Loss of ability to work temporary benefit. Is an employer required to pay compensation to an employee injured at work? Amount of benefit for loss of working capacity due to caring for a child or other family member

A person’s ability to work is his ability to perform professional activities efficiently and fully. People devote most of their lives to their work. It begins with choosing a profession, studying and mastering it. Over the course of 30 - 40 years, a person develops his own and sells them in exchange for wages. This is considered work

Types of labor

Qualification of work ability implies the presence of several types:

Regardless of which one a person chooses, they have legal protection if partial or total disability occurs.

Causes of disability

Deprivation of the opportunity to fully perform work can occur due to an occupational or general illness. Common diseases include health problems that are not related to working conditions or the complexity of the profession. Most often, this is a person’s general ability to work, when he is not required to master a specialty for a long time or have any specific skills. The resulting illnesses are non-occupational in nature, but, nevertheless, the temporary loss of the opportunity to work is paid by the state or the employer in accordance with labor legislation.

The loss of professional ability of people is directly related to the risks of their specialty or any diseases acquired as a result of unfavorable working conditions. In this case, not only the Labor Law comes into force, but also the rules of life insurance against accidents at work.

Partial disability

Every person has the right to quality health care in the event of partial or total disability. The degree of disability and, accordingly, monetary compensation is determined by the attending physician or a commission. The amount of payments depends either on the insured event or is prescribed by law. Partial is the temporary inability of a person to perform his professional duties. In this regard, the percentage of the degree of disability is established, which is determined by the medical commission. It can be 10 - 30% of the previous level of performance, when the employee requires different working conditions or less output. The level of 40 - 60% is determined when a person can continue only with a significant reduction in the amount of work or a decrease in the level of qualifications. When an employee can perform work only under a complete change in conditions and not in full, the examination of work ability sets the level of loss of ability to work at 70 - 90%.

Payment for partial loss of performance

If an employee’s illness is of a general rather than professional nature, then he is issued and paid sick leave for the entire period of treatment.

Payment of sick leave is made in accordance with labor legislation.

In case of temporary disability, the state or the employer partially or fully compensates the employee for lost earnings due to illness.

• So, if an employee’s work experience is less than 5 years, then he receives 60% of the salary.
• With experience from 5 to 8 years - 80%.
• When the employee’s length of service is 10 years or more, the compensation will be 100% of the average salary.

Special list

According to the law, partial loss of ability to work by persons included in a special list is paid at the rate of 100%, regardless of their length of work. These include:

• war veterans and combatants;
• employees who support 3 or more minor children;
• wives or husbands of military personnel (this does not apply to conscripts);
• women who are granted maternity leave;
• former orphans and children deprived of parental care.

Partial disability involves temporary absence from work due to a general illness.

Complete loss of ability to work

If an employee has obvious impairments in the functioning of the body that are directly related to his professional activities, and he cannot continue to work under any conditions, he is assigned 100% loss of ability to work.

When such a person is injured at work or becomes incapacitated due to his professional activities, he is entitled to monetary compensation. The qualification of an employee’s ability to work is determined in accordance with the insured event or a special commission.

Complete loss of ability to work includes not only injuries and injuries sustained as a result of an accident, but also occupational diseases that prevent the employee from further engaging in his or her activities.

Occupational diseases

Diseases that a person received in connection with his professional activities are divided into two types:

• The former have partial or complete reversibility. They are treatable, and such loss of professional ability to work is most often associated with allergic manifestations or the initial stages of bronchitis and intoxication. Sometimes it is enough to change working conditions and undergo a course of treatment to fully recover. For the first group of people, there are preventive and treatment institutions where they can receive qualified assistance.

  

• The second group cannot be completely cured. These include occupational diseases such as pneumoconiosis, hearing loss, and severe forms of intoxication. The medical commission determines the degree of damage to the human body and decides to establish a disability group. Often such diseases are “overgrown” with side diseases that develop against the background of chronic manifestations. In this case, the disability group may change.

Workers of the second group should be provided with a referral for treatment to specialized clinics.

Registration of disability



The issue of assignment is considered only when a full examination of the employee’s ability to work has been carried out. Facts of contracting the disease in connection with professional activities or at the workplace are also checked. considers the issue of disability based on the conclusion of the medical commission and the current list of occupational diseases. According to existing guidelines, which consider the qualifications of workers’ ability to work, expressed as a percentage, the degree of its loss is established.

The first and second disability groups are awarded in the event of intoxication or injury in an accident. This group may also include workers whose occupational diseases have become irreversible or difficult to cure.

If a person has, along with work-related illnesses, other illnesses, then their exacerbation due to the impact of a “work” illness on them also falls into the category of occupational and can be considered as a basis for receiving disability.

In order to accurately determine the degree of workers’ ability to work, the expert must be a highly qualified specialist.

Compensation for health damage

In accordance with the physical or mental damage that the employee received during his work activity, he is awarded financial compensation in the amount provided for by labor legislation.

It is now common practice for employees to take out life insurance contracts in the event of disability. If an employee is partially unable to work, then he is paid a salary, compensation for medications and hospital care, and a one-time payment from the Social Insurance Fund.

If a certain disability rating is established as a result of severe injuries, the employee is paid monthly benefits, provided with appropriate medical care and given the opportunity to recover in a sanatorium.

on disability

In the event that an employee becomes disabled due to an occupational disease or in connection with and loses the ability to work fully, he is transferred to light work or a reduced day with compensation of wages. This applies to those with disability groups 1 and 2.

The third group is awarded in case of complete disability, when the employee can no longer perform his duties or retrain due to an industrial illness or injury.

The transition from one disability group to another is carried out on the basis of a medical examination.

The decision on the amount of sick pay, reimbursement for medicines and hospital treatment is made by the Social Insurance Fund, based on data provided by a forensic medical expert. According to the examination and determination of the degree of physical and moral damage to the victim, in the absence of his fault, the amount of compensation is assigned, as well as possible solutions for the rehabilitation of the patient. This applies to such measures as placing the victim in a specialized clinic, issuing a voucher to a sanatorium, and paying for psychologist consultations.

Payment through court

If an employee has become disabled due to his work activities, he has the right to monetary compensation for health and compensation for moral damage.

The issue of the amount of compensation is decided according to the conclusion given by the forensic expert. He checks the degree of mental disorder of the victim in connection with the incident and assesses the moral damage caused to him. You can also contact him if the employee does not agree with the disability group assigned to him by VTEK.



In this case, the employee files a claim against the employer or insurance company. You can win it only after receiving expert conclusions about the discrepancy between the assigned disability group or the amount of compensation and the mental and physical state in which the injured party is.

Re-examination of an employee who has lost his ability to work

There are deadlines for re-examination of the health status of workers who have lost their ability to work. This is done due to the fact that the disease can progress, and the deterioration of the physical health of the victim requires a different level of disability or compensation payments.

Re-examination takes place 6 months, a year or two after the first diagnosis. Typically this procedure takes place once a year. This does not apply to those workers whose illness is determined to be irreversible or whose injuries prevent them from continuing to work. Such people are assigned disability with lifelong pension payments.

You can undergo early re-examination if the patient’s condition has deteriorated sharply, which is confirmed by the medical commission. In this case, the Bureau of Medical and Social Expertise carries out an inspection and makes a decision based on the new results.

The employee also has the right to apply for an early check of his condition. In addition to the employee, an insurance company or employer can apply for re-examination if inconsistencies in the documents or forgery were discovered.

Temporary disability benefits very often allow Russian families to keep their financial condition afloat, especially if the situation has developed in such a way that one or more family members are, due to certain circumstances, unable to support their family. This is a very delicate issue in Russian legislation, the solution of which depends on the correct combination of many factors and nuances.

Who is eligible to receive disability benefits?

In our country, the following categories of citizens have the right to receive financial support for temporary disability:

• Former military personnel who left the location of the armed forces of the Russian Federation upon the onset of an incapacitated condition, but on the condition that their application for benefits will be no later than 30 calendar days from the date of dismissal.

• Russian citizens, subjects of foreign states, citizens with dual citizenship and stateless persons (stateless persons) who officially work in enterprises, organizations and commercial structures of Russia; Moreover, the form of ownership is not important; the enterprise can be either state-owned or private.

• Those citizens who officially have the status of unemployed and are registered with regional, federal and local employment institutions.

• Those citizens who received limited ability to work no later than 30 days from the date of dismissal from permanent work for valid reasons.

Who regulates the rights of working citizens to benefits?

Virtually all working citizens of our country are entitled to temporary disability benefits. The FSS regulates this with the help of regulatory documents.

The structure of Russian social protection is structured in such a way that benefits are the main instrument of assistance to socially vulnerable categories of citizens. The most common instrument of financial support is temporary disability benefits. The definition of this phenomenon can be found in the legislative framework.

A special place in the hierarchy of social protection of the population is occupied by benefits for temporary loss of ability to work. It is worth noting that very often financial assistance from the state for loss of ability to work is identified with disability benefits. This is not entirely true, since temporary disability benefits are awarded exclusively in cases where the process of deterioration in health is reversible.

That is, if a citizen is seriously ill, and as a result of the illness his ability to work has been completely or partially reduced, then he can count on financial support from the social security authorities, but on the condition that the disease can be completely cured.

Types of financial benefits for disability

The types of temporary disability benefits directly depend on the definition of insured events. To receive benefits for temporary disability, the following insured events are determined at the legislative level:

1. General improvement of the body at resorts and sanatoriums.

Benefits for this insured event are provided on the condition that the leave is not enough to visit a sanatorium in order to improve the general state of health. From time to time, situations arise when an employee has already used vacation, but over time he needs treatment. Then the travel voucher indicates the period during which the employee was undergoing treatment. It is worth noting that benefits are not accrued for unused days according to the voucher.

2. Quarantine.

Temporary disability benefits under this insurance type are accrued if the sanitary service authorities remove the employee from fulfilling his work obligations if someone from his family falls ill with an infectious disease. The incubation period and sick leave are determined by epidemiologists.

3. Diseases or injuries resulting in loss of ability to work.

When calculating benefits for this type of insured event, differentiated rules are applied, which depend on the type: domestic injury, work injury, general illness or occupational disease. At the same time, in the event of a work injury or occupational disease, benefits are accrued from the moment of the onset of the disease until the restoration of able-bodied activity, or the establishment of disability otherwise. The state guarantees the accrual of benefits for temporary disability in the shortest possible time.

Situations are allowed when disability manifests itself during vacation. In such cases, the employee must receive sick leave, and his leave will be extended by the total number of days of incapacity. If a person was on leave without pay, or he continued to be ill at the time of returning to work, then the accrual and subsequent payment of disability benefits occurs from the moment he was supposed to begin implementing the terms of his employment contract.

If this case coincides with a period of idle production capacity, then the amount of the benefit corresponds to the full salary, thus, the enterprise will repay part of the benefit with its own money. If the employee’s incapacity for work continues after the resumption of production activities, then, based on the general rules and principles of accrual, he will receive temporary disability benefits. An example of this is manifested in occupational diseases at enterprises of a high hazard class (chemical, radiation, etc.).

Benefits for forced termination of pregnancy are accrued only for the first 3 days of incapacity, and starting from the 4th day of this period, payment of financial assistance will continue only if the operation was forced according to medical indications or as a result of spontaneous abortion. If the incapacity continues, then the payment of benefits is resumed from the 11th day. Accounting for temporary disability benefits in this case is determined by the Social Insurance Fund.

For certain categories of citizens, the Russian legislative framework establishes limited periods for providing disability benefits. For example, temporary and seasonal workers can receive disability benefits for a period of time that is 75 calendar days, but provided that this period was not interrupted without good reason.

Working disabled people (in particular disabled people during the Second World War and those injured as a result of the explosion at the Chernobyl nuclear power plant) have the full right to receive a certain amount of benefits, but not more than for 4 consecutive months. Such restrictions are not introduced if the cause of disability is determined to be a work injury or occupational disease. Previously, a similar restriction also existed for persons who did not have official work in the amount of 30 calendar days, but as of today this restriction has been abolished.

4. Transfer to another place of work due to an occupational disease or tuberculosis.

The legislation allows for situations in which a sick employee is incapacitated for his professional activities, but can still perform other duties. In such cases, he can be transferred to another place of work; if the salary level is lower, he will receive benefits. The enterprise has a so-called additional payment sheet, according to which additional wages will be paid.

The benefit is calculated on a general basis, but its combination with the new salary should not exceed earnings from the previous job. It is worth noting that different rules for calculating this benefit apply for different occupational diseases. You can find out more about this in the law on compulsory insurance against accidents at work and occupational diseases.

5. Financial payments for caring for a family member who, due to illness, has lost the ability to care for himself.

If an employee has a sick child who requires care, then one of the parents has the right to stay in the hospital during the entire period of treatment. In this example, he will receive sick leave.

If other family members require care, then the following conditions must be met in order to issue benefits:

• there are no other relatives in the family who are able to provide care;
• lack of care poses a danger to the general health and life of the patient;
• if the patient cannot be admitted to hospital.

6. Prosthetics.

Temporary disability benefits for this insured event are paid only in a situation where the process of prosthetics is carried out in inpatient conditions. This benefit is paid for the entire period of time that the person spent in a hospital setting.

A package of documents that confirms the occurrence of temporary disability and the amount of benefits

The main reason for receiving benefits for partial disability is a certificate of temporary incapacity for work or a similar certificate of the established form, which is issued in some cases.

A certificate of temporary incapacity for work is issued to all working citizens, the unemployed who have been registered with employment authorities, persons whose loss of ability to work occurred within a period of no more than 30 days from the date of dismissal from their previous job for good reasons, as well as former military personnel who were dismissed in stock within 30 calendar days from the date of dismissal.

Temporary disability certificates are issued by doctors of medical institutions of any form of ownership, in particular state, private and municipal. However, a license is required for an expert assessment of disability. Those medical specialists who practice privately can acquire the right to issue sick leave after further training.

How to get sick leave

To obtain sick leave, you must present an identification document (passport, military ID). According to the general rules, the attending physician can issue a sick leave certificate personally if the incapacitated condition lasts up to 30 days, while he has the right to issue a sick leave certificate for no more than 10 days.

In fact, during the 1st full calendar month, the doctor will issue 3 sick leaves. If the disability lasts more than 30 days, then the issue of temporary disability is decided by an expert commission based in a medical institution. The procedure for issuing sheets must comply with the canons of the legislation of the Russian Federation, and for its violation, doctors may incur both disciplinary and criminal liability. In fact, everything is decided by the law. Temporary disability benefits must have a legal basis, otherwise the doctor may lose his license.

Calculation of financial assistance in the USSR

For a long time, the amount of benefits for sick leave and the procedure for issuing them was calculated on the basis of rules approved by the Council of Ministers of the USSR. In accordance with this set of rules, the amount of benefits was determined based on continuous length of service. The decree of April 13, 1973, Rules for calculating continuous length of service for workers when assigning state insurance benefits, states that continuous work experience is the duration of the last continuous work at a specific enterprise, subject to all the conditions established by law.

Such a definition contradicts the Constitution of the Russian Federation, which gives its citizens the right to use and apply their labor force freely. Therefore, the calculation of temporary disability benefits in some cases may occur without taking into account the total length of service, but in those cases provided for by law.

Frequency of interruption of work experience in accordance with Soviet legal norms

However, the interruption of work activity was recorded in documentary form, taking into account the frequency. Today, there are the following clear types of periods that can interrupt general work activity:

• Periods of time that are not counted towards the length of service, however, do not violate it. An example is training in higher educational institutions, postgraduate schools and vocational schools.

• The period of residence of family members of military personnel who serve on a contract basis is far from their main place of work. In this case, the rules are differentiated into two parts: military service until 1992, regardless of the place of deployment, and starting from the same year, depending on the location of the military unit, provided that members of the serviceman’s family did not have the opportunity to find employment in their specialty and received official status of unemployed.

• Periods that count towards the total length of service (military service).

• The period of maternity leave until the child reaches 3 years of age.

• The period from the moment of dismissal of a pregnant woman or a woman with a young child under 3 years of age. According to the law, they cannot be dismissed from their positions on the initiative of administrative employees. Dismissal can only occur independently or in the event of liquidation of the enterprise.

• Upon termination of an employment contract by women who have children under 14 years of age.

• Upon voluntary dismissal from their positions, pregnant women and women who have a disabled child or an HIV-infected child under 18 years of age.

If an employee wishes to change his place of work, then the general rule of maintaining continuous length of service applies. The length of service is considered continuous if the break in work activity was no more than 30 days from the date of termination of the employment contract. However, there are some reasons why the allowed break may be up to 1 year.

At the same time, there was the following relationship between length of service and the amount of temporary disability benefits. The benefit was assigned accordingly in the amount of the full average salary (100%), but provided that the total length of work was not less than 8 years. If the length of service was from 5 to 8 years, then the amount of the benefit was equal to 80% of the average annual earnings, but if less than 5 years, then 60%.

It is worth noting that some categories of citizens applied for 100% replacement of benefits relative to wages without taking into account length of service. These included citizens who suffered as a result of the Chernobyl disaster, workers of the Far North, disabled people from the Second World War who did not stop working, citizens who live in resettlement zones, workers exempted from fulfilling labor obligations due to the need to care for children under 14 years of age, and also members of large families.

Similar rules for calculating disability benefits remained until 2004, when some changes were made to the Russian legislative system. However, this change in the accrual principles was insignificant; most of the rules were still guided by the Soviet version. Since then, every year some changes have been made to the legislative framework, which must be independently monitored.

So, for example, now when calculating sick leave benefits, it is not the average annual salary that is taken into account, but earnings for 2 calendar years, and only the length of service that was accompanied by mandatory insurance payments to the Social Insurance Fund is taken into account. But still, the main document according to which disability benefits are now calculated is Order of the Ministry of Health and Social Development of the Russian Federation No. 21n dated January 24, 2011. It is impractical to consider changes for each year, especially since the main stages are a copy of the Soviet past. Therefore, let’s look at how financial support is calculated and what determines the amount of temporary disability benefits.

The procedure for calculating disability benefits (sickness benefits) in 2014

According to current regulations (Article 14 of the Law of the Russian Federation No. 255-F3 of December 29, 2006 and Decree of the Government of the Russian Federation No. 375 of July 15, 2007), in 2014, hospital financial benefits are calculated with some changes to the 2013 base.

Regardless of the reason for the employee’s incapacity for work (occupational illness, injury, pregnancy and maternity leave, caring for a child or another family member), the same procedure for calculating benefits applies. Our state guarantees the provision of temporary disability benefits to all those in need. In order to calculate it in accordance with the recommendations of the legislative system, the following points must be taken into account:

1. the period for which the employee will receive sick leave benefits;
2. a person’s income for a specific period;
3. the maximum benefit amount established by law;
4. the average salary of a person for a full day of work;
5. percentage rate of average full-time earnings, which will be taken into account when calculating benefits;
6. final amount of sick leave benefit.

It is worth noting that, starting from 2004, a maximum limit on the amount of temporary disability benefits has been established. Federal Law No. 255 regulates this issue. Also, the amount of benefits may be affected by some other factors (hazardous production, work in the Far North, etc.).

Time period for calculating sick leave benefits

When calculating the amount of benefits, the time period during which the employee could not fulfill his work obligations for one reason or another is taken into account, but provided that it relates to loss of ability to work. In this case, it is necessary to consider 2 main divisions when calculating benefits.

1. Temporary disability benefits can be calculated taking into account the employee’s average earnings for 2 working years (730 calendar days), while no time periods (illness, additional day off, business trip, vacation, etc.) are not taken into account.

2. A completely different situation becomes clear when calculating benefits for loss of ability to work during pregnancy, maternity leave or caring for a sick child (another family member). Here, the average earnings for 730 calendar days are also taken into account, but it is necessary to take into account the actual number of days in a year. So, for example, in a leap year it is necessary to take into account 366 days, and not 365, as in other years. In addition, according to the explanations of the legislative framework, when determining the amount of sick leave benefits, it is necessary to exclude from the overall calculation certain time periods, in particular:

• period of illness (if the illness is not occupational);

• recovery of the body from the consequences of injury (if the injury was not received while performing work duties);

• time of additional maternity leave;

• period of caring for a young child;

• those periods of time during which the employee was released from performing her work duties, but at the same time her earnings were retained in full or in part, provided that FSS insurance contributions were not accrued for it, in all cases, payment of temporary disability benefits will be made in in accordance with the wishes of the regulatory documents regulating this issue.

Calculation of benefits taking into account the insurance period and causes of disability

In order to calculate the amount of disability benefits as accurately as possible, it is necessary to take into account 2 main factors: the cause of disability and the employee’s total insurance period. In fact, the determination of the benefit amount in 2014 is similar to the Soviet era, but with some changes.

So, for example, in the USSR the total length of service was taken into account, but now the period of time that was accompanied by mandatory insurance payments to the Social Insurance Fund is taken into account; in addition, some causes of disability have lost their original meaning. Let us consider in more detail the impact of the insurance period and the causes of disability on the total amount of benefits.

• Any employee who becomes disabled due to illness, injury, quarantine or prosthetics (except for cases of injury or illness in connection with professional activities), but who has a total insurance period exceeding 8 years, will receive benefits at the rate of full (100%) average earnings for 730 days (Law No. 255-F3).

• If the employee has an insurance period of 5 to 8 years, he has the right to receive benefits in the amount of 80% of the amount of average daily earnings for the past 730 working days for each day of sick leave.

• An insurance certificate of less than 5 years will be paid at the rate of 60% of earnings for 2 full years of work, provided that the employee has not changed his place of work more than once. In this case, the calculation of temporary disability benefits will be carried out within 3 days.

• If an employee has lost his work skills due to his professional activity (injury at work, occupational disease), then the benefit will be accrued to him in the amount of 100% of the amount of average daily earnings for 730 days for each day of sick leave. In this case, the insurance period will not be taken into account at all.

• If an employee quits his position, but within 30 days partially loses the opportunity to realize his work skills, then he is entitled to a benefit in the amount of 60% of his average earnings from his previous job for 2 calendar years. Insurance experience will not be considered. However, there is one exception. A person who suffered as a result of the Chernobyl accident will receive full (100%) financial benefits for temporary disability. The length of your insurance certificate will also not be taken into account.

Amount of benefit for loss of working capacity due to caring for a child or other family member

When determining the amount of benefits for people who lose the opportunity to work as a result of caring for a sick family member, the insurance period is also taken into account, and in addition, how the sick family member is being treated (inpatient or at home).

1. The amount of benefits for caring for a child under 14 years of age, provided that he is being treated at home, but under the supervision of a doctor:

• If you have a total insurance period of more than 8 years, the amount of the benefit will correspond to 100% of the amount of average earnings for 730 days (but only during the first 10 days, then the benefit will be accrued in half the amount (50%). In this case, temporary disability benefits are paid in within 5 calendar days.

• If you have an experience supported by regular insurance payments to the Social Insurance Fund for at least 5 full years and no more than 8 years, the benefit amount will be 80% of the average income for 2 years in the first 10 days, starting from the 11th day, the benefit will be accrued in the amount of half the average earnings.

• with a total insurance period of less than 5 years, the benefit amount will be 60% of the average two-year earnings in the first 10 days, then for each day half (50%) of the employee’s earnings for 1 working day will be accrued.

2. The amount of temporary disability benefits for caring for a child under 14 years of age if he is undergoing treatment in a hospital setting:

• If the length of service exceeds 8 years, then the benefit will be accrued in full of the average two-year earnings for the entire period of the child’s stay in the hospital.

• If the work experience is from 5 to 8 years, then the benefit amount will be 80% of the average salary for 2 years of work.

• If the insurance period is less than 5 years, then the benefit amount will be equal to 60% of the employee’s average income for 730 calendar days.

When caring for an adult family member, the benefit amount will be 100% (if the insurance period is more than 8 years), 80% (if the insurance period is from 5 to 8 years), 60% (if the insurance period is less than 5 years). This does not take into account exactly how the patient is being treated, at home under the supervision of doctors or in a hospital setting.

Payment of temporary disability benefits is made to a bank account or in person through the cash desk of the enterprise or institution in which the person works.

This benefit is essentially compensation to the employee for earnings lost due to illness or some other reason. You can find out how much money you can count on and what you need to get it by reading this page.

Who is entitled to temporary disability benefits?

The insured person has the right to temporary disability benefits in the following cases:

• loss of ability to work due to illness or injury (including abortion and IVF);
• caring for a sick family member;
• quarantine of the insured person, as well as quarantine of a child under seven years of age attending kindergarten, or another incapacitated family member;
• implementation of prosthetics for medical reasons in a hospital specialized institution;
• follow-up treatment in Russian sanatoriums immediately after inpatient treatment (Part 1, Article 5 of Federal Law No. 255-FZ of December 29, 2006; hereinafter referred to as the law on compulsory social insurance).

In what cases is temporary disability benefits paid?

The benefit is paid if the disability occurred during the period of work, as well as in cases where the illness or injury occurred within 30 calendar days from the date of termination of work or in the period from the date of conclusion of the employment contract until the day of its cancellation ().

From July 1, 2017, medical organizations have the right, at the patient’s choice and with his written consent, to issue sick leave in the form of an electronic document signed by the attending physician and medical institution using an enhanced qualified electronic signature (Federal Law dated May 1, 2017 No. 86-FZ).

It is paid according to the general rule for the entire period of temporary incapacity until the day of restoration of working capacity or determination of disability ().

To an insured person recognized as disabled (except for tuberculosis), benefits are paid for no more than four consecutive months or five months in a calendar year.

If a fixed-term employment contract was concluded for a period of up to six months, as well as if an illness or injury occurred between the date of conclusion of the employment contract and the day of its cancellation, temporary disability benefits (except for tuberculosis) are paid for no more than 75 calendar days.

In the last two cases, for patients with tuberculosis, benefits are paid until the day of restoration of working capacity (establishment of disability).

Temporary disability benefits for the need to care for a sick family member are paid for a period specified by law. More details about this are in Table 1.

Table 1. Duration of payment of temporary disability benefits when caring for a sick family member, depending on his age and illness.

There are two more cases of payment of temporary disability benefits. The first concerns situations where quarantine was introduced. Those who have been in contact with an infectious patient or are themselves a carrier of bacteria can count on benefits for the entire period of suspension from work due to quarantine. And if children under seven years of age attending kindergarten or incapacitated family members are quarantined, benefits will be paid to their legal representatives throughout the entire quarantine period.

The second case is prosthetics for medical reasons in a hospital setting. The benefit must be paid for the entire period of absence from work for this reason, including travel time to and from the place of prosthetics.

When to apply for temporary disability benefits

You must apply for payment no later than six months from the date of restoration of working capacity (establishment of disability) or the end of the period of release from work in cases of caring for a sick family member, quarantine, prosthetics and after-care ().

If there are good reasons, the period may be extended. The decision on the extension must be made by the territorial body of the FSS of Russia. The list of valid reasons contains the following:

• emergency, unavoidable circumstances (earthquake, hurricane, flood, fire, etc.);
• long-term temporary disability due to illness or injury lasting more than six months;
• moving to a place of residence in another locality, change of place of residence;
• forced absenteeism due to illegal dismissal or suspension from work;
• damage to health or death of a close relative;
• other reasons recognized as valid in court when the insured persons apply to court ().

Benefit amount

The amount of the benefit is calculated based on average earnings for the two calendar years preceding the year of disability (). That is, if an employee was sick in 2016 (no matter in January or November), the average earnings should be calculated for 2015 and 2014.

For 2017, you can take into account earnings in an amount not exceeding 755 thousand rubles. (even if it is actually larger), and for 2016 and 2015 - in an amount not exceeding 718 thousand rubles. and 670 thousand rubles. respectively ( , ).

In this case, only those amounts for which insurance premiums were calculated will be included in the calculation of average earnings. For example, vacation pay is subject to contributions, but for payments under civil contracts, contributions to the Federal Social Insurance Fund of Russia are not accrued (clause 2, part 3, article 9 of the Federal Law of July 24, 2009 No. 212-FZ "").

As a general rule, temporary disability benefits for loss of ability to work due to illness or injury, during quarantine, prosthetics for medical reasons and after-care in sanatorium-resort institutions immediately after inpatient treatment are paid in the following amount:

• for an insured person with eight or more years of insurance experience - 100% of average earnings;
• for an insured person with an insurance period of five to eight years - 80% of average earnings;
• for an insured person with up to five years of insurance experience - 60% of average earnings ().

EXAMPLE

Let's calculate the amount of temporary disability benefits for an employee who has been working for the company from 2013 to the present. His total work experience at the time of granting the benefit is seven years and two months. The employee’s salary for 2016 amounted to 780 thousand rubles, for 2015 – 612 thousand rubles.

Let’s assume that the employee was sick from April 17 to April 23 inclusive (seven calendar days), which is confirmed by sick leave.

First, let's compare the employee's annual salary with the maximum values. Remuneration for labor in 2015 did not exceed the permissible figure (670 thousand rubles), which means that its entire amount can be used - 612 thousand rubles. In contrast to earnings for 2016, which is more than the maximum (RUB 780 thousand versus RUB 718 thousand). Therefore, for the 2016 salary, the maximum value should be used.

Thus, earnings for two years will be:
612,000 rub. + 718,000 rub. = 1,330,000 rub.
Now this amount needs to be divided by 730 to determine the average daily earnings:
1,330,000: 730 = 1821.92 rubles.
The amount of temporary disability benefits will be equal to:
1821.92 x 7 x 80% = RUB 10,202.75

There are cases when the benefit is calculated based on , there are two of them: if the employee did not receive any earnings during the billing period or if his earnings turned out to be below the minimum wage in terms of days. In this case, to determine the amount of benefits, the minimum wage will be used on the day the insured event occurred, that is, on the day of illness ().

Average daily earnings are determined by the formula: minimum wage x 24/730 (7800 x 24/730 = 246.58 rubles). Then, by analogy with the calculation from the example above, you need to determine the amount of the benefit depending on the time for which the sick leave was issued and the length of service.

Who pays temporary disability benefits?

As a general rule, benefits are paid by the employer at the place of work.
If the insured person works for several employers and has worked for them over the past two calendar years, benefits are assigned and paid to him for each place of work.

If an employee works in several companies, and over the past two years he has also worked in several organizations, but in different ones, the benefit will be paid at one of the last places of work of the employee’s choice. In this case, he will need to bring certificates from other employers about the amount of their salary and that they did not provide benefits.

If a citizen works for several employers, and over the past two calendar years he worked for both them and others, the benefit will be paid either for all places of work or one at a time at the employee’s choice (,). In the latter case, you will also need certificates from employers.

For persons who have lost their ability to work within 30 days after dismissal, benefits are paid either by the employer at the last place of work or by the territorial body of the Social Insurance Fund of Russia. By the way, other insured persons can also apply to the Fund, these include the self-employed (lawyers, individual entrepreneurs, members of peasant (farm) households, individuals, private notaries, other persons engaged in private practice), as well as members of family (tribal) communities indigenous peoples of the North. But all these persons can apply for payment only if they voluntarily paid contributions to the Federal Social Insurance Fund of Russia - they have no obligation to make contributions ().

In addition, ordinary employees can apply to the Federal Social Insurance Fund of Russia for the appointment and payment of benefits if:

• the employer has ceased its activities;
• there is not enough money in his accounts to pay benefits;
• it is impossible to establish the location of the employer and his property if there is a court decision that has entered into force, which confirms the fact of non-payment of benefits;
• bankruptcy proceedings are being carried out against the employer ().

This benefit is assigned and paid only on the basis of a certificate of incapacity for work (sick leave) ().

These Temporary criteria for determining the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases were developed in pursuance of Decree of the Government of the Russian Federation of October 16, 2000 N 789 “On approval of the Rules for determining the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases " for use by medical and social examination institutions in determining the degree of loss of professional ability of persons who have suffered health damage as a result of industrial accidents or occupational diseases (hereinafter referred to as victims), their need for measures of medical, professional and social rehabilitation.

These criteria are temporary for the period of studying their application in practice and making possible adjustments.

I. General principles for determining the degree of loss

professional work capacity as a percentage

1. The degree of loss of professional ability to work is determined based on the consequences of health damage due to an industrial accident, taking into account the victim’s professional abilities, psychophysiological capabilities and professionally significant qualities that allow him to continue to perform professional activities that preceded the industrial accident and occupational disease, the same content and in the same volume or taking into account the reduction in qualifications, reduction in the volume of work performed and the severity of labor in ordinary, specially created production or other conditions; expressed as a percentage and set between 10 and 100 percent.

2. The main methodological principle of examining the professional working capacity of the victim is a cumulative analysis of the following criteria:

clinical and functional;

the nature of professional activity (qualifications, quality and volume of work, ability to perform it);

3. Clinical and functional criteria include:

nature and severity of injury, occupational disease;

features of the course of the pathological process caused by an accident at work or occupational disease;

nature (type) of dysfunctions of the body;

degree of dysfunction of the body (significantly expressed, pronounced, moderate, insignificant);

clinical and rehabilitation prognosis;

psychophysiological abilities;

clinical and labor prognosis.

4. When determining the degree of loss of professional ability to work, the severity of dysfunction of the victim’s body, leading to limited ability to work, and other categories of life activity are taken into account. Characteristic of traumatic injuries and occupational diseases is a variety of clinical manifestations, varying both in nature and in the severity of dysfunction. The polymorphism of the clinical picture in victims may be due to the presence of both direct consequences of injuries, occupational diseases, and their complications. In this regard, the method of expert examination of this category of victims requires a comprehensive clinical and physiological study using modern diagnostic methods and retrospective analysis of post-traumatic and previous periods of development of an occupational disease, a careful study of anamnestic information, data from medical institutions, medical, expert documentation, etc. Analysis of a set of clinical and physiological indicators helps to clarify the main medical and biological factors (nature, degree of dysfunction, course of the disease, etc.), which are the basis of clinical and functional criteria for determining the degree of loss of professional ability.

II. Criteria for assessing ability

to professional activities

5. When determining the degree of loss of professional ability to work, it is necessary to take into account the professional factor, in particular, the ability of the victim after an accident at work or the occurrence of an occupational disease to perform work in full in his previous profession (before the accident or occupational disease) in ordinary or specially created production facilities or other working conditions.

(as amended by Order of the Ministry of Health and Social Development of the Russian Federation dated April 18, 2007 N 280)

6. Professional activity in full involves a full working day, a full working week, and fulfillment of production standards by at least 100 percent.

7. The criteria for assessing the possibility of performing professional activities are related to the difference in tariff and qualification categories within the relevant profession.

8. The frequency of reduction in qualifications is determined taking into account the established tariff categories, classes, categories for a given professional activity.

9. The ranking of work by degree of complexity (and therefore by skill level) is based on labor complexity factors:

technological - the complexity of managing (maintaining, using) tools; complexity of technological (working) processes;

organizational - the breadth of the complex of operations (work) performed and the degree of independence of the employee in the process of performing work;

responsibility - material and responsibility for life and health;

specific - special requirements for work, for example, work in unusual, close to extreme conditions of production activity.

10. The assessment of the level of complexity of work is carried out differentially for work that differs in the degree of mechanization: manual, machine-manual, machine, automated, hardware.

11. When determining the tariff and qualification category, the employee’s qualifications are taken into account as a set of knowledge, skills and work habits, as well as the time spent on preparation (study). Qualification requirements for knowledge increase from initial information in the scope of incomplete secondary school (1st - 2nd category) to knowledge of individual disciplines in the scope of a full course of secondary specialized educational institutions (6th category).

12. The tariff and qualification system for assessing work and professions of workers is characterized by a pattern of increasing complexity of work for each of the factors taken as the basis for determining the category. For example, according to the technological factor: when moving from 1 category to the next, the complexity, power, and dimensions of a unit of serviced equipment for a similar purpose increase. According to the organizational factor of complexity, the degree of independence in performing work increases and the functions of managing workers of lower skill levels are included.

13. Professions of skilled manual workers are classified into six tariff and qualification categories. The tariff-qualification category indicates the compliance of the worker’s qualifications with the complexity of the work performed, as well as the level of his knowledge, skills and work habits.

Skilled worker professions can have a different range of ranks (1 - 6, 4 - 6, 3 - 5, etc.).

14. If the victim cannot perform work of the same complexity (qualification), then the question arises of transferring him to work of less complexity (qualification) in accordance with the types of work provided for by the Unified Tariff and Qualification Directory of Work and Professions of Workers (UTKS), with optimal ( 1st class of working conditions) or acceptable (2nd class of working conditions) physical, neuro-emotional load, which does not contain contraindicated production factors and corresponds to the psychophysiological capabilities of the victim to perform it.

15. In this case, the degree of loss of professional ability to work is established depending on the level of reduction in qualifications, taking into account the reduction in the coefficient of complexity of work. For example, transferring a 6th grade worker to 2nd grade leads to a decrease in qualifications with the loss of four grades and a decrease (by 60 percent) in the work complexity coefficient.

16. The degree of loss of professional working capacity of a worker of unskilled physical labor is established depending on his psychophysiological state, physical ability to perform simple physical labor and is associated with the assessment of classes of working conditions based on the severity of labor.

The loss of professional working capacity for a given contingent of workers is determined taking into account the degree of reduction in the category (class) of the severity of work, for example, when transferring a worker of heavy physical labor of the 4th category of severity (lifting and carrying a load weighing more than 35 kg) to the shown work of the 1st category of severity with light physical stress (one-time lifting of a load weighing no more than 2 kg) with a pronounced reduction in the category (class) of the severity of the labor process.

17. When determining the degree of loss of professional ability to work, it is necessary to take into account the classes of working conditions in terms of the harmfulness and danger of factors in the working environment, the severity and intensity of the labor process.

18. A set of indicators reflecting production factors is the basis for resolving the issue of the need to change the profession, qualifications of an employee, and the volume of his production activity in connection with an injury or occupational disease.

19. Loss of professional working capacity of employees (engineers, managers at various levels, people in creative professions, etc.), to whose activities labor standards are applicable, is determined taking into account the reduction in the volume of work performed, its complexity and intensity, and job responsibilities.

III. Determining the degree of professional loss

working capacity as a percentage

20. In cases where, as a result of an industrial accident or occupational disease with significant impairment of body functions, the victim has a complete loss of ability to perform professional activities, including in specially created production or other working conditions, 100 percent loss of professional ability is established.

(as amended by the Resolution

21. Examples of clinical and functional criteria for establishing 100 percent loss of professional ability to work, which determine the complete loss of professional ability to work, are significantly pronounced violations of the static-dynamic function:

a) lower paraplegia; significantly pronounced tetraparesis, triparesis, paraparesis with increased spastic type muscle tone or hypotension, with a minimum volume (5.0 - 6.0 degrees) of active movements in all joints of the lower extremities, a significant decrease in muscle strength (up to 1 point), with inability to move independently; Type III EMG - frequent fluctuations in potential, distortion of the normal structure of the electromyogram "in bursts of frequent oscillations" (significantly pronounced paresis); IV type EMG - complete bioelectrical silence during functional loads (paralysis of the limbs);

b) significantly pronounced paresis of both upper extremities with a minimal range of active movements in all joints (shoulder - 5.5 - 10 degrees, elbow - 4.3 - 7.7 degrees, wrist - 5.5 - 8.5 degrees); significant limitation of the opposition of the thumb (the distal phalanx of the latter reaches the base of the second finger), flexion of the fingers into a fist (the distal phalanges of the fingers do not reach the palm at a distance of 5 - 8 cm); decrease in muscle strength of the upper extremities (up to 1 point); violation of the main function of the upper limb: grasping and holding large and small objects is not possible, only the auxiliary function is preserved - maintaining and pressing objects;

c) vestibular-cerebellar disorders: significantly pronounced static, dynamic ataxia; hyperreflexia of vestibular excitability with a duration of grade III post-rotational nystagmus of more than 120 seconds, grade III caloric nystagmus of more than 130 seconds;

d) amputation stumps of both lower extremities (non-prosthetic) in combination with the stump of the upper extremity, starting with the absence of all fingers;

e) respiratory failure of the III degree, circulatory disorders of the III stage (shortness of breath at rest, respiratory rate of 30 or more per minute, increased respiratory rate by 10 - 15 per minute after minor physical stress without restoring the original level, significantly pronounced cyanosis, participation at rest auxiliary respiratory muscles, pronounced tachycardia - 130 or more beats per minute, epigastric pulsation, liver enlargement, peripheral edema, decrease in vital capacity of the lungs to 50% of the proper value, maximum ventilation of the lungs - up to 50 percent, increase in minute respiratory volume up to 180 percent, decrease in the index Tiffno less than 40 percent and oxygen utilization rate up to 20 percent, decreased contractility of the right ventricular myocardium in combination with impaired pulmonary hemodynamics);

e) significantly expressed sensory impairments (practical or absolute blindness of the only or better seeing eye: visual acuity with correction - 0.04 - 0, field of vision equal to - 0 - 10 degrees (peripheral boundaries along the meridian from the point of fixation and/or central or paracentral confluent scotomas); visual performance - a significant decrease or absence, EPI indicators - E-U thresholds are more than 300 μA or not determined, lability is less than 20 Hz or absent, RF is less than 20 p/sec or absent - in the presence of contraindications to any. labor);

g) significantly pronounced dysfunctions of the pelvic organs (urinary and fecal incontinence).

22. In the case where the victim, due to severe impairment of body functions, can perform professional labor (work) only in specially created production conditions, the degree of loss of professional ability to work is established from 70 to 90 percent.

In this case, the degree of loss of professional ability for victims with severe impairments of body functions is established depending on the level of reduction in qualifications and the possibility of using professional knowledge and skills when performing work in specially created production conditions:

a) has become invalid. - Order of the Ministry of Health and Social Development of the Russian Federation dated September 24, 2007 N 620;

b) in cases where the victim can perform lower-skilled work in specially created production conditions, taking into account professional knowledge and skills, 80 percent of the loss of professional ability to work is established;

c) in cases where the victim can perform work in a profession that preceded an industrial accident or occupational disease in specially created production conditions, 70 percent of the loss of professional ability to work is established.

23. Examples of clinical and functional criteria for establishing 70 - 90 percent loss of professional ability for victims with the consequences of industrial injuries and occupational diseases, with the possibility of professional activity in specially created conditions, are pronounced violations of the static-dynamic function:

(as amended by Resolution of the Ministry of Labor of the Russian Federation dated April 26, 2004 N 61)

a) pronounced paresis of both lower extremities, tetraparesis, triparesis, hemiparesis with a pronounced increase in muscle tone of the spastic type or muscle hypotonia, with a pronounced limitation of the amplitude of active movements in all joints of the lower extremities - hip (up to 20 degrees), knee (up to 10 degrees) , ankle (up to 6 - 7 degrees); with a pronounced decrease in muscle strength (up to 2 points) of the lower extremities, pronounced varus, equinovarus deformity of the feet; spastic, paretic, peroneal gait with pronounced foot drop; moving with additional support (crutches);

b) a pronounced violation of the biomechanics of walking - an increase in the number of steps when walking 100 meters to 204 - 226 (normally 80 - 120 steps), an increase in the duration of a double step to 2.6 - 3.6 seconds (normally 1.0 - 1, 3 seconds), reducing the walking pace to 29 - 46 steps per minute (normally 80 - 100 steps), reducing the walking rhythm coefficient to 0.52 - 0.58 (normally 0.94 - 1.00), reducing movement speed up to 1.0 km per hour (normally 4 - 5 km/hour); Type II EMG with a pronounced disturbance of the bioelectrical activity of muscles - low-frequency potentials of the “fasciculations” type with a clear rhythm at rest and during functional loads;

c) severe paresis of both upper extremities, contractures of the joints of the upper extremities with a range of active movements within 10 - 20 degrees, with a pronounced limitation in flexing the fingers into a fist (the distal phalanges of the fingers do not reach the palm at a distance of 3 - 4 cm), with a violation of the basic function of the upper limbs: it is not possible to grasp small objects, to hold large objects for a long time and firmly, EMG - type II;

d) pronounced vestibular-cerebellar disorders (dizziness at rest, severe and frequent attacks of dizziness - 4 or more times a month), spontaneous nystagmus II - III degrees, severe disturbances in statics and coordination of movements, movement with the help of aids (cane, crutches) , hyperreflexia of vestibular excitability with a duration of post-rotational nystagmus II - III degree 85 - 120 seconds, caloric nystagmus II - III degree 110 - 130 seconds;

e) amputation stumps of the thighs or legs at different levels, false joints of both leg bones with a defective position of the lower limb, with a functionally unfavorable position of the knee joint with flexion contracture with the inability to extend more than 140 degrees, a defective installation of the lower limb in a functionally disadvantageous position of the hip joint with limitation extension up to 150 degrees or abduction of the leg over 165 degrees with a pronounced distortion of the pelvis and functional shortening of the limb by 10 cm, severe contracture with a range of motion of no more than 30 degrees or ankylosis of the joints in a functionally disadvantageous position;

f) respiratory failure of the second degree, circulatory disorders of the second stage (respiratory rate at rest 21 - 29 per minute, increased respiratory rate by 12 - 16 per minute after physical activity, severe cyanosis, participation of auxiliary respiratory muscles in the act of breathing during minor physical activity load, heart rate 100 - 129 beats per minute, slight peripheral edema, decrease in vital capacity of the lungs to 50 - 55% of proper, maximum ventilation of the lungs - up to 51 - 54%, increase in minute respiratory volume up to 150%, decrease in the Tiffno index to 54 - 40%, oxygen utilization rate up to 28%, decreased contractility of the right ventricular myocardium in combination with impaired pulmonary hemodynamics);

g) pronounced sensory impairment: high degree of low vision in the only or better seeing eye, corrected visual acuity is equal to or less than 0.1 - 0.05, field of vision - peripheral boundaries are equal to or less than 20 degrees, but wider than 10 degrees and (or) single central scotomas, visual performance - a pronounced decrease, EFI indicators - E-U thresholds - 200 - 300 μA, lability - 20 - 35 Hz, CFSM - 20 - 35 p/sec.;

pronounced hearing loss: perception of spoken speech up to 0.5 - 1.5 meters, hearing threshold - 61 - 80 dB, speech intelligibility threshold - 80 - 90 dB;

h) severe dysfunction of the pelvic organs, absence of the urge to urinate and the feeling of urine passing through the urethra; with cystometry, the capacity of the bladder with detrusor hypotension is 500 - 600 ml, residual urine - up to 400 ml, with detrusor hypertension the capacity is 20 - 30 ml; long delay in defecation - up to 5 days; anal reflex, sphincter tone and pressure during monometry are reduced - in the anal canal of the external sphincter - 10 - 15 mm Hg. Art., internal sphincter - 16 - 25 mm Hg. Art. (norm 35 - 62 mm Hg).

24. In cases where the victim can, under normal production conditions, perform professional work with a pronounced decrease in qualifications or with a decrease in the volume of work performed, or if he has lost the ability to continue professional activities due to a moderate impairment of body functions, but can, under normal production conditions, continue professional activities of a lower level qualifications, it is established from 40 to 60 percent of loss of professional ability to work.

(as amended by Resolution of the Ministry of Labor of the Russian Federation dated April 26, 2004 N 61)

25. In this case, the degree of loss of professional ability for victims with moderate impairments of body functions is established depending on the level of reduction in qualifications, the volume of production activity or the category of labor severity:

a) 60 percent loss of professional ability to work is established in the following cases:

if the victim can perform work in the profession, but with a reduction in qualifications by four tariff categories;

if the victim can perform work using professional knowledge, skills and abilities, but with a reduction in qualifications by four tariff categories;

the paragraph is no longer valid. - Order of the Ministry of Health and Social Development of the Russian Federation dated May 13, 2005 N 329;

if the victim can perform unskilled physical labor with a reduction in the level of work by four categories of severity;

(paragraph "a" as amended by Resolution of the Ministry of Labor of the Russian Federation dated April 26, 2004 N 61)

b) 50 percent loss of professional ability to work is established in the following cases:

if the victim can perform work in a profession with a reduction in qualifications by three tariff categories;

if the victim can perform work in his profession with a decrease in the volume of production activity (by 0.5 times the rate);

if the victim can perform unskilled physical labor with a reduction in the level of work by three categories of severity;

c) 40 percent loss of professional ability to work is established in the following cases:

if the victim can perform work in his profession with a decrease in the volume of production activities;

if the victim can perform work using professional knowledge, skills and abilities, but with a reduction in qualifications by two tariff categories;

(as amended by Resolution of the Ministry of Labor of the Russian Federation dated April 26, 2004 N 61)

if the victim can perform work in a profession with a reduction in qualifications by two tariff categories;

if the victim can perform unskilled physical labor with a reduction in the level of work by two categories of severity.

26. Examples of clinical and functional criteria for establishing 40 - 60 percent loss of professional ability for victims with the consequences of industrial injuries and occupational diseases, when it is possible to perform professional activities in normal production conditions, are moderate violations of the static-dynamic function:

(as amended by Resolution of the Ministry of Labor of the Russian Federation dated April 26, 2004 N 61)

a) moderate paresis of both lower extremities, tetraparesis, triparesis, hemiparesis, monoparesis with muscle wasting of the thigh by 5 - 7 cm, lower leg - by 4 - 5 cm, increased muscle tone of a spastic type or muscle hypotonia, with a moderate limitation of the amplitude of active movements during all joints of the lower extremities - hip (up to 15 - 20 degrees), knee - (up to 16 - 20 degrees), ankle - (up to 14 - 18 degrees); moderate decrease in muscle strength (up to 3 points), spastic, paretic, peroneal gait with slight or moderate foot drop; movement sometimes with the use of additional support (cane);

b) moderate violation of the biomechanics of walking - increasing the number of steps when walking 100 meters to 170 - 190, increasing the duration of a double step to 2.0 - 3.0 seconds, reducing the pace of walking to 50 - 60 steps per minute, reducing the rhythmicity coefficient of walking to 0.82 - 0.75, moderate reduction in movement speed to 2.0 km per hour;

c) moderate disturbance of bioelectrical activity - ACBA within more than 25 percent, but less than 70 percent of the norm;

d) moderate paresis of the upper limb: hemiparesis with limited range of active movements in the shoulder joint (35 - 40 degrees), elbow (30 - 45 degrees), wrist (30 - 40 degrees), moderate decrease in muscle strength of the upper limb (3 points) , limited opposition of the thumb to the hand (the distal phalanx of the thumb reaches the base of the 4th finger), limited flexion of the fingers into a fist (the distal phalanges of the fingers do not reach the palm at a distance of 1 - 2 cm), with difficulty grasping small objects; on EMG - a moderate decrease in the amplitude of bioelectrical activity of the muscles of the upper extremities within 25 - 75 percent of normal;

e) contracture of the shoulder joint with a range of motion within 30 - 90 degrees, elbow joint - 80 - 130 degrees, wrist joint - 120 - 130 degrees (flexion contracture and extension contracture - 200 - 220 degrees); ankylosis of joints in a functionally advantageous position; absence of three fingers, excluding the first finger, with difficulty grasping small objects;

f) moderate vestibular-cerebellar disorders: dizziness with sudden changes in the position of the head, torso, or driving a vehicle; spontaneous nystagmus I or I - II degree; moderate static-dynamic disturbances (staggering in the Romberg position, when walking, missing the mark during the heel-knee test); hyperreflexia of vestibular excitability with a duration of post-rotational nystagmus of 50 - 80 seconds, caloric nystagmus - 90 - 110 seconds;

g) amputation stumps of a limb (thigh, lower leg, both feet at the level of the Chopart, Lisfranc joint), moderate flexion or extension contracture of the hip joint, knee joint; flexion contracture of the ankle joint (foot equinus); shortening of the lower limb by 5 - 7 cm; ankylosis of the joints in a functionally advantageous position - the angle of flexion in the hip joint is within 160 - 170 degrees, in the knee joint - 170 - 180 degrees, in the ankle joint - 95 - 100 degrees;

h) respiratory failure of the I - II degree, circulatory disorders of the I - II stage (shortness of breath with moderate physical exertion, increased cyanosis after moderate physical activity, respiratory rate at rest up to 20 per minute, increased respiratory rate by 12 - 16 per minute after physical exercise load with restoration to the initial level within 5 minutes, slight tachycardia (90 - 99 beats per minute), moderate decrease in vital capacity of the lungs to 56 - 69 percent of the proper, maximum ventilation of the lungs - up to 55 - 58 percent, increase in minute respiratory volume to 142 - 148 percent, reduction in the Tiffno index to 74 - 55 percent, oxygen utilization rate to 36 - 44 percent, oxygen absorption per minute - 277 - 287 ml, signs of a moderate decrease in the contractility of the right ventricular myocardium in combination with impaired pulmonary hemodynamics);

i) moderate sensory impairments: dysfunction of the visual analyzer - moderate degree of low vision: reduction in visual acuity of the only or better seeing eye with correction equal to or more than 0.1, field of vision - peripheral boundaries less than 40 degrees, but wider than 20 degrees, visual performance is moderately reduced , EPI indicators - E-U thresholds - 100 - 150 μA, lability from 30 - 35 to 40 - 43 Hz, CFSM from 30 - 35 to 40 - 43 p/sec; moderate hearing loss - perception of spoken speech up to 2 - 3 meters, whispered speech - up to 0.5 - 0 meters, average hearing threshold - 41 - 60 dB, speech intelligibility threshold - 50 - 70 dB;

j) moderate dysfunction of the pelvic organs: lack of sensation of bladder filling, with cystometry, the capacity of the bladder with detrusor hypotonia is 500 - 400 ml, residual urine - more than 100 ml with detrusor hypertension, the capacity is 20 - 125 ml; long delay in defecation - up to 3 - 4 days; sphincter insufficiency - incontinence of gases, the anal reflex is reduced, the tone and volitional contractions of the sphincter are weakened, manometry reveals a moderate decrease in the pressure of the external sphincter - 16 - 25 mm Hg. Art., internal sphincter - 26 - 40 mm Hg. Art.

27. In cases where the victim can, under normal production conditions, perform professional work with a moderate or slight reduction in qualifications, or with a decrease in the volume of work performed, or when working conditions change, leading to a decrease in the victim’s earnings, or if the performance of his professional activities requires more stress, than before, 10 to 30 percent of loss of professional ability is established.

28. In this case, the degree of loss of professional ability for victims who have minor impairments in body functions due to industrial injuries or occupational diseases is determined depending on the level of reduction in qualifications, the volume of production activity or the category of labor severity:

a) 30 percent loss of professional ability to work is established in the following cases:

if the victim can perform work in a profession with a reduction in qualifications by one tariff category,

if the victim can perform unskilled physical labor with a reduction in the level of work by one category of severity,

if the victim can perform work in his profession with a slight decrease in the volume of professional activity (reduction in the production rate by 1/3 of the previous load);

(as amended by Resolution of the Ministry of Labor of the Russian Federation dated April 26, 2004 N 61)

b) 20 percent loss of professional ability to work is established if the victim can perform work with a reduction in the volume of professional activity by 1/5 of the previous load;

c) 10 percent loss of professional ability to work is established if the victim can perform work in his profession with a reduction in the volume of professional activity by 1/10 of the previous workload.

29. Examples of clinical and functional criteria for establishing 10 - 30 percent loss of professional ability for victims with the consequences of industrial injuries and occupational diseases, with the possibility of performing professional activities in normal production conditions with a slight decrease in qualifications, category of labor severity or a decrease in the volume of production activities are minor violations of the statistic -dynamic function:

(as amended by Resolution of the Ministry of Labor of the Russian Federation dated April 26, 2004 N 61)

a) slight paraparesis, tetraparesis, hemiparesis, monoparesis of the lower limb with hypotrophy of the muscles of the thigh and lower leg by 1.5 - 2.0 cm (flaccid paresis), a decrease in muscle strength (up to 4 points) with a full range of motion in all joints, with a slight violation of the biomechanics of walking - increasing the number of steps when walking 100 meters to 150 - 160, increasing the duration of a double step to 1.5 - 1.7 seconds, reducing the walking pace to 64 - 70 steps per minute, reducing the walking rhythm coefficient to 0.85 - 0.90, reduction in movement speed to 3.0 km per hour; with a slight decrease in the EMG amplitude of fluctuations in bioelectrical activity to 25 percent of normal;

b) minor paresis of one or both upper extremities with muscle wasting of the shoulder and forearm by 1.5 - 2.0 cm (flaccid paresis), a decrease in muscle strength in all parts of one or both upper extremities up to 4 points, with preservation of active movements in the joints in full and the main function of the hand - grasping and holding objects; on EMG - a slight decrease in the amplitude of bioelectrical activity of the muscles of the upper extremities to 25 percent of normal;

c) minor contracture of the shoulder, elbow or wrist joints; absence of one or two fingers, excluding the first finger, with preservation of the main function of the hand;

d) minor vestibular-cerebellar disorders: dizziness that occurs occasionally; sometimes spontaneous nystagmus of the first degree;

e) minor stato-dynamic disturbances (instability in the Romberg, Sarbo position), hyperreflexia of vestibular excitability with a duration of post-rotational nystagmus of 50 - 80 seconds, caloric nystagmus of 80 - 90 seconds;

f) minor contracture of the joints of the lower extremities: in the ankle joint, extension to an angle of 100 degrees with the equinus position of the foot (flexion contracture), flexion to an angle of 80 degrees - heel foot (extension contracture);

g) respiratory failure of the first degree, circulatory disorders of the first stage (shortness of breath with significant physical exertion, fast walking, respiratory rate at rest within the normal range of 16 - 20 per minute, increased respiratory rate by 10 - 12 per minute after physical activity - 10 squats or bending the body forward with restoration to the initial level within 3 minutes, a slight increase in cyanosis after physical activity, a slight decrease in the vital capacity of the lungs to 80 - 90 percent of the proper one, maximum ventilation of the lungs - up to 60 - 74 percent, an increase in minute respiratory volume to 130 - 140 percent, oxygen absorption per minute - up to 260 - 270 ml, signs of compensatory hyperfunction of the right ventricular myocardium);

h) minor sensory impairments: dysfunction of the visual analyzer - a small degree of low vision in the only or better seeing eye, visual acuity with correction of more than 0.3, visual fields - peripheral boundaries are normal or the fields are narrowed to 40 degrees, visual performance is normal, EFI indicators - E-U thresholds from 80 to 100 µA, lab. over 40 to 43 - 45 Hz, KFSM over 40 to 43 - 45 p/sec.; hearing impairment - perception of spoken speech up to 3 - 5 meters, whispered speech - up to 1.5 - 2.0 meters, average hearing threshold 20 - 40 dB, speech intelligibility threshold - 30 - 40 dB;

i) minor dysfunctions of the pelvic organs: a weak feeling of the urge to urinate, with cystometry the bladder capacity is 200 - 250 ml, residual urine is up to 50 ml; defecation delay - for 2 - 3 days; gas incontinence, anal reflex is reduced, sphincter tone is reduced, monometry reveals a decrease in external sphincter pressure - 22 - 33 mm Hg. Art., internal sphincter - 41 - 58 mm Hg. Art.

30 - 31. Lost power. - Resolution of the Ministry of Labor of the Russian Federation dated December 30, 2003 N 92.

32. The degree of loss of professional ability to work in the event of repeated industrial accidents or newly emerging occupational diseases is established for the victim for each of them separately, depending on the impact of their consequences on his ability to perform professional activities preceding the repeated accident, taking into account the results of the implementation of the individual rehabilitation program for the victim to restore professional ability to work in the previous profession (preceding the previous accident) and in total cannot exceed 100 percent.

33. The degree of loss of professional ability to work during the next re-examination is established taking into account the results of the victim’s rehabilitation.

Often a person finds himself in situations as a result of which he cannot fulfill the obligations assigned to him. The loss of an employee’s professional ability to work carries with it the consequences and amount of compensation payments. In our article we will consider the types of disability, the procedure for conducting an examination and other nuances relating to receiving payments.

Types of disability

The following types of disability are defined:

• General - performing simple functions that do not require qualifications.
• Professional - ability to work (the right of a subject to qualified activity in a certain profession).
• Special - a person’s qualification in a “narrow” specialty.
• Temporary - loss of ability to work occurs as a result of illness and injury that can be treated. It is divided into partial and complete.
• Persistent - a situation where the resulting injuries and injuries (or their consequences) cannot be completely cured.

Establishing the degree

Establishing the degree of loss of professional disability (LUC) as a percentage is carried out for persons who have suffered health damage as a result of an accident, a work-related injury or as a result of an occupational disease. For citizens who were injured while not performing their job duties, the level of UPT is established by MSEC institutions.

The degree of loss of professional performance is determined during a medical and social examination (MSE) based on the received documentation and information, personal examination of the citizen, based on the consequences of harm to health as a result of an industrial accident. Moreover, they take into account the professional abilities of the victim, his psychophysiological capabilities and work qualities, which allow him to further carry out work activities that precede the industrial injury and occupational disease, of the same content and in the same volume. Or taking into account a reduction in qualifications, a reduction in the volume of work performed and the severity of labor in ordinary, specially available production or other conditions. Expressed as a percentage and set from 10 to 100.

Criteria

The basic principle of establishing the degree of loss of professional ability of the victim is a combined analysis of medical and social criteria.

The first include a timely, complete clinical diagnosis, taking into account the severity of morphological changes, the nature and severity of the disease, the presence of decompensation and its stage, various complications, and the determination of long-term and short-term prognosis.

Social criteria include everything related to the professional activity of the victim: the characteristics of neuropsychic or physical stress, the organization, rhythm and frequency of work, the load on individual internal organs and systems, the presence of unfavorable working conditions.

Procedure

The examination of the victim at the ITU institution is carried out on the basis of the following regulatory framework:

It is carried out on the basis of an application from an employer, an insurance company, as determined by a judicial authority, or upon an independent application of the victim or his representative upon presentation of a report on an industrial accident, or a supporting document on an occupational disease.

The examination is carried out:

• at the ITU institution at the victim’s place of residence;
• at home, if the person, due to health reasons, is unable to come to the ITU institution or moves with the help of technical means (crutches, wheelchair, etc.);
• in the hospital where the citizen is being treated.

The victim is referred to a medical examination to determine the degree of UPT by the organization providing assistance after rehabilitation, diagnostic and therapeutic measures. In this case, a persistent violation of body functions in the event of an accident at work or occupational disease must be established.

In some situations, before signs of permanent loss of professional ability are identified, i.e. during the period of treatment, the citizen is sent for an examination to determine the need for certain types of rehabilitation.

Expertise

The percentage of loss of general ability to work is measured relative to the persistent consequences of the damage caused. To calculate this indicator, a forensic medical examination is carried out on the basis of regulatory documentation, namely the table of permanent loss of general ability to work as a percentage, which is an appendix to Order No. 194n. It establishes criteria for approving the extent and severity of harm that caused harm to human health. Based on it, a specialist who determines the percentage of loss of general ability to work identifies the damage caused to human health and the corresponding amount of loss.

Serious harm to health includes injuries, illnesses, as well as pathological conditions that entailed a significant permanent loss of general ability to work by at least 1/3 (insignificant - in the amount of 5%).

An examination to determine the percentage of loss of general ability to work is carried out only by court determination. During these activities, the specialist takes into account all the materials of the case. The duration of the ITU is 3 working days, when completing an additional examination - no more than 45 working days.

Compensation and benefits

Disability benefits are compensation to an employee for earnings that he lost due to illness or other reasons.

Subjects who, due to an injury or acquired occupational disease, are unable to perform work activities can count on compensation. They have the right to receive cash payments at their place of work for 30 days from the date of loss of ability to work.

The amount of the benefit depends on the time worked. Its maximum value is 100% of wages.

Disability and degree of disability

In each specific case, disability, or permanent loss of ability to work, may appear due to:

• general illness;
• occupational disease;
• work injury;
• disability since childhood.

If, within one year from the moment of the accident, an irreversible deterioration in the mental or physical condition of the insured (disability) occurs as a result, then he is paid compensation in the form of a certain amount, the amount of which depends on the degree of disability. Disability is determined by a doctor within 3 months after a year after the accident, which must be declared to the insurance company in the prescribed manner.

An experienced lawyer will help restore violated rights and achieve benefits provided by law. The specialist will contact the employer or the judicial authority directly. On our portal you can get reliable information about the amount and procedure for compensation. To do this, you should report your problem and get advice online or by phone.