What do disability codes mean on a sick leave certificate?

Classification of sick leave codes and their decoding

The structure of a sick leave certificate (certificate of incapacity for work, approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2011 No. 347n) provides for the use of such types of codes as:
1. Codes of the cause of incapacity for work.

There are 15 codes in total for the cause of disability on the sick leave (their decoding is also given in Order No. 347n).

These 2-digit codes are entered in the “Code” cell directly opposite the line “Cause of disability.”

If the original disability code on the sick leave certificate needs to be changed, the new one must be entered in the “Change code” cell, which is located next to it.

2. Additional codes.

They are recorded next to the disability code in certain cases. Namely if:

• the person is undergoing treatment in a sanatorium (in this case, an additional code 017 is entered on the sick leave);
• the employee is undergoing treatment in a sanatorium due to an incident at work (code 018);
• the person is being treated in a clinic belonging to a research organization (code 019);
• the employee is granted additional maternity leave (code 020);
• the employee fell ill due to intoxication or actions related to it (code 021).

3. Codes reflecting family relationships.

They are indicated above the line “Family relationship” if the sick leave is issued for an employee who does not go to work due to caring for a sick family member. In this case, the code must correlate with the one that reflects the cause of disability. If this is code 38, indicating that the employee is a mother and is caring for a child, then code 09 is entered in the line “Cause of disability.”

4. Code reflecting the employee’s violation of the treatment regimen.

Fixed opposite the line “Note about violation of the regime”, if a corresponding violation has taken place. For example, code 24 indicates that a sick employee did not show up for an appointment with a doctor at the appointed time.

5. Other codes.

Indicated opposite the line “Other”. May reflect other significant information about the employee’s health status. For example, if this is code 31, it will mean that the employee has not recovered and is going on new sick leave.

6. Code reflecting the conditions for calculating compensation for sick leave.

Fixed in the line “Accrual conditions”. For example, if a person has already left the company, but fell ill within 30 days after dismissal, code 47 is entered. If necessary, several codes can be indicated in the corresponding line.

Among other significant elements of the document on which compensation for temporary disability is calculated is the subordination code on the sick leave. It, unlike the codes discussed above, is not unified and is set depending on the region of registration of the company in the Social Insurance Fund. You can find out this code from the notice of registration of the employer with this department or by contacting them.

What do the three-digit codes in the second block mean?

In the line “reason of disability”, after the two-digit code, an additional three-digit code may be indicated:

• 017 - during treatment in a specialized sanatorium;
• 018 - for sanatorium treatment in connection with an accident at work during a period of temporary disability;
• 019 - during treatment in the 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

Causes of illness and legal consequences for the employer (codes 01, 02, 04)

What is the impact of recording certain codes on the certificate of incapacity in practice? What does sick leave code 01 or 02 mean?

Let's study these issues in the context of the possible legal consequences of indicating certain codes on the certificate of incapacity for work for the employer.

First of all, what specific cause of the employee’s illness is reflected in the sick leave (code “Cause of disability”) may be important:

• One of the most common disease codes on sick leave is 01. It reflects the fact that the employee has contracted a common illness, such as ARVI. If this code is indicated on the sick leave, the employer calculates sick leave compensation in the usual manner established in paragraph 1 of Art. 14 of Law No. 255-FZ.
• In turn, what does sick leave code 02 mean? The fact that the employee suffered an injury not related to work. The presence of sick leave code 02 implies that the employer has the same obligation to calculate the amount of compensation according to the general rules (in particular, taking into account the employee’s length of service).
• The fact of injury at work is reflected on the sick leave using code 04. In this case, the enterprise must pay the employee compensation for sick leave in the amount of 100% of his average earnings (Clause 1, Article 9 of the Law “On Compulsory Social Insurance...” dated July 24, 1998 No. 125-FZ). This is a fundamental difference between the employer’s responsibilities compared to when the cause of incapacity 01 is indicated on the sick leave and the amount of compensation depends on the length of service.

Among the other responsibilities of the employer in the event of an employee’s work-related injury is an investigation of the incident in accordance with the requirements of the Labor Code of the Russian Federation, as well as the rules adopted in local documents. Actually, the presence of code 04 on an employee’s sick leave should not be a surprise to the employer, since it is unlikely that he will not be aware of what happened (and will not take the measures prescribed by the provisions of Articles 228–231 of the Labor Code of the Russian Federation even before the employee returns from sick leave).

But if the company really, for some reason, did not know that the employee was injured as a result of an incident at work, this relieves the employer of responsibility for its investigation, unless the employee applies for an investigation (Article 229.1 of the Labor Code of the Russian Federation).

You will learn more about the rules for calculating sick leave compensation in certain cases from the selection of materials in this section.

Updated disability codes

From September 2022, the usual list of causes of disability will be reduced. Now there are 15 of them, only 13 will remain. Codes associated with injuries sustained at work due to an accident and occupational diseases will be completely abolished.

Namely, for occupational diseases, code 07 will be excluded. They will issue sick leave with code 01, as for a regular illness.

For industrial accidents, code 02 will be assigned - now this code is assigned exclusively for domestic injuries.

Despite the code change, sick leave related to work-related injuries and occupational diseases will continue to be calculated in a special manner.

Code 11 on sick leave: employer's responsibilities

Other responsibilities may arise for the employer if the disease code on the sick leave certificate is 11. It reflects the fact that the employee suffered the disease specified in clause 1 of the list of socially significant ones, approved. by Decree of the Government of the Russian Federation dated December 1, 2003 No. 715, - tuberculosis.

In this case, the duration of treatment can be up to 12 months (Clause 4, Article 59 of the Law “On the Fundamentals of Health Protection...” dated November 21, 2011 No. 323-FZ), and the employer must be prepared to compensate for it. The maximum duration of treatment in the general case is 10 months (clause 13 of the procedure approved by order of the Ministry of Health and Social Development of the Russian Federation dated June 29, 2011 No. 624n).

In addition, if an employee, along with a sick leave certificate, brings a medical order according to which he will need to be transferred to another position for health reasons, the employer will be obliged to provide such a position or remove the employee from work and pay him temporary disability benefits (Article 73 of the Labor Code of the Russian Federation , paragraph 3 of article 14 of the law “On preventing the spread of tuberculosis” dated June 18, 2001 No. 77-FZ).

List of diseases that relate to this code

As mentioned above, code “11” includes dangerous diseases that are listed in the List of Socially Significant Diseases. This list was approved by Decree of the Government of the Russian Federation of December 1, 2004 N 715 “On approval of the list of socially significant diseases and the list of diseases that pose a danger to others.” In accordance with this legislative act, the following diseases belong to code “11”:

1. Tuberculosis.
2. Sexually transmitted infections.
3. Hepatitis B and C.
4. HIV.
5. Malignant neoplasms.
6. Diabetes.
7. Mental disorders and behavioral disorders.
8. Diseases characterized by high blood pressure.

What do violation codes mean (23, 24)

Knowing what code 01 means on a sick leave certificate is not enough. It is also necessary to check whether the medical institution has identified other circumstances characterizing the employee’s state of health. Which for example?

Thus, the commonly used sick leave code 01 can be supplemented with a code that gives the employer a basis for reducing the amount of compensation for sick leave. These may be codes that reflect (Clause 1, Article 8 of the Law “On Compulsory Social Insurance...” dated December 29, 2006 No. 255-FZ):

• non-compliance with the prescribed treatment regimen (code 23 in the line “Note about violation of the regimen”);
• failure to appear for a medical examination on time (code 24 in the line “Note about violation of the regime”);
• illness due to intoxication (code 021 in the “Additional code” line).

Sick leave compensation in this case is reduced to the level of the minimum monthly wage:

• from the moment of violation under codes 23 and 24;
• for the entire period of illness using code 021.

Read more about paying sick leave for alcohol intoxication here.

Thus, deciphering the disease code on the sick leave sheet 01, 02, 04 must necessarily be done taking into account the possible presence of the 3 considered codes in the document. Their presence directly affects the size of the company’s obligations for sick leave compensation.

What is this code and why is it needed?

In case of health problems, a working person takes sick leave and undergoes treatment at home or in a medical facility. Upon completion of treatment, he is entitled to payments that are approved by law. The basis for payment is the sickness certificate.

The document is issued by a doctor who has passed the FSS check. The form must be filled out correctly and submitted to the management of the organization within the required time frame.

The disease codes written on the sheet represent the reasons for the inability to work. That is, 2 digits of the code represent a disease due to which the patient is not present at work. Coding has many purposes, one of which is to hide confidential patient information.

In addition, coding is used for the following purposes:

1. 
   preservation of medical confidentiality regarding the disease and personal information;

2. rational placement of information on the form;
3. simplification of work for personnel department employees;
4. functioning with international medical organizations;
5. minimizing errors when issuing a certificate of incapacity for work.

Persons who are not involved in coding and filling out information on sick leave certificates will not be able to understand what the person is sick with and for what reason he was not present at the workplace.

According to the standards, doctors and the organization in which the patient works are responsible for issuing sick leave. The doctor fills out some columns, and the employees of the organization fill out others.

Information that the doctor must fill out:

• information about honey institution, about the specialist who performed the treatment;
• patient information;
• period of incapacity.

Organization employees:

• the amount to be paid;
• amount to request to the Social Insurance Fund;
• employee experience;
• average salary.

It is important to understand that if you indicate all the information about the circumstances of the disease, more than one sheet will be needed.

It is easier for HR workers to understand digital coding than to parse text that was written by hand. The fact is that specialists in the medical industry are usually very busy, which provokes them to write quickly and, consequently, illegibly.

Functioning with foreign medical institutions is also very important. In the case when a citizen was sick with any disease and this is recorded in the certificate of incapacity for work and there was a relapse of the disease abroad.

Line “Other” (using code 31 as an example)

In some cases, along with disease codes, information on the line “Other” is recorded on sick leave. For example, code 31, reflecting the fact that the employee did not have time to recover and cannot go to work (the consequence may be the opening of another certificate of incapacity for work).

The fact that the employer received this sheet with code 31 obliges him to pay compensation for it, calculated in the prescribed manner, despite the fact that the employee has not yet returned to work. A sick leave with code 31 is considered closed one way or another. The total number of sheets does not matter: the employer is obliged to pay for each one brought by the employee.

These are the features of deciphering sick leave in cases where the employee himself falls ill. But situations are possible in which it is not he who is sick, but his relative. In this case, a special code is entered on the certificate of incapacity - 09. Let us study what legal consequences its presence on sick leave can create for the employer.

Why is coding needed?

The sick leave certificate, although small in size, contains a huge amount of information:

• about the patient (personal data);
• about the medical institution that issued the sick leave;
• about the employer;
• about the type of work;
• about the employee’s health;
• about his illness.

Moreover, each item is divided into sub-items, which cannot be described in a fairly small format.

Encoding is used to compress information while storing it.

Complete instructions for using codes (with their designations) are contained in Order No. 624n. This document explains in detail:

• how sick leave is issued;
• what the doctor fills out;
• which is filled out by the employer’s HR officer or accountant.

From the part filled out by the doctor, the personnel officer can glean a lot of information about the sick employee of the company, for example:

• whether he is disabled (in this case, it is necessary to register disability in personnel documents and review the work function);
• Is the disease dangerous for the team?

What does code 09 mean on sick leave: legal consequences for the employer

If an employee’s sick leave is coded 09, this means that he was absent from work due to caring for a child who was sick. Indication of this code in the document implies payment of sick leave in an amount determined in the general manner, as if code 01 or 02 were on the sick leave. As for the number of paid days an employee is on sick leave, it is established taking into account certain provisions of the law.

The duration of paid sick leave for an employee who was absent from work to care for a child is (Article 6 of Law No. 255-FZ):

1. If the child is under 7 years old:

• 90 days a year if the child’s illness is reflected in the list approved by order of the Ministry of Health and Social Development of the Russian Federation dated February 20, 2008 No. 84n;
• 60 days in other cases.

2. If the child is from 7 to 15 years old - up to 45 days a year for all cases of illness (no more than 15 days for each individual case).

3. If the child is under 18 years old:

• up to 120 days if the parent is caring for a child with disabilities;
• without restrictions, if a parent is caring for a child with HIV;
• without restrictions, if a parent is caring for a child who has suffered from vaccination complications or is undergoing treatment for malignant neoplasms.

These rules are the same for employees, regardless of whether their child is a son or daughter, grandson or granddaughter.

IMPORTANT! The specified time restrictions relate specifically to the payment of sick leave, and not to the duration of stay. Read more here.

Procedure for paying sick leave.

Payment for sick leave with this code is most often made on a general basis. This means that it has the following distinctive features:

• the first three days are paid by the employer;
• the rest of the period of illness starting from the fourth day - the Social Insurance Fund of the Russian Federation.

In this case, the amount of payment depends on two main factors:

1. The average salary for the last two years;
2. The duration of the employee's total work experience.

Moreover, the last factor has the following characteristics:

• less than five years of experience - 60% of the average salary per day;
• experience from five to eight years - 80% of the average salary per day;
• more than eight years of experience - 100% of the average salary per day.

However, for citizens who suffer from tuberculosis, the state provides differences in the payment procedure from the general conditions. Article 6 of the Federal Law “On compulsory social insurance in case of temporary disability and in connection with maternity” dated December 29, 2006 N 255-FZ establishes the obligation to pay benefits to such employees even if they are removed from the labor process. Persons who have been assigned the status of a disabled person in accordance with current legislation have the right to apply for benefits in the event of a temporary impossibility of working for no more than four to five months in a calendar year. If the status of a disabled person was assigned due to tuberculosis, the legislation establishes special conditions for the assignment and payment of benefits: it is paid throughout the entire period of incapacity until recovery or revision of the disability group.

Separately, it is worth stipulating the maximum periods of sick leave established by law for this type of disease. As already mentioned, the legislation establishes not only the procedure for paying sick leave, but the maximum period for which it can be issued for a particular disease. In exceptional cases, by decision of the medical commission, this period may be extended. In general, for diseases that belong to code “11”, the following terms of sick leave are established:

Application of a new sick leave (by order of the Ministry of Health and Social Development of Russia No. 347n): nuances

It will be useful to consider a number of other nuances that characterize the use of sick leave certificates of the new type by employers (of course, relatively new - they were approved in 2011, but nevertheless they have specifics that should be paid attention to).

First of all, there are a number of formal requirements for filling out a certificate of incapacity for work. So:

• it must be filled with ink, gel, capillary or fountain pen, but not ballpoint;
• characters are not allowed to go beyond the boundaries of document cells;
• characters must be recorded in the document starting from the very first cell.

The sick leave must be certified with a seal that does not appear on certain cells of the document. The fact that, for example, code 02 and not any other is indicated on the sick leave certificate should be obvious to the inspector. In this case, the check can be carried out using a scanner, which will not be able to recognize the code if the seal is layered on the sick leave information field.

The seal of the medical institution must be clear - so that its name is readable (which must coincide with that indicated in the document).

If there are errors in the sick leave certificate or it is filled out incorrectly, the employer must ask the employee to bring a duplicate of the document, filled out taking into account all the requirements.

In Russia, along with paper sick leave, hospitals are increasingly issuing an electronic bulletin. And from 2022, paper sick leave will be abolished. When an employer uploads a document into the system, it has status 030. This means that the sick leave is closed by the medical organization and the employer can work with the document - calculate and pay benefits based on it.

ConsultantPlus experts explained in detail how to organize work with electronic sick leave. If you do not have access to the system, get a trial demo access and go to the Ready Solution to find out all the details of this procedure. It's free.

Actions of the employer upon receipt of sick leave

When it is established that a citizen has a serious illness, employees of a medical institution are obliged to issue him a medical certificate on his condition in the established form. Often, such conclusions contain information for the management of the enterprise about the inability of their employee to perform the same work for a certain time. In accordance with Article 73 of the Labor Code of the Russian Federation, it is the employer’s responsibility to transfer such an employee to easier work that will not be contraindicated for his health status.

If a written refusal is received from the employee, the head of the enterprise must temporarily suspend the employee from his position without pay.

It is worth noting that in this case there are certain nuances. These include situations where an employee falls ill with a disease such as tuberculosis. A citizen suffering from this illness and suspended from work is guaranteed by the state to receive benefits. Letter of the Social Insurance Fund dated 09/01/2000 No. 02-18/5766 on sending recommendations “Approximate periods of temporary disability for the most common diseases and injuries (in accordance with ICD-10)” explains that the period of treatment and rehabilitation of tuberculosis has a fairly long period time, and in severe cases can reach a year or more. In this case, a sick leave certificate is issued only when the citizen has fully recovered or has achieved stable remission, that is, a state in which he ceases to be dangerous to others.

Based on the above, we can conclude that as soon as the employer has not received a medical report from the employee, which indicates the need to transfer the latter to lighter work for health reasons, no specific actions are required. At the same time, an important nuance is the extremely correct procedure for accruing and paying sick leave.

Results

A sick leave certificate is a document on the basis of which the employer determines, firstly, the amount of compensation for the employee’s temporary disability, and secondly, the duration of paid sick leave. To do this, the various codes recorded on the certificate of incapacity for work are deciphered. When applying sick leave, the employer needs to take into account their correlation.

You will learn more about the peculiarities of using sick leave by employers from the articles:

• “Is sick leave (sick leave) subject to personal income tax?”;
• “Payment for sick leave to care for a sick relative”.

You can find more complete information on the topic in ConsultantPlus. Free trial access to the system for 2 days.