Extension of sick leave standards, possibility and procedure

Author of the article: Anastasia Ivanova Last modified: January 2020 6560

Having a ballot opened due to illness gives a working citizen the right to temporarily stop performing work duties. The document is issued for a fixed period and subsequently presented to the employer. If there are grounds, then extension of sick leave is allowed. However, the period cannot exceed the period established by law. True, there are exceptions when the ballot can be extended, but only by decision of a specially convened commission.

For how long is the BC issued?

A certificate of temporary incapacity for work (hereinafter referred to as LVN) is issued to a citizen by the attending physician. The doctor's specialization does not matter for the order of execution and validity of the sheet. The BL is a form that is strictly registered with a medical institution, and therefore must be completed in compliance with all formalities. Sometimes it is allowed to fill out the LVN retroactively, if the doctor was called to the patient’s home address.

The conclusion on the decision to issue an extension of the BC is made by a group of doctors. The patient has the right to ask the doctor to record the date of the visit so that it is taken into account by the commission.

Previously, the law did not require a committee of doctors to consider the issue of renewing the form.

However, innovations were introduced for the following reasons:

1. There have been many cases of form falsification.
2. Compensation for sick days to employees is provided from the Social Insurance Fund. Since the funds are budgetary, each payment is strictly accounted for.

The legislator decided that if there is a whole group of doctors, there will be fewer cases of illegal issuance of drugs, which will reduce unnecessary budget expenses.
If a citizen goes to the clinic after work, the doctor can issue a slip from the next day. This practice is understandable, since a person has worked the whole day at work, which means he no longer needs time off, and he is already entitled to payment.

In the usual manner, the LVN is issued from the day the patient contacts the medical institution. The doctor usually makes a primary diagnosis, prescribes treatment and sets a date for the next appointment. If during the second visit it turns out that the illness has not subsided, then you need to issue an extension of the sick leave. This can happen several times until complete recovery.

However, the doctor is limited in the timing of scheduling subsequent appointments and issuing additional days by instructions established by the Ministry of Health of the Russian Federation. Thus, Order No. 624 dated June 29, 2011 (hereinafter referred to as the Order) sets out the rules for issuing and extending BC. Clause 11 of the Order establishes a duration of 15 days for regular LVN, which is issued by a therapist for acute respiratory viral infections and tonsillitis. In paragraph 3 of Art. 29 of Law No. 323 of November 21, 2011 (hereinafter referred to as the Law) states that the duration of the sheet is 15 days. To do this, the head of the clinic appoints medical experts on temporary disability issues, who decide whether to extend the sick leave.

In Part 2 of Art. 29 states that the BL, which is issued by a paramedic or dentist alone, cannot exceed 10 days. It is allowed to give the patient 30 days to recuperate from such illnesses, but this is also determined by a commission of doctors.

The above periods are given for outpatient treatment; for inpatient treatment, the periods of release from work depend on what illness the citizen is suffering from, whether it is a sore throat or a fracture.

For example:

• if it concerns an operation with appendicitis, then the sick leave lasts 5 days, after which it is transferred to the clinic for extension;
• if the patient needs to undergo gynecological plastic surgery, then the duration is 15 days, excluding extensions;
• 10 days are allocated for the removal of kidney stones, etc.

According to general rules, it is also not allowed to write with errors on the form or enter false data. The document should be checked before submitting it to the organization for calculations.

Duration of sick leave

A sick leave certificate is issued by any doctor to whom the patient turns . This may include a highly specialized specialist. A strict reporting form can be issued even retroactively, but only if you called a medical professional to your home.

This type of sick leave is issued only after a medical commission. The patient can ask the doctor to record or record the day the patient went to the medical facility.

It often happens that a person comes to the clinic only after finishing his working day. In this case, the doctor has the right to issue a sick leave from the next day.

The document is issued from the first day of application to a medical institution and is periodically extended until the day the illness ends. But the period for which the specialist issues a certificate of ability to work is limited by the regulatory norms of the order of the Ministry of Health. Often, peculiar amendments are made to it, which are aimed at improving the level of the state.

Is it possible to ask a therapist to extend sick leave? Yes, but the maximum period for which a certificate of incapacity for work can be extended at a time is three calendar days .

The Health Care Order specifies the procedure for renewing the document, for how long it can be issued, how often it should be renewed, and what the maximum period per year is during the hospital period.

The order also contains other cases in which an extension for a period is possible, but only after signing by a medical commission. There should be no errors in the sick leave certificate and it must be checked for compliance and correctness before sending it to the company’s accounting department.

According to the new rules, the doctor can no longer issue a certificate of incapacity for work, as previously for 10 days, and after 30 days after a medical commission. Now this period is 15 days, and he can extend this period only after the conclusion of the commission .

In dentistry, doctors and paramedics have the right to issue only for 10 days, and previously they had the right to issue for up to five days. In an individual situation, they write out 30 days, but also by decision of the commission.

During inpatient treatment, all terms are individual. For example, during laparoscopy, on average, the sick leave is open for five days. After discharge, the patient has the right to renew the document at the clinic. You can learn more about the duration of sick leave after laparoscopy from the article “How many days of sick leave are given after resection of appendicitis?”

For plastic surgery related to gynecology, a certificate of incapacity for work can be opened for 15 days, with its subsequent extension. When stones are removed, sick leave is issued for up to 10 days, depending on the severity of the operation and recovery time.

Renewal procedure

As already mentioned, the LVN opens from the day of the first visit to the clinic. After this, the data is entered into a computer database. The doctor fills out all the data and, according to the patient, enters his personal information, including the name of the employer’s organization. It is necessary to indicate the official name, as well as the legal form of the enterprise. If an error is made in the data, the organization may refuse to pay for the slip, and the procedure for replacing sick leave is not provided for by law. Therefore, before going to the hospital, you should clarify the details of the place of work.

Of course, you can try to come to an agreement with the medical staff, but this will again require convening a commission, and not every institution will make concessions.

Upon opening, the BC is transferred to the patient, but in practice, in order to save it, doctors keep the document until the end of the period of incapacity. The paper must be neat, not wrinkled, and clean. If the requirements are not met, the company will not allocate funds under such a document.

Drugs are issued through a special window in a medical institution.
To receive a certificate, the patient must present an identification document, after which the employee verifies all the data. After verification, the patient must sign to confirm receipt of the form. We recommend you study! Follow the link:

The procedure for paying sick leave according to the law

After this, the patient with the form goes to see a doctor, who makes a decision about extending or ending treatment. If a decision is made to continue medical observation, the next appointment date must be no later than three days later. The total duration of treatment, which the doctor alone has the right to prescribe, is 15 days. All further extension days are provided based on the conclusion of the expert commission.

After asking the treating specialist the question of prolonging the BL, which the doctor can extend independently, the following actions occur:

1. The doctor orders additional tests to identify potential problems.
2. The specialist writes a statement to the chief physician asking him to increase the duration of the document and convene a group to consider a specific case.
3. The chief physician convenes an expert commission on temporary disability to identify the circumstances for prolonging the form.
4. Experts consider a particular case by studying the medical documentation of the patient. The citizen is not present.
5. A protocol is drawn up, which sets out the final position of the doctors.

Before discussions are held, each committee member examines the patient and takes notes on observations of the subject's health status. After the commission approves the application, the certificate of incapacity for work is extended for the period specified in the protocol.

Renewal terms

According to established rules, the fact of illness is documented immediately. Therefore, you don’t need to think long about what to tell your doctor to extend your sick leave: just make an appointment or come to an appointment.

Registration begins on the day of the visit. Two points require special clarification:

1. the sick person called the doctor home;
2. The patient, who was busy all day at work, visited the doctor at the end of the day.

In the first case, the documentation will be completed the next day, but taking into account the visit to the patient (retroactively), in the second - more likely, from the next day.

The specific duration of the minimum period of temporary disability depends on the standards approved by the Ministry of Health, and it may change periodically. The limit duration of incapacity for work during the year is also determined: if it is exceeded, the employer has every reason to insist on the dismissal of the employee for health reasons (transfer to other working conditions).

Important . Since it is easiest to extend an existing sick leave with a therapist, in emergency situations, when there is no other option, you can turn to him as a non-core specialist. The maximum period will be 3 days .

The most difficult thing is to determine the length of stay for treatment in a hospital. Different diseases, different patients require a differentiated approach. Especially when it comes to undergoing surgery or a long rehabilitation period.

Here, any situation is tied to the type of treatment prescribed, the complexity of the operation performed, and the specialization of the medical institution. In accordance with Federal law, the countdown of the time spent in the hospital, which affects payment for the patient’s temporary disability, begins immediately after his admission. And it ends only after complete recovery and obtaining the conclusion of the treating specialist.

Attention ! In special, non-standard situations, the decision to discharge (as well as assign a disability group to the patient due to the impossibility of his full rehabilitation) is made by a medical board or a permanent commission.

This category also includes an additional recovery period associated with a stay in sanatoriums, dispensaries, and spa treatment. The procedure for processing documents is completely similar to the standard one, but the total duration of disability should not exceed 24 days . If there are compelling reasons, a commission from the sanatorium staff may extend the rehabilitation period.

Since any blots or adjustments in the completed documentation are excluded, before extending sick leave or issuing a new certificate of incapacity for work, you need to have all the information about your place of work.

This applies even to such seemingly trifles as the form of ownership:

• PJSC,
• COMPANY,
• Emergency
• or SP.

Not to mention the exact name of the position and profession. Otherwise, there are often situations when an indignant patient, burning with righteous anger, tries to figure out why exactly the accounting department rejected the payment if he did everything correctly.

Prolongation after surgery or hospital treatment

Often, in severe forms of illness, patients have to be operated on and treated in an inpatient setting. Since surgery is not an easy procedure, the patient needs some time after it to recuperate. A sick leave certificate is issued for a citizen admitted to the hospital from the day of admission to the ward. Closing, respectively, from the day of departure from the inpatient medical facility.

Extension of sick leave after hospitalization is carried out in the outpatient department based on the decision of the attending physician and certificates from the inpatient clinic. The doctor’s decision must be submitted for discussion to a medical commission, which will determine the final verdict regarding the issue of extending BL for a specific period.

When concluding a commission, two factors are taken into account:

• prolongation of LVN is allowed for a period of up to ten months;
• it is possible only if the patient recovers.

The list is closed.

Thus, the stages of prolonging sick leave are as follows:

1. Receiving a document from a stationary clinic.
2. Visiting a clinic at your place of registration. The required treating specialist is presented with a sheet from the hospital.
3. After this, an expert committee of doctors is convened, which determines the need to prolong the LVN.

After the validity of the certificate of incapacity for work has been extended after inpatient treatment, the patient must see a doctor every two weeks to monitor the condition and further prolong the validity of the document. When there are no signs of improvement and the patient’s health is still unsatisfactory, a decision is made to assign the citizen a degree of disability. Disability is determined after an examination.

If doctors recommend that a person complete his recovery in a sanatorium, then the patient has the right to receive BC for all days of rehabilitation in the institution. The deadline for such a certificate of incapacity for work is twenty-four days. An increase in the period of prevention and rehabilitation is possible by decision of the commission of the institution where the citizen is undergoing further treatment.

Extension in another locality or hospital

It is not always possible for an illness to find you at home. But even if you get sick while visiting in another city or on a business trip, you have the right to seek medical help and apply for sick leave. After this, it is not necessary to stay in a foreign city until complete recovery.

According to the law, you can close your sick leave in another city, then upon arrival home, immediately go to the district clinic, where they will open a new sick leave for you. The same applies to extending sick leave in another medical institution.

In general, the design procedure will look like this:

1. You close your sick leave at the medical institution where you were treated. In one of the columns a mark is placed indicating that you continue to be ill.
2. Then you go to another clinic, providing a closed sick leave certificate.
3. The doctor writes you a new certificate of incapacity for work, which, in fact, is a continuation of the first one. The sheet may contain information about the sheet that was extended.
4. Next, you are observed by your attending physician and, if necessary, extend your sick leave if time permits.

A certificate of incapacity for work can be extended not only by the specialized doctor who opened it for you, but also by your local physician.

The decision to extend sick leave is made either by the attending physician if you have been ill for less than 15 days, or by a special medical commission if, after the specified time, you have not been able to fully recover. When treated in a hospital setting, the decision on the duration of sick leave is made by the attending physician and depends on the severity of the disease.

Sometimes you have to miss work, no matter how important it is. Illnesses await every person, and often because of them it is impossible to work normally. In such cases, people go on sick leave. This paid period of time seems to be enough time to recover.

But sometimes unforeseen complications occur, and then the question of extending sick leave arises. Fortunately, extending it is not as difficult as it might seem at first glance. You just need to prove to the attending physician that the disease has not yet receded - and everything will be fine.

Dear readers! Our articles talk about typical ways to resolve legal issues, but each case is unique.

If you want to find out how to solve your particular problem, please use the online consultant form on the right or call. It's fast and free!

Limit terms for prolongation of LVN

In some cases, when there was a complex surgical intervention, the certificate of incapacity for work can be extended up to a year, but this must also be determined by a group of doctors.

The reasons for increasing the period of stay on treatment are:

• previous surgery;
• pregnancy, childbirth and postpartum rehabilitation;
• injury received.

For example, for a fracture of the tibia, sick leave may be 3-8 months, but this is at the discretion of the surgeon or orthopedist.

So, based on the causes of the illness, the certificate of incapacity for work continues for a period of ten months, when the patient has undergone a difficult operation. If the procedure was particularly complex, the period increases to a year.

For strokes of varying degrees, the following deadlines are established:

• three months – for a microstroke;
• four months – moderate;
• in complex manifestations – eight months.

The list is closed.

We recommend you study! Follow the link:

How to take sick leave to care for a sick relative

In the case of cancer, four months are given, which can be increased to ten if necessary. Depending on the progression of the disease, a citizen may be assigned an examination to determine disability. For tuberculosis disease, the duration of treatment is up to 12 months.

In any case, the period for extending sick leave should not exceed a year; after 12 months of treatment, the citizen is sent for an examination to determine disability.

The patient must take into account that the entire time he is undergoing treatment according to documents, he must strictly follow the recommendations and instructions of doctors - undergo procedures, perform physical exercises, follow nutritional rules, daily routine, etc. Be sure to appear for an appointment with the doctor at appointed day. If the requirements are not met, the specialist will make a note on the form, which will be the basis for reducing the amount of payments from the Social Insurance Fund.

Entry requirements

The form has sections in which the doctor or employer enters information, respectively. There are several basic requirements common to all types of sheets:

• records are made in specially designated cells in printed handwriting in black ink or typescript;
• If an error is made in filling out or the form is lost, it is replaced with a duplicate, which can be requested from the same medical institution where the original was received.

The sick leave form has sections in which the doctor and employer enter information

To whom is it issued?

Sick leave is issued due to childbirth, pregnancy, one’s own illness or illness of a relative who needs help, as well as during an unexpected quarantine period. Persons who are entitled to this document:

• those who have entered into employment agreements and work under them;
• main participants of cooperatives;
• Individual entrepreneurs, people who have joined farms and have social insurance;
• civil servants;
• clergy;
• unemployed people registered with the territorial body responsible for the employment of citizens;
• insured people from other countries performing work in Russia and receiving traumatic disability or inability to begin work as a result of an illness received during work;
• women who became pregnant within a year from the date of dismissal due to the cessation of the organization’s existence.

There are several basic requirements for making entries on a sick leave sheet.

Nuances when opening sick leave

Let's consider the main problems that arise both when opening sick leave and when extending it:

The beginning of the document (the spine) is completed by the doctor.

1. When entering information into the original, a note is made in the “primary” cell. In the event that a duplicate is issued, a tick is placed next to the required box.
2. If the sheet is a continuation of the previous one, the number of the previous one is written in place of the number with the corresponding section.
3. The diagnosis is not indicated in letter form, because it is a medical secret. Therefore, the reason for the inability to carry out work activities is indicated by a code. For example, 06 – installation of a prosthesis in a hospital. The ongoing treatment is also indicated in the “additional code” column: 020 – additional maternity leave time. If the reason for disability has changed, this is indicated as “change code.” All code designations can be found in order No. 624n dated June 29, 2011.

The beginning of the document is filled out by a doctor of a medical organization

The second section is also filled out by the doctor.

1. “Date 1” - the date of change in the basis of disability, the possible time of birth, the beginning of the patient’s trip. “Date 2” is the end of treatment at the medical institution.
2. The “care” columns are filled in if the employee is unable to work due to the illness of a relative. The first cells for entering information are the age of the relative in years, the second - in months due to the baby’s illness.
3. If there is a deviation from the correct execution of the mode, the code is entered in the required column. For example, 24 – failure to show up to the doctor.
4. Information is entered into “Exemption from work” in accordance with the period of illness. Extension during home treatment is recorded separately from the new day after the doctor’s appointment; when being treated in a hospital or sanatorium, it is extended until the end of treatment and a note is made about this. In the duplicate, a single line entry is made about the full period of incapacity for work.
5. If a person continues to feel unwell after follow-up treatment, he receives a new sheet after entering the number 31 in the “other” column.

Filling out another section by a doctor

The last section is drawn up by the employer.

1. In the column “reg. number" you should indicate the number from the insurance notice issued after successful registration at the territorial office of the Insurance Fund for Citizens of the Russian Federation. “Subordination code” is the code of this institution.
2. The line “Act Form N-1” is filled in if an industrial accident occurs.
3. Filling out “average earnings” is carried out in accordance with the calculation rules according to the Labor Code of the Russian Federation: this is the ratio of the total annual earnings to the previous year and the average number of days in a month (29.3).
4. “Calculation conditions” are filled in using 1 or more codes: 43 – insured employee who received radiation exposure and has the right to compensation; 44 – person performing work in the North. Arctic Circle since 2007; 45 – citizen with a disability; 46 – citizen carrying out work activities under a contract for up to 6 months; 47 – onset of illness no later than a month after cessation of work; 48 – a valid reason for violating the rules of the regime; 49 – treatment for a person with a disability for more than 4 months in a row; 50 - like the previous one, only more than 5 months a year; 51 – during part-time work.

The last part of the sick leave certificate is filled out by the employer

Sheet of temporary incapacity for work for a pregnant woman

During pregnancy, a woman registers with a medical institution, where at certain intervals she must appear for examination by the attending physician. This condition requires constant and careful monitoring, so the role of the physician cannot be underestimated. BL (not maternity leave) opens to a woman at the thirtieth week of pregnancy; until this time, she regularly visits an obstetrician-gynecologist and undergoes prescribed procedures and tests.

In some cases, the need to open the LVN for a pregnant woman occurs prematurely, before the 30th week. This is usually due to a difficult pregnancy: this means that doctors have identified a threat to health or the child, and the patient needs additional care and observation.

After childbirth, the woman is given some time to recuperate, which is also paid according to a certificate of incapacity for work. The duration of LVI depends on the condition of the pregnant woman, the course of pregnancy, the process of childbirth and the consequences.

The following periods are distinguished during pregnancy and childbirth:

1. Seventy days are given to a healthy woman who has successfully given birth, for the period from 30 weeks before birth and the postpartum period.
2. When the birth took place with the use of surgery or other complications, a total of 156 days is given. Situations involving caesarean section are also suitable for these cases.
3. When a woman is about to give birth to two or more children, she is given 192 days. Not only the period after childbirth, but also the prenatal period is subject to prolongation. A woman in labor comes out 82 days before the due date set by doctors. After the birth of children, the patient has the right to take advantage of 110 days to recuperate.

The extension of the certificate is not issued in advance if difficulties arose during childbirth. The patient does not have to do anything; everything is completed by the medical staff. During childbirth, emergency situations often arise, and then there is certainly a need to increase the recovery period. The woman must provide a certificate issued with an increased rehabilitation period at her place of work, and then additional payments will be made for the added days.

When a pregnancy is terminated at the request or without the desire of a woman, she is also issued a BC, but other criteria will be taken to assess the rehabilitation period

Reasons for extension

There are often cases when an employer, upon presentation of a certificate of incapacity for work

makes round eyes: they say, for any reason they run away on sick leave. Such claims make the employee feel almost like a malingerer. In addition to the diseases directly listed in the medical reference book, the grounds for issuing sick leave may be:

• injury;
• operation;
• pregnancy and childbirth.

You can take out sick leave without being sick yourself in the following cases:

• the need for constant care for a sick relative;
• illness of a child for which he needs constant care.

Sick leave issued for any of the above reasons may be extended.

Methods for prolongation without the presence of disease

If an employee wants to stay home and not go perform job functions, he can use several methods:

• swap with a work partner (if it is shift work) and work his hours in the future;
• take time off at your own expense.

If you don’t want to work off or lose your daily earnings, then you’ll have to apply for a BL. To do this, you don’t need to be really sick, you need to awaken the actor within you. This document is a strict reporting form, and it is not so easy to obtain it without reason.

When people need to solve their problems and use working time to do this, they will need advice on how to extend sick leave if you are not sick. The patient should not invent symptoms that are easy to check, such as a sore throat or cough. The doctor will examine the patient and immediately reveal the deception.

However, such a factor as body temperature can be invented. It is unlikely that the doctor will recheck the temperature in the office, and even if so, you can always refer to the use of antipyretics. A citizen may say that he is bothered by a fever in the morning or evening. It is not worth mentioning large numbers, since at a temperature above 38 C, additional tests and examinations may be prescribed. With this simple method you can find a few more days to answer your questions.

How to extend sick leave if you are not sick

Some would dream of not going to work longer, resting at the expense of their organization or the state. However, the attitude of doctors towards such scoundrels has never been favorable. Each issued certificate of incapacity for work is registered

, and unscrupulous patients may be added to the “
ignore list
”. Therefore, it will become more difficult for deceivers to get medical help in the future.

There is no way to extend sick leave if you have recovered while complying with Russian laws. However, a healthy person can apply for a certificate of temporary incapacity for work if supervision of a sick person

family member (in particular, a minor child). The period will vary depending on the age of the sick children:

• For disabled children, the parent or guardian has the right not to go to work until the child has fully recovered;
• sick children over 7 years of age but under 15 can “exempt” their legal guardians or parents from work for a maximum of 2 weeks;
• 3 days is the period of sick leave if family members over 15 years of age need care (in exceptional cases, the commission may release an able-bodied citizen from work for a week so that he can look after loved ones).

Many illnesses are cured when the mark on the thermometer does not rise above 36.6, and patients worry about how long they can extend sick leave without a fever

?
Some patients mistakenly believe that if they do not have a fever, they will be considered healthy. This is not so - the doctor takes into account the general condition
of the patient who contacts him, and according to a single rule, he can increase the period of temporary disability to 15 days.

Procedure for transferring funds during illness

Compensation for illness is made after providing a closed document at the place of work. While the employee is sick, the company will not calculate compensation.

In order for funds to be transferred on time, the employee is recommended to follow the following rules:

1. Information about the patient must correspond to official documents.
2. Information about the place of work must be reliable and correct.
3. Submit the certificate as soon as possible after returning to work (the document is valid for six months).
4. Strictly follow the doctor’s instructions and visit the hospital within the specified time frame. If the doctor reports violations, the amount of payments is reduced.

Since some patients are undergoing treatment for a long time, and money is paid after the form is closed, the Ministry of Health has established a procedure for prematurely closing a BC and opening a new one. This manipulation allows a person to receive funds gradually and not be in poverty until the final payment.

The employer is responsible for making payments, and his actions are under the supervision of the Social Insurance Fund.

Proper execution of a certificate of incapacity for work will allow you to regain strength and receive compensation from your place of work, so you always need to follow the deadlines, procedures and procedures for completing the document.

Extension in hospital

While undergoing inpatient treatment, the patient does not have to worry about the doctor forgetting to extend the sick leave. Depending on the dynamics of recovery, the attending physician will determine the duration of your treatment and will also record it in the document.

During long-term treatment, you may end up with several sick leaves. The first will indicate that the person continues treatment; the subsequent ones must indicate the number of the sheet that you are renewing.

On the recommendation of a doctor, after discharge from the hospital, your certificate of incapacity for work may be extended at the clinic at your place of residence, but the duration of sick leave cannot exceed more than 10 days.