Reason for incapacity for work, code 02. Codes of causes of incapacity for work

The registration of disability sheets of a new sample assumes the inclusion of information in digital form. This type of filling facilitates the processing of documentation. In addition, the time is saved for both health workers and accounting specialists in compiling the form and entering data into other necessary papers. Next, consider some of the causes of incapacity for work in a new hospital sheet.

General information

The code instead of the diagnosis in the new hospital - one of the requirements of the form. References are provided to the enterprise's accounting department for the calculation of benefits. In order to correctly implement the calculus, it is necessary to identify the cause of the incapacity for work: an accident or occupational disease, a domestic trauma or a common pathology. The benefit is calculated in the manner prescribed in Federal Law No. 255, which regulates the rules of compulsory social insurance of the employee. Decoding of disease codes in hospital sheets is given on the reverse side of the form. This information is used by both the health worker and the accountant when completing the information.

Codes of causes of incapacity for work in the new hospital sheet

Non-employment may be related to domestic or industrial situations. According to the Federal Law, several values have been established, which determine the cause of incapacity for work. Code 02 - any pathology, not related to production. The worker can also receive a personal injury. In the form it is indicated under the value 01. If incapacity for work is associated with an accident at work, then 04 is set, with occupational disease or its aggravation - 07. The last two values indicate that the calculation of benefits will be carried out in a special order.

General rules of calculation

As it was said above, the allowance is calculated depending on which code on the disability sheet in the line "Reason" is indicated by the medical officer. Consider household, not related to production situations. If the reason for the incapacity for work is 02 or 01, the calculation takes into account the earnings for 2 calendar years that precede the incident. In consideration also the insurance experience is accepted . If the cause of the incapacity for work is indicated - code 02 or 01, the right to replace the year (years) of the calculation period if it was due to maternity leave or child care in the event that it leads to an increase in payment is taken into account when calculating the benefit. If in the completed form there are notes on violation of the regime (if the employer considers it disrespectful), compensation should be reduced. If the cause of incapacity for work is code 02 or 01, the expenses for payment in the first 3 days are reimbursed from the enterprise's funds, then - at the expense of the FSS of the Russian Federation. If the average salary of an employee in the calculation for the full month (calendar) is less than the minimum wage or not, the amount of the minimum wage at the time of the occurrence of the insurance situation is used to calculate the allowance.

Calculation of benefits for occupational injuries: regulatory documents

When calculating compensation related to disability resulting from occupational diseases or accidents, it is necessary to be guided by:

• FZ No. 125.
• A number of provisions of Law No. 255 FZ, which do not contradict the above-mentioned Federal Law. They include, in particular, articles 12-15. In Art. 12 establishes the period during which you can apply for the payment of benefits, in Art. 13 - on the appointment of compensation at the place of work and the choice of an enterprise that will compensate for the damage (if a person works in several places). Article 14 establishes the procedure for calculation, and Art. 15 - terms of accrual and payment.
• Regulation on the calculation of compensation, which is approved by a government decree.
• Rules of accounting, charging and spending of funds for the purpose of compulsory social insurance against work-related injuries and occupational diseases.

Assignment and payment

If the codes of causes of incapacity for work 04 and 07 are indicated in the completed form, the procedure for establishing and issuing compensation is similar to that used for household injuries or pathologies. However, there are no restrictions on the amount of earnings. As well as in calculating the usual allowance, compensation for incapacity for work due to occupational disease or occupational injury is accrued in accordance with the employee's salary for 2 years, which were before the year of occurrence of the case. The absence of restrictions on the maximum value of s / n is due to the fact that the taxable base for such premiums is not of the maximum size, in contrast to that established for holidays in connection with maternity.

Insurance experience

According to Art. 9 FZ No. 125, payment of a disability benefit related to work-related injuries or occupational diseases is paid in the amount of 100% of the average salary of an employee. The length of the insurance period does not matter. This relationship is established in art. 7 FZ No. 255. However, this article is not mentioned in art. 1, Part 2 of Federal Law No. 255. Thus, the insurance experience is not taken into account in the calculations.

Allowance Size

The amount of compensation is not subject to reduction, even if in the completed sheet form the health worker has placed a mark indicating a violation of the regime. The benefit is paid for the entire period of absenteeism until the recovery or complete restoration of the loss of ability to perform their duties in 100% of the average salary. Reduce the amount of compensation, even if there are grounds listed in Art. 8 FZ No. 255, the employer has no right, since this article is not on the list given in art. 1, Part 2 of the Federal Law № 255.

Source of payment

The company's expenses for payment of compensation in connection with incapacity for work due to occupational diseases or occupational injuries are fully reimbursed at the expense of FSS funds aimed at compulsory social insurance. The authorized body shall account for these costs in the account of deductions of insurance premiums, according to art. 15, clause 7 of Federal Law No. 125, as well as clause 10 of the Rules on the calculation, accounting and expenditure of funds approved by a government decree.

Compensation for part-time employees

The allowance given to the employee in connection with disability due to work-related injury or occupational disease is paid in full at the place of employment under conditions of external compatibility. However, there is a nuance. The employee must be employed for the last 2 years from the same employers as on the date of occurrence of the insured event. This prescription is established art. 13 of the Federal Law No. 255. The allowance is accrued according to the average salary established under art. 14 FZ No. 255, received for the period of service, work and other activities of the insurer appointing and paying compensation. In the case if specified in Art. 13 the condition is not fulfilled, the employee receives an allowance for one place (at his choice), including the payment of part-time jobs.

Personal Income Tax

The Tax Code provides for a list of non-taxable compensations. The disablement allowance is not included in this list. Thus, compensation in connection with absenteeism due to work-related injury or occupational disease should be subject to personal income tax.

Examples

1. A specialist with an insurance experience of less than five years was temporarily incapacitated due to an industrial injury from January 1 to February 15, 2013. The total number of non-working days was 46 days. In the form of the hospital doctor noted a violation of the regime - a specialist did not come to the reception on the appointed day. The following amounts are taken into account for calculating the benefit:

• 635 000 rubles. - for 2012;
  613 000 rubles. - for the year 2011.

The amount of benefits is determined as follows. Since the salary for the years of the billing period is not limited by the limit value, the average earnings per day is (613,000 + 635,000): 730 = 1,709.59 rubles. Since compensation to the employee for loss of ability to work is charged in a hundred percent of cf. S / n and will not depend on the duration of the insurance period, the daily allowance will also be 1709.59 rubles. Since compensation in this case can not be reduced under any circumstances, the healthcare worker's mark on violation of the regime is ignored. Thus, the total amount of the benefit is 1709.59 X 46 days = 78 641.14 rubles.

2. A specialist with an insurance experience of less than five years was on sick leave due to a domestic trauma from March 19 to April 5, 2012. The general period is 18 days. In the hospital doctor, a note was made on the violation of the regime. To calculate the benefit, the following amounts are taken into account:

• 102 000 rubles. - for 2010;
  73 573.33 rubles. - for 2011

Define the amount of compensation. According to the decision of the commission on social insurance, the reason for violation of the regime was recognized as disrespectful. This means that the accountant should reduce the amount of benefits with the doctor specified dates before the day of the employee's discharge. Average salary per day (73 573.33 + 102 000): 730 = 240.51 rubles. The daily allowance will be 60% of the average salary - 144.31 rubles. Until the day of reduction, the compensation will be equal to 144.31 X 11 (from 19 to 29 March) = 1587.41 rubles. Now we should calculate the compensation after the violation (from March 30 to April 5 - 7 days). First, the daily allowance for the SMIC for each day in which it is reduced is calculated. Here it should be taken into account that if the district coefficient was applied to the terrain, then the pay increases on it. In addition, we should add that with temporary disability due to maternity (pregnancy and childbirth), the federal SMIC is used, and not specifically established for the subject of the Russian Federation. So, the daily allowance will be:

• For March 2012 - the 4611: 31 = 148.74 rubles.
  For April of 2012 - 4611: 30 = 153.7 rubles.

Next, we should compare the amounts of benefits calculated at the minimum wage and the average actual earnings:

144.31 and 148.74 in March and 144.31 and 153.7 in April.

Here, a choice is made in favor of a smaller amount - 144.31 rubles. And determine the amount of compensation for the time when it should be reduced:

144.31 X 7 = 1010.17 rubles.

The total amount of compensation is then determined:

1010.17 + 1587.41 = 2597.58 rubles.

From the received sum, the first three days are compensated by means of the employer. Starting from the 4th day the allowance is reimbursed from the FSS Fund.