Sick leave register (form and sample). Filling out a sick leave certificate Sick leave certificate

The sick leave form, the form of which has remained unchanged for 5 years, still raises questions about its design. It is enough for the employee to evaluate the correctness of filling out the form by the medical institution, so as not to go to the clinic several times. The employer's representative also needs to know how to verify the authenticity and enter the data on his part.

Who issues sick leave?

1. Medical institutions and employees with appropriate authority. It is useless to ask for sick leave at the reception or ambulance - they cannot be given this document. Stamps are usually placed at the register. Some private clinics may also not have the right to issue certificates of incapacity for work - you need to ask about this in advance.
2. Employers, who are also insurers, do not issue sick leave, but draw up their own section of the document. Without the data entered by them, the FSS (Social Insurance Fund) will not pay for sick time. It is employers who provide identification information about the recipient of the payment and transmit information to calculate the amount of funds due. This is also true for the regions participating in the pilot project (a project for introducing processes for the transition to a new system of insurance payments).

The employee, who is also the insured person, does not have the right to write anything on the sick leave. He only brings the document from the medical center to work: to the human resources department, accounting department or workshop manager. When implementing a pilot project in the region, the employee’s actions are similar.

Form of certificate of incapacity for work

The form was introduced to automate processes in the Social Insurance Fund and document flow between the Social Insurance Fund, medical institutions and employer-insurers. The developers made mainly technical changes to the sick leave certificate - the form changed in form, but the content remained the same. Clinics can enter data into it, and employers do not have to calculate the amount of benefits - the program calculates it. Although in regions not participating in the pilot project, settlements still remain the responsibility of policyholders.

A modern certificate of incapacity for work has several degrees of protection against counterfeiting: special paper, watermarks, microtexts, etc. In fact, it is not profitable to falsify a sick leave certificate - you can download the form, but printing it out with proper quality is problematic.

Another level of protection is the issuance of forms to medical institutions strictly according to instructions. To obtain them, a clinic or private doctor must have a license, and the forms themselves are subject to strict reporting. When people offer to buy sick leave on the Internet, they expect to negotiate with a doctor.

How to fill out a sick leave form

General requirements are dictated by machine processing of documents: fountain, gel or capillary pen of black color, printed capital letters, only Cyrillic (Russian alphabet). The digital fields should be filled in most carefully; the rest are for human readability and are less demanding on calligraphy.

The most difficult thing for doctors is to fill out a certificate of incapacity for work: they cannot make mistakes. In case of errors or serious technical defects, for example, the letter does not fit into the square, the health worker must issue a duplicate. You can reduce the number of errors if you download the program from the FSS website or more convenient options from third-party developers. To receive benefits, it is important that the stamps are legible.

In the pilot regions (Nizhny Novgorod Region, Karachay-Cherkess Republic, Novgorod, Astrakhan, Novosibirsk, Kurgan, Tambov Regions and Khabarovsk Territory), the process has been simplified for the insurer’s representative issuing sick leave: there is no need to calculate benefits. The fields “at the expense of the Social Insurance Fund” and “Total accrued” are filled out in the Fund according to the organization’s data. As before, the first 3 days of illness are paid by the employer, but their cost can be calculated in the electronic register. True, the average salary, length of service, etc. are still determined and entered by personnel officers or accountants. In other regions, calculations are done at the enterprise.

The procedure for filling out sick leave in 2016 by an employer– a pressing question that interests many entrepreneurs. In 2016, there were innovations or changes in the rules for document execution, and we will look at what nuances you should pay attention to in this material.

The standard for drawing up and filling out sick leave was approved five years ago by the Ministry of Health, and employers must strictly follow it. On the one hand, thanks to the existing model, it is much easier for an entrepreneur to avoid mistakes and inaccuracies that could lead to undesirable consequences. After all, it is a violation of the rules for drawing up documents that can cause a delay in the registration process with the FFS, and, consequently, all subsequent cash accruals. So, we’ll talk further about how an employer should fill out a sick leave certificate, what’s new in recent years and what data should be indicated.

Format of the new sick leave form.

The sick leave certificate itself is an official document with which a company employee can confirm that he was unable to work for a certain period of time. The document allows the employee not to attend the workplace until his health improves. At the same time, he has the right to receive financial resources for the period that he missed due to illness, in accordance with the established wage rate.

New sick leave form (new sample):

In modern times, health care authorities are striving to facilitate documentation and reduce bureaucratic processes. Therefore, every year new changes are introduced aimed at making it easier to fill out sick leave and other papers. The new sick leave form that employers should use in 2016 is no exception. These changes not only make the task easier, but also minimize the likelihood of entering erroneous data at an even higher level. The new sick leave form is confirmed by order number three hundred and forty-seven, which takes into account all the nuances and features of filling out sick leave in a special form. What should a sick leave sheet look like in 2016?

An example for filling out a sick leave certificate in 2016.

In all regions and regions of our country, without exception, since July 2011, a generally accepted, standard format for filling out and issuing sick leave has been used. In 2016, this document must all be drawn up on A4 paper and be machine readable. In addition, it is protected with the help of special nuances aimed at preventing the provision of counterfeit papers. Among the protective indicators, the sick leave must have the following:

Binary pincode;
Unique digital, twelve-digit barcode;
Background grid;
Watermarks, different types.

A modern sick leave form is filled out on both sides. In order for the employer to accurately and legibly enter data, special cells are placed on it - each of which is designed for one letter. Filling out sick leave in 2016 by the employer must be carried out exactly according to the standards, which is explained by the need for further scanning of the paper in order to enter information into the computer and store it in the Social Insurance Fund database.

Important criteria for a document are clarity, legibility, and compliance of each written letter with the restrictions set for it in the cell. It is forbidden to enter information using ballpoint pens, since when scanning it is difficult to read by a machine, and this may cause a delay in the payment of expected funds.

There are three subsections on the front side of the new sick leave form. These include:

The subsection in which the employee of the medical institution enters information;
A subsection where the information is indicated by the head of the organization in which the patient works;
A subsection in which sick leave stubs filled out by medical unit workers are placed so that there are no problems with control and systematic processes.

Sample of filling out a new sick leave form by an employer:

But, before you start filling out the sick leave form, you need to study in detail the information that is placed on the other side of the form. It is here that recommendations regarding the necessary leave, its duration and frequency, methods of treating the disease, and the sequence of issuing funds due for benefits should be indicated. In addition, data is provided on which code determines the illness of the subordinate, which caused his release from work. Using code values, it is much easier to reduce and summarize data, which also makes filling out sick leave easier.

Filling out sick leave in 2016 by the employer - nuances.

All financial resources that are due to subordinates, according to the benefits issued to them, are in any case paid by their boss, who is the direct employer. Therefore, it is in his interests to carefully check the information that was indicated on the sick leave by the doctor or other employee of the medical unit. It is imperative to pay attention to what start and end dates of the employee’s illness are indicated on the sheet. Most often, such documents are given for three days, unless there are any serious problems or complications. There are several types of sick leave, these include:

A document that was issued on the basis of caring for a child or relative who has lost the ability to work for fifteen days. It should be borne in mind that if a person is released due to caring for relatives, the boss will pay him only for the first three days of vacation;
The document, which is issued due to pregnancy or childbirth, lasts for one hundred and forty days, and if there are additional problems, the period can be extended;
If a person is faced with standard health problems, he has the right to be released from work for no more than thirty days. When he has to extend his own treatment, the employee must submit a report from a medical commission.

Filling out sick leave by employer should be started after he checks not only the information about the beginning and end of the vacation, but also the correctness of the information entered, down to names and surnames. This is explained by the fact that any typo or incorrectly specified figure can cause a delay in payment, but it is not advisable to cross out and correct information in the document. If during the inspection an inaccuracy or inconsistency in the data is discovered, you should point out this fact to the medical unit employee. He, in turn, can either replace or duplicate the document. If all the data is entered correctly, then you can begin filling out the sick leave, which is carried out taking into account certain features.

The procedure for filling out a sick leave certificate.

It should be noted that filling out a sick leave certificate by the employer is not mandatory. Instead, the information can be entered by responsible persons: representatives of accounting, human resources departments. Exactly which lines they must fill out are indicated below:

A line indicating the full legal name of the company, its registration number, and the subordination code that was assigned to it. In the form, this line consists of twenty-nine cells, therefore, if the information does not fit, abbreviations are allowed. Next, you will need to indicate by ticking whether this service is the main place of work of the subordinate or whether he works on a part-time basis.
A line indicating SNILS and citizen identification number;
The line indicating the acts of the form presupposes a list of conditions under which financial payments will be accrued, which the instructions for filling out sick leave require to be included in the document. In the event that an employee is on sick leave due to injuries received at work, the report must be entered into the document, but if any codes and reports are missing, then the lines can be left blank.
The procedure for filling out sick leave involves entering data in the field of the start date of work if the employment agreement with a subordinate was terminated;
A line with information about the subordinate’s insurance experience and his non-insurance period. The insurance period takes into account all full years that the employee has worked, as well as months. In the case where a person did not work for the entire month, he is designated as OO, and the same applies to years. The non-insurance period includes: military service, work in the field of law enforcement or fire safety;
Instructions for filling out sick leave require the mandatory provision of information about the average salary per working day and the overall average salary. This will be needed in order to determine the amount of benefit payments. On the sick leave, salaries are indicated without personal income tax, in full;
And at the end there is a line in which the surname, patronymic and first name of the head of the company, as well as the employee who is the chief accountant, are entered. For individual entrepreneurs, you should simply duplicate your data if the chief accountant is not included in the individual entrepreneur. He signs twice and thereby confirms the authenticity of the document. Afterwards, a seal impression is placed, but not on the part of the sheet where there are filled cells.

Detailed instructions for filling out a new sick leave form in 2016 by an employer:

In order to learn more about the procedure for filling out sick leave in 2016 by an employer, you can visit the official website of the Social Insurance Fund, where both an example and a sample of the correct preparation of documentation are presented.

Carolina Emelyanova

The basis for assigning temporary disability benefits to an employee and recognizing his absence from work as legal is a sick leave certificate (certificate of incapacity for work). So, what is a sick leave certificate? This document is a standard form containing information about the reason and period during which the employee was on sick leave, as well as other necessary information.

The photo below shows a sample sick leave form:

When and who issues sick leave?

Certificates of incapacity for work issued by licensed medical institutions, in which an employee or a member of his family in need of care is undergoing treatment. A sick leave certificate is issued on the day a person seeks medical help, if the doctor determines the need for his release from work duties for the period of treatment.

Of course, if desired, an employee can go to work while sick, but he will receive a salary for his activities only if he refuses to hand over his sick leave to his employer. It is not possible to officially combine work and illness. Thus, going to work on sick leave is not prohibited, but will not be paid.

Document submission procedure

So, let’s move on to the following questions: “How long must sick leave be provided for work?”, “When is an employee obliged to submit sick leave to the employer?” Clause 1 Art. 12 of Federal Law No. 255 states that an employee can apply for sick leave within six months from the date of his leave; in other words, the deadline for providing sick leave to the employer is those same 6 months.

However, it is only worth waiting that long if it is not possible to provide it earlier. If there are no reasons for delay, it is better to submit it as soon as possible.

Who should I give sick leave to at work? You can send sick leave to the accounting department, human resources department or directly to the employer. If it is not possible to deliver the document in person, for example, the employer and the HR department are located in another city, then it can be sent by mail. No additional statements or documents are required.

Cases of non-payment

In some cases, it is possible not to pay the employee during his period of incapacity, for example:

• cases of injuries that the employee caused to himself (to obtain sick leave or during a suicide attempt);
• time of treatment of injuries received by the employee in the process of committing a crime;
• periods of release from work or idle time;
• period of detention.

Rules for filling out a ballot by an employer

What does the employer fill out on the sick leave certificate? There is a separate section on the sick leave form entitled “TO BE COMPLETED BY THE EMPLOYER.”

It includes:

• (if it is not included completely, the record can be broken where the cells end, in addition, indicating an abbreviated name is acceptable);
• information about the document registration number;
• information about the nature of the employee’s work (main place or part-time job);
• the period to be paid;
• data necessary for calculating the amount of benefits (experience, average earnings) and other things in accordance with the names of the columns.

An example of how an employer fills out a sick leave certificate with stamps is shown in the photo below:

Is it possible to fill out a sick leave certificate with a black ballpoint pen? No, you cannot use ballpoint pens to fill out sick leave, It is recommended to use a gel, capillary or fountain pen with black ink. It is also possible to use printing devices. It is important that all entered data is within the provided cells.

If the illness is registered in a timely manner and the employer is notified, the employee should not have any difficulties in receiving payment for this period. It is necessary to remember that sick leave is issued on the day of visiting the doctor and cannot be issued “retrospectively,” so you should not delay visiting the clinic or calling a doctor (not to be confused with an ambulance).

In the modern world, many people try not to go on sick leave, because their bosses don’t welcome it. This sometimes leads to sad consequences in the form of complications and infected colleagues. Of course, everyone decides for themselves whether to be treated at home or to suffer an illness on their feet; this decision must be made in accordance with common sense; no salary can return lost health.

The main nuances that an employer needs to remember when filling out a certificate of incapacity for work are:

• It must be filled out exclusively in Russian and Cyrillic.
• Write words in printed, strictly capital letters.
• The color of the words should be black.
• You need to start from the very first cell.
• We must not forget about spaces between all words. They are required.
• It is strictly prohibited to go beyond the marked boundaries.
• Be sure to write with a fountain pen, gel pen or capillary pen. It is also allowed to type letters on the computer. In this case, all filled characters should not differ in that some of them were written, for example, with different pens, even if all of them are allowed.

But it is prohibited to write with a ballpoint pen on a sick leave certificate. Corrections by the doctor on the sheet are also not allowed. After the first mistake made by the health worker when filling out, or failure to comply with one of the required points, you can throw away the form and start filling out a new one without errors, taking into account all the rules. But the employer can make corrections to the certificate of incapacity for work, but it must be done correctly - carefully cross out the incorrect information and write the correct information on the back of the sick leave with a signature - .

The procedure for filling out sick leave by an employer

A certificate of incapacity for work indicates that the employee did not attend his place of work for some time for a valid reason. The employee provides sick leave to the employer on the day on which he returned to work after absence. After this, the employer is obliged to check the correctness of the registration and fill out the sick leave on its own behalf.

In the left corner of the employee’s temporary disability document there is a subsection “To be completed by the employer.” This is the section that needs to be completed. Each line, and there are 20 of them, from the name of the place of work to the employer’s seal must be filled out by the employer.

Also, special attention should be paid to filling out each of the following certificates of incapacity for work:

• Assignment of the required benefits during the temporary impossibility of fulfilling work obligations.
• Assignment of financial support during pregnancy.

Sick leave for granting benefits to temporarily disabled employees

When reading the items to be filled out on the certificate of incapacity for work, you need to pay attention to items 15 and 16.
In the first case (line 15), you need to write the amount that the employer must pay from its own resources for the first three sick days of the employee.

In the second case, enter the exact amount that will be paid from the country's social insurance fund.

Sick leave for granting benefits to pregnant women and those who gave birth

In this case, it is necessary to analyze several points at once, 10, 15, 16, 17.

Didn't find the answer to your question in the article?

A sick leave certificate is the basis for payment of temporary disability and maternity benefits. To be filled out at the medical institution. This is stated in the Labor Code of the Russian Federation, in part 5 of the Law of December 29, 2006 No. 255-FZ. He also confirms that the employee was not at work for a good reason (paragraph 17 of the letter of the Federal Social Insurance Fund of Russia dated October 28, 2011 No. 14-03-18/15-12956).

Sick leave starts from the first day of incapacity for work. That is, they should open it already in the first medical institution where the patient went.

Who issues sick leave and the terms of its payment at the expense of the Federal Social Insurance Fund of Russia

Medical organizations issue sick leave certificates to working people in case of loss of ability to work, to confirm the right to maternity leave, as well as for the period of caring for unhealthy family members. The official name of the document is a certificate of incapacity for work. However, they are often called simply “sick leave.”

The form of the certificate of incapacity for work was approved by order of the Ministry of Health and Social Development of Russia dated April 26, 2011 No. 347n.

Along with the usual paper sick leave certificates, all clinics that have an electronic signature can issue them.

Only those medical organizations have the right to issue certificates of incapacity for work who have a license to practice medicine. Moreover, the license must provide for the right to work (services) for the examination of temporary disability (clause 2 of the Procedure approved by order of the Ministry of Health and Social Development of Russia).

If a certificate of incapacity for work is issued by a medical organization that does not have a license, then the employer is not responsible for this. There is no need to check whether the medical organization has a license.

If the sick leave certificate was issued by a branch of the medical organization, then you are also not obligated to control whether it is named in the license.

The FSS of Russia issues sick leave forms only to those medical organizations that have a license. The employer, unlike employees of the Federal Social Insurance Fund of Russia, cannot control whether the procedure for issuing sick leaves by medical organizations is observed (clause 1 of the Instructions approved by order of the Ministry of Health of Russia, Federal Social Insurance Fund of Russia dated January 29, 2004 No. 18/29, Resolution of the Presidium of the Supreme Arbitration Court of the Russian Federation dated December 11, 2012 No. 10605 /12).

The following persons are not entitled to issue sick leave certificates:

• emergency medical care organizations;
• blood transfusion stations;
• hospital emergency departments;
• balneological clinics and mud baths;
• medical organizations of a special type - centers for medical prevention, disaster medicine, forensic medical examination bureaus;
• healthcare institutions for supervision in the field of consumer rights protection and human well-being.

Note: Clause 3 of the Procedure approved by order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n.

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Filling out a certificate of incapacity for work, sick leave by a doctor of a medical organization, clinic

Note: According to Order No. 624n dated June 29, 2011 “On approval of the procedure for issuing certificates of incapacity for work”

56. Entries on the certificate of incapacity for work are made in Russian in printed capital letters in black ink or using printing devices. You can use a gel, capillary or fountain pen. The use of a ballpoint pen is not permitted. Entries on the certificate of incapacity for work should not go beyond the boundaries of the cells provided for making the corresponding entries, and also should not come into contact with the boundaries of the cells.

All entries in specially designated cells are entered starting from the first cell.

Seals of a medical organization, medical and social examination institutions may extend beyond the designated area, but should not fall on the cells of the information field form of certificate of incapacity for work.

Stamp of the seal of the medical organization must match the title specified in the charter of the medical organization. When issuing certificates of incapacity for work in some medical organizations (psychiatric, drug treatment organizations, centers for the prevention and control of AIDS and infectious diseases, etc.), special seals or stamps may be used without indicating the organization’s profile.

If there are errors in filling out the certificate of incapacity for work in the hospital, he considered spoiled and in its place a new certificate of incapacity is issued.

FILLING IN THE SPINE (lower tear-off part) of a HOSPITAL CARD by a POLYCLINIC employee

Sick leave. Tear-off spine

57. When filling out the spine of the form for a certificate of incapacity for work:

in the line “primary” a corresponding mark “V” is made if the certificate of incapacity for work is primary;

in the line “duplicate” a mark “V” is placed in the case when, due to the loss of a certificate of incapacity for work, a duplicate certificate of incapacity for work is issued to the insured person by the attending physician and the chairman of the medical commission;

in line " continuation of leaflet no.“the number of the previous certificate of incapacity for work is indicated if the certificate of incapacity being issued is a continuation of a previously issued certificate;

in the line “Date of issue - -” the day, month, year of issue of the certificate of incapacity for work is indicated;

in line "( surname, initials of the doctor)" indicates the name of the medical worker who issued the certificate of incapacity for work and his initials (with a space of one cell);

in line " Case history no.“the number of the medical card of the outpatient or inpatient patient is indicated;

in the line "" the full or abbreviated name of the organization, or the surname and initials of the employer - an individual (with an interval of one cell between the surname and initials of the employer) is indicated.

Note: This information is provided according to the citizen. Teach employees to correctly name their organization;

in line " Part-time no.

in field " recipient's receipt“The signature of the citizen who received the certificate of incapacity for work is affixed.

Sick leave. Top part. To be completed at a medical facility

58. When filling section "TO BE COMPLETED BY A DOCTOR OF THE MEDICAL ORGANIZATION" of the certificate of incapacity for work:
strings "primary", "duplicate", " continuation of leaflet no." are filled out in accordance with paragraphs two - four of paragraph 57 of this Procedure;

in line "( name of medical organization)" indicates the full or abbreviated name of the person holding a license for medical activities, including work (services) for the examination of temporary disability, who received medical care and was issued a certificate of incapacity for work;

Note: Indication of quotation marks, periods, commas, and dashes in the names of organizations (separate divisions) is not a basis for re-issuing a certificate of incapacity for work and refusal to assign and pay benefits for temporary disability, pregnancy and childbirth.

in line "( address of the medical organization)" indicates the address for the provision of medical services by a person who has a license for medical activities, including work (services) for the examination of temporary disability (name of urban or rural settlement, street, number of the house, building, apartment (office), corresponding to the address of the actual issuance of certificates of incapacity and carrying out medical activities in accordance with the license for medical activities. Entering the specified data is carried out at intervals of one cell, the building number is indicated through the sign "/" in the cell after the house number, the apartment (office) number is indicated through a space in one cell after the house or building number
(for example, |Б|а|р|н|а|у|л| |С|у|х|о|в|а|| |5|/|3| |13|)";

in the line “Date of issue - -” the day, month and year of issue of the certificate of incapacity for work is indicated;

in the line “(OGRN)” the main state registration number of the person holding a license for medical activities, including work (services) for the examination of temporary disability, who issued the certificate of incapacity for work, is indicated;

Note: When filling out, it is imperative to accurately and clearly indicate the OGRN of the medical organization for further identification in information systems.

in the line “Full name” in the appropriate cells the surname, first name and patronymic (patronymic is indicated if available) of the temporarily disabled citizen are indicated in accordance with the identity document;

in the line “Date of birth - -” the date of birth of the disabled citizen is indicated;

in cells "M" "F" the corresponding mark "V" is placed;

in line " Cause of disability":

Disease code

in the "code" cells the corresponding two-digit code is indicated:
01 - disease;
02 - injury;
03 - quarantine;
04 - industrial accident or its consequences;
05 - maternity leave;
06 - prosthetics in a hospital;
07 - occupational disease or its exacerbation;
08 - after-care in a sanatorium;
09 - caring for a sick family member;
10 - other condition (poisoning, manipulation, etc.);
11 - the disease specified in paragraph 1 of the List of Socially Significant Diseases, approved by Decree of the Government of the Russian Federation of December 1, 2004 No. 715;

Note: Collection of legislation of the Russian Federation, 2004, No. 49, art. 4916.

12 - in case of illness of a child under 7 years of age included in the list of diseases determined by the Ministry of Health and Social Development of the Russian Federation in accordance with Part 5 of Article 6 of the Federal Law of December 29, 2006 No. 255-FZ;
13 - disabled child;
14 - in case of an illness associated with a post-vaccination complication, or in case of a malignant neoplasm in a child;
15 - HIV-infected child;

Note: To be inserted only with the consent of the insured person.

In the “additional code” cells, an additional three-digit code is indicated:
017 - during treatment in a specialized sanatorium;
018 - for sanatorium-resort treatment in connection with an accident at work during a period of temporary incapacity for work (before referral to medical examination);
019 - during treatment in a clinic of a research institution (institute) of balneology, physiotherapy and rehabilitation;
020 - with additional maternity leave;
021 - in case of illness or injury resulting from alcohol, drug, toxic intoxication or actions related to such intoxication;

in the “change code” cells, the corresponding two-digit code (from those listed above) is indicated in the event of a change in the cause of temporary disability;

in line "( place of work - name of organization)" indicates the full or abbreviated name of the organization (separate division); surname and initials of the insured - an individual (with an interval of one cell);

in the line “Basic” a mark “V” is made if the certificate of incapacity for work is issued for presentation at the main place of work;

in line " Part-time no.“A mark “V” is made if the certificate of incapacity for work is issued for presentation at the place of work on an external part-time basis and the number of the certificate of incapacity for work issued for presentation at the main place of work is indicated;

in line " Registered with government employment agencies“A mark “V” is made if there is information that the citizen is recognized as unemployed in the prescribed manner; if this mark is made, the lines “(place of work - name of the organization)”, “Main”, “Part-time No.” - are not filled in;

in the line “date 1” the date of change in the cause of incapacity, the expected date of birth, the start date of the voucher are entered - when sending tuberculosis patients on vouchers to specialized (anti-tuberculosis) sanatorium-resort institutions for treatment in the case when sanatorium treatment replaces inpatient treatment, as well as after-care after inpatient treatment, when a citizen is referred by a medical organization for treatment to a clinic of a research institution (institute) of balneology, physiotherapy and rehabilitation; when referred for follow-up treatment to specialized sanatorium-resort organizations (departments) immediately after inpatient treatment; when sending persons injured in connection with a serious accident at work to sanatorium-resort treatment during a period of temporary incapacity for work (hereinafter referred to as a voucher for treatment (aftercare);

in the line “date 2” the end date of the voucher for treatment (follow-up treatment) is entered;

in the line “Voucher number” the number of the voucher for treatment (follow-up treatment) is indicated;

in line " OGRN of the sanatorium or clinic of the research institute"a sanatorium-resort institution, a clinic of a research institution (institute) of balneology, physiotherapy and rehabilitation indicates the main state registration number in accordance with the document confirming the state registration of the medical organization;

subsection "care" filled in the hospital in case of caring for a sick family member (including during quarantine of a child):

in line " age (years/months)“The first two cells indicate the number of full years of the sick family member being cared for, and in the case of caring for a sick child under the age of 1 year, the first two cells are not filled in, and the second two cells indicate the child’s age in months;

in line " family connection" the corresponding two-digit code is indicated:
38 - mother;
39 - father;
40 - guardian;
41 - trustee;
42 - another relative who is actually caring for a sick family member.

in line " Name of the family member being cared for"indicates the surname, first name, patronymic (patronymic is indicated if available) of the citizen being cared for (with spaces in one cell).

When caring for two children at the same time, in the first row of cells of the named line the age, relationship, surname, first name, patronymic of the first child being cared for is indicated, in the second row of cells of the said line the mentioned data for the second child being cared for is indicated. When caring for more than two children at the same time, when a second certificate of incapacity is issued, in the first and second row of cells of the named lines the age, relationship, surname, name, patronymic of other children being cared for are indicated, the remaining lines (columns) of the certificate of incapacity are drawn up identical to the lines (columns) of the first certificate of incapacity for work.

In line " Registered in the early stages of pregnancy (up to 12 weeks)" in the cells " yes " " no " a “V” is marked if the relevant information is available.

In line " Regime violation notes"Depending on the type of violation, the following two-digit code is indicated:
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.

In the line "Date - -" the date of the violation is indicated, in the field "Doctor's signature" the signature of the attending physician is placed.

If there were no violations of the regime, the specified lines are not filled in.

In line " Was in hospital" in cells " From - - " " to - - " the start and end dates of the citizen's inpatient treatment are entered accordingly; in the table "Exemption from work" of the certificate of incapacity, a record is made of the duration of treatment.

In the case of long-term inpatient treatment and the need to submit a certificate of incapacity for payment, the corresponding terms of treatment are indicated in the table “Exemption from work” and the line “Stayed in hospital”; in the line “Other” the corresponding two-digit code is entered - “continues to be ill”.

When discharged from a hospital, a disabled citizen is issued a new certificate of incapacity for work, which is a continuation of the previously issued one, while in the line “Was in hospital” the total duration of treatment is indicated, and in the table “Exemption from work” the terms of treatment minus the days indicated in the previously issued certificate of incapacity for work ".

Registration of a certificate of incapacity for work during treatment in a “day hospital” setting, it is carried out according to the rules established for issuing certificates of incapacity for work during outpatient treatment.

59. When referred for a medical and social examination (MSE) the certificate of incapacity for work indicates the corresponding dates in the lines: “Date of referral to the ITU bureau: - -”, “Date of registration of documents in the ITU bureau: - -”, “Certified at the ITU bureau: - -”.

In line " Disability group set/changed"The disability group (1, 2, 3) is indicated in Arabic numerals if, as a result of examination at an ITU institution, the person's disability group is established or changed.

In field " Signature of the head of the ITU Bureau"The signature of the head of the ITU bureau is affixed.

Release from work

in the column “From what date” the date (day, month and year) from which the citizen is released from work is indicated;

in the column “By what date” the date (day, month and year) (inclusive) is indicated on which the citizen is released from work.

For outpatient treatment, the extension of the certificate of incapacity for work is carried out from the day following the day the citizen is examined by a doctor. Each extension of a certificate of incapacity for work is recorded in separate rows of the table column.

When issuing a duplicate certificate of incapacity for work, in the columns “From what date” and “To what date” of the “Exemption from work” table, the entire period of incapacity for work is indicated in one line.

When issuing a certificate of incapacity for work by decision of the medical commission, including for the past time, in the columns “Position of the doctor” and “Last name and initials of the doctor or identification number,” the surname, initials and position of the attending physician, the surname and initials of the chairman of the medical commission after each case are indicated , considered by the medical commission.

During treatment (follow-up treatment) in a specialized (anti-tuberculosis) sanatorium-resort institution, a certificate of incapacity for work is drawn up (opened) and signed by the attending physician of the medical organization and the chairman of the medical commission before the citizen’s departure for sanatorium treatment (follow-up treatment).

In the treatment of tuberculosis, when sanatorium-resort treatment replaces hospital treatment, in the columns “From what date” and “To what date” of the table “Exemption from work” the days of stay in the sanatorium-resort institution are indicated in one line, taking into account the days required to travel to place of treatment and back.

When a medical organization sends a citizen for treatment to the clinic of a research institution (institute) of balneology, physiotherapy and rehabilitation, a certificate of incapacity for work is drawn up (opened) and signed by the attending physician of the medical organization and the chairman of the medical commission before the citizen leaves for treatment at the clinic of the research institution (institute) ) balneology, physiotherapy and rehabilitation. In the columns “From what date” and “To what date” of the “Exemption from work” table, one line indicates the days of stay in the clinic of the research institution (institute) of balneology, physiotherapy and rehabilitation, taking into account the days required to travel to the place of treatment and back .

When referred for follow-up treatment immediately after inpatient treatment, a code is entered on the certificate of incapacity in the “Other” line - “in case of referral for follow-up treatment immediately after inpatient treatment.” The continuation of the certificate of incapacity for work is issued by the medical organization that refers the citizen for further treatment. In the table "Exemption from work" in the column "From what date" the date of start of treatment is indicated. Further registration of the certificate of incapacity for work is carried out by the attending physician of the sanatorium-resort institution (department): in the line “Was in hospital” the length of stay in the sanatorium is indicated, in the columns “From what date” and “To what date” of the table “Exemption from work” is indicated in one line length of stay in a sanatorium-resort institution (department).

When sending persons injured in connection with a serious accident at work to sanatorium-resort treatment during a period of temporary incapacity for work, in the columns “From what date” and “To what date” of the table “Exemption from work” of the certificate of incapacity for work, the date of the start of sanatorium treatment is indicated in one line -resort treatment according to the direction of the medical commission; in the line “Stayed in a hospital” the length of stay in a sanatorium-resort institution is indicated.

The closure of the certificate of incapacity for work in these cases is carried out by the organization that referred the citizen for treatment (follow-up treatment).

In the column "Position of a doctor" of the table "Exemption from work" the position of the doctor is indicated, and in cases considered by the medical commission, the chairman of the medical commission (for example, |p|r|e|d| |В|К|).

When issuing certificates of incapacity for work in some medical organizations (psychiatric, drug treatment organizations, centers for the prevention and control of AIDS and infectious diseases, etc.), in agreement with the disabled citizen or his legal representative, the positions of general practitioners or “dentist” may be indicated. , "paramedic";
in the columns "" and "Signature of the doctor" of the table "Exemption from work" - the surname and initials of the doctor are indicated respectively (with a space in one cell), and in cases considered by the medical commission, the chairman of the medical commission or his (their) identification number is indicated ( identification numbers) and signature(s) are placed.

Note: surname and initials of the doctor (with a space in one cell)- understand as IVANOV_AV.
see Letter of the Federal Social Insurance Fund of the Russian Federation dated October 28, 2011 No. 14-03-18/15-12956

When filling out a certificate of incapacity for work, if in the “line” “Position of a doctor” of the table “Exemption from work” there are not enough cells to indicate the position, it is possible to shorten the name of the position of the medical worker within the available cells.

When filling out the "line" Doctor's name and initials or identification number" in the "Exemption from work" table, indicate the doctor's surname, then, with a space in one cell, his initials, which you need indicate with a space without any punctuation.

If the doctor’s last name and initials exceed 14 characters in the first row of cells, then it is allowed to move the end of the doctor’s last name and initials to the second row of cells in this line. If the specified line does not have enough cells to fill in the surname and initials of the medical worker (more than 28 characters), it is possible to fill in only the doctor’s surname without indicating the initials, and if there are not enough cells to fill in the surname, it can be shortened within the available cells.

When issuing a certificate of incapacity for work by decision of the medical commission, when in the “line” “Last name and initials of the doctor or identification number”, in addition to the surname and initials of the attending physician, the surname and initials of the chairman of the medical commission are indicated, if in the first row of the specified line there are not enough cells to fill in the surname and the initials of the attending physician (more than 14 characters), in the second row there are not enough cells to fill in the surname and initials of the chairman of the medical commission (more than 14 characters), it is possible to fill in only the surnames of the doctor (in the first row of cells) and the chairman of the medical commission (in the second row of cells) without indicating initials, and if there are not enough cells to fill in surnames, it is possible to reduce them within the existing first and second row of cells of the specified line, respectively.

Note:

Explanations of certain provisions of the Procedure for issuing certificates of incapacity for work,
approved by Order of the Ministry of Health and Social Development of the Russian Federation dated June 29, 2011 No. 624n

1. Letter of the Federal Social Insurance Fund of the Russian Federation dated August 5, 2011 No. 14-03-11/05-8545
2. Letter of the Federal Social Insurance Fund of Russia dated September 14, 2011 No. 14-03-11/15-8605
3. Letter> FSS of the Russian Federation dated October 28, 2011 No. 14-03-18/15-12956

61. In line " Get to work" in cells " with - - " the date of restoration of working capacity is indicated the next day after the examination and recognition of the citizen as able to work.

In the line "Other:" the following two-digit code is indicated:
31 - if the citizen continues to be ill and is issued a new certificate of incapacity for work (continued);
32 - when disability is established;
33 - when the disability group changes;
34 - in case of death;
35 - in case of refusal to conduct a medical and social examination;
36 - in the case when a citizen, after issuing or extending a certificate of incapacity for work, did not show up for an appointment, but at the next visit was recognized as able to work;
37 - in case of referral for follow-up treatment immediately after inpatient treatment.

Following the two-digit code entered in the line “Other:”, in cells “- -” for codes 32, 33, 34 and 36, the date of establishment, change of disability group, date of death of the citizen, date of appearance as able-bodied is also entered.

62. In line " Issued slip (continued) No."The number of the continuation of the certificate of incapacity for work is indicated.

63. In the field “Doctor’s signature” the signature of the attending physician is placed.

Filling out a duplicate sick leave certificate

There was an error in the child’s name on the sick leave, so a duplicate was issued, with a check mark in the “primary” column, the employer returned the duplicate for correction, but the clinic believes that everything was filled out correctly.

Question : Is it necessary to fill in the “primary” column on a duplicate sick leave sheet??

The procedure for filling out a certificate of incapacity for work is set out in section IX of the Order of the Ministry of Health and Social Development of the Russian Federation dated June 29, 2011 No. 624n. Clause 58 of the Procedure states that when filling out the section “To be completed by a doctor of a medical organization,” the lines “primary” and “duplicate” are filled in in accordance with paragraph. 2 and 3 clause 57 of the Order.

In para. 2 and 3 clause 57 states that in the line “primary” a corresponding mark “V” is made if the certificate of incapacity for work is primary, and in the line “duplicate” a mark “V” is placed in the case when due to the loss of the certificate of incapacity The insured person is issued a duplicate certificate of incapacity for work by the attending physician and the chairman of the medical commission.

Also, in Letter dated December 23, 2011 No. 14-03-11/15-16055, the FSS of the Russian Federation indicated that in the case when, instead of a damaged certificate of incapacity for work, another certificate of incapacity for work is issued, the corresponding mark “V” is placed in the “duplicate” line. Taking into account the above, when issuing a new certificate of incapacity to replace a damaged one, the “V” mark should be placed only in the “duplicate” line.

How to extend a certificate of incapacity for work if the patient continued treatment in another hospital

If a sick leave certificate is opened in one medical institution, and further treatment takes place in another institution, then when the sick leave is extended, a new form of a certificate of incapacity for work is issued. If, in the described situation, the sick leave is extended by filling out the empty lines in the “primary” bulletin, the sheet cannot be accepted for payment. This conclusion follows from the FSS resolution dated May 22, 2017 No. 02-09-11/22-03-11096.

Paragraph 6 of Order 624n states that the extension and closure of the certificate of incapacity for work is carried out by the medical organization to which the citizen is sent for treatment. In this case, an extension should be understood as the issuance of a “continuation” of a bulletin issued by a previous medical organization. To do this, a new form is drawn up and at the same time the previous certificate of incapacity for work is “closed” for submission for payment. The fact is that the sick leave certificate, in addition to the period of incapacity for work, indicates, among other things, the name of the medical organization, its OGRN, and the address of the provision of medical services. And it is impossible to indicate the details of two different medical organizations on one form.

Therefore, a certificate of incapacity for work extended by issuing a new form certificate of incapacity for work. Extension of sick leave extended by filling out empty lines in the primary bulletin issued by the previous medical organization is not allowed.

Data is provided on minor errors in the sick leave certificate when it should be paid.

Recommendations and procedure for filling out sick leave by the employer.

Brief rules for filling out a sick leave certificate for temporary disability. What laws govern it? Examples of filling are provided. Protection, counterfeits.