Cause of disability 05 on sick leave - what does it mean to pay the employer in 2022

Starting from 07/01/2011, medical institutions use the form of a hospital bulletin approved by Order of the Ministry of Health and Social Development of the Russian Federation No. 347n dated 04/26/2011. In order to maintain medical confidentiality, this document format obliges doctors to record information on certain diseases in encrypted form. For this purpose, appropriate codes have been specially developed and approved.

Important! Disease codes, which only a doctor has the right to indicate in the bulletin, affect the amount of social benefits.

The payment calculation depends on the specified code. So, for example, in one case the length of service of the sick employee is not taken into account, in another - the calculation is carried out taking into account the minimum wage or the number of paid sick days is reduced.

Conventionally, we can distinguish between main and additional codes. The purpose of each of them is determined by order of the Ministry of Health and Social Development of the Russian Federation No. 624n dated June 29, 2011 (Procedure, part 6, clause 43). Code “05” refers to the main ones; it is registered in the line “Reason of disability”, which must be filled out.

The explanation of each code is presented on the back of the bulletin. According to the available information on the form, code “05” means “maternity leave”. That is, this code is used to mark maternity leave. For your information, the line “Cause of disability” may also indicate:

1. Additional information (using a three-digit code in the “additional code” cell);
2. Changed cause of illness (using a two-digit code in the “code.change” cell).

As stated in paragraph 56 of Order of the Ministry of Health and Social Development No. 624n dated June 29, 2011, you can write down the code, like other information, manually or by printing on a computer. Handwritten entries are made in black ink in capital letters strictly in the cells designated for them, without going beyond them.

The requirements for filling out the form established by this order are the same for the employer and doctors. Failure to comply with them may lead to refusal to pay social benefits by the fund. Basis - clause 4 clause 1 art. 4. 2 Federal Law of the Russian Federation No. 255 of December 29, 2006, as well as clause 18 of Resolution No. 101 of February 12, 1994.

Registration of a newsletter with code “05”

The hospital bulletin is issued at the antenatal clinic at the place of registration by an obstetrician-gynecologist (paramedic or family doctor) to a woman at 30 weeks of pregnancy. Its standard duration is 140 days. Of these, half is provided before childbirth, and the rest after it. Thus, it turns out that 70 days of rest are provided and paid to the woman before childbirth and the same amount after.

In case of early labor (22-30 weeks), as an exception, a bulletin is issued from the first day of birth for the entire vacation period. If, for example, a multiple pregnancy is detected, it is possible to issue sick leave at the 28th week of pregnancy for a period of 194 days. Social benefits are assigned under these circumstances based on the documents submitted, namely:

1. A woman's application for leave.
2. Bulletin with code "05".
3. Certificates of early registration.

If necessary, the above list is accompanied by information from the previous place of work about earnings, etc. All maternity leave dates are specified in detail in the sick leave bulletin.

A woman has the right to go on maternity leave later than required by law. Please note that if you go on maternity leave later, the established deadlines will not be moved. The basic information that must be included in the sick leave is:

• personal information of the woman (full name, date of birth, place of work);
• early registration mark;
• date of issue of the bulletin, its validity period (start and end);
• doctor's signature and seal.

At the request of the woman and if there is such an opportunity, the medical institution can issue her an electronic bulletin or issue a regular sick leave on paper.

An electronic bulletin and a paper sick note are equivalent.

FSS RF.

Functions of disability codes

The main function of codes on a sick leave certificate is to protect medical confidentiality. However, this is not the only reason why they were approved for the entire territory of the Russian Federation. Other features are:

• optimization of the work of the personnel and accounting departments (funds are accrued using two-digit or three-digit codes for periods of absence from work);
• saving space on the form (some names of diseases are too long);
• opportunity to work internationally.

All ciphers are developed in accordance with international standards. If a person was undergoing treatment abroad, the code for the cause of disability will be the same for countries participating in international cooperation. This significantly simplifies the work of medical institutions, as well as the HR department in the organization.

Assignment of social benefits using a ballot with code “05”

Maternity sick leave is generally calculated based on the provisions of the Federal Law of the Russian Federation No. 81 of May 19, 1995 (on state benefits for citizens with children), as well as guided by the norms of the Federal Law of the Russian Federation No. 255 of December 29, 2006 (on social benefits for illness). To receive the required social payment on the ballot, you must first register it.

Thus, a sick leave certificate with code “05” is the main document that provides a woman with the right to maternity leave.

What guides a medical institution when choosing a code for sick leave?

The contents of the certificate of incapacity for work (approved by Order of the Ministry of Health and Social Development of April 26, 2011 No. 374n) are strictly regulated. Doctors are required to follow the established procedure for filling out the fields allocated for the medical institution. What information needs to be indicated on the sick leave certificate is established by Order of the Ministry of Health and Social Development dated June 29, 2011 No. 624.

What codes are used in this or that case are described in Chapter. IX of this document.

The list of values ​​is also located on the back of the form.

Example 1. Application for maternity leave and social benefits

The application is written by the woman in any form. As is customary, it states:

• Full name of the head of the organization;
• the applicant's initials, as well as her position and the department in which she is registered;
• a request for maternity leave from a specific date and for the assignment of social benefits;
• link to the hospital bulletin indicating its details.

The following form can be considered as a sample.

Amount and payment of social benefits for sick leave with code “05” for 2022

The right to pay maternity leave by ballot is enshrined in Art. 255 and t. 256 of the Labor Code of the Russian Federation and applies to all working and studying women. This norm also applies to the unemployed who are listed in the employment center.

Payment for maternity leave (letter with code “05”) is made from the funds of the Federal Social Insurance Fund of the Russian Federation in the amount of 100% of the SDZ for 140 days (for the general case). The payment is calculated for each pregnant woman individually. For calculation purposes, the following factors are taken into account.

Formula for calculation: average daily earnings * number of days of maternity leave according to the ballot (140, 156 or 194 days, respectively). You can calculate the amount of social benefits yourself using the calculator on the website of the Federal Social Insurance Fund of the Russian Federation. If a woman works for more than 2 years for several employers, then each of them must pay maternity leave.

Decoding codes

Each disability code corresponds to a specific reason. It is by these two-digit codes that accountants and the HR department recognize exactly how the employee’s sick leave should be paid, and in what amount. The codes are indicated in clauses 58, 61 of the Procedure. The first cells are two-digit and are coded by cells from 01 to 15 (paragraph 11, 16 paragraph 58 of the Order).

However, some codes can be entered on a sick leave certificate only with the consent of the insured person. These include the ciphers “14” and “15”. If a person does not want to inform the employer that there are health problems with the child of the described nature, then he has the right not to do so.

Additional codes

There are three-digit codes that are entered in addition to the main ones to indicate the most complete information necessary for the employer and the Social Insurance Fund. Situations in which additional three-digit codes are entered are defined in paragraph 2 of clause 58 of the Procedure.

Additional codes allow you to supplement information on disability. For example, if the code “05 020” is on the sick leave certificate, then the employer automatically increases the amount of maternity benefits . In this case, the basis for this is the legislative norm.

Federal Law “On compulsory social insurance in case of temporary disability and in connection with maternity”, Article 10, paragraph 1:

Maternity benefits are paid to the insured woman in total for the entire period of maternity leave lasting 70 (in the case of a multiple pregnancy - 84) calendar days before childbirth and 70 (in the case of complicated childbirth - 86, for the birth of two or more children - 110) calendar days after birth.

The following codes are used to indicate relationships. To be paid when caring for a sick relative, depending on who provided the care (paragraph 44, clause 58 of the Procedure):

• 38 – mother,
• 39 – father,
• 40 – guardian,
• 41 – trustee,
• 42 – other family members.

Special two-digit codes are intended to indicate violations of the treatment regimen prescribed by the doctor (paragraph 53, paragraph 58 of the Procedure):

• 23 – unauthorized leaving the hospital; failure to comply with doctor's instructions, incl. travel to another area for treatment,
• 24 – missing the appointed time to report to a medical institution,
• 25 – going to work without being discharged from sick leave,
• 26 – refusal to participate in a medical examination (medical examination),
• 27 – violation of deadlines for appearing for examination (examination),
• 28 – other violations.

There are also codes for the “Other” category:

• 31 – extension of the previous sick leave,
• 32 – establishment of disability group,
• 33 – change of previously assigned disability group,
• 34 – death,
• 35 – refusal to participate in ITU.
• 36 – ability to work,
• 37 – referral for follow-up treatment after hospitalization.

Common mistakes when issuing a ballot with code “05”

Error 1. Only a woman who is preparing to give birth to a child can receive a hospital bulletin with code “05” (for pregnancy and childbirth). Accordingly, only she is assigned and paid social benefits according to such a ballot, which replaces her salary.

At the same time, a father, grandmother or other relative can apply for leave to care for a newborn child. To apply for it, the potential vacationer will need to present a certificate from his mother’s place of work stating that she did not take such a vacation, i.e., it remained unclaimed.

Error 2. Social benefits, which are due during maternity leave, are not paid for those days when salaries were calculated. Social benefits and salary are also not assigned at the same time.

So, for example, if a pregnant woman went on maternity leave later than she was supposed to, then social benefits will be assigned and paid from the first day of leave, but not earlier than that.

Cause of disability 05 and 020

The initial sick leave is issued with code 05. Later, the employee can submit the following sheet, which will indicate the reason for disability 05 and additional ones. code 020. This is how the form is filled out when a woman should be granted additional maternity leave. This is a continuation of the insured event established in the first sheet; it is issued the next day after the end of the previous vacation.

In what cases is an increase in maternity days issued:

• if instead of one expected child, 2 or more babies were born;
• complications arose during childbirth.

Sick leave with the disability reason code 05 020 in the first case is issued for 54 days, in the second - for 16. In fact, this means that the woman needs additional leave, which the employer is obliged to provide her.

Answers to frequently asked questions

Question No. 1: Is maternity leave paid for a non-working woman?

No, because maternity leave is provided and paid for by those who work or study. Unemployed women, in fact, have nowhere to apply for it. Therefore, they are deprived of this social benefit.

Exception: if a woman is fired due to layoffs or bankruptcy of the organization and no more than a year has passed since that moment. Then the unemployed mother is paid social benefits according to the ballot. For your information, an unemployed woman can receive the social benefits that are due in her situation only by registering with the employment center.

How do you pay for b/l?

If a woman is officially employed, the entire period of incapacity for work is paid one-time through the employer through compulsory social insurance, but if not, then directly through the Social Insurance Fund of the Russian Federation. Maternity leave benefits are paid for each day of incapacity for work . The amount is 100% of the average daily earnings for the previous 2 calendar years. If the insurance period is less than 6 months, then payment is made according to the minimum wage.

After issuing a sick leave certificate, the woman needs to give it to the accounting department at her place of work so that the amount payable can be calculated. If a situation occurs that it is necessary to extend the maternity leave time under code 05 020, then the additional leave will also be paid.

A benefit for the period of additional leave under the BiR is issued to a woman on the basis of a written application and a certificate of incapacity for work provided to the employer (in accordance with Article 255 of the Labor Code of the Russian Federation). Calculation and payment of funds for another vacation under the BiR is carried out according to the same procedure as for a regular vacation under the BiR.

Codes, the meaning of which is legally established, are necessary for accountants when calculating temporary disability benefits, because the amount of payment directly depends on the type of code. Read articles from our experts about how ballots with numbers , , , , , , and in the “Other” column are paid for.

Thus, you have learned which codes are used to register sick leave under the BiR and its extension, as well as how payments are made, including when extending leave.