There are situations when a person for anyreasons can no longer do their job. Permanent and temporary disability - these are the main factors influencing the further possibility of continuing the work process.
Definition
Disability is the impossibility of a personperform work for one reason or another. Such causes may be associated with illness, disability, accident, motherhood, and other similar factors.
Disability is classified according to many factors. Here are the main ones:
- If possible, restore the state of health:
- permanent;
- temporary. - According to the degree of preservation of working capacity:
- complete;
- partial. - By type of activity:
- general;
- professional.
Most often in the employment relationship between the employee and the employer can be found permanent and temporary disability.
Permanent disability
Under permanent disability understandundermining health or any disease, the cause of which is the work, disaster, professional costs, accidents, violent crime, etc.
Permanent disability is divided into:
- partial: due to the undermining of health, a person cannot perform work duties that meet the national standards of working time;
- complete: a person is unable to work and support himself due to illness or injury.
In the first case, disability varies from 10% to 90%, in the second - 100%.
Determination of disability
Examination of permanent disability can be identified. About her conduct may ask:
- People of working age from 16 to 55 (60) years.
- Человек после наступления пенсионного возраста or less than 16 years old, if his health was undermined in the enterprise, in the performance of official duties, as a result of a catastrophe or violent acts.
The percentage of disability is determined by 6months, 1, 2 or 3 years and for 5 years. The initial date for determining the period of permanent disability is the date of submission of the application for examination. In case of re-examination, the last day of the period of permanent disability, which is established by the first examination, will be considered as such date. Conducts such expertise Social Security Department, involving doctors in the work.
In the application, the citizen must specify all the data.from the doctor who observes him and has all the information about the state of health necessary to determine permanent disability. Before submitting a petition, a citizen must visit a doctor for at least three months.
If an application is submitted for determination of permanentdisability and any disease at the same time, one petition is filled for examination. If necessary, a citizen must file with the application a document confirming the reason for the disability:
- act of an accident at work;
- occupational disease act;
- the medical board decision if the disease was obtained during the service;
- a medical document confirming the connection between a catastrophe, trials or accidents and disability;
- certificate from the authorities about the accident;
- a court decision or a certificate from the investigating authorities if the injury was received as a result of violent acts.
The examination is carried out on the basis of submitteddocuments and interviews with the doctor who leads the patient. As a result, the Department issues a written opinion, which is sent to the citizen and the attending physician. In case of disagreement with the decision of the Department, the person submitting the petition may protest it in court.
Temporary incapacity for work
Temporary disability is a temporary loss by an employee of the ability to perform his or her immediate duties.
This type of disability is of a short-term nature, so after a certain period of time an employee can take up his duties.
According to Russian legislation, a citizen, when it is temporarily impossible to work, is released from labor and should receive monetary compensation from social insurance.
Depending on why the disability came, there are a number of reasons. Let us consider in more detail each of them.
Causes
Temporary disability may occur for the following reasons:
- Disease.This reason is most common and, due to temporary disability, the employee cannot perform the work assigned to him. Labor significance may be lost completely or partially, and after the necessary treatment fully recovered.
- Accident.This reason, which occurred at work or at home, equally leads the worker to temporary disability. The payments and the number of days the patient will be treated will differ.
- Беременность, роды, прерывание беременности.Temporary disability due to maternity is issued at enterprises as maternity leave and lasts a set number of days depending on the number of children born and the severity of labor and the postpartum period. In order for such a hospital to be issued properly, a woman must provide a certificate of pregnancy from the medical institution, and then a medical certificate allowing her to go on maternity leave. If the pregnancy has been terminated, then a sick list of a pre-established sample is also provided to the organization from the medical institution. The duration of such a hospital will depend on the presence or absence of complications.
- Quarantine. This is a specific case of temporary disability when an employee is suspended from work if:
- a contagious disease was discovered, because of which it is strictly forbidden to communicate with other people;
- нахождение рядом с носителем болезни может airborne and affect the overall condition of the employee. In this case, the disability ends as soon as the employee is cured and leaves the quarantine. - Dismissal This reason may occur due to a number of factors:
- the lack of special rights that are needed to perform a certain work;
- being in alcoholic or toxic intoxication;
- obtaining negative certification results (depending on each case, the employee can then either continue to work, or transferred to another position, or be dismissed). - Care for a sick relative.This reason most often applies to the care of persons under the age of majority. But the rule may apply to more adult family members, if it is proved that the disease is serious. In this case, the period of disability is limited.
- Sanatorium treatment.In connection with temporary disability, the attending physician may issue a referral for sanatorium treatment, which must be confirmed by a hospital certificate and the relevant prescriptions. The hospital is issued on a general basis and is presented at the place of work.
- Adoption of children. In this case, the right to the hospital appears, if the child is less than three months. The rules are the same as with the decree.
- Rehabilitation. Hospital for this reason and its duration is determined by the attending physician.
- Prosthetics The term of the hospital is the time that is necessary for full recovery and procedures.
In almost all these cases, the employee is entitled to the calculation of benefits for temporary incapacity for work. The amount and terms of payment are determined by the reasons for disability.
Cash payments on the occasion of temporary disability occur if one of the above cases occurred:
- during work under an employment contract;
- during the performance of official or other activities that are subject to compulsory insurance of temporary disability;
- when the disease or injury occurred within a month after the termination of the specified work.
To receive benefits from the FSS, you need insurance. Temporary disability in this case is paid by the employer for two days, and then by social insurance, if:
- injury due to interruption of pregnancy or due to artificial insemination;
- The injury occurred on the way to or from work not on the employer's transport.
Who is eligible for benefits
Граждане РФ, нерезиденты, имеющие временную или permanent residence in the Russian Federation, as well as stateless persons have the right to receive benefits in case of temporary disability. And in this regard, there are the following categories of such persons:
- citizens who carry out activities under an employment contract, admitted on the fact to work in accordance with labor legislation;
- citizens performing state and municipal service;
- citizens who are lawyers, individual entrepreneurs, farmers;
- физлица, не являющиеся частными entrepreneurs, members of the clan communities of small northern peoples who voluntarily issued insurance for temporary disability and pay for contributions to the FSS under the Federal Law No. 190 dated 12/31/02;
- other categories of citizens subject to compulsory social insurance in case of temporary inability to perform work, subject to the payment of contributions to the FSS.
Who and how much they pay
Calculation of temporary disability occursfrom the first day the employee lost the opportunity to work. The amount of payment is as follows: 80% of the average income - in the first six days of sick leave, 100% - for the next days.
Who is eligible for temporary disability benefit in the amount of 100% from the first day of disability:
- war invalids and other categories of persons with disabilities equal to this benefit;
- participants in the liquidation of the accident in Chernobyl;
- internationalist warriors, if temporary incapacity for work is a consequence of injuries or diseases caused by the performance of international duty;
- citizens who have dependents of three or more children under the age of 16;
- the wives of officers and military personnel working under contract;
- donors within a year after the last blood donation (at the same time last year the donor man donated blood at least five times, the donor woman at least three times);
- organ or tissue donors;
- orphans under 21;
- граждане при временной нетрудоспособности и в relations with motherhood, when caring for a sick child up to 14 years old, when caring for a disabled person up to 18 years old, when caring for a child up to three years old in case of maternal ailment; with spa treatment;
- citizens injured at work due to an accident or occupational disease;
- Citizens who were in the performance of public duties.
Insured persons receive benefits from social insurance from day one if:
- there is a need to care for a sick family member;
- the person is in quarantine;
- the person is caring for a child under 7 years old or an unworkable family member who is under quarantine;
- prosthetics were performed on inpatient medical examinations;
- Aftercare is carried out in a sanatorium in the territory of the Russian Federation after inpatient treatment.
The calculation for temporary disability occurs at 50% in the following cases:
- when the inability to start work was due to injuries resulting from alcohol, toxic or narcotic intoxication;
- when a citizen violated the regime established by the doctor, or did not appear at the appointed physical examination;
- when the inability to start work came during the absenteeism of working time.
Documents for calculating benefits
Temporary disability is a kind of sick leave. Therefore, to receive cash payments, you must submit the following documents:
- Sheet of temporary disability (sick leave).
- Help form 095 or 095y.
- An extract from the medical history, if the allowance is issued by a student for academic admission, according to form 027 or 027u.
- Certificate in any form, certified by the seal of the state medical institution or the attending physician.
Special attention should be paid to the sick-list. He is entitled to issue only those persons who hold a medical position on the basis of a special license.
Functional signs of sick leave:
- The presence of legal force. On its basis, the employer releases the employee from the performance of labor duties.
- Availability of accounting function. The bulletin is attached to the rest of the documents in personnel, accounting, insurance office work.
- Create medical statistics. Based on the hospital bulletin, various medical reports are created and analytical studies are conducted on the spread of a disease.
- Having a financial aspect. Upon presentation, temporary disability is paid. The calculation takes place according to the reasons for absence and the number of days of non-presence at the workplace.
Deprivation of benefits
Пособием по временной нетрудоспособности называют cash payments at the expense of social insurance, which compensate for the salaries lost by an employee if they are temporarily unable to visit the workplace due to illness or other factors established by law.
To deprive such benefits for the following reasons:
- intentional self-harmin order to evade the performance of work duties or to simulate a disease (in these cases, cash payments that were made before the violation was discovered are recovered from the employee in court);
- abuse of alcohol, drugs or actions based on the effects of these substances;
- criminal actions by the employee;
- violation by the worker of the prescribed regimeby the attending physician, without valid reasons: failure to attend the doctor at the appointed time without a valid reason, non-appearance at the medical and social commission (the benefit is no longer paid from the moment of the discovery of these grounds);
- committing a truancy until the moment of temporary incapacity for work (here the employee is deprived of the benefit for the entire period of disability).
A special case
For details, consider the insurance risks andcases according to Federal Law No. 213 of July 24, 2009. This includes temporary disability and maternity, as well as expenses for family members due to the insured event. These include:
- Illness or injury of the insured.
- Pregnancy and childbirth.
- Birth of a child or children.
- Caring for a child up to one and a half years.
- Death of the insured person or a family member of a minor age.
We found out what the insurance is based on. Temporary disability and maternity are paid based on the following types of insurance coverage:
- Cash payments for temporary disability.
- Cash payments for maternity.
- A lump sum cash payment for those women who registered at an early date.
- One-time cash payment at birth.
- Monthly payment of up to one and a half years.
- Payment for burial.
The conditions, the amount of benefits and the procedure for payment are defined in Federal Law No. 81 of May 19, 1995 and Federal Law No. 8 of January 12, 1996.
Insured persons have the right to:
- timely receive collateral with the occurrence of insurance claims;
- receive information on the assessment of contributions to the FSS and monitor the transfer of funds in social insurance;
- Seek advice on insurance and free assistance required to receive benefits (drafting applications, motions and other documents of a legal nature);
- apply to the FSS to verify the correctness of the calculation of benefits;
- protect your rights and interests in court.
Insured persons are required to:
- submit reliable documents on the basis of which payments will be made and legal issues are resolved;
- inform the FSS or the employer about any circumstances that may affect the conditions and amount of the benefit received;
- observe the regimen prescribed by the doctor, determined for the period of disability or maternity;
- fulfill other requirements established by Russian legislation.
