Electronic sick leave: what do personnel officers need to know? Electronic sick-lists: not everything is as good as we would like.

Starting from July 1 of this year, sick leave at the request of the patient will be issued in in electronic format in all regions of the Russian Federation

Since 2017, medical institutions have begun to issue electronic sick leave certificates. The electronic version of the sick leave goes to the employer's accounting department via the Internet; Social Insurance is not entitled to refuse to offset benefits on such a sick leave.

As part of the Salaries and Human Resources program from Buchsoft, there is a convenient module - a sick leave calculator, with which it is easy to correctly calculate and pay sick leave benefits.

Electronic sick leave from 1 July 2017

On March 10, 2017, the State Duma adopted the Law on Electronic Disability Sheets. Starting from July 1 of this year, sick leave at the request of the patient will be issued in electronic form in all regions of the Russian Federation.

At the moment, electronic sick leave is issued in the regions - participants of the pilot project: in the Belgorod and Astrakhan regions, the Republic of Crimea and in the city of Moscow.

It is worth noting that the law determines the issuance of an electronic sick leave only with the consent of the patient, he has the right to refuse it and receive a regular paper certificate of incapacity for work.

An electronic sick leave is equated to a paper version and must be signed with a strengthened qualified electronic signature of a doctor and a medical institution. In addition to the patient's consent, in order to issue an electronic sick leave, both the medical institution and the employing company where the patient works must connect to the Unified Information System and have access to the global network.

Working principle of electronic sick leave

As we have already noted above, an electronic certificate of incapacity for work is equated to a paper document.

Electronic hospital can be issued by medical organizations connected to the Medical Information System.

After issuing an electronic document, the clinic or hospital sends it to the Unified Integrated Information System "Sotsstrakh" (EIIS "Sotsstrakh"). Upon receipt of an electronic sick leave, the employer fills in the Register of information for the payment of disability benefits, certifies it with his enhanced qualified electronic signature and also sends it to the EIIS "Sotsstrakh". The assignment and payment of benefits are dealt with by the regional branches of Social Insurance. An employee who has expressed a desire to issue an electronic sick leave is informed of his number upon receipt, with which you need to go to the employer's accounting department.

The accounting officer drives this number into the unified database of the information system and finds out all the information necessary for calculating the benefit: the name of the medical institution that issued the sick leave, the period of illness, the patient's full name, the date of issue and closing of the sheet, its number.

It is impossible to forge such a certificate of incapacity for work, unlike a paper one, since it is received through secure communication channels, in addition, the document must be signed by the EDS of the medical organization and the doctor who issued it.

Who pays for sick leave in 2017?

Payment for an electronic sick leave is similar to that made when working with a paper document. The basis for issuing a certificate of incapacity for work directly affects the payment of benefits under it. In case of illness of the employee himself, sick leave is paid from two sources: for the first three days - from the employer's own funds, for the remaining - from Social Insurance funds. Sick leave certificates for child care are paid in full from the FSS budget.

Please note that in 2017 the payment for sick leave issued to employees in connection with pregnancy and childbirth is made entirely from the funds of the Social Insurance Fund.

In addition, the list of regions participating in the FSS pilot project is gradually expanding. From July 1, 2017, the number of such regions will grow to 33 (now 20). In accordance with the provisions of the Decree of the Government of the Russian Federation of 21.04.2011 No. 294 in the pilot regions of the Russian Federation, the FSS pays benefits for temporary disability directly to employees, and not through the employer.

The employer's accountant calculates sick leave benefits within 10 calendar days, the employer must pay the allowance on the next salary transfer date.

V following material we will look at the issues of accounting for electronic sick leave and reimbursement of costs for them.

The spread of the practice of issuing electronic sick leave certificates throughout the country since July, announced by Prime Minister Dmitry Medvedev, does not mean an immediate transition to the new system. About it FBA "Economics Today" told the member public council at Federal Service on supervision in the field of health care (Roszdravnadzor) Igor Tsikorin.

“If we talk about Moscow, the medical institutions of the capital are ready for the full-scale introduction of the electronic hospital system now. But the regions still have problems with broadband high-speed Internet that works continuously. Just like not all medical institutions in Russia are equipped with modern computers.

As you know, Russia has embarked on a course of converting the workflow in medicine into electronic format. Here we see another "pitfall" - if there is a fairly "young" composition of doctors in the capital, then in other regions of the Russian Federation experienced and highly qualified specialists are already aged. Unfortunately, not all of them are ready to master the computer and tomorrow to conduct all the treatment of patients with the help of a computer, "the specialist notes.

Today, Prime Minister Dmitry Medvedev, at a meeting with deputy prime ministers, announced that the practice of issuing an electronic sick leave will spread throughout the country "from next month." With this, he confirmed the entry into force of the law, signed earlier by the President - from July 1, a certificate of incapacity for work in electronic form will be used to pay benefits for temporary disability, pregnancy and childbirth. Medvedev pointed out: new system it is more convenient and faster than issuing a paper document - you do not need to stand in line at clinics to receive signatures from specialists, and doctors will have to fill out less paperwork.

"Managing patients in electronic form will indeed to some extent simplify the work of doctors. They do not have to keep maps" on paper ", and all analyzes, examination results, diagnoses and appointments will go to the personal electronic database of each patient. drawing up a sick leave, it is enough to indicate the necessary points on a computer in an already compiled file, and not to do a lot of duplicating paperwork, as today. For several years now, the pilot project has been operating in several regions of the country, and its results have been recognized as successful, "the expert emphasizes.

Electronic sick leave will be protected from counterfeiting

Currently, electronic sick leave certificates are being piloted in six regions of the Russian Federation. Moscow, Belgorod and Astrakhan regions have partially switched to "electronic". And also Crimea, where the innovation began to be tested immediately after the reunification of the peninsula with Russia. It is assumed that the citizens of the Russian Federation will now be able to receive an electronic sick leave if they wish, or use the paper one in the old fashioned way. Labor Minister Maksim Topilin said that in 2016, 240 thousand "e-mails" were issued.

Deputy Prime Minister Olga Golodets said that 52 million people in Russia are insured under this type of insurance, 11.8 thousand organizations are involved in issuing sick leave certificates, last year 40 million sick leave certificates were issued, payments for them amounted to 331 billion rubles. She added that in the first few years, along with the electronic version, the paper certificate of incapacity for work will continue to circulate.

"In fact, three subjects become participants in the electronic sick leave system. The first one is Insurance Company, on the servers of which certificates of incapacity for work are collected. In theory, this could also be the MHIF. The second subject is a medical facility, where the patient is examined, diagnosed and decided on his disability. The third is the employer, who must fill out his part of the document in the electronic sick leave. The electronic system really simplifies many processes, avoiding unnecessary bureaucracy.

At the same time, it is no secret that the practice of providing fake sick leave certificates is widespread in Russia - citizens often just buy them. The transition to digital format completely eliminates this possibility. As well as the document cannot be lost or accidentally lost in another way. That is, there are solid pluses here for all parties.

From July 1, 2017, amendments to electronic sick leave certificates will come into force. You can get them throughout the territory of the Russian Federation. What will change in the work of companies, read the article.

From July 1, 2017, medical institutions will begin to issue not only paper, but also electronic hospital (Federal Law of 05/01/2017 No. 86-FZ). However, clinics that have an electronic signature will be able to issue an electronic form to employees. We will tell you more about the changes in electronic sick leave certificates in 2017 later.

What is an electronic sick leave certificate in 2017

The electronic sick leave in 2017 is an electronic form that specialists fill out medical institutions and employers.

To arrange it, you need a special computer program. Accordingly, medical institutions will be connected to the electronic hospital system and modernize the workflow. In this case, the costs of paper documents, and the risk of forgery of certificates of incapacity for work will decrease.

In the electronic sick leave, the same fields are planned as in a regular paper certificate of incapacity for work. The electronic certificate of incapacity for work will have equal legal force with the certificate of incapacity for work, which is issued in paper form.

See the table below for the procedure for issuing electronic sick leave certificates.

Pilot project "electronic sick leave" in 2017

The pilot project "electronic sick leave" appeared back in 2014. In Moscow, the Astrakhan and Belgorod regions, as an experiment, they began to issue electronic sick leave to patients. In Crimea, electronic sick leave has appeared since 2016.

And now the changes on sick leave came into force. From July 1, 2017, you can receive an electronic sick leave certificate in all territories of Russia.

Changes in sick leave from 2017

The changes in sick leave from 2017 are that you can receive both paper and electronic sick leave from employees. To work with electronic sick leave, open your personal account on the FSS website cabinets.fss.ru. The cabinet is already working, but in test mode.

If you have registered with personal account, inform workers that they can receive both paper and electronic sick leave. In this case, employees themselves will decide which document to receive.

You have the right not to use innovations and not connect to electronic sick leave. Then explain to employees that they can only receive documents on paper.

What are the advantages of electronic sick leave certificates in 2017

The transition to electronic sick leave certificates in 2017 has a number of advantages. For medical institutions, the time for paperwork is reduced. For employees, a plus - an electronic sick leave cannot be lost or spoiled, unlike a paper one.

In addition, the information on the certificate of incapacity for work is confidential. No one except the doctor and the patient has access to it.

For the employer, the advantages of electronic sick leave are: -

• fraud is excluded, electronic sick leave will not be faked;
• no need to look for a pen of a certain color to fill out a document;
• you cannot spoil the electronic sick leave, which eliminates the risk of non-refund of benefits due to errors in the document.

Sick leave in 2017: how to fill out

The sick leave in 2017 is drawn up on a form from the order of the Ministry of Health and Social Development of Russia dated 04/26/2011 No. 347n. The procedure for issuing sick leave certificates was approved by Order of the Ministry of Health and Social Development of the Russian Federation of June 29, 2011 No. 624n.

How to fill out the sick leave to the employer, you will learn from the letters of the FSS of the Russian Federation dated 09/14/2011 No. 14-03-11 / 15-8605, dated 08/05/2011 No. 14-03-11 / 05-8545 and dated 10/28/2011 No. 14-03 -18 / 15-12956.

If you receive a paper sick leave, fill it out with a black ink gel, fountain pen, or capillary pen. Enter capital block letters in the cells without going beyond the borders of the cells. Separate words with blank cells. Indicate the following details on the sick leave:

• full or abbreviated name of the organization without quotes and dashes;
• the main place of work of the employee or part-time - put a tick in the required box;
• registration number and subordination code of the employer from the FSS notification;
• TIN and SNILS of the employee;
• calculation conditions - the corresponding code, for example, 45 for disabled people.

Fill in the line "Form N-1 Act" only for accidents at work. And in the field "start date of work" enter the information if the employee terminated the contract with you. In other cases, do not fill in the fields. Next, specify:

• insurance experience in years and full months and non-insurance periods, if any;
• the start and end dates of the benefit payment periods;
• the amount of payments that you included in the calculation of benefits;
• average daily earnings from which you are calculating benefits;
• the amount of the benefit at the expense of your company and at the expense of the Social Insurance Fund;
• the total amount of the benefit.

Write down the names and initials of the head and chief accountant of your organization.

Changes in the calculation of sick leave 2017

Changes in the calculation of sick leave in 2017 are as follows. If an employee took sick leave in 2017, include in the calculation of benefits the last two years - 2015 and 2016.

Accordingly, the maximum average earnings for benefits. It is equal to 1901.37 rubles. [(670,000 rubles + 718,000 rubles): 730 days]. In calculating this amount, you include the 2015 and 2016 contribution bases.

If you are counting maternity or child benefits from payments for 2015 and 2016, include 731 days in the billing period. 2016 is a leap year with 366 days.

There is another important change for benefits paid in 2017. This year you pay insurance premiums to the tax office. However, you should contact the FSS for benefits.

If you want to receive a refund, contact the Social Insurance Fund with the documents filled in according to the new forms (order of the Ministry of Labor of Russia dated October 28, 2016 No. 585n and the letter of the FSS of Russia dated December 7, 2016 No. 02-09-1 / 04-03 / 27029).

Work experience for calculating sick leave in 2017

To calculate the allowance, you need to determine the length of service for calculating sick leave in 2017. Determine the insurance experience in full years and months (letter of the FSS dated 10/30/2012 No. 15-03-09 / 12-3065П). The length of service includes documented periods (Art. 16 of Law No. 255-FZ):

• work on labor contract, as well as the state civil or municipal service;
• military, law enforcement, fire fighting and other similar services;
• other periods when the employee was insured in the compulsory social insurance system in case of temporary incapacity for work. For example, when an employee was registered as an individual entrepreneur and voluntarily paid contributions.

If several periods coincide, include only one in the insurance experience (Art. 16 of Law No. 255-FZ). First, determine how many full years of insurance coverage the employee has. Then, calculate the number of full calendar months that are not included in full years.

Then count the number of days outside of full years and months. Translate numbers greater than 30 into months, discard the rest of the days.

How to pay sick leave in 2017

Hospital benefits are calculated and paid for the entire period of illness: from the first day of illness or injury to the recovery of an employee (a member of his family) or until the moment of disability.

At the same time, the employer pays for the first three days of illness, the rest - the Social Insurance Fund. The maternity allowance on the basis of sick leave is paid in full at the expense of the FSS.

Health care

V recent times in the media and social networks the introduction of the so-called "electronic sick leave certificates" is being actively discussed. This innovation is often touted as a significant step forward in reducing paperwork and creating benefits for citizens and employers. But from the point of view of medical organizations and doctors, all this does not look so rosy. And about the developers of the MIS, who are actually forced to do double work at their own expense, and needless to say.

First, let's look at the situation from a legislative point of view.

Federal Law No. 86-ФЗ dated 01.05.2017 provides for the introduction of electronic certificates of incapacity for work (sick leave) from July 1, 2017. To this end, from June 1, 2017, the Social Insurance Fund (FSS) of the Russian Federation launched electronic services for the personal accounts of the policyholder and the insured person (cabinets.fss.ru). These services have been developed and tested in 6 regional pilot projects since 2014. According to the Federal Law of medical institutions that came into force may issue them on a par with the usual paper forms. While medical organizations don't have to switch to electronic sick leave - from a legal point of view, this process is spelled out as a voluntary organizational measure.

Moreover, for every case of incapacity for work !!! it is imperative to draw up the patient's written consent to create an electronic document (to talk about saving paper and paperless technologies).

In order to forge an electronic sick leave, it was impossible, it is transmitted in encrypted form and certified by an enhanced electronic signature (ES) of the doctor, which seems to be not provided free of charge and centrally. The medical organization must decide on its own to purchase it. The cost of electronic signature per year is about 1 thousand rubles, for example >>>. In addition to the cost of electronic signature, a communication channel through the Internet should be organized between the MO and the UIIIS FSS, which is not always the case. Moreover, in a number of regions, open access to the Internet from the doctor's workplace is generally prohibited for security reasons. Therefore, setting up such a communication channel is likely to require organizational and maybe even technical and financial costs for implementation.

Further. From this program, the document is automatically transferred to the employer through the EIIS FSS. After the closure, the employee is issued a number of the issued sick leave for the accounting department, according to which the company and the FSS will be able to receive through the electronic system all the calculated data for payments. The employer sees in the database the name of the medical institution, the days of illness, the number and date of issue of the sheet, but the employee's diagnosis remains closed to him. The schematic diagram of work is shown in the figure below.

To switch to electronic sick leave, the employer needs to come to the FSS branch and sign an agreement on information interaction. In the personal account on the FSS website, the accountant will see all the open sick leave certificates of the company's employees and fill in his part of the form (as in the paper version). If you are interested in details, then at buhguru.com this process is scheduled in more detail.

One way or something like this, electronic sick leave is presented in the media and the whole PR-company deployed around them. Now let's look at these same processes through the eyes of an ordinary doctor and his medical organization.

First, let's start with the fact that the MO and the doctor work in the health care system, and not in the FSS. And first of all, in their work, they are guided by departmental regulations (NLA). In terms of sick leave, they are guided by the current Order of the Ministry of Health of June 29, 2011 N 624n "On approval of the procedure for issuing sick leave", which defines the procedure issuing certificates of incapacity for work. This order unambiguously determines the need to issue a paper certificate of incapacity for work on a form, while the form of a certificate of incapacity for work is a protected printing product with a level of protection of “B” level. No changes or additions related to the transition to electronic disability sheets (ELN) were made in this order, which means that the doctor is obliged to issue a paper sick leave.

Secondly, at present, in most regions and MOs, various medical information systems (MIS) have been introduced, with the help of which doctors draw up sick leave. These MISs are part of the Unified State Health Information System - the departmental state information system of the Ministry of Health itself, which recently received a legally significant status thanks to the adoption Federal law dated July 29, 2017 No. 242-FZ "On Amendments to Certain Legislative Acts of the Russian Federation on the Application of Information Technologies in the Sphere of Health Protection".

With the help of several years of existing MIS, doctors enter information about the case of incapacity for work and then insert the form prepared by the typographic method into the printer, with the help of which the necessary information is simply "printed" into the necessary cells of this form. Manual filling out of sick leave is rather an anachronism, although it is still used in some cases. At the same time, as a rule, a doctor needs to enter only basic information about disability in the MIS, all other data, such as the patient's full name, diagnosis and a number of other fields, are already available in the MIS database. This approach, which has been introduced in the country for several years already, allows reducing the cost of issuing paper sick leave. Moreover, all modern MIS are equipped with the functions of elementary format-logical control (FLC), which allow avoiding routine mistakes when drawing up this document. In many systems in use, the functions of centralized sick leave certificate have been implemented for a long time, which solve the problem of waiting for a patient to hand over a document. The entered information is reused by the MIS while automatically filling in other medical documents, for example, certificates, discharge reports or referrals to other medical organizations. On the basis of the data entered by the doctor, the MIS automatically generates the "Book of registration of certificates of incapacity for work". And finally, let's not forget that the data entered by the doctor is also used to form the corresponding departmental statistical reporting, for example, “Forms No. 16-VN. Information on the causes of temporary disability "approved by the Order of Rosstat dated December 25, 2014 N 723 (as amended on December 30, 2015)" On the approval of statistical tools for the organization by the Ministry of Health Russian Federation Federal Statistical Surveillance in Healthcare "and many other statistical forms. Thus, the electronic management of sick leave, in fact, in our country has long been developed and wherever they wanted it was introduced. But at the same time, it has not violated any of the adopted laws and regulations so far. Let not everywhere, but already in a working and generally brought to mind form. And the doctor who draws up the paper sick leave is only required to enter a minimum of data. But then this data is reused by other MIS modules.

And what will happen now if the doctor is very strongly asked to write out an electronic sick leave according to the new cherry? In addition to working with MIS, which no one is going to cancel, the doctor will now have to issue a paper patient consent in writing(yes, we are fighting paperwork and are introducing an electronic service with a new mandatory piece of paper, which was not required before) and, plus, re-enter the same data into another program. Both options do not fit the slogan of improving working conditions. medical staff or reduction of labor costs for registration of sick leaves. Apparently, no one actually set such a goal. Rather, it is necessary to talk about the additional burden on the doctor and the costs of the medical organization, and not in the interests of this doctor or medical organization, but in the interests of the FSS.

But in fact, the situation here is not just an additional inconvenience for the doctor, whose troubles seem to be of little interest to the FSS. Everything will be cooler here. Recall that back in 2011, the Ministry of Health issued Order 364 "On Approval of the Concept for the Creation of Uniform State Health Information System", one of the basic principles of which is written, I quote “… Single entry and multiple use primary information(received from a medical (pharmaceutical) worker, citizen, official)…» ... In fact, the sick leave scheme being implemented now is a direct violation of this current order. Let's add here at least a discrepancy in Order N 624н. Additionally, we present one more interesting fact: the FSS program forces doctors to use a job reference book when issuing a sick leave certificate, which does not closely match the “Job Nomenclature medical professionals and pharmaceutical workers ", approved by the Order of the Ministry of Health of Russia dated 20.12.2012, No. 1183n, posted on the federal portal of reference information nsi.rosminzdrav.ru. Well, and it’s a very boring little thing, but all the same - in the order of the Ministry of Health No. 624n, the term "sick leave" is used, in the FSS program - "sick leave". Well, at least in this it would be possible to comply with the terms and definitions of the Ministry of Health, right?

Thus, we have not just a legislatively enshrined additional load on doctors, but also ignoring those already in force at the time of preparation and approval of 86-FZ normative documents Ministry of Health and operating services of the Uniform State Health Information System.

Moreover, even the implementation of the current regulatory act, to which everyone refers - FZ of May 1, 2017 N 86-FZ "On Amendments to Article 13 of the Federal Law" On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Maternity "and Article 59 and 78 of the Federal Law “On the basics of protecting the health of citizens in the Russian Federation” ”- not provided in full. The changes introduced by this Federal Law say that:

• you can issue certificates of incapacity for work on paper or in the form of an electronic document (with big amount"If" above)
• the form, procedure for issuing and the procedure for issuing certificates of incapacity for work (paper and electronic) is established by the federal executive body responsible for the development and implementation of state policy and legal regulation in the field of health care - i.e. Ministry of Health. Let me remind you that no changes have been made to the current "Procedure for issuing a medical certificate" and there is not a word about electronic sick leave
• The procedure for information interaction between the insurer, insurers, medical organizations and federal state ITU in terms of work with ELN is approved by the Government of the Russian Federation - and this procedure has not yet been developed, which equates all the services offered for use to a departmental gag ...

Thus, there is a paradoxical situation when one department (FSS) in its own interests and on their own terms forces other participants in the information interaction of another department (the Ministry of Health) to perform actions that complicate the already difficult working conditions and, moreover, also come into conflict with the approved legally significant orders, regulations and information systems taken together.

A reasonable question arises as to why it was necessary to spend 3 years and conduct 6 pilot projects in order to either ignore all these problems, or not bother to find out about them at all ?! Well, it would be very interesting to know.

In general, as the well-known comrade Chernomyrdin used to say, "This never happened and suddenly again."

It seems that, after all, a normal and reasonable implementation would not be to force doctors to work with additional software, but to integrate 2 departmental systems - the Unified State Health Information System and the Unified Information System of the FSS. For example, through the federal service "Integrated electronic medical card"(IEMK), into which the MIS would upload, in addition to the already implemented SEMDs, another one - information about temporary disability, which then automatically and via a single secure communication channel at the federal level entered the corresponding FSS IS and then were available to the FSS and employers in that the way it is implemented now.

We cherish the hope that over time, approximately such a realization will be provided. And now the only way to save doctors from at least double input is the integration of all used MIS (and there are more than a dozen of them in the country have been created and implemented!) With the Unified Information System of the FSS. To do this, on the FSS website at >>> published technical documentation describing the connection to the service, there is a test and production environment. Most likely, the costs of such work will be borne traditionally by the Ministry of Defense and the MIS developers - but, apparently, we are no longer able to influence this celebration of life.