RUSSIAN FEDERATION
THE FEDERAL LAW
dated 29.12.06 N 255-FZ
ON PROVISION OF BENEFITS FOR TEMPORARY DISABILITY,
ON PREGNANCY AND BIRTH OF CITIZENS SUBJECT TO MANDATORY
SOCIAL INSURANCE
Chapter 1. GENERAL PROVISIONS
Article 1. Subject of regulation of this Federal Law
1. This Federal Law determines the conditions, amounts and procedure for providing benefits for temporary disability, for pregnancy and childbirth to citizens subject to compulsory social insurance.
2. This Federal Law does not apply to relations related to the provision of citizens with temporary disability benefits in connection with an accident at work or an occupational disease, with the exception of the provisions of Articles 12, 13, 14 and 15 of this Federal Law applicable to these relations in part , which does not contradict the Federal Law of July 24, 1998 N 125-FZ "On Compulsory Social Insurance against Industrial Accidents and Occupational Diseases".
Article 2. Persons entitled to benefits for temporary disability, pregnancy and childbirth
1. Citizens who are subject to compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter referred to as insured persons) are entitled to benefits for temporary disability, pregnancy and childbirth, subject to the conditions provided for by this Federal Law and other federal laws.
2. Insured persons are citizens Russian Federation, as well as permanently or temporarily residing on the territory of the Russian Federation Foreign citizens and stateless persons:
1) persons working under labor contracts;
2) state civil servants, municipal employees;
3) lawyers, individual entrepreneurs, including members of peasant (farmer) households, individuals, not recognized as individual entrepreneurs, members of tribal, family communities of the small peoples of the North, who voluntarily entered into relations on compulsory social insurance in case of temporary disability and in connection with motherhood and pay insurance premiums to the Fund for themselves social insurance Russian Federation in accordance with the Federal Law of December 31, 2002 N 190-FZ "On the provision of benefits for compulsory social insurance of citizens working in organizations and individual entrepreneurs using special tax regimes, and some other categories of citizens" (hereinafter - the Federal Law "On the provision of benefits for compulsory social insurance of citizens working in organizations and for individual entrepreneurs applying special tax regimes, and some other categories of citizens");
4) other categories of persons who are subject to compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with other federal laws, provided that they or for them pay taxes and (or) insurance contributions to the Social Insurance Fund of the Russian Federation.
3. Persons working under labor contracts, for the purposes of this Federal Law, shall be recognized as persons who have concluded an employment contract in accordance with the established procedure from the day on which they were supposed to start work, or persons actually admitted to work in accordance with labor legislation.
4. Legislative, regulatory legal acts of the Russian Federation, the constituent entities of the Russian Federation, other payments may also be established to provide federal state civil servants, state civil servants of the constituent entities of the Russian Federation in connection with temporary disability, pregnancy and childbirth, financed from the funds federal budget, budgets of subjects of the Russian Federation.
Article 3. Financing the payment of benefits for temporary disability, pregnancy and childbirth
1. Financing of the payment of benefits for temporary disability, for pregnancy and childbirth to insured persons is carried out at the expense of the budget of the Social Insurance Fund of the Russian Federation, as well as at the expense of the employer in the cases provided for by part 2 of this article.
2. Temporary disability benefit in the cases specified in Clause 1 of Part 1 of Article 5 of this Federal Law shall be paid to insured persons (with the exception of insured persons specified in Part 4 of this Article) for the first two days of temporary disability at the expense of the employer, and for the rest of the period starting from the 3rd day of temporary disability - at the expense of the Social Insurance Fund of the Russian Federation.
3. Temporary disability benefit in the cases provided for in paragraphs 2-5 of Part 1 of Article 5 of this Federal Law shall be paid to insured persons (with the exception of insured persons specified in Part 4 of this Article) at the expense of the Social Insurance Fund of the Russian Federation from the 1st days of temporary disability.
4. Financing the payment of temporary disability benefits to insured persons working under employment contracts concluded with organizations and individual entrepreneurs applying special tax regimes (switched to a simplified taxation system or being payers of a single tax on imputed income for certain types of activities or a single agricultural tax) , as well as persons who voluntarily entered into relations on compulsory social insurance in case of temporary disability and in connection with motherhood, is carried out in accordance with the Federal Law "On the provision of benefits for compulsory social insurance of citizens working in organizations and for individual entrepreneurs applying special tax regimes, and some other categories of citizens".
5. In cases established by the laws of the Russian Federation, federal laws, the financing of expenses related to the payment of benefits for temporary disability, for pregnancy and childbirth in amounts in excess of those established by the legislation of the Russian Federation on compulsory social insurance, is carried out at the expense of federal budget funds transferred for these purposes of the Social Insurance Fund of the Russian Federation.
Article 4
Persons sentenced to deprivation of liberty and involved in paid work are subject to provision with benefits for temporary disability, for pregnancy and childbirth in the manner determined by the Government of the Russian Federation.
Chapter 2. PROVISION OF BENEFITS FOR TEMPORARY INABILITY
Article 5. Cases of providing benefits for temporary disability
1. Provision of insured persons with benefits for temporary disability is carried out in the following cases:
1) disability due to illness or injury, including in connection with an operation for artificial termination of pregnancy or in vitro fertilization (hereinafter referred to as disease or injury);
2) the need to care for a sick family member;
3) quarantine of the insured person, as well as quarantine of a child under the age of 7 attending preschool educational institution, or another family member recognized in the prescribed manner as incapacitated;
4) implementation of prosthetics for medical reasons in a stationary specialized institution;
5) follow-up treatment in accordance with the established procedure in sanatorium-resort institutions located on the territory of the Russian Federation, immediately after inpatient treatment.
2. Temporary disability benefit shall be paid to the insured persons upon the occurrence of the events specified in paragraph 1 of this article, during the period of work under employment contract, carrying out official or other activities during which they are subject to compulsory social insurance, as well as in cases where the disease or injury occurred within 30 calendar days from the date of termination of the specified work or activity or in the period from the day the employment contract was concluded until the day it was canceled .
Article 6. Conditions and duration of payment of benefits for temporary disability
1. Temporary disability benefit in case of disability due to illness or injury is paid to the insured person for the entire period of temporary disability until the day of restoration of working capacity (establishment of disability with limited ability to work), except for the cases specified in parts 3 and 4 of this article.
2. When the insured person receives aftercare in a sanatorium and resort facility located on the territory of the Russian Federation, immediately after inpatient treatment, temporary disability benefits are paid for the period of stay in the sanatorium and resort facility, but not more than 24 calendar days.
3. An insured person recognized as a disabled person in the prescribed manner and having a limited ability to work, temporary disability benefits (except for tuberculosis) are paid no more than four consecutive months or five months in a calendar year. If these persons become ill with tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity or until the day when the degree of limitation of the ability to work due to tuberculosis increases.
4. An insured person who has concluded a fixed-term employment contract (fixed-term service contract) for a period of up to six months, as well as an insured person whose illness or injury occurred in the period from the date of conclusion of the employment contract to the day of its cancellation, temporary disability benefits (except for tuberculosis) is paid for no more than 75 calendar days under this agreement. In case of tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity (establishment of disability with limited ability to work). In this case, the insured person, whose illness or injury occurred in the period from the date of conclusion of the employment contract until the day of its cancellation, is paid temporary disability benefits from the day from which the employee was supposed to start work.
5. Temporary disability benefit, if it is necessary to take care of a sick family member, is paid to the insured person:
1) in the case of caring for a sick child under the age of 7 years - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical institution, but not more than 60 calendar days in a calendar year for all cases of caring for this child, and in case of illness of a child included in the list of diseases determined by federal agency executive power, carrying out the functions of developing public policy and legal regulation in the field of healthcare and social development, - no more than 90 calendar days in a calendar year for all cases of care for this child in connection with the specified disease;
2) in the case of caring for a sick child aged 7 to 15 years - for a period of up to 15 calendar days for each case of outpatient treatment or joint stay with a child in an inpatient medical institution, but not more than 45 calendar days in a calendar year in all cases of care for this child;
3) in the case of caring for a sick disabled child under the age of 15 - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical institution, but not more than 120 calendar days in a calendar year for all cases of care for this child;
4) in the case of caring for a sick child under the age of 15 who is HIV-infected - for the entire period of joint stay with the child in an inpatient medical institution;
5) in the case of caring for a sick child under the age of 15 with his illness associated with a post-vaccination complication - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical institution;
6) in other cases of caring for a sick family member in outpatient treatment - no more than 7 calendar days in advance for each case of illness, but no more than 30 calendar days in a calendar year for all cases of caring for this family member.
6. Temporary disability benefit in case of quarantine is paid to the insured person who has been in contact with an infectious patient or who has a bacteriocarrier, for the entire time of his suspension from work due to quarantine. If children under the age of 7 who attend preschool educational institutions or other family members who are duly recognized as incapacitated are subject to quarantine, temporary disability benefits are paid to the insured person (one of the parents, other legal representative or other family member) for the entire period of quarantine .
7. Temporary disability benefit in the event of prosthetics for medical reasons in a stationary specialized institution is paid to the insured person for the entire period of release from work for this reason, including the travel time to the place of prosthetics and back.
8. Temporary disability benefit is paid to the insured person in all cases specified in Parts 1-7 of this Article for the calendar days falling on the relevant period, with the exception of calendar days falling on the periods specified in Part 1 of Article 9 of this Federal Law.
Article 7. The amount of benefits for temporary disability
1. Temporary disability benefit in case of disability due to illness or injury, with the exception of cases specified in paragraph 2 of this article, during quarantine, prosthetics for medical reasons and aftercare in sanatorium-resort institutions immediately after inpatient treatment is paid in the following amount:
1) for an insured person with an insurance record of 8 or more years - 100 percent of average earnings;
2) for an insured person with an insurance record of 5 to 8 years - 80 per cent of average earnings;
3) for an insured person with an insurance record of up to 5 years - 60 per cent of average earnings.
2. Temporary disability benefit in case of disability due to illness or injury is paid to insured persons in the amount of 60 percent of the average earnings in case of illness or injury occurring within 30 calendar days after the termination of work under an employment contract, official or other activity during which they are subject to compulsory social insurance.
3. Temporary disability allowance, if it is necessary to care for a sick child, is paid:
1) in case of outpatient treatment of a child - for the first 10 calendar days in the amount determined depending on the duration of the insurance period of the insured person in accordance with paragraph 1 of this article, for the following days in the amount of 50 percent of the average earnings;
2) in case of inpatient treatment of a child - in the amount determined depending on the duration of the insurance period of the insured person in accordance with paragraph 1 of this article.
4. Temporary disability benefit if it is necessary to care for a sick family member during his outpatient treatment, with the exception of cases of caring for a sick child under the age of 15, is paid in the amount determined depending on the length of the insurance period of the insured person in accordance with part 1 of this article.
5. The amount of temporary disability benefit cannot exceed maximum size temporary disability benefits, established federal law on the budget of the Social Insurance Fund of the Russian Federation for the next fiscal year. If the insured person works for several employers, the amount of the temporary disability benefit cannot exceed the specified maximum amount of the specified benefit for each place of work.
6. An insured person who has an insurance period of less than six months is paid a temporary disability benefit in an amount not exceeding for a full calendar month minimum size wages established by federal law, and in areas and localities in which regional coefficients are applied to wages in the prescribed manner, in an amount not exceeding the minimum wage, taking into account these coefficients.
7. Temporary disability benefit for the period of downtime shall be paid in the same amount in which the salary is maintained during this time, but not more than the amount of benefit that the insured person would receive under the general rules.
Article 8. Grounds for reducing the amount of temporary disability benefits
1. The grounds for reducing the amount of temporary disability benefits are:
1) violation by the insured person without good reason during the period of temporary incapacity for work of the regimen prescribed by the attending physician;
2) non-appearance of the insured person without good reason at the appointed time for a medical examination or for a medical and social examination;
3) illness or injury resulting from alcohol, narcotic, toxic intoxication or actions related to such intoxication.
2. If there are one or more grounds for reducing the temporary disability benefit specified in Part 1 of this article, the temporary disability benefit is paid to the insured person in an amount not exceeding the minimum wage established by federal law for a full calendar month:
1) if there are grounds specified in clauses 1 and 2 of part 1 of this article, from the day when the violation was committed;
2) if there are grounds specified in paragraph 3 of paragraph 1 of this section - for the entire period of incapacity for work.
Article 9 Grounds for refusing to grant temporary disability benefits
1. Temporary disability benefit is not assigned to the insured person for the following periods:
1) for the period of release of the employee from work with full or partial retention wages or without payment in accordance with the legislation of the Russian Federation, with the exception of cases of disability by an employee due to illness or injury during the period of annual paid leave;
2) for the period of suspension from work in accordance with the legislation of the Russian Federation, if no wages are accrued for this period;
3) for the period of detention or administrative arrest;
4) for the period of the forensic medical examination.
2. The grounds for refusing to grant an insured person temporary disability benefits are:
1) the onset of temporary incapacity for work as a result of the intentional infliction by the insured person of harm to his health or a suicide attempt established by the court;
2) the onset of temporary disability due to the commission of an intentional crime by the insured person.
Chapter 3. PROVISION OF PREGNANCY AND MATERNITY BENEFITS
Article 10. Duration of payment of benefits for pregnancy and childbirth
1. The benefit for pregnancy and childbirth is paid to the insured woman in total for the entire period of maternity leave lasting 70 (in case of multiple pregnancy - 84) calendar days before childbirth and 70 (in case of complicated childbirth - 86, in case of birth of two or more children - 110) calendar days after childbirth.
2. When a child (children) under the age of three months is adopted, the maternity allowance is paid from the date of its adoption until the expiration of 70 (in the case of simultaneous adoption of two or more children - 110) calendar days from the date of birth of the child (children).
3. If during the period of a mother's leave to care for a child until the child reaches the age of one and a half years, she has a maternity leave, she has the right to choose one of the two types of benefits paid during the periods of the corresponding holidays.
Article 11. The amount of benefits for pregnancy and childbirth
1. The benefit for pregnancy and childbirth is paid to an insured woman in the amount of 100 percent of the average earnings.
2. The amount of the maternity benefit may not exceed the maximum amount of the pregnancy and maternity benefit established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year. If the insured person works for several employers, the amount of the maternity benefit cannot exceed the specified maximum amount of the specified benefit for each place of work.
3. An insured woman who has an insurance period of less than six months is paid a pregnancy and childbirth allowance in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in areas and localities in which regional coefficients are applied in the prescribed manner to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
Chapter 4
Article 12
1. Temporary disability benefit is assigned if the application for it was followed no later than six months from the date of restoration of working capacity (establishment of disability with limited ability to work), as well as the end of the period of release from work in cases of caring for a sick family member, quarantine, prosthetics and aftercare.
2. Benefit for pregnancy and childbirth is assigned if the application was followed no later than six months from the date of the end of the maternity leave.
3. When applying for benefits for temporary disability, for pregnancy and childbirth after a six-month period, the decision to grant benefits is made by the territorial body of the Social Insurance Fund of the Russian Federation if there are good reasons for missing the deadline for applying for benefits. The list of valid reasons for missing the deadline for applying for benefits is determined by the federal executive body responsible for developing state policy and legal regulation in the field of compulsory social insurance.
Article 13
1. Appointment and payment of benefits for temporary disability, pregnancy and childbirth are carried out by the employer at the place of work of the insured person (except for the cases specified in parts 2 and 3 of this article). If the insured person works for several employers, benefits are assigned and paid to him by each employer.
2. An insured person who lost his ability to work due to illness or injury within 30 calendar days from the date of termination of work under an employment contract, service or other activities during which he is subject to compulsory social insurance, temporary disability benefits are assigned and paid by the employer at his last place work or by a territorial body of the Social Insurance Fund of the Russian Federation.
3. For the insured persons specified in Clause 3 of Part 2 of Article 2 of this Federal Law, as well as for other categories of insured persons in the event of termination of activity by the employer at the time the insured person applies for benefits for temporary disability, for pregnancy and childbirth, the assignment and payment of these benefits are carried out by the territorial body of the Social Insurance Fund of the Russian Federation.
4. To assign and pay benefits for temporary disability, for pregnancy and childbirth, the insured person submits a certificate of incapacity for work issued by a medical organization in the form and in the manner established by the federal executive body that performs the functions of developing state policy and legal regulation in the field of compulsory social insurance, and for the appointment and payment of benefits by the territorial body of the Social Insurance Fund of the Russian Federation, also information on earnings (income), from which the benefit should be calculated, and documents confirming the length of service, determined by the specified federal executive body.
5. The employer pays benefits for temporary disability, for pregnancy and childbirth to the insured person in the manner established for the payment of wages to employees.
6. In cases of appointment and payment of benefits for temporary disability, for pregnancy and childbirth by the territorial body of the Social Insurance Fund of the Russian Federation, provided for in parts 2 and 3 of this article, the payment of benefits for temporary disability, for pregnancy and childbirth is made in the prescribed amount directly by the territorial body of the Fund social insurance of the Russian Federation, who appointed the specified allowance, or through the organization of the federal postal service, credit or other organization at the request of the recipient.
Article 14. The procedure for calculating benefits for temporary disability, for pregnancy and childbirth
1. Benefits for temporary disability, pregnancy and childbirth are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months preceding the month of temporary disability, maternity leave.
2. Earnings, on the basis of which benefits for temporary disability, for pregnancy and childbirth are calculated, include all types of payments provided for by the remuneration system, taken into account when determining tax base one by one social tax credited to the Social Insurance Fund of the Russian Federation, in accordance with Chapter 24 of Part Two tax code Russian Federation. Earnings for the calculation of benefits for temporary disability, for pregnancy and childbirth to insured persons who voluntarily entered into relations under compulsory social insurance in case of temporary disability and in connection with motherhood, include the income received by them, from which insurance premiums to the Social Insurance Fund of the Russian Federation in accordance with the Federal Law "On providing benefits for compulsory social insurance to citizens working in organizations and for individual entrepreneurs applying special tax regimes, and some other categories of citizens."
3. The average daily earnings for the calculation of benefits for temporary disability, for pregnancy and childbirth is determined by dividing the amount of accrued earnings for the period specified in part 1 of this article by the number of calendar days falling on the period for which wages are taken into account.
4. The amount of the daily allowance for temporary disability, for pregnancy and childbirth is calculated by multiplying the average daily earnings of the insured person by the amount of the benefit established as a percentage of the average earnings in accordance with Articles 7 and 11 of this Federal Law.
5. The amount of benefits for temporary disability, for pregnancy and childbirth is determined by multiplying the amount of the daily allowance by the number of calendar days falling on the period of temporary disability, maternity leave.
6. If the amount of benefits for temporary disability, for pregnancy and childbirth, calculated in the manner established by this article, exceeds the maximum amount of benefits for temporary disability, for pregnancy and childbirth, established in accordance with Articles 7 and 11 of this Federal Law, the said allowances shall be paid at the stated maximum amounts.
7. Features of the procedure for calculating benefits for temporary disability, pregnancy and childbirth, including for certain categories insured persons are determined by the Government of the Russian Federation.
Article 15
1. The employer assigns benefits for temporary disability, for pregnancy and childbirth within 10 calendar days from the date of the insured person's application for its receipt with necessary documents. Payment of benefits is carried out by the employer on the next day after the assignment of benefits, set for the payment of wages.
2. The territorial body of the Social Insurance Fund of the Russian Federation, in the cases provided for by Parts 2 and 3 of Article 13 of this Federal Law, assigns and pays benefits for temporary disability, for pregnancy and childbirth within 10 calendar days from the date of submission by the insured person of the relevant application and necessary documents .
3. Assigned, but not received by the insured person in a timely manner, benefits for temporary disability, pregnancy and childbirth are paid for the entire past time, but not more than three years prior to applying for it. A benefit not received by the insured person in whole or in part due to the fault of the employer or the territorial body of the Social Insurance Fund of the Russian Federation is paid for the entire past time without limitation by any period.
4. The amounts of benefits for temporary disability, for pregnancy and childbirth, overpaid to the insured person, cannot be recovered from him, except for cases of accounting error and dishonesty on the part of the recipient (submission of documents with deliberately incorrect information, concealment of data affecting the receipt of benefits and its size, other cases). The deduction is made in the amount of not more than 20 percent of the amount due to the insured person for each subsequent payment of benefits or his wages. When the payment of benefits or wages is terminated, the remaining debt is collected in court.
5. Accrued amounts of benefits for temporary disability, for pregnancy and childbirth, not received due to the death of the insured person, are paid in the manner established by the civil legislation of the Russian Federation.
Article 16
1. The insurance period for determining the amount of benefits for temporary disability, for pregnancy and childbirth (insurance period) includes periods of work of the insured person under an employment contract, state civil or municipal service, as well as periods of other activities during which the citizen was subject to compulsory social insurance in case of temporary disability and in connection with motherhood.
2. Calculation of the insurance experience is made in calendar order. In the event of coincidence in time of several periods counted in the length of service, one of such periods is taken into account at the choice of the insured person.
3. The rules for calculating and confirming the insurance period are established by the federal executive body, which carries out the functions of developing state policy and legal regulation in the field of compulsory social insurance.
Chapter 5. PROCEDURE FOR THE ENTRY INTO FORCE OF THE PRESENT FEDERAL LAW
Article 17
1. Establish that citizens who have started work under an employment contract, official or other activities during which they are subject to compulsory social insurance, before January 1, 2007 and who before January 1, 2007 were entitled to receive temporary disability benefits in in the amount (as a percentage of average earnings) exceeding the amount of benefits (as a percentage of average earnings) due in accordance with this Federal Law, temporary disability benefits are assigned and paid in the same higher amount (as a percentage of average earnings) , but not higher than the maximum amount of temporary disability benefits established in accordance with this Federal Law.
2. In the event that the duration of the insurance period of the insured person, calculated in accordance with this Federal Law for the period before January 1, 2007, turns out to be less than the duration of its continuous seniority, applied when assigning benefits for temporary disability in accordance with the previous regulatory legal acts, for the same period, the duration of the insurance period is taken as the duration of the continuous work experience of the insured person.
Article 18
1. This Federal Law applies to insured events that occur after the day this Federal Law enters into force.
2. For insured events that occurred before the day this Federal Law came into force, benefits for temporary disability, for pregnancy and childbirth are calculated in accordance with the norms of this Federal Law for the period after the day it comes into force, if the amount of the benefit calculated in accordance with this Federal Law by law, exceeds the amount of benefits due under the norms of the previous legislation.
Article 19. Entry into force of this Federal Law
2. From January 1, 2007, legislative acts and other regulatory legal acts of the Russian Federation that provide for the conditions, amounts and procedure for providing benefits for temporary disability, for pregnancy and childbirth to citizens subject to compulsory social insurance, shall be applied to the extent that they do not contradict this Federal Law.
The president
Russian Federation
V. PUTIN
1. This Federal Law regulates legal relations in the system of compulsory social insurance in case of temporary disability and in connection with motherhood, determines the circle of persons subject to compulsory social insurance in case of temporary disability and in connection with motherhood, and the types of compulsory insurance coverage provided to them, establishes the rights and obligations of subjects of compulsory social insurance in case of temporary disability and in connection with motherhood, and also determines the conditions, amounts and procedure for providing benefits for temporary disability, pregnancy and childbirth, monthly allowance for caring for a child of citizens subject to compulsory social insurance in case of temporary disability and in connection with motherhood.
2. This Federal Law does not apply to relations related to the provision of citizens with temporary disability benefits in connection with an accident at work or an occupational disease, with the exception of the provisions of and this Federal Law applicable to these relations insofar as it does not contradict July 24 1998 N 125-FZ "On compulsory social insurance against accidents at work and occupational diseases".
1. The legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood is based on the Russian Federation and consists of this Federal Law, dated July 16, 1999 N 165-FZ "On the Basics of Compulsory Social Insurance", dated July 24, 2009 of the year N 212-FZ "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Fund for Compulsory health insurance"(hereinafter referred to as the Federal Law "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund"), other federal laws. Relations related to compulsory social insurance in case of temporary disability and in connection with motherhood are also regulated by other regulatory legal acts of the Russian Federation.
2. In cases where an international treaty of the Russian Federation establishes other rules than those provided for by this Federal Law, the rules of the international treaty of the Russian Federation shall apply.
1) compulsory social insurance in case of temporary disability and in connection with motherhood - a system of legal, economic and organizational measures created by the state aimed at compensating citizens for lost earnings (payments, remunerations) or additional expenses in connection with the onset of insured event on compulsory social insurance in case of temporary disability and in connection with motherhood;
2) an insured event under compulsory social insurance in case of temporary disability and in connection with motherhood - an accomplished event, upon the occurrence of which the obligation of the insurer arises, and in individual cases established by this Federal Law, the insured to carry out insurance coverage;
3) compulsory insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter also referred to as insurance coverage) - the fulfillment by the insurer, and in some cases established by this Federal Law, by the insured of his obligations to the insured person upon the occurrence of an insured event through payment of benefits established by this Federal Law;
4) funds of compulsory social insurance in case of temporary incapacity for work and in connection with motherhood - funds generated by the payment of insurance premiums by insurers for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, as well as property under the operational management of the insurer;
5) insurance premiums for compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter - insurance premiums) - mandatory payments made by policyholders to the Social Insurance Fund of the Russian Federation in order to ensure compulsory social insurance of insured persons in case of temporary disability and in connection with with motherhood;
6) average earnings- the average amount paid by the insured in favor of the insured person in billing period wages, other payments and remunerations, on the basis of which, in accordance with this Federal Law, benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for child care are calculated, and for persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with motherhood - established by federal law on the day of the insured event.
2. Other concepts and terms used in this Federal Law shall be applied in the same sense as they are used in other legislative acts of the Russian Federation.
1. Insurance risks under compulsory social insurance in case of temporary disability and in connection with motherhood are recognized as temporary loss of earnings or other payments, remuneration by the insured person in connection with the occurrence of an insured event or additional expenses of the insured person or members of his family in connection with the occurrence of an insured event.
1) temporary disability of the insured person due to illness or injury (with the exception of temporary disability due to accidents at work and occupational diseases) and in other cases provided for by this Federal Law;
1. The types of insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood are the following payments:
2. The conditions, amounts and procedure for the payment of insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood are determined by this Federal Law, dated May 19, 1995 N 81-FZ "On State Benefits to Citizens with Children" Law "On State Benefits to Citizens with Children"), dated January 12, 1996 N 8-ФЗ "On Burial and Funeral Business" (hereinafter - the Federal Law "On Burial and Funeral Business").
1. Citizens of the Russian Federation, foreign citizens and stateless persons permanently or temporarily residing in the Russian Federation, as well as foreign citizens and stateless persons temporarily staying in the Russian Federation (for with the exception of highly qualified specialists in accordance with N 115-FZ of July 25, 2002 "On the legal status of foreign citizens in the Russian Federation"):
1) persons working under labor contracts, including heads of organizations who are the sole participants (founders), members of organizations, owners of their property;
1. Assignment and payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care are carried out by the insured at the place of work (service, other activity) of the insured person (except for the cases specified in parts 3 and 4 of this article).
2. If the insured person at the time of the occurrence of the insured event is employed by several insurers and in the two previous calendar years was employed by the same insurers, benefits for temporary disability, pregnancy and childbirth are assigned and paid to him by the insurers at all places of work (service , other activities), and the monthly allowance for the care of a child - the insured at one place of work (service, other activity) at the choice of the insured person and are calculated based on the average earnings determined in accordance with Article 14 of this Federal Law, for the time of work (service , other activities) from the insured who appoints and pays the allowance.
2.1. If the insured person at the time of the occurrence of the insured event is employed by several insurers, and in the previous two calendar years was employed by other insurers (another insured), temporary disability benefits, pregnancy and childbirth benefits, monthly allowance for child care are assigned and paid to him by the insurant at one of the last places of work (service, other activity) at the choice of the insured person.
2.2. If the insured person at the time of the occurrence of the insured event is employed by several insurers, and in the two previous calendar years was employed by both these and other insurers (another insured), temporary disability benefits, pregnancy and childbirth benefits are assigned and paid to him either in in accordance with part 2 of this article by insurers at all places of work (service, other activity) based on the average earnings for the time of work (service, other activity) with the insurant assigning and paying benefits, or in accordance with part 2.1 of this article by the insurant for one of last places of work (service, other activities) at the choice of the insured person.
3. An insured person who lost his ability to work due to illness or injury within 30 calendar days from the date of termination of work under an employment contract, official or other activities, during which he was subject to compulsory social insurance in case of temporary disability and in connection with motherhood, temporary allowance disability is assigned and paid by the insured at his last place of work (service, other activity) or by the territorial body of the insurer in the cases specified in part 4 of this article.
4. To the insured persons specified in Part 3 of Article 2 of this Federal Law, as well as to other categories of insured persons in the event of termination of activity by the insured on the day the insured person applies for benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for child care, or in the absence of the possibility of their payment by the insured due to insufficient Money in his accounts at credit organizations and the application of the order of debiting funds from the account provided for by the Civil Code of the Russian Federation, or in the absence of the possibility of establishing the location of the insured and his property, which may be levied, in the presence of a court decision that has entered into force to establish the fact of non-payment of benefits by such an insurer to the insured person, or in the event that on the day the insured person applied for the specified benefits, the procedures applied in the case of the insured's bankruptcy are being carried out with respect to the insured, the appointment and payment of the specified benefits, with the exception of temporary disability benefits paid at the expense of the insured in accordance with clause 1 of part 2 of article 3 of this Federal Law are carried out by the territorial body of the insurer.
5. Appointment and payment of benefits for temporary disability, pregnancy and childbirth are carried out on the basis of a certificate of disability issued by a medical organization in the form of a document on paper or (with the written consent of the insured person) formed and placed in information system insurer in the form of an electronic document signed using an enhanced qualified electronic signature medical worker and a medical organization, if the medical organization and the insured are participants in the information exchange system for the exchange of information in order to form a sick leave certificate in the form of an electronic document. To assign and pay these benefits, the insured person submits a certificate (certificates) on the amount of earnings from which the allowance should be calculated from the place (s) of work (service, other activity) with another insured (other insurers), and for the appointment and payment of the specified benefits by the territorial body of the insurer - a certificate (certificates) on the amount of earnings from which the benefit should be calculated, and documents determined by the federal executive body responsible for the development and implementation of state policy and legal regulation in the field of labor and social protection of the population, documents confirming insurance experience. The form, procedure for issuing and the procedure for issuing sick leave certificates, as well as the procedure for generating sick leave certificates in the form of an electronic document, is established by the federal executive body responsible for the development and implementation of state policy and legal regulation in the field of healthcare, in agreement with the federal executive body , which performs the functions of developing and implementing state policy and legal regulation in the field of labor and social protection of the population, and the Social Insurance Fund of the Russian Federation. The procedure for information interaction between the insurer, policyholders, medical organizations and federal state institutions of medical and social expertise for the exchange of information in order to form a sick leave certificate in the form of an electronic document is approved by the Government of the Russian Federation.
5.1. In the cases specified in parts 2.1 and 2.2 of this article, the insured person, when applying for temporary disability benefits, pregnancy and childbirth benefits to the insured at one of the last places of work (service, other activity), at the choice of the insured person, also submits a certificate (certificates ) from the place of work (service, other activity) with another insurant (with other insurers) that the appointment and payment of benefits by this insurant are not carried out.
6. To assign and pay a monthly allowance for child care, the insured person submits an application for the assignment of the specified allowance, a birth (adoption) certificate of the child being cared for, and a copy of it or an extract from the decision on establishing custody of the child, a birth certificate (adoption, death) of the previous child (children) and a copy of it, a certificate from the place of work (service) of the mother (father, both parents) of the child that she (he, they) does not use parental leave and does not receive a monthly childcare benefits, and if the mother (father, both parents) of the child does not work (does not serve) or is studying full-time on basic educational programs in organizations engaged in educational activities, a certificate from the bodies of social protection of the population at the place of residence (place of stay, actual residence) mother (father) of the child about non-receipt of the monthly allowance for child care. In order to assign and pay a monthly child care allowance, the insured person shall also submit, if necessary, a certificate (certificates) on the amount of earnings from which the allowance is to be calculated. For the appointment and payment of a monthly allowance for child care in accordance with part 4 of this article, a certificate (information) from the social protection authorities at the place of residence (place of stay, actual residence) of the father, mother (both parents) of the child on non-receipt of a monthly allowance for care for a child is requested by the insurer from the authorized executive body of the subject of the Russian Federation, which has such information at its disposal. The insured person has the right, on his own initiative, to submit the specified certificate for the appointment and payment of benefits. The interdepartmental request of the insurer for the submission of documents (information) shall be sent within three calendar days from the date of receipt of the application for the payment of a monthly allowance for child care in accordance with part 4 of this article. The term for preparing and sending by the authorized executive body of the subject of the Russian Federation a response to the said interdepartmental request may not exceed five calendar days from the date of receipt of the interdepartmental request by the said bodies.
7. An insured person employed by several insurers, when applying to one of the indicated insurers of his choice for the appointment and payment of a monthly child care allowance, along with the documents provided for in paragraph 6 of this article, submits a certificate (certificates) from the place of work (service , other activities) from another insurant (from other insurers) that the appointment and payment of a monthly allowance for child care by this insurant is not carried out.
7.1. The insured person, instead of the original certificate of the amount of earnings, from which benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care must be calculated, may submit a copy of the certificate of the amount of earnings, certified in the prescribed manner.
7.2. If the insured person is unable to submit a certificate (certificates) on the amount of earnings from which the allowance must be calculated from the place (places) of work (service, other activities) with another insurant (with other insurers) in connection with the termination of activities by this policyholder (these policyholders) or for other reasons, the policyholder assigning and paying benefits, or the territorial body of the insurer assigning and paying benefits in the cases specified in Parts 3 and 4 of this Article of this Federal Law, at the request of the insured person, sends a request to the territorial organ pension fund of the Russian Federation on the provision of information on the salary, other payments and remuneration of the insured person with the relevant insured (relevant insurers) on the basis of information on individual (personalized) accounting in the system of mandatory pension insurance. The form of the said application of the insured person, the form and procedure for sending a request, the form, procedure and terms for submitting the requested information by the territorial body of the Pension Fund of the Russian Federation are established by the federal executive body responsible for developing state policy and legal regulation in the field of social insurance.
8. The insured pays benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for child care to the insured person in the manner established for the payment of wages (other payments, remuneration) to insured persons.
9. Payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care in the cases provided for in paragraph 4 of this article, is carried out in the established amounts by the territorial body of the insurer that assigned these benefits, through the organization of the federal postal service, credit or other organization at the beneficiary's request.
10. Information on the appointment and payment to insured persons in the cases provided for in paragraph 4 of this article, temporary disability benefits, benefits for pregnancy and childbirth, monthly benefits for child care is placed in the Unified State Social Security Information System. The placement and receipt of this information in the Unified State Social Security Information System is carried out in accordance with the Federal Law of July 17, 1999 N 178-FZ "On State Social Assistance".
The federal law determines the conditions, amounts and procedure for providing benefits for temporary disability, for pregnancy and childbirth to citizens subject to compulsory social insurance.
Previously, in accordance with paragraph 30 of the Regulations, approved by the Decree of the Presidium of the All-Union Central Council of Trade Unions of November 12, 1984 N 13-6, the amount of the allowance was determined depending on the length of continuous work experience. In accordance with the law, the amount of the benefit depends on the length of the insurance period, which includes periods of work under an employment contract, state civil or municipal service, as well as periods of other activities during which the citizen was subject to compulsory social insurance in case of temporary disability and in connection with motherhood. The amount of the temporary disability benefit is: 100% of the average earnings for persons with an insurance record of 8 or more years; 80% - for persons with insurance experience from 5 to 8 years and 60% if the insurance experience is less than 5 years. The benefit for pregnancy and childbirth is paid to an insured woman in the amount of 100% of the average earnings if she has an insurance period of more than 6 months, otherwise the amount of the benefit should not exceed 1 minimum wage.
It is established that the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year determines the maximum amount of disability benefits, as well as benefits for pregnancy and childbirth.
Temporary disability benefit is granted in the following cases:
1) disability due to illness or injury, including in connection with an operation for artificial termination of pregnancy or in vitro fertilization;
2) the need to care for a sick family member;
3) quarantine of the insured person, as well as the quarantine of a child under the age of 7 attending a preschool educational institution, or another family member recognized as legally incompetent;
4) implementation of prosthetics for medical reasons in a stationary specialized institution;
5) follow-up treatment in accordance with the established procedure in sanatorium-resort institutions located on the territory of the Russian Federation, immediately after inpatient treatment.
At the same time, temporary disability benefits due to illness or injury are paid for the entire period of disability until the day of restoration of working capacity or the establishment of disability with limited ability to work. Disabled persons are paid temporary disability benefits for no more than four consecutive months or five months in a calendar year, except for the case of tuberculosis. If temporary incapacity for work has occurred as a result of deliberate infliction of harm to one's health or suicide attempt established by the court, or as a result of a deliberate crime committed by a person, the award of temporary disability benefits is refused. If temporary disability has occurred due to illness or injury, then the payment of benefits for the first two days of temporary disability is carried out at the expense of the employer, and starting from the third day - at the expense of the Social Insurance Fund. In other cases, the payment of benefits is carried out at the expense of the Fund.
The term for applying for temporary disability benefits, pregnancy and childbirth benefits is six months from the date of restoration of working capacity or the end of maternity leave, respectively. The employer assigns benefits for temporary disability, pregnancy and childbirth within 10 calendar days from the date the person applied for it with the necessary documents and pays benefits on the next day after the appointment, set for the payment of wages.
The federal law comes into force on January 1, 2007 and applies to insured events that occur after the date of its entry into force.
