Since 01.01.2022, disability certificates in Russia are issued in electronic format by default. The transition practically abolished the functions of the insured person (who is ill or caring for sick relatives of an employee) to transfer paper to an economic entity and the previously owned “transit” role of accruing and issuing benefits to the insured (employer).
The regime of direct payments from the insurer (Social Insurance Fund) directly to the employee, bypassing the company or sole proprietor, can be controlled by the insured person through the website of Public Services. But how can a person check their sick leave through Public Services and in the personal account of the SFR? Let’s talk about this in more detail.
Organization of document flow for the calculation of hospital benefits
As a result of the transition to the electronic version of the registration of sick leave, the procedure for document management has changed since 2022. All information regarding the appointment and payment of benefits is sent to the personal account of the insured employee on a single portal. A sequence of actions is provided for the accrual and transfer of funds (paragraphs 16-22 of the Rules approved by Decree of the Government of the Russian Federation dated 11/23/2021 No. 2010), including:
Action # 1
Formation by a medical institution of a disability certificate in electronic format, sealed by the UKEP, indicating:
- hospital number and opening date;
- FULL name and date of birth of the patient or caregiver;
- period and number of working days for calculating insurance payments;
- causes of disability (own illness or injury, pregnancy, quarantine or sanatorium treatment);
- type of payment (primary – when opening the document for the first time, secondary – when provided that the benefit continues to accrue after the previously closed sick leave with the inscription “continues to hurt”);
- data from the doctor who opened the leaflet and information about the medical institution;
- information about the policyholder or policyholders (if there are several employers).
Action # 2
Checking the disability certificate of the SFR with sending information to the policyholder-employer and to the employee’s personal account:
- about each change in status – opening, extension, closure or cancellation of sick leave;
- about additions concerning the referral of an employee to the ITU for registration by the medical qualification commission of disability.
Action # 3
The placement of information by the employer in response to the request of the SFR after the closure of the hospital by the medical institution. Within three banking days, the policyholder must provide information signed by the UKEP regarding:
- the duration of the total insurance period at the time of opening the disability certificate;
- the amounts of remuneration included in the base for calculating insurance premiums;
- replacement calendar years of the billing period subject to the submitted application by the employee;
- the regime of the established working time at the conclusion of an employment contract with a part-time or week;
- the district increasing coefficient used for calculating benefits;
- downtime and the amount of salary saved for the period.
After receiving information from the employer, the SFR has the right to check the salary information for the last two years, appearing in the calculation of benefits, with the tax service.
In the absence or resolution of disputed issues, the SFR calculates payments, informing the employee by sending notifications. If the reason for the disability is the employee’s own illness or injury, then the allowance at the expense of the SFR is accrued from the fourth working day, and the first three are paid by the employer.
Algorithm for controlling the assignment of insurance payments through Public services
Information about each step in relation to the sick leave is posted in the personal account of the insured citizen on a single portal. To receive information, you need to create an account by entering a phone number, email, SNILS, and creating and confirming a password.
If the account is not confirmed at the time of the onset of disability and the opening of a hospital by a medical institution, then the data on the sheet will be downloaded automatically after its confirmation.
Information about electronic sick leave (EBL) is grouped at: https://eln.gosuslugi.ru /.
Notifications of all changes in the EBL status are received within two days from the moment:
- opening EBL by visiting a clinical facility or calling a doctor at home;
- extending or closing after a repeat visit at the time specified during the initial visit by the doctor;
- cancellation or reduction of payments for a certain period to a minimum amount if a violation of the hospital regime is detected;
- accrual of benefits after checking the information provided by the employer with the indication of the category, type and period;
- sending a document for payment in the absence of objections from the insurer fund;
- transferspayments according to the details of the insured person with a reflection of the resulting indicators – the accrued amount of benefits, withheld personal income tax and the amount to be paid or exemption from personal income tax at the source of payment (for example, when calculating maternity benefits).
If the information about the sick leave did not arrive or was received with errors regarding the opening date or the reason for disability, then it is necessary to contact the medical institution that opened the EBL.
If discrepancies are found in the accrued amount, you should receive the provided information about the salary for the two years preceding the onset of disability from the employer, and if it is correct, directly to the SFR by calling the hotline: 8(800) 100-00-01.
To get information for any period of interest, you need to select the “All services” option in the “Services” tab, and then the “My health” section. In the window that opens about requesting information on EBL, click the “Request information” button:
To view, select the search method by number or by period. You can set any time interval, for example, six months:
According to the results of the request for the specified period, information on all EBL is reflected:
By selecting the “More details” option, you can get detailed information on each document.
The mechanism for checking accrued benefits on the SFR website
The insured person has the opportunity to view all issued disability certificates through the Social Fund of Russia, using the recipient’s account on the website: https://sfr.gov.ru . Tabs are provided for displaying information:
Disability sheets – a register of issued EBLS in chronological order with detailed information in the appropriate tabs:
- in the basic information – about the serial number, the date of treatment, the code of the cause of disability, violations of the hospital regime (if detected) and patient data;
- in the information about the medical organization – information about the name and address of the medical institution, the name of the doctor, as well as the period of release from work and the date of employment;
- in the history of status changes – information about the opening, extension and closure of the EBL without displaying canceled documents.
Benefits and payments – information about all indicators that appear in the calculation of payments and affect their size:
- in the information on the insured person – personal data of the citizen, tax status, payment details, as well as the name and registration number of the employer with a reflection of the main place of work or external part–time work;
- in the data for calculating the payment – the amount of earnings for the previous two years of disability, broken down by year, the number of calendar days involved in the calculation, as well as an indication of the estimated amount accrued and payable;
- in the history of statuses – the dates of receipt of information from employers, accrual and payment of benefits.
On the SFR website, you can get information about all disability certificates in the context of each stage – from opening an EBL to transferring the amount of the benefit to the personal account of the insured person.
Actions of the insured in the absence of paid benefits
Although direct payments do not imply the employer’s transit participation in calculations linked to the days of salary payments to staff, the accrual scheme does not exclude the involvement of the policyholder.
The absence of a benefit may indicate an incorrect reflection of any of the operations by any participant in the chain concerning:
- informing the medical institution of the SFR;
- notifying the employer by the fund;
- transmitting information about earnings by the insured;
- money transfers using erroneous bank details.
Since the “moves” of each participant are recorded, you need to try to determine the reason yourself or contact the territorial branch of the SFR to clarify the circumstances.