Law 255 FZ of the latest edition. New rules for calculating benefits for temporary disability, pregnancy and childbirth, monthly childcare benefits
Chapter 1. General Provisions
Article 1. Subject of regulation of this Federal law
1. This Federal Law determines the conditions, amounts and procedure for providing benefits for temporary incapacity for work, for pregnancy and childbirth of citizens, subject to compulsory social insurance.
2. This Federal Law does not apply to relations related to the provision of citizens with benefits for temporary disability in connection with an industrial accident or occupational disease, with the exception of the provisions of Articles 12, 13, 14 and 15 of this Federal Law, which apply to these relations in part which does not contradict the Federal Law of July 24, 1998 N 125-FZ "On compulsory social insurance against industrial accidents and occupational diseases."
Article 2. Persons entitled to benefits for temporary incapacity for work, for pregnancy and childbirth
1. The right to benefits for temporary incapacity for work, for pregnancy and childbirth have citizens subject to compulsory social insurance in case of temporary incapacity for work and in connection with maternity (hereinafter - the insured persons), subject to the conditions provided for by this Federal Law and other federal laws.
2. The insured persons are citizens Russian Federation, as well as foreign citizens and stateless persons permanently or temporarily residing in the territory of the Russian Federation:
1) persons working under employment contracts;
2) state civil servants, municipal servants;
3) lawyers, individual entrepreneurs, including members of peasant (farmer) households, individuals who are not recognized as individual entrepreneurs, members of clan, family communities of small peoples of the North, who voluntarily entered into a relationship on compulsory social insurance in case of temporary disability and in connection with motherhood and who pay for themselves insurance contributions to the Social Insurance Fund of the Russian Federation in accordance with the Federal Law of December 31, 2002 N 190-FZ "On the provision of benefits for compulsory social insurance of citizens working in organizations and individual entrepreneurs using special tax regimes, and some other categories of citizens "(hereinafter - the Federal Law" On the provision of benefits for compulsory social insurance of citizens working in organizations and individual entrepreneurs applying special tax regimes, and some other categories of citizens ");
4) other categories of persons who are subject to compulsory social insurance in case of temporary disability and in connection with maternity in accordance with other federal laws, provided that they or for them pay taxes and (or) insurance contributions to the Social Insurance Fund of the Russian Federation.
3. Persons working under employment contracts, for the purposes of this Federal Law, are recognized as persons who have entered into an employment contract in accordance with the established procedure from the day from which they should have started work, or persons who are actually admitted to work in accordance with labor legislation.
4. Legislative and regulatory legal acts of the Russian Federation, constituent entities of the Russian Federation may establish other payments to provide federal state civil servants, state civil servants of the constituent entities of the Russian Federation in connection with temporary disability, pregnancy and childbirth, financed from funds federal budget, budgets of the constituent entities of the Russian Federation.
Article 3. Financing the payment of benefits for temporary incapacity for work, for pregnancy and childbirth
1. Financing of the payment of benefits for temporary incapacity for work, for pregnancy and childbirth to insured persons is carried out at the expense of the budget of the Social Insurance Fund of the Russian Federation, as well as at the expense of the employer in the cases provided for in part 2 of this article.
2. Allowance for temporary disability in the cases specified in Clause 1 of Part 1 of Article 5 of this Federal Law shall be paid to insured persons (except for the insured persons specified in Part 4 of this Article) for the first two days of temporary incapacity for work at the expense of the employer, and for the rest of the period starting from the 3rd day of temporary disability - at the expense of the Social Insurance Fund of the Russian Federation.
3. Allowance for temporary disability in the cases provided for by clauses 2-5 of part 1 of Article 5 of this Federal Law shall be paid to insured persons (with the exception of the insured persons specified in Part 4 of this Article) at the expense of the Social Insurance Fund of the Russian Federation from the 1st days of temporary disability.
4. Financing the payment of temporary disability benefits to insured persons working under labor contracts concluded with organizations and individual entrepreneurs applying special tax regimes (who have switched to a simplified taxation system or are payers of the single tax on imputed income for certain types activities or the unified agricultural tax), as well as to persons who voluntarily entered into relations on compulsory social insurance in case of temporary disability and in connection with maternity, is carried out in accordance with the Federal Law "On the provision of benefits for compulsory social insurance of citizens working in organizations and individual entrepreneurs applying special tax regimes, and some other categories of citizens. "
5. In the cases established by the laws of the Russian Federation, federal laws, financing of expenses related to the payment of benefits for temporary disability, for pregnancy and childbirth in excess of those established by the legislation of the Russian Federation on compulsory social insurance, is carried out at the expense of the federal budget allocated for these goals of the Social Insurance Fund of the Russian Federation.
Article 4. Provision of benefits for temporary incapacity for work, for pregnancy and childbirth of persons sentenced to imprisonment and involved in paid work
Persons sentenced to imprisonment and involved in paid work are subject to benefits for temporary disability, pregnancy and childbirth in the manner determined by the Government of the Russian Federation.
Chapter 2. Provision of benefits for temporary incapacity for work
Article 5. Cases of provision of benefits for temporary incapacity for work
1. Provision of insured persons with temporary disability benefits is carried out in the following cases:
1) disability due to illness or injury, including in connection with an operation to artificially terminate pregnancy or the implementation of in vitro fertilization (hereinafter - disease or injury);
2) the need to take care of a sick family member;
3) quarantine of the insured person, as well as quarantine of a child under the age of 7 years attending a preschool educational institution, or another family member recognized as legally incompetent in the established manner;
4) the implementation of prosthetics for medical reasons in a stationary specialized institution;
5) follow-up care in accordance with the established procedure in sanatoriums located on the territory of the Russian Federation, immediately after inpatient treatment.
2. Allowance for temporary disability is paid to insured persons upon the occurrence of the cases specified in part 1 of this article, during the period of work under an employment contract, performance of official or other activities, during which they are subject to compulsory social insurance, as well as in cases when a disease or the injury occurred within 30 calendar days from the date of termination of the specified work or activity, or in the period from the date of the conclusion of the employment contract until the day of its cancellation.
Article 6. Conditions and duration of payment of benefits for temporary incapacity for work
1. Temporary disability benefit in case of disability due to illness or injury is paid to the insured person for the entire period of temporary disability until the day of restoration of the ability to work (establishment of disability with limited ability to work), except for the cases specified in parts 3 and 4 of this article.
2. In case of further treatment of the insured person in a sanatorium-resort institution located on the territory of the Russian Federation, immediately after inpatient treatment, temporary disability benefit is paid for the period of stay in a sanatorium-resort institution, but not more than 24 calendar days.
3. An insured person who has been recognized as a disabled person in accordance with the established procedure and has a limited ability to work, a temporary disability benefit (except for tuberculosis) is paid no more than four months in a row or five months in a calendar year. In case of tuberculosis disease of these persons, the temporary disability benefit is paid until the day of restoration of the ability to work or until the day of the increase in the degree of limitation of the ability to work due to tuberculosis.
4. The insured person who has entered into a fixed-term employment contract (fixed-term service contract) for a period of up to six months, as well as the insured person whose illness or injury occurred during the period from the date of the conclusion of the employment contract to the day of its cancellation, temporary disability benefit (except tuberculosis disease) is paid for no more than 75 calendar days under this agreement. In case of tuberculosis, the temporary disability benefit is paid until the day of restoration of the ability to work (establishment of disability with limited ability to work). In this case, the insured person whose illness or injury occurred during the period from the date of the conclusion of the employment contract until the day of its cancellation, the temporary disability benefit is paid from the day from which the employee was supposed to start work.
5. Allowance for temporary incapacity for work, if it is necessary to take care of a sick family member, is paid to the insured person:
1) in the case of caring for a sick child under the age of 7 years - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical and prophylactic institution, but not more than 60 calendar days in a calendar year for all cases of caring for this child, and in case of illness of a child included in the list of diseases, determined federal body executive power, carrying out the functions of developing public policy and legal regulation in the field of health care and social development, no more than 90 calendar days in a calendar year for all cases of caring for this child in connection with the specified disease;
2) in the case of caring for a sick child aged 7 to 15 years - for a period of up to 15 calendar days for each case of outpatient treatment or joint stay with a child in an inpatient medical and prophylactic institution, but not more than 45 calendar days in a calendar year for all cases of caring for this child;
3) in the case of caring for a sick disabled child under the age of 15 - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical and prophylactic institution, but not more than 120 calendar days in a calendar year for all cases of caring for this child;
4) in the case of caring for a sick child under the age of 15 who is HIV-infected - for the entire period of joint stay with the child in an inpatient medical and prophylactic institution;
5) in the case of caring for a sick child under the age of 15 with his illness associated with a post-vaccination complication - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical and prophylactic institution;
6) in other cases of caring for a sick family member during outpatient treatment - no more than 7 calendar days for each case of the disease, but no more than 30 calendar days in a calendar year for all cases of caring for this family member.
6. Temporary disability allowance in case of quarantine is paid to the insured person who has been in contact with an infectious patient or who has been identified as carrying a bacterium, for the entire period of his suspension from work in connection with quarantine. If children under 7 years of age attending preschool are subject to quarantine educational institutions, or other family members recognized as legally incompetent, temporary disability benefits are paid to the insured person (one of the parents, another legal representative or another family member) for the entire quarantine period.
7. Allowance for temporary incapacity for work in the case of prosthetics for medical reasons in a stationary specialized institution is paid to the insured person for the entire period of release from work for this reason, including the time of travel to the place of prosthetics and back.
8. Temporary disability benefit is paid to the insured person in all cases specified in parts 1 to 7 of this article, for calendar days falling on corresponding period, with the exception of calendar days falling on the periods specified in Part 1 of Article 9 of this Federal Law.
Article 7. Amount of allowance for temporary incapacity for work
1. Allowance for temporary incapacity for work in case of loss of ability to work due to illness or injury, with the exception of the cases specified in part 2 of this article, in case of quarantine, prosthetics for medical indications and aftercare in sanatoriums immediately after inpatient treatment is paid in the following amount:
1) to an insured person with an insurance experience of 8 years or more - 100 percent of the average earnings;
2) to an insured person with an insurance experience of 5 to 8 years - 80 percent of the average earnings;
3) to an insured person with an insurance record of up to 5 years - 60 percent of the average earnings.
2. Allowance for temporary incapacity for work in case of loss of ability to work due to illness or injury is paid to insured persons in the amount of 60 percent of the average earnings in case of illness or injury that occurred within 30 calendar days after the termination of work under an employment contract, service or other activities during which they are subject to compulsory social insurance.
3. Allowance for temporary incapacity for work, if it is necessary to take care of a sick child, is paid:
1) for outpatient treatment of a child - 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 the next days in the amount of 50 percent of the average earnings;
2) for inpatient treatment of a child - in the amount determined depending on the length of the insurance period of the insured person in accordance with paragraph 1 of this article.
4. Allowance for temporary incapacity for work if it is necessary to care for a sick family member during his outpatient treatment, except for cases of caring for a sick child under 15 years of age, is paid in an amount determined depending on the length of the insured person's insurance period in accordance with Part 1 of this article.
5. The amount of temporary disability benefit cannot exceed maximum size benefits for temporary disability established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next fiscal year... If the insured person works for several employers, the amount of the temporary disability benefit cannot exceed the specified maximum amount of the specified benefit for each place of work.
6. An insured person with an insurance experience of less than six months is paid temporary disability benefits in an amount not exceeding a full calendar month minimum size wages established by federal law, and in areas and localities in which in the prescribed manner apply district coefficients to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
7. Temporary disability allowance for the period of inactivity is paid in the same amount in which it is retained during this time wage, but not more than the amount of the benefit that the insured person would receive according to the general rules.
Article 8. Grounds for reducing the amount of temporary disability benefit
1. The grounds for reducing the amount of temporary disability benefits are:
1) violation by the insured person without good reason during the period of temporary incapacity for work of the regime prescribed by the attending physician;
2) failure of the insured person to appear without good reason at the appointed time for a medical examination or for a medical and social examination;
3) illness or injury resulting from alcoholic, narcotic, toxic intoxication or actions related to such intoxication.
2. If there are one or more grounds for reducing the temporary disability benefit specified in Part 1 of this article, the temporary disability benefit is paid to the insured person in an amount not exceeding the minimum wage established by federal law for a full calendar month:
1) if there are grounds specified in clauses 1 and 2 of part 1 of this article - from the day when the violation was committed;
2) if there are grounds specified in clause 3 of part 1 of this section - for the entire period of incapacity for work.
Article 9. Periods for which temporary disability benefit is not awarded. Grounds for refusal to grant temporary disability benefits
1. Temporary disability benefit is not awarded to the insured person for the following periods:
1) for the period when the employee is released from work with full or partial retention of wages or without payment in accordance with the legislation of the Russian Federation, except for cases of disability due to illness or injury during the period of annual paid leave;
2) for the period of suspension from work in accordance with the legislation of the Russian Federation, if no salary is accrued for this period;
3) for the period of taking into custody or administrative arrest;
4) for the period of the forensic medical examination.
2. The grounds for refusing to grant the insured person benefits for temporary incapacity for work are:
1) the onset of temporary incapacity for work as a result of the deliberate infliction of harm to his health by the insured person or attempted suicide established by the court;
2) the onset of temporary incapacity for work due to the commission of an intentional crime by the insured person.
Chapter 3. Provision of maternity benefits
Article 10. Duration of payment of maternity benefits
1. The maternity allowance is paid to the insured woman in total for the entire period of maternity leave lasting 70 (in case of multiple pregnancy - 84) calendar days before childbirth and 70 (in case of complicated childbirth - 86, at the birth of two or more children - 110) calendar days after childbirth.
2. In case of adoption of a child (children) under the age of three months, the maternity allowance is paid from the date of his adoption until the expiration of 70 (in the case of simultaneous adoption of two or more children - 110) calendar days from the date of birth of the child (children).
3. In the event that during the period of a mother's childcare leave until she reaches the age of one and a half years, she has a maternity leave, she has the right to choose one of two types of benefits paid during the periods of the corresponding leave.
Article 11. Amount of maternity allowance
1. The maternity allowance is paid to the insured woman in the amount of 100 percent of the average earnings.
2. The amount of the maternity benefit may not exceed the maximum amount of the maternity benefit established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year. If the insured person works for several employers, the amount of the maternity benefit cannot exceed the specified maximum amount of the specified benefit for each place of work.
3. An insured woman with an insurance experience of less than six months is paid maternity benefits in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in regions and localities in which regional coefficients are applied in the prescribed manner to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
Chapter 4. Assignment, Calculation and Payment of Benefits for Temporary Disability, Pregnancy and Childbirth
Article 12. Terms for applying for benefits for temporary incapacity for work, for pregnancy and childbirth
1. Temporary disability allowance is granted if the application for it was followed no later than six months from the day of restoration of the ability to work (establishment of disability with limited ability to work), as well as the end of the period of release from work in cases of caring for a sick family member, quarantine, prosthetics and aftercare.
2. The maternity allowance shall be granted if the application for it was followed no later than six months from the date of the end of the maternity leave.
3. When applying for benefits for temporary disability, for pregnancy and childbirth after a six-month period, the decision on granting benefits is made by the territorial body of the Social Insurance Fund of the Russian Federation if there are good reasons for missing the deadline for applying for benefits. The list of valid reasons for missing the deadline for applying for benefits is determined by the federal executive body responsible for the development of state policy and legal regulation in the field of compulsory social insurance.
Article 13. Procedure for the appointment and payment of benefits for temporary incapacity for work, for pregnancy and childbirth
1. The assignment and payment of benefits for temporary disability, for pregnancy and childbirth are carried out by the employer at the place of work of the insured person (except for the cases specified in parts 2 and 3 of this article). In the event that the insured person works for several employers, benefits are assigned and paid to him by each employer.
2. An insured person who has lost the ability to work due to illness or injury within 30 calendar days from the date of termination of work under an employment contract, service or other activities during which he is subject to compulsory social insurance, temporary disability benefits are assigned and paid by the employer at his last place work either by the territorial body of the Social Insurance Fund of the Russian Federation.
3. The insured persons specified in clause 3 of part 2 of Article 2 of this Federal Law, as well as other categories of insured persons, in the event of termination of activity by the employer at the time of the request of the insured person for benefits for temporary disability, for pregnancy and childbirth, the appointment and payment of these benefits are carried out by the territorial body of the Social Insurance Fund of the Russian Federation.
4. For the appointment and payment of benefits for temporary incapacity for work, for pregnancy and childbirth, the insured person presents a certificate of incapacity for work issued medical organization in the form and in the manner established by the federal executive body responsible for the development of state policy and legal regulation in the field of compulsory social insurance, and for the appointment and payment of benefits by the territorial body of the Social Insurance Fund of the Russian Federation, also information on earnings (income) , from which the allowance must be calculated, and documents confirming the insurance experience, determined by the specified federal executive body.
5. The employer pays benefits for temporary incapacity for work, for pregnancy and childbirth to the insured person in the manner prescribed for the payment of wages to employees.
6. In cases of the appointment and payment of benefits for temporary disability, pregnancy and childbirth by the territorial body of the Social Insurance Fund of the Russian Federation, provided for in parts 2 and 3 of this article, the payment of benefits for temporary disability, pregnancy and childbirth is made in the established amount directly by the territorial body of the Fund social insurance of the Russian Federation, who have appointed the specified allowance, or through the organization of the federal postal service, a credit or other organization at the request of the recipient.
Article 14. The procedure for calculating benefits for temporary incapacity for work, for pregnancy and childbirth
1. Benefits for temporary disability, for pregnancy and childbirth are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months preceding the month of the onset of temporary disability, maternity leave.
2. The earnings, on the basis of which benefits for temporary incapacity for work, for pregnancy and childbirth are calculated, include all types of payments provided for by the wage system that are taken into account when determining tax base on a single social tax credited to the Social Insurance Fund of the Russian Federation, in accordance with chapter 24 of part two Tax Code Russian Federation. The earnings for calculating benefits for temporary incapacity for work, for pregnancy and childbirth to insured persons who voluntarily entered into a relationship on compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, include the income received by them, from which they were paid insurance premiums to the Social Insurance Fund of the Russian Federation in accordance with the Federal Law "On the Provision of Benefits for Compulsory Social Insurance of Citizens Working in Organizations and Individual Entrepreneurs Using Special Tax Regimes, and Some Other Categories of Citizens."
3. Average daily earnings for calculating benefits for temporary disability, for pregnancy and childbirth is determined by dividing the amount of accrued earnings for the period specified in part 1 of this article by the number of calendar days falling on the period for which the wages are taken into account.
4. The amount of the daily allowance for temporary incapacity for work, for pregnancy and childbirth is calculated by multiplying the average daily earnings of the insured person by the amount of the allowance established as a percentage of the average earnings in accordance with Articles 7 and 11 of this Federal Law.
5. The amount of the allowance for temporary incapacity for work, for pregnancy and childbirth is determined by multiplying the amount of the daily allowance by the number of calendar days falling on the period of temporary incapacity for work, maternity leave.
6. In the event that the amount of benefits for temporary incapacity for work, for pregnancy and childbirth, calculated in the manner prescribed by this article, exceeds the maximum amount of benefits for temporary incapacity for work, for pregnancy and childbirth, established in accordance with Articles 7 and 11 of this Federal Law, these allowances are paid in the specified maximum amounts.
7. Features of the procedure for calculating benefits for temporary disability, for pregnancy and childbirth, including for selected categories insured persons are determined by the Government of the Russian Federation.
Article 15. Terms of appointment and payment of benefits for temporary incapacity for work, for pregnancy and childbirth
1. The employer assigns benefits for temporary disability, for pregnancy and childbirth within 10 calendar days from the day the insured person applied for it from necessary documents... The payment of benefits is carried out by the employer on the day following the assignment of benefits, established for the payment of wages.
2. The territorial body of the Social Insurance Fund of the Russian Federation in the cases provided for by Parts 2 and 3 of Article 13 of this Federal Law shall appoint and pay benefits for temporary disability, pregnancy and childbirth within 10 calendar days from the date the insured person submits the relevant application and the necessary documents ...
3. The temporary disability, maternity and childbirth allowance assigned but not received by the insured person in a timely manner shall be paid for the entire past time, but not more than three years prior to applying for it. The allowance not received by the insured person in whole or in part through the fault of the employer or the territorial body of the Social Insurance Fund of the Russian Federation is paid for the entire past time without any time limit.
4. The amounts of benefits for temporary incapacity for work, for pregnancy and childbirth, overpaid to the insured person, cannot be recovered from him, except for cases counting error and bad faith on the part of the recipient (submission of documents with deliberately incorrect information, concealment of data affecting the receipt of benefits and its amount, other cases). Withholding is made in the amount of not more than 20 percent of the amount due to the insured person for each subsequent payment of benefits or his salary. Upon termination of the payment of benefits or wages, the remaining debt is recovered in court.
5. The accrued amounts of benefits for temporary incapacity for work, for pregnancy and childbirth, not received in connection with the death of the insured person, are paid in the manner prescribed by the civil legislation of the Russian Federation.
Article 16. The procedure for calculating the insurance period for determining the amount of benefits for temporary disability, for pregnancy and childbirth
1. The insurance experience to determine the amount of benefits for temporary disability, pregnancy and childbirth (insurance experience) includes the periods of work of the insured person under an employment contract, state civil or municipal service, as well as periods of other activities during which the citizen was subject to compulsory social insurance in case of temporary disability and in connection with motherhood.
2. Calculation of the insurance period is carried out in calendar order... In case of coincidence in time of several periods included in the insurance period, one of such periods is taken into account at the choice of the insured person.
3. The rules for calculating and confirming the length of service are established by the federal executive body responsible for the development of state policy and legal regulation in the field of compulsory social insurance.
Chapter 5. Procedure for the entry into force of this Federal Law
Article 17. Retention of previously acquired rights when determining the amount of temporary disability benefit and the duration of the insurance period
1. Establish that citizens who started work under an employment contract, service or other activity, during which they are subject to compulsory social insurance, before January 1, 2007 and who until January 1, 2007 had the right to receive benefits for temporary disability in in the amount (in percentage terms of the average earnings) exceeding the amount of the benefit (in percentage terms of the average earnings), due in accordance with this Federal Law, the temporary disability benefit is assigned and paid in the same higher amount (in percentage terms of the average earnings) , but not higher than the maximum amount of benefits for temporary disability established in accordance with this Federal Law.
2. In the event that the duration of the insurance period of the insured person, calculated in accordance with this Federal Law for the period up to January 1, 2007, turns out to be less than the duration of his continuous work experience applied when assigning benefits for temporary disability in accordance with the previously valid regulatory legal acts , for the same period, the duration of the uninterrupted work experience of the insured person is taken as the duration of the insurance period.
Article 18. Application of this Federal Law to insured events that occurred before and after the day of its entry into force
1. This Federal Law shall apply to insured events that occurred after the day this Federal Law came into force.
2. For insured events that occurred before the date of entry into force of this Federal Law, the allowance for temporary disability, for pregnancy and childbirth shall be calculated according to the norms of this Federal Law for the period after the day of its entry into force, if the amount of the allowance calculated in accordance with this Federal Law by law, exceeds the amount of the benefit relying on the norms of the previous legislation.
Article 19. Entry into force of this Federal Law
2.From January 1, 2007 legislative acts and other regulatory legal acts Of the Russian Federation, stipulating the conditions, amounts and procedure for providing benefits for temporary disability, for pregnancy and childbirth of citizens subject to compulsory social insurance, are applied in the part that does not contradict this Federal Law.
The president
Russian Federation
V. Putin
Approx. ed .:
Article 14. The procedure for calculating benefits for temporary incapacity for work, for pregnancy and childbirth, monthly allowance for child care
1. Benefits for temporary incapacity for work, for pregnancy and childbirth, monthly childcare benefits are calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of temporary incapacity for work, maternity leave, parental leave, including during work (service, other activities) with another policyholder (other policyholders). Average earnings for the time of work (service, other activity) with another insured (other insured) is not taken into account in cases where, in accordance with Part 2 of Article 13 of this Federal Law, benefits for temporary disability, for pregnancy and childbirth are assigned and paid to the insured person for all places of work (service, other activity) based on the average earnings for the time of work (service, other activity) with the insured who appoints and pays 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) on parental leave, the corresponding calendar years (calendar year) at the request of the insured person can be replaced in order to calculate the average earnings in the previous calendar years (calendar year), provided that this leads to an increase in the amount of the benefit.
1.1. In the event that the insured person did not have earnings during the periods specified in paragraph 1 of this article, as well as in the event that average earnings calculated for these periods, calculated for a full calendar month below the minimum wage established by federal law on the day of occurrence insured event, the average earnings, on the basis of which the benefits for temporary disability, for pregnancy and childbirth, the monthly allowance for childcare are calculated, is taken equal to the minimum wage established by federal law on the day of the insured event. If the insured person at the time of the occurrence of the insured event is working part-time (part-time, part-time), the average earnings, on the basis of which the benefits are calculated in these cases, is determined in proportion to the working time of the insured person. At the same time, in all cases, the calculated monthly childcare allowance cannot be less than the minimum monthly childcare allowance established by the Federal Law "On State Benefits to Citizens with Children".
2. The average earnings, on the basis of which benefits for temporary incapacity for work, for pregnancy and childbirth, monthly childcare allowances are calculated, include all types of payments and other benefits 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 premiums in Pension Fund Russian Federation, Social Insurance Fund of the Russian Federation, Federal Obligatory Fund health insurance"(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).
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 the benefits for temporary disability, for pregnancy and childbirth, the monthly allowance for childcare are calculated, shall be equal to the minimum wage established by the federal law on the day of occurrence insured event. At the same time, the calculated monthly childcare allowance cannot be less than the minimum monthly childcare allowance established by the Federal Law "On State Benefits to Citizens with Children".
2.2. For insured persons who worked under employment contracts concluded with organizations and individual entrepreneurs for whom the reduced tariff insurance contributions to the Social Insurance Fund of the Russian Federation in the amount of 0 percent, in the average earnings, on the basis of which benefits for temporary disability, maternity benefits, monthly childcare benefits, include all types of payments and other benefits 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, Social Insurance Fund of the Russian Federation, Federal Mandatory 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) in the corresponding calendar year and do not exceed the limit value of the base for calculating insurance contributions to the Social Insurance Fund Russian Federation ai set for that calendar year. Information about the specified payments and remuneration in favor of the insured person for the relevant period is indicated in the certificate of the amount of earnings issued by the insured in accordance with clause 3 of part 2 of article 4.1 of this Federal Law.
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.
3.1. Average daily earnings for calculating maternity benefits, monthly childcare benefits is 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 on the following periods :
1) periods of temporary disability, maternity leave, parental leave;
2) the period of the employee's release 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 on 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, Social Insurance Fund of the Russian Federation, Federal Mandatory 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).
3.2. The average earnings, on the basis of which the benefits for temporary disability, for pregnancy and childbirth and the monthly allowance for childcare are calculated, are taken into account for each calendar year in an amount not exceeding the amount established in accordance with Federal Law No. 212-FZ of July 24, 2009 " On insurance contributions to the Pension Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, 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. In the event that the appointment and payment of benefits for temporary incapacity for work, for pregnancy and childbirth to the insured person are carried out 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, are taken into account for each calendar year in an amount not exceeding the specified limit value, when calculating these benefits for each of these policyholders.
3.3. The average daily earnings for calculating maternity benefits, monthly childcare benefits, determined in accordance with part 3.1 of this article, cannot exceed the value determined by dividing by 730 the sum of the limit values of the base for calculating insurance contributions to the Russian Social Insurance Fund. Federation established in accordance with Federal Law No. 212-FZ of July 24, 2009 "On Insurance Contributions to the Pension Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, Federal Mandatory 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 the onset of maternity leave, parental leave.
4. The amount of the daily allowance for temporary incapacity for work, for pregnancy and childbirth is calculated by multiplying the average daily earnings of the insured person by the amount of the allowance established as a percentage of the average earnings in accordance with Articles 7 and 11 of this Federal Law.
5. The amount of the allowance for temporary incapacity for work, for pregnancy and childbirth is determined by multiplying the amount of the daily allowance by the number of calendar days falling on the period of temporary incapacity for work, maternity leave.
5.1. The monthly childcare allowance is calculated from the average earnings of the insured person, which is determined by multiplying the average daily earnings determined in accordance with parts 3.1 and 3.2 of this article by 30.4.
5.2. The amount of the monthly childcare allowance is determined by multiplying the average earnings of the insured person by the amount of the allowance established as a percentage of the average earnings in accordance with Article 11.2 of this Federal Law. When caring for a child for an incomplete calendar month, the monthly childcare allowance is paid in proportion to the number of calendar days (including non-working holidays) in the month during the period of care.
7. The specifics of the procedure for calculating benefits for temporary incapacity for work, for pregnancy and childbirth, monthly benefits for childcare, including for certain categories of insured persons, are determined by the Government of the Russian Federation.
The legislation of the Russian Federation provides for the accrual of monetary compensation for temporarily disabled citizens. When injured, during illness, pregnancy and after childbirth, a citizen cannot fully work, so the employer is obliged to pay him a sick leave.
The basis for receiving compensation is a certificate of incapacity for work. The conditions for calculating payments are regulated by Federal Law 255. Let's consider its main provisions.
What is the document about?
The full title of the document is “On Compulsory Social Insurance of Disabled Citizens”.
It describes the main provisions for obtaining monetary compensation:
- Terms of accrual;
- Payment amount;
- Regulations for crediting funds.
The last amendments to the law were made in 2020.
Main tasks
The document was created by the Russian government to regulate the payment of monetary compensation to disabled people. The tasks of Federal Law 255 are as follows:
- Determine which categories of workers are entitled to paid disability leave;
- Outline the grounds for granting such leave;
- Determine the amount of monetary compensation.
General Provisions
The main points that are described in Federal Law 255:
- Only officially employed citizens of the Russian Federation (working on a work book) have the right to receive monetary compensation;
- If a person is officially employed in several places, the money for sick leave or injury is transferred from all organizations. However, maternity allowance is calculated by only one employer.
- Pregnant women and girls on maternity leave, as well as people who have been injured at work, can receive payment from the employer;
- The amount of compensation depends on the severity of the injury, therefore, it is possible to determine how much the employee will receive only after the sick leave is issued.
Video: 5 questions about sick leave
Provision of benefits for temporary incapacity for work
There are two types of temporary disability benefits:
- Injury or illness sustained by an employee (also pregnancy and childbirth);
- An employee looks after a disabled family member.
In the first case, payments are transferred to officially employed citizens who, due to illness or injury, are temporarily unable to go to work. The allowance is paid for the entire period of incapacity for work, but not more than four months from the date of opening the sick leave.
In the second case, the duration of the vacation depends on the age and diagnosis of the sick family member:
Provision of maternity benefits
During the carrying of a child, a representative of the beautiful half of humanity cannot fully work. The legislation provides for the provision of benefits for pregnant workers.
The duration of the benefit payment depends on whether there were any complications during pregnancy and childbirth, how many children the woman gave birth to:
- In the absence of problems while carrying a child, a woman is given 70 days before childbirth and the same number of days of leave after;
- If there were complications during childbirth, postpartum leave is increased to 86 days;
- When carrying two or more babies, a woman is given 86 days of leave before childbirth, and 110 - after.
Assignment, Calculation and Payment of Benefits
To determine the amount of disability benefits, it is necessary to calculate the employee's average daily earnings.
To do this, add up all payments received at the official place of work, including:
- Wage;
- Vacation;
- Hospital funds;
- Good work awards.
After that, the sum of all payments is divided by the number of days in two years (730 or 731 if the year was a leap year). The resulting figure is average daily earnings person.
Depending on the length of service at the official place of work, the amount of benefit for one day of sick leave may differ:
- For employees with less than five years of experience, a payment is accrued in the amount of 60% of daily earnings;
- Work experience from five to eight years - 80% of the average daily earnings are paid;
- More than eight years of experience - 100% of earnings per day are paid.
Let's look at an example of how the amount of temporary disability benefit is calculated for one day.
Example. A person received a monthly salary of 40,000 rubles. We multiply this amount by 24 (the number of months) and we get 960,000 rubles. Also, within two years, the employee received two bonuses, both in the amount of 1,000 rubles. We also add these amounts and get 980,000 rubles. Now we divide all earnings for two years by 730 (the number of days), and we get 1,342 rubles: this is how much the employer is obliged to charge for each day of sick leave to his employee.
With less than eight years of experience, the amount of payments is also reduced.
Entry into force
The sick leave comes into force from the moment the employee provides it to the official place of work. It is worth noting that according to the labor code, a person has the right to bring a document to the accounting department of an organization within six months from the end of the vacation. The leave will be paid only after it has been granted to the employer.
To go to maternity leave a pregnant woman needs to bring sick leave within two weeks after receiving it in antenatal clinic... After that, the employee has the right to take a well-deserved vacation and prepares for the birth of a baby.
What changes have been made?
In 2020, some articles of Federal Law 255 were amended. We will consider them in the following subsections.
Article 8.
The eighth article included the reasons why the amount of compensation can be reduced:
- The patient did not follow the doctor's instructions;
- At the time of injury, the employee was intoxicated with alcohol or drugs;
- A person's failure to appear for a scheduled medical examination.
Article 11.
According to the amendments made to this article, the officially employed woman receives a maternity allowance equal to 100% of the official salary.
If the length of service in the last job does not exceed six months, the girl is paid monthly compensation in the amount of the minimum wage established in the region of her residence.
Article 12.
This article outlines the procedure for an employee to contact the employer for payment. In 2020, the deadlines for granting sick leave have increased significantly: now the employee has half a year in order to apply to the accounting department of the organization for payment.
Article 13
Starting in 2020, a doctor can issue a sick leave not only in writing, but also electronically. In the second case, to confirm the authenticity of the document, an electronic stamp of the doctor or hospital is put on it.
Sick leave
To receive payment, the certificate of incapacity for work must comply with all the norms of Russian legislation.
In particular, it should contain the following information:
- The address of the medical institution that issued the document;
- Patient information: full name, date of birth, identification code, place of work;
- Sick leave start and end date;
- Diagnosis;
- Treatment measures that were taken in relation to the patient;
- At the bottom of the sick leave there is the date of filling it out, the signature of the attending physician, and the seal of the hospital.
You can familiarize yourself with a sample certificate of incapacity for work.
Among social benefits, the legislation of the Russian Federation emphasizes a guarantee for all individuals for which the employer pays mandatory sums insured, as well as compensation payments pregnant women and those caring for a child before reaching a certain age. All these payments for the most part are carried out precisely at the expense of the funds that the employer transfers for each of his employees.
All of the above aspects are considered directly in the Federal Law 255 "On compulsory social insurance in case of temporary disability and in connection with motherhood" (hereinafter referred to as the Law).
Basic Provisions
This Law was adopted on December 29, 2006, replacing the previously effective Federal Law on July 16, 1999 "On the Basics of Compulsory Social Insurance".
The new Law introduced new rules for calculating sick leave and benefits in connection with the onset of pregnancy and childbirth. In particular, the changes affected. Under the new legislation in settlement period now includes not one previous year, but two.
New Law in detail describes the following questions:
Issues addressed
Conventionally, the text of the Law can be distinguished three main directions:
- General cases when temporary incapacity for work occurs;
- Maternity benefits;
- Payments for caring for a child under one and a half years of age.
Same the amount of insurance deductions is set for each employee and the procedure for their transfer to the Social Insurance Fund.
Payment of insurance premiums
The law obliges all employers pay insurance premiums for their employees to social insurance bodies. Their size is set as a percentage of the salary received by the employee. At present it equals 2.9%.
These contributions transferred monthly after the salary has been calculated.
It is from these transfers that benefits are paid, with the exception of the first 3 days of the usual sick leave (his employer pays at his own expense).
The employer calculates all benefits and then pays them out of their own funds, and only then the FSS will reimburse him the spent funds by transferring funds.
Temporary disability
The law deals with this issue in Chapter 2, Articles 5 to 9.
They reveal next questions:
All citizens for whom the accrual and transfer takes place will have the right to benefits. insured amounts to the Social Insurance Fund and also in some cases payments will be made to the persons who will be caring, in particular.
Incapacity for work any illness or injury that prevents an employee from performing his or her duties is considered. It can only be installed medical institution, which issues a certificate of incapacity for work, where the reason and the term will be indicated.
Incapacity for work has a unified form and is a blank strict accountability... The Law sets out clear rules on how to fill out this document. It is filled in by employees of the medical institution and employees of the organization where it is provided for payment. The Social Insurance Fund conducts periodic inspections during which the correctness of the completion and calculation of benefits is checked. In the event that gross mistakes are made when filling out the form of the certificate of incapacity for work, such a form of social insurance may not be accepted for payment, respectively, the sick leave paid to the employer is not compensated.
The amount of payment depends on the number of years of the employee and is as follows percentages from average earnings:
- 60% - with work experience up to 5 years;
- 80% - with work experience of 5 - 8 years;
- 100% - with more than 8 years of experience.
This applies to ordinary situations when the person who received the leaflet is personally on sick leave. In the case when the sick leave is issued for caring for children or other family members payment is made in the amount of 60%, regardless of the length of service.
Payments are made in the following way:
- the employee provides sick leave to the employer;
- accrual is carried out;
- the payment of benefits is made at the nearest wage.
Despite the fact that the benefit is accrued only to those for whom insurance premiums are paid, the employer pays for 3 days of sick leave at his own expense, and the rest of the amount is reimbursed by the FSS.
Pregnancy and childbirth
Chapter 3 is devoted to this issue, it regulates the amount and timing of benefits.
For this period, a woman is also issued a sick leave, which has strictly fixed duration... It is:
Since pregnancy and childbirth are issued with a sick leave, then algorithm for its payment and accrual similar to a regular sick leave, with some exceptions:
- this sick leave is paid in full, that is, 100%, regardless of the length of service of the woman who received it;
- has a minimum and maximum size that is limited by the Law. This size changes almost annually and depends on the change.
A sick leave is issued on this basis 70 or 84 days before the date of birth approximately set in the consultation.
Baby care
According to the Law, anyone who directly cares for a small child can receive monthly benefits, until the child is 1.5 years old.
This type of compensation begins to be paid only after the end of the leave given in connection with pregnancy and childbirth.
If a woman has the right to receive both types of benefits at the same time, then she can choose only one of them, she cannot receive two at once. This situation can arise when a short time after the first birth.
Calculation principle the benefits are the same as when calculating sick leave, but the entire amount is not paid in full, but in installments every month and not in full, but only 40% per child. Accordingly, if there are 2 children, then the amount of the benefit will be 80%, if three children are born at the same time, then the benefit will be paid at 100%.
The allowance is paid by the employer. And then it is reimbursed by social insurance.
Methods of calculating benefits, timing of payments
All benefits are calculated based on average wages, which is defined as the amount of income, for the two calendar years that precede when the benefit is calculated, divided by the number of days in these years, that is, 730 or 731.
Thus, the average wage per day is calculated, then the amount received is multiplied either by the number of sick leave days, or by 30.4, that is, the average number of days in a month. Then the required percentage is calculated from the amount received.
Benefits are paid in the following terms:
In cases of pregnancy and maternity, the law permits replacement of billing periods, provided that in this case the amount of the benefit will be greater.
In particular, it is allowed to remove from the calculation those periods in which the woman had leave in connection with pregnancy and childbirth or with childcare. And also if her salary was higher in previous years.
If the person to whom the benefit will be paid is employed immediately at two employers, then only one of them will be accrued, at the choice of the employee, and only the salary that is accrued from this employer will be taken into account. To include in the calculation all the salaries accrued from all employers, you will have to quit one job.
Last changes
Major changes in 2019:
State benefits for children from February 1, 2019 will be indexed by the inflation rate, which will lead to an increase of 4.3%.
In connection with the increase in the minimum wage from January 1, 2019 to 11,280 rubles, the minimum and maximum values of payments for compulsory social insurance have been indexed, including maternity benefits and monthly benefits for caring for a child up to 1.5 years.
Since 2019, the average daily earnings cannot go beyond the extreme boundaries of 370.85 rubles and 2,150.69 rubles (minimum and maximum values). That is, for a normal pregnancy, for 140 days, the amount of the payment must be at least 51,919 rubles and no more than 301,095.2 rubles.
In case of premature pregnancy, BIR leave lasts 156 days, respectively, the minimum will increase to 57,852.6 rubles, the maximum - to 335,506.08 rubles.
In case of multiple pregnancies, the BIR leave is extended to 194 days, for this period the allowance is provided in the range of 417,231.92 rubles - 71944.9 rubles.
The rules for calculating disability benefits are described in the following video:
Of this article, in case of quarantine, prosthetics for medical indications and follow-up treatment in sanatorium-resort organizations immediately after the provision of medical care in stationary conditions is paid in the following amount:
1) to an insured person with an insurance experience of 8 years or more - 100 percent of the average earnings;
2) to an insured person with an insurance experience of 5 to 8 years - 80 percent of the average earnings;
3) to an insured person with an insurance record of up to 5 years - 60 percent of the average earnings.
2. Allowance for temporary incapacity for work in case of loss of ability to work due to illness or injury is paid to insured persons in the amount of 60 percent of the average earnings in case of illness or injury that occurred within 30 calendar days after the termination of work under an employment contract, service or other activities during which they are subject to compulsory social insurance in case of temporary disability and in connection with maternity.
3. Allowance for temporary incapacity for work, if it is necessary to take care of a sick child, is 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 the next days in the amount of 50 percent of the average earnings;
2) when treating a child in inpatient conditions - in the amount determined depending on the length of the insurance period of the insured person in accordance with paragraph 1 of this article.
4. Allowance for temporary incapacity for work, 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 insured person's insurance experience in accordance with Part 1 of this Article.
6. An insured person with an insurance record of less than six months is paid temporary disability benefits in an amount not exceeding the minimum wage for a full calendar month established by federal law, and in regions and localities in which regional coefficients are applied in the prescribed manner wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
7. In the event of temporary disability that occurred before the period of inactivity and continues during the period of inactivity, the temporary disability benefit for the period of inactivity is paid in the same amount in which the salary is retained for this time, but not higher than the amount of temporary disability benefit that the insured the person would receive according to the general rules.
Judicial practice under article 7 of the Federal Law of December 29, 2006 No. 255-ФЗ
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