Violation of the sick leave regime 2021 how to pay

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Russian labor legislation provides certain guarantees of maintaining a job, length of service and financial security for an employee who, due to objective reasons, due to his state of health, cannot start work. But, in order to receive benefits in a timely manner and in full, a temporarily disabled employee must refrain from non-compliance with the hospital regime and abuse of the situation that has arisen.

Otherwise, the violation will be recorded in the text of the sick leave by the attending physician, after which consequences will occur that will prevent proper payment of the sick leave. This article will tell you about the consequences of such non-compliance.

Reflection of non-compliance with regime rules

The hospital regime is usually called a set of rules that must be followed when recovering or caring for a patient. They are formed by many years of medical practice and are aimed at a speedy recovery and control over this process.

In addition to medical indications, it also includes organizational requirements, such as timely visits to the doctor.

However, in practice, unruly behavior of patients is quite common. The most common violations of the regime are :

Going to work without a doctor's permission. Not allowed, since in this case both wages and benefits will be accrued at the same time.
Failure to comply with the instructions of the attending physician - failure to comply with bed rest, failure to appear for the next examination or prescribed procedures, unauthorized departure from the hospital. Such violations usually lead to an increase in the length of stay on sick leave, which cannot be influenced by the attending physician.
Refusal to undergo examination, including in medical and social examination institutions, calling into question the validity of the patient’s visit to the doctor.
Transfer to another clinic or hospital without the consent of the attending physician.

Violations of the sick leave regime are reflected on the certificate of incapacity for work in the line “Note on violation of the regime.” The code and date of the violation are indicated and certified by the signature of the attending physician.

You can find out what a note about violation of the regime on a sick leave certificate means and what the consequences of paying for such a document are here.

Reasons for violating the sick leave regime

An employee's sick leave schedule may be violated for good or bad reasons. A note indicating a violation by the employee will be made by the doctor if the following occurred:

failure of the patient to appear for a scheduled examination or examination by a doctor;
unreasonable violation of instructions regarding the method of treatment.

Despite the fact that an employee may have many reasons for violating the regime, the reasons mentioned above are taken as the basis for marking the violation. This is because these are the reasons that allow employers to pay sick leave benefits in a smaller amount than expected.

Any detected violation of the regime will be noted in the document in the form of a digital code, which will depend on the exact reason for which the violation occurred:

Digital code	Decoding the code	Possible violations
23	The patient ignored the doctor’s instructions, left the hospital at his own discretion, and went to another subject of the Russian Federation without permission.	Refusal to follow a diet, disruption of sleep patterns, skipping medications, refusal to be examined by a doctor, etc.
24	The patient did not show up for the next examination or arrived at the appointment at the wrong time.	This violation will be reflected in the document, even if the reason for failure to appear was valid.
25	The patient returned to work before the doctor allowed him to start working.	The mark will be made even if the person went to the employer simply to settle the payment.
26	The patient refused to go for a medical and social examination.	The sick leave will be closed by the doctor on the day of refusal.
27	The patient showed up for the medical and social examination at the wrong time.	The sick leave will be closed on the date for which the examination was scheduled, unless the doctor receives evidence that the reason for failure to appear was valid.
28	The patient committed any other violations.	Any violation may be reflected here if the doctor considers it such. For example, the patient was visited by family members while he was in the infectious diseases department.

What does it mean if the numbers in the b/l are 23, 24, 25, 26, 27 and 28?

The procedure for filling out sick leave is established by order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n. To reflect violations of the hospital regime, it provides 6 codes:

23 – failure to comply with the prescribed regimen, unauthorized leaving the hospital, traveling for treatment to another administrative region without the permission of the attending physician;
24 – late attendance at a doctor’s appointment;
25 – going to work without being discharged;
26 – refusal to refer to a medical and social examination institution;
27 – late appearance at the medical and social examination institution;
28 – other violations.

Common mistakes

Error: The employer reduced the amount of sick leave benefits for violating the regime prescribed by the doctor, starting calculations from the very first day of being on sick leave.

Comment: The amount of sick leave benefits is reduced from the day the doctor recorded a violation of the sick leave regime.

Error: For an employee due to a violation of the sick leave regime, benefits were calculated based on the amount of the minimum wage. The payment for a month of sick leave turned out to be less than 1 minimum wage.

Comment: In this case, the employee is paid a sick leave benefit in the amount of 1 minimum wage per month.

Additional marks

For a number of cases of closure of a sick leave certificate associated with the issuance of a new one, recognition of the patient as able to work or unable to work for objective reasons, additional codes must be indicated on the sheet:

31 – issuance of a new certificate of incapacity for work if the illness continues;
32 – determination of disability;
33 – change of disability group;
34 – death of the patient;
35 – refusal of the patient to conduct a medical and social examination;
36 – failure of the patient to appear for the next appointment and recognition of him as able to work at the next visit to the doctor;
37 – referral for follow-up treatment immediately after hospitalization.

They are indicated in the “Other” line, immediately after the “Get to work” line. For codes 32, 33, 34 and 36, the date of establishment or change of the disability group, the date of death or the date of appearance as able-bodied are indicated, respectively.

Valid and disrespectful reasons for violating the regime

The employer, at its discretion, may consider the reasons for the employee’s violation of the sick leave regime as valid, but he is not obliged to be guided by the generally accepted list of such reasons. So, in most cases, the following are considered valid reasons:

illness or death of a close family member;
moving to a permanent place of residence in another locality, changing the place of temporary residence;
long period of temporary disability - more than six months;
the presence of force majeure circumstances (fire, flooding, military action, natural disaster).

If the employer or judge finds the reasons why the doctor's orders were violated to be unjustified, the amount of sick leave benefits will be reduced. If so, then the amount of sick leave benefits will be calculated based on the current minimum wage from the date the violation was noted.

Filling out a certificate of incapacity for work if the regime is violated

Filling out sick leave with a violation of the regime does not differ from the standard registration procedure. Only the above fields require special attention.

If you fail to show up for an appointment with a doctor scheduled for May 25, 2021, an entry is made in the line “Note about violation of the regime”: “Note about violation of the regime 24 Date 05/25/2018 Signature of doctor Sidorov.”

If after this the patient came for an appointment on June 16, 2021 and was recognized as able to work, “36 06/16/2018” is indicated in the “Other” line. The “Get Started” line is not filled in.

New position

However, now FSS specialists have reconsidered their position and withdrawn the June letter No. 14-15/7710-2216l. The new letter dated 01.09.20 No. 14-15/7710-2216l states that sick leave benefits should be calculated as follows:

for the period from April 17 to April 20 - according to the general rules, that is, based on average earnings.
for April 21 - based on the minimum wage;

Calculate your salary and benefits taking into account the increase in the minimum wage from 2021 Calculate for free

But for the period from April 22 to April 24, benefits are not provided at all. The fund department believes that the days following the date when the employee was supposed to see a doctor (that is, from April 22 to April 24) can be considered:

or absenteeism (subparagraph “a”, paragraph 6, part 1, article of the Labor Code of the Russian Federation), if the reason for failure to appear was considered disrespectful;
or absence from the workplace for a good reason (if the explanations and supporting documents provided by the employee prove, in the opinion of the head of the organization, the presence of a good reason for absence from work).

Therefore, the days following the date when the employee was supposed to appear for an appointment with a doctor do not apply to the period of temporary incapacity for work and are not subject to payment, according to the Social Insurance Fund department.

Consequences

Is sick leave paid in full if the patient violated the regime and the document contains a mark, for example, code 24?

If the incapacity regime is violated, the benefit paid to the employee must be reduced. In this case, it cannot exceed the minimum wage for a full calendar month. The minimum wage established by Federal Law No. 82-FZ of June 19, 2000 is taken into account, but taking into account the regional coefficients in force at the employee’s main place of work.

The exception is cases where the violation was committed for valid reasons. Then the benefit should be calculated in the usual amount. The list of such reasons was approved by order of the Ministry of Health and Social Development of Russia dated January 31, 2007 No. 74. These, in particular, include:

force majeure, that is, extraordinary circumstances;
illness or injury resulting in long-term temporary disability lasting more than six months;
moving to another area, due to which visiting a medical institution becomes impossible;
damage to health or death of a close relative.

Other reasons can be recognized as valid only by a court decision.

An employee who violates the rules is required to give an explanation and provide documents confirming his compliance. Issues of recognizing a reason as valid or disrespectful can only be considered by the social insurance commission created by the employer, formed from among the administration of the business entity and the workforce.

We talked more about what consequences can be expected at work if sick leave is violated in a separate article.

Sick leave with violation of payment regime in 2021

In case of violation of the procedure for treatment and the regime of stay in a hospital, a sheet of temporary incapacity for work (legally established name for sick leave) is paid to the employee in a slightly different amount, different from that if the calculation was carried out for consequences of a valid nature. The benefit is cut if there is a reason for this, which the doctor must make a note about on the sick leave form.

Read about the nuances of applying for sick leave to care for a child at the following link:

Violation of hospital regime consequences

In case of violation of the sick leave regime, the leave is paid at the main job, but the Social Insurance Fund has the right to reduce the amount of benefits if there is an appropriate mark. How the sick leave is paid for in violation also depends on what situation might have existed at the time the sick leave was issued, causing the employee to become incapacitated. The reasons that cannot be valid for non-compliance with the regime and entail the issuance of a note are the following:

failure to attend an appointment;
the employee left the medical institution without permission;
treatment prescribed during the period of incapacity was rejected by the patient;
an act of refusal to undergo procedures, examinations or any hospital treatment;
employee returning to work early;
organization by the patient of a trip to another region with subsequent treatment by another specialist.

Sick leave is paid from the day on which the violation occurred. The consequences of this are that benefits are calculated not on the average employee’s earnings, but on the minimum wage. The calculated value is multiplied by the time spent at work (experience) and a calculation is made for payment of benefits. Until the moment when a violation occurs, sick leave payment is made in the required amount.

Example: Employee Petrov, having a disability due to illness, was undergoing treatment from August 11 to August 28. Petrov did not attend the reception scheduled for August 21. The reason for absence is not valid. But he comes for examination on August 26th. A note about the violation is placed on the sheet form. The benefit is paid based on this example as follows:

From August 11 to August 21 - the sheet is paid on a general basis, and payment is based on the value of average earnings (10 calendar days);
from August 21 to 28 - the sheet is paid based on the minimum wage (7 calendar days), since there is no valid reason for its absence. At the moment it is 7500 rubles.

The example showed us that with Petrov’s average earnings at work being 800 rubles and with more than eight years of experience - before the procedure is not followed, his allowance is: 10x800 = 8000 rubles. Whereas from the same example it is clear that payment for the time elapsed after non-compliance with the treatment conditions will be: 7x(7500:31) = 1693.55 rubles. For the specified period, benefits are paid exclusively in the order given in this example.