General rules in 2022
The key responsibility of all policyholders is the timely accrual and payment of insurance coverage in favor of working citizens. VNiM contributions generate funds from the Social Insurance Fund, which pays for sick leave, maternity leave and other categories of social benefits.
The first three days of sick leave are paid by the employer, the rest is paid by the extra-budgetary fund. This rule applies only if the employee himself is ill. For example, when calculating maternity leave or monthly child care benefits, the payment amounts are fully compensated by Social Insurance.
IMPORTANT!
In 2022, all regions of the Russian Federation switched to a system of direct payments (RF RF No. 2375 dated December 30, 2020). This means that social payments and benefits for temporary disability, pregnancy and childbirth are paid by the Social Insurance Fund. The employer transfers funds only for the first 3 days of illness. The offset system is no longer in effect: Social Insurance does not reimburse money to the employer, but pays the insured persons independently.
But there are also exceptions. In 2022, the Social Insurance Fund continues to compensate policyholders for the costs of paying funeral benefits and paying for additional days off to care for a disabled child.
Situation 1: an employee quit, didn’t get a job, and a week later went on sick leave
Who pays the benefit
Sick leave is paid if the insured event occurred when the person was employed and within 30 calendar days after dismissal (Clause 5 of Federal Law No. 255-FZ of December 29, 2006). The first three days are paid by the employer, now a former one, the rest is paid by the Social Insurance Fund (clause 3, 255-FZ). This rule applies to sick leave listed in Part Art. 5 255-ФЗ:
- sick leave due to illness or injury;
- patient care;
- quarantine of the insured person or his child;
- prosthetics;
- aftercare.
A former employee can apply for such benefits within 6 months from the date of restoration of working capacity or establishment of disability (clause 5, clause 12 of the 255-FZ).
In case an employee got another job, but did not tell you about it, you can take a statement from him confirming that at the time of going on sick leave he was not working anywhere. If it later turns out that this is not so, the FSS will have claims against the employee, and not against the company.
If your situation is different, the Standard. They will answer you within 24 hours - in detail and with links to laws.
How do we calculate benefits?
We make the calculation based on 60% of average earnings. The employee's insurance length is not taken into account (Part 7, 255-FZ).
On June 1, Vasily left the company after working for 12 years. On June 5 he was on sick leave. His benefit was calculated based on 60% of his earnings, although his insurance coverage was more than 8 years.
How do we reflect such benefits in accounting?
After an employee quits, payments must be made to account 76 “Settlements with various debtors and creditors”, and not 70.
Since the employee is no longer involved in the main activities of the company, his benefit is not related to the sale of goods, provision of services or performance of work (clause 5 of PBU 10/99). This means that the costs can be attributed to other expenses (clause 12 of PBU 10/99).
Accounting records are prepared:
- calculation of benefits - Dt 91.2 Kt 76;
- personal income tax calculation - Dt 76 Kt 68;
- payment of benefits - Dt 76 Kt 51 (50).
How to fill out the FSS register
When creating the Register of Information, in column 32 you need to indicate code 47 (Appendix No. to the FSS Order No. 26 dated 02/04/2021). In the field of the certificate of incapacity for work “Calculation conditions”, code 47 is also indicated.
How to fill out the “Calculation conditions” field on sick leave for a dismissed employee
When an organization has the right to reimburse money from the Social Insurance Fund
In 2022, the rules on how to write an application to the Social Insurance Fund for compensation have changed. Policyholders do not submit claims for reimbursement of sick leave, maternity benefits accrued and paid in 2021. Payment is made by Social Insurance: no compensation is paid to the policyholder.
IMPORTANT!
The amount of benefits that the employer pays at his own expense (for the first three days of the employee’s illness) is also not accepted for reimbursement.
And if it is impossible to apply for compensation for temporary disability payments for 2022, the Fund is allowed to apply for compensation for benefits assigned and paid in the last year, 2020. If at the end of 2022 Social Insurance has incurred a debt, the policyholder has the right to compensate for the costs and submit an application for compensation, attaching accompanying documents. There are no deadlines for applying for compensation that has already been paid.
In addition, in 2022, policyholders have the right to reimburse the costs of paying funeral benefits and paying for additional days off to care for a disabled child. The application procedure is no different from the previous one.
Cases when an application for benefits is mandatory
It is mandatory to submit an application to receive maternity benefits. But this should not just be an application for sick leave, but an application for maternity leave.
A sample application for sick leave for pregnancy and childbirth can be found on our website:
The application may also be accompanied by sick leave, for the payment of which the employee wishes to use a billing period different from the standard one to determine average earnings.
For an example of an application to change years in the billing period for calculating sick leave, see ConsultantPlus. Demo access to the legal system is provided free of charge.
An application will also be required to recalculate sickness benefits if an error was made in the calculation or if information about the employee’s income for previous years has appeared. An application for recalculation of sick leave benefits must be drawn up in a form approved by the Federal Social Insurance Fund of the Russian Federation (clause 2 of the Regulations on the payment of benefits for VNIM in 2021, approved by Government Decree No. 2375 dated December 30, 2020). So far this form exists only as a project.
ConsultantPlus experts explained in detail how sick leave is recalculated. Study the material by getting trial access to the K+ system for free.
Find out how quickly you should pay for sick leave in the publication “What are the deadlines for paying sick leave in 2022 - 2021?”
What documents to submit for reimbursement
To restore funds paid for burial, you will have to prepare a special package of documents for the Social Insurance Fund:
- application for compensation from the policyholder;
- a copy of the death certificate;
- a copy of the document confirming the payment of social benefits;
- a copy of the order on the hiring and dismissal of the employee.
To receive reimbursement for additional days off to care for a disabled child, submit to Social Insurance:
- application for compensation;
- a certified copy of the order granting additional days off;
- a copy of the document confirming the payment of social benefits;
- a copy of the document confirming the payment of insurance premiums.
To compensate for social benefits for temporary disability for the last year, 2022, fill out the following papers:
- application for compensation;
- certificate-calculation;
- breakdown of expenses or calculation according to Form 4-FSS;
- copies of supporting documents. These are copies of certificates of incapacity for work, certificates of birth of children, certificates of registration in the early stages of pregnancy, and so on. That is, those documents on the basis of which social benefits were paid.
IMPORTANT!
The application form for compensation in 2022 has also changed. From 05/02/2021, application forms from the FSS order No. 26 of 02/04/2021 are valid. All applications for compensation for social benefits for funerals and payments for additional days off are made according to the new form. But an application for compensation for disability payments for the past year must be filled out on the old form - from the letter of the Federal Social Insurance Fund of the Russian Federation No. 02-09-11/04-03-27029 dated 12/07/2016.
Maternity leave: documents
Maternity leave is granted on the basis of the following documents (Article 255 of the Labor Code of the Russian Federation):
- Written statement from the employee.
It is compiled in any form and submitted to the head of the organization. We will consider the procedure for drawing up an application below.
- Certificate of incapacity for work.
Issued at the antenatal clinic where the employee is registered at the 30th week of pregnancy (28th week for multiple pregnancies).
- Certificates of registration in the early stages of pregnancy (optional).
This document is needed to pay the employee a one-time benefit when registering in the early stages of pregnancy. More information about this payment can be found in the article “Payment of benefits in the early stages of pregnancy.”
- Salary certificates for the last 2 years.
This document is provided only if the employee has changed jobs in the last 2 years. It is needed to calculate maternity benefits.
Important information about deadlines
There is no deadline for filing a refund claim. The policyholder has the right to apply for any reporting period if there are documented grounds. There are no restrictions on the number of applications for FSS reimbursement for two years or more. The policyholder is not limited in terms of terms.
The fund will consider the appeal within 10 calendar days and refund the funds. But only on condition that the policyholder has provided the entire package of necessary documents.
IMPORTANT!
The review period will be extended if Foundation controllers request additional information. Or, upon request, a desk or field inspection will be scheduled. The money will be refunded only after the inspections are completed.
How long to wait for a refund
After the collected package of documents is transferred to the Social Insurance Fund, the policyholder can wait to receive funds within no more than ten days from the date of transfer of the papers.
However, it should be remembered that in some cases, the insurer may initiate a desk or on-site audit in order to analyze the fairness and reliability of the costs of paying benefits.
This is due to the fact that from the beginning of 2022, the responsibility for administering and monitoring the payment of insurance premiums has transferred to the tax authorities. During the inspection, inspectors may request additional information and papers from the organization.
In such cases, the duration and even the very possibility of paying insurance coverage depends solely on the results of the verification event.
In this case, the organization must receive the insurer’s decision no later than three days after its adoption.
If the company does not agree with the results of the inspection, it can appeal them in court (of course, it is better to do this only when there is one hundred percent confidence in its own rightness).
How to make an application
Recommendations on how to fill out the annex to the application for reimbursement of FSS expenses for 2022 are presented in letter No. 02-09-11/04-03-27029. The application to Social Security contains the following required details:
- name and address of the location of the policyholder;
- policyholder registration number;
- the amount of funds claimed for reimbursement.
This is the application that policyholders submit in 2022 to reimburse last year's expenses.
The rules for how to fill out an application for FSS compensation in the 2021 form are enshrined in Order No. 26. In applications, you must fill out information about the policyholder and the recipient of social benefits. Current sample application for compensation for additional days off to care for disabled children in 2022:
