefit is paid in 100 percent, even if the employee’s experience is less than 6 months (paragraph 1 of Article 9 of Law No. 125-FZ).
Thus, the hospital fee will be calculated according to the formula:
BL = NW × KN,
where:
NW — average daily earnings;
KN is the number of days of an employee’s disability.
The CP indicator is calculated according to the formula:
NW = ZV/730,
where:
The total amount of an employee’s earnings for which contributions to the SFR (formerly the FSS) are accrued, including contributions for occupational injuries (in accordance with Law No. 125-FZ) for 2 years preceding the one in which the sick leave is issued.
Important!The amount of the benefit calculated for a full calendar month must be at least the minimum wage. If it turned out to be lower, the benefit is calculated based on the minimum wage (Article 1 of Law No. 104-FZ dated 04/01/2020). For more information about the allowance from the minimum wage, see here.
At the same time, the value of the SV indicator may not have restrictions in terms of the amounts for which contributions for occupational injuries are accrued (paragraph 1 of Article 20.1 of Law No. 125-FZ).
At the same time, the maximum amount of the monthly allowance in case of an injury at work cannot exceed the maximum amount established by law, which is multiplied by 4 (paragraph 2 of Article 9 No. 125-FZ).
From 02/01/2023 to 01/31/2024, this limit was 101,288.68 rubles (Decree of the Government of the Russian Federation No. 119 of 30.01.2023). That is, the disability allowance for a month in 2023 could not be more than 405,154.72 rubles.
Since 02/01/2024, the limit has increased and amounts to 108,784.04 rubles (Decree of the Government of the Russian Federation No. 46 dated 01/23/2024). Thus, in 2024, the monthly allowance cannot be more than 435,136.16 rubles.
Read hereabout whether sick leave charges will be included in the calculation of vacation pay.
Results
If an employee receives an occupational injury, the allowance is paid by the SFR from the 1st day of the sick leave. The calculation of the amount to be paid is based on the average earnings of the employee for whom the “unfortunate” insurance premiums are accrued in accordance with Law No. 125-FZ. The reduction factor, which takes into account the length of service, is not applied. However, restrictions in the form of a legally established amount of the maximum possible payment must be taken into account.