Who and how pays us for loss of ability to work and maternity leave? Establishing the percentage of loss of total working capacity The essence of the concept of “working capacity”

If you are injured at work or have an occupational disease, you have the right to benefits or compensation. Who will receive how much or not at all will be decided by the institution of a medical and social examination according to the new rules, which were recently signed by Prime Minister Mikhail Kasyanov.

Who is better to be - sick or healthy?

Conditions are getting tougher

A friend of mine once decided to jump from a parachute. As a result, he landed unsuccessfully and broke both legs. When the private company where he worked learned about what had happened, they decided to pay for the operation free of charge. A few months later, he left the hospital and sued the management of the unfortunate company to receive compensation for an injury at work. The parachutist lost the case and was also fired from his job. The story is instructive, but that’s not the point. Those rules that existed before pitted the employee and the employer head-on. The former always tried to attribute any bruise to a work injury, and the latter refused to recognize people without an arm or leg as disabled. And all because the employer had to pay for treatment and compensation. Now this function is taken over by the Social Insurance Fund.

Another key point: the new rules more clearly spell out in which cases disability is established and in which it is not. “It used to be like this,” says Elena Andreeva, deputy head of the department of labor relations of the Ministry of Labor, “a person, having graduated from a technical school, received, for example, a diploma as a plumber. But for the last 10 years he worked in a company, sitting on a home phone. And then he breaks his leg and demands compensation because he is a mechanic by profession and cannot work. But this has nothing to do with his current occupation: he is quite capable of performing his duties while sitting at home." So now compensation will be paid in relation to the job in which the victim is currently located.

In ordinary cases (fracture, sprain, etc.) this is 15% of the salary. If a person cannot work at all, he will receive 100%. If the injury is so serious that the employee will now have to limit his activities, it is realistic to receive from 40% to 90%. How much exactly will be determined by a medical and social examination.

Appeal if possible

According to the new rules, it turns out that people who become disabled in the workplace will receive less. Previously, the victim was paid a salary, a pension and compensation for the amount of damage. Now it will only be a pension and, if necessary, payment for treatment.

Depending on how badly you were injured, the Ministry of Labor, the Ministry of Health and the Social Insurance Fund will decide whether you need treatment in a sanatorium, surgery, retraining in a new specialty or not. If it decides that it is necessary, the Social Insurance Fund will pay.

In addition, another significant change was made to the rules: now the victim and the insurer will have equal conditions to appeal their position. That is, previously an employee could demand compensation, but the one who had to pay it to him could not. Now they can sue each other. By the way, in addition to the court, you will also be heard at the Main Bureau of Medical and Social Expertise and the local department of social protection. The Bureau even set a strict deadline for making a decision - a month from the date of receipt of the application.

And the last thing many of us will now have to put up with. As you know, some people are not enough to earn one salary and have to work part-time in several places. So, if a person is injured, then he applies for compensation for all, say, three jobs. On one it turns out to be 60%, on the other - 40%, on the third another 40%. As a result, it turns out that, having become disabled, he receives more than when he was healthy. Now officials have introduced a restriction: no matter how many jobs the victim has, he should receive no more than 100% compensation in total.

The latest rules on this subject were issued in 1994. It is unknown how long the new document will last. Wait and see.

RULES FOR ESTABLISHING THE DEGREE OF LOSS OF PROFESSIONAL WORK CAPACITY AS A RESULT OF OCCUPATIONAL ACCIDENTS AND OCCUPATIONAL DISEASES

I. General provisions

1. These Rules determine the procedure for establishing by medical and social examination institutions the degree of loss of professional ability for persons who have suffered health damage as a result of industrial accidents and occupational diseases (hereinafter referred to as victims).

2. The degree of loss of professional ability to work is established as a percentage at the time of examination of the victim, based on the assessment of the loss of ability to carry out professional activities due to an industrial accident and occupational disease, in accordance with the criteria for determining the degree of loss of professional ability to work, approved by the Ministry of Labor and Social Development of the Russian Federation according to in agreement with the Ministry of Health of the Russian Federation and the Social Insurance Fund of the Russian Federation.

3. Simultaneously with establishing the degree of loss of professional ability to work, the institution of a medical and social examination, if there are grounds, determines the need of the victim for medical, social and professional rehabilitation, and also recognizes the victim as disabled.

4. The examination of the victim is carried out in a medical and social examination institution at the place of his residence or at the place of attachment to a state or municipal medical and preventive health care institution (hereinafter referred to as a health care institution).

If, in accordance with the conclusion of a health care institution, the victim cannot come to the medical and social examination institution for health reasons, the examination can be carried out at home or in a hospital where the victim is being treated.

5. The medical and social examination institution is obliged to familiarize the victim in a form accessible to him with these Rules.

6. For citizens who were injured while not performing their work duties, the degree of loss of professional ability to work is established by forensic medical examination institutions.

II. Examination of victims

7. An examination of the victim in a medical and social examination institution is carried out on the basis of an application from the employer (insured), the insurer, by a ruling of the court (judge) or at the independent request of the victim or his representative when submitting a report on an industrial accident or a report on an occupational disease.

8. The employer (insurer) submits to the medical and social examination institution the conclusion of the state examination body of working conditions on the nature and working conditions of the victims that preceded the industrial accident and occupational disease.

9. The health care institution carries out the necessary diagnostic, therapeutic and rehabilitation measures and, based on their results, issues a referral to the victim to a medical and social examination institution for examination to determine the degree of loss of professional ability. The referral contains data on the victim’s health status, reflecting the degree of dysfunction of organs and systems, the state of the compensatory capabilities of his body and the results of the treatment and rehabilitation measures taken.

In some cases, before identifying signs of permanent loss of professional ability in a victim, a health care institution may refer him to a medical and social examination institution to determine the need for certain types of rehabilitation.

10. If it is necessary to conduct an examination using special techniques or equipment, or to obtain additional data, the medical and social examination institution sends the victim for additional examination to a medical, rehabilitation or other institution, requests the necessary information, carries out an examination of the victim’s working conditions, his social and living conditions and accepts other measures.

11. If the victim refuses additional examination, an expert decision on the degree of loss of professional ability to work is made on the basis of available data, about which a corresponding entry is made in the examination report of the victim.

12. Based on the received documents and information, personal examination of the victim, the degree of loss of his professional ability to work is determined, based on an assessment of the victim’s professional abilities, psychophysiological capabilities and professionally significant qualities that allow him to continue to perform professional activities preceding the industrial accident and occupational disease, the same content and in the same volume, or taking into account the reduction of qualifications, the reduction in the volume of work performed and the severity of labor in ordinary or specially created production conditions.

Specially created production conditions mean the organization of work in which the victim is given a shortened working day, individual production standards, additional breaks at work, appropriate sanitary and hygienic conditions are created, the workplace is equipped with special technical means, systematic medical supervision and other measures are carried out.

13. An expert decision on the degree of loss of professional ability to work is made in the presence of the victim by a simple majority vote of the specialists who conducted the examination.

14. If the victim has a complete loss of professional ability to work due to a pronounced impairment of body functions in the presence of absolute contraindications for performing any type of professional activity, even in specially created conditions, the degree of loss of professional ability to work is established at 100 percent.

15. If the victim, due to a pronounced impairment of body functions, can perform work only in specially created conditions, the degree of loss of professional ability to work is established from 70 to 90 percent.

16. If a victim as a result of an accident at work and an occupational disease can, under normal production conditions, continue his professional activities with a pronounced decrease in qualifications or with a decrease in the volume of work performed, or if he has lost the ability to continue professional activities due to a moderate impairment of body functions, but can in normal in production conditions to perform professional activities of lower qualifications, the degree of loss of professional ability to work is established from 40 to 60 percent.

17. If the victim can continue his professional activity with a moderate or slight reduction in qualifications, or with a decrease in the volume of work performed, or with changes in working conditions that entail a decrease in earnings, or if the performance of his professional activity requires more stress than before, the degree of loss is established professional work capacity from 10 to 30 percent.

18. The degree of loss of professional ability to work in case of repeated industrial accidents and occupational diseases is determined at the time of examination for each of them separately, regardless of whether they occurred during the period of work for one employer or different employers, taking into account the professional knowledge and skills of the victim and generally cannot exceed 100 percent.

19. When re-examining the victim after rehabilitation measures, specialists from the medical and social examination institution, when establishing the degree of loss of professional ability to work, take into account damage to health due to an industrial accident and occupational disease, the ability to perform work in the profession acquired as a result of training or retraining, the ability of the victim to perform professional activity preceding an industrial accident and occupational disease, taking into account his existing professional knowledge and skills.

In case of evasion (refusal) of the victim from carrying out recommended rehabilitation measures, the question of the degree of loss of professional ability to work is considered taking into account the ability to perform any work activity.

20. When establishing the degree of loss of professional ability of the victim, the need of the victim for medical, social and professional rehabilitation is determined.

21. The conclusion of a medical and social examination institution on the need for medical, social and professional rehabilitation is drawn up taking into account the potential capabilities and abilities of the victim to carry out professional, household and social activities and is formalized in the form of a rehabilitation program for the victim as a result of an industrial accident and occupational disease.

The rehabilitation program for the victim determines the specific types, forms, volumes of necessary rehabilitation measures and the timing of their implementation.

The rehabilitation program for the victim is drawn up within one month after the expert decision is made in a form approved by the Ministry of Labor and Social Development of the Russian Federation in agreement with the Ministry of Health of the Russian Federation and the Social Insurance Fund of the Russian Federation.

22. The data from the examination of the victim and the expert decision are entered into the minutes of the meeting and the certificate of examination of the victim, which are signed by the head of the medical and social examination institution, the specialists who conducted the examination, certified by the seal of this institution and, along with all medical documents, are stored for 10 years in the specified institution.

23. The results of the examination are announced to the victim in a form accessible to him by the head of the medical and social examination institution in the presence of specialists who made the expert decision. The specialists who made the expert decision provide explanations to the victim or his representative.

24. A certificate from the medical and social examination institution on the results of establishing the degree of loss of professional ability to work, and, if necessary, a rehabilitation program, is issued to the victim against signature.

25. An extract from the examination report indicating the results of establishing the degree of loss of professional ability and the rehabilitation program for the victim are sent to the employer (insurer) or insurer within 3 days after their execution, and are also issued to the victim if the examination was carried out at his request.

III. Re-examination of victims

26. Re-examination of the victim is carried out in the manner established to determine the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases.

27. The period for re-examination of the victim when determining the degree of loss of professional ability to work is established after six months, one year or two years based on an assessment of the victim’s health status and the forecast for the development of his compensatory and adaptive capabilities.

The degree of loss of professional ability of the victim is established indefinitely in the event of irreversible consequences of health damage due to an industrial accident and occupational disease with a persistent impairment of professional abilities and the ability to perform production activities.

28. If the victim misses the deadline for the next re-examination, the degree of loss of professional ability for the missed period is established if there is a referral from the employer (policyholder), insurer or a court (judge) order.

29. Re-examination of the victim earlier than the deadlines specified in paragraph 27 of these Rules is carried out in the event of: a change in the health status of the victim in the presence of a referral from a health care institution or a personal appeal of the victim or his representative to a medical and social examination institution and medical documents confirming this change; identifying facts of an unreasonably made decision (including based on forged documents) or an appeal by the victim, employer (insurer), or insurer of the decision of the institution of a medical and social examination in the prescribed manner.

30. The medical and social examination institution conducts an examination in order to dynamically monitor the implementation of rehabilitation measures to assess their effectiveness within the time frame established by the victim’s rehabilitation program.

IV. Appealing the decision of the medical and social examination institution

31. The victim, his representative, employer (insurer) or insurer, in case of disagreement with the decision of the medical and social examination institution, may appeal it by submitting a written statement to the institution that examined the victim, or to the main bureau of medical and social examination, or to the social authority protection of the population of a constituent entity of the Russian Federation.

The Bureau of Medical and Social Expertise, which examined the victim, sends this application with all documents to the main Bureau of Medical and Social Expertise within 3 days from the date of receipt of the application.

32. The Main Bureau of Medical and Social Expertise, within a month from the date of receipt of the application, conducts a re-examination of the victim and makes a decision based on the results obtained.

The decision of the main bureau of medical and social examination can be appealed within a month to the social protection body of the population of the constituent entity of the Russian Federation, which can entrust the re-examination of the victim to another group of specialists of the required profile of the specified institution.

33. The decision of the institution of medical and social examination may be appealed to the court in the manner established by the legislation of the Russian Federation.

DECREE OF THE GOVERNMENT OF THE RUSSIAN FEDERATION of October 16, 2000 N 789 ON APPROVAL OF RULES FOR ESTABLISHING THE DEGREE OF LOSS OF PROFESSIONAL CAPACITY AS A RESULT OF WORK ACCIDENTS AND OCCUPATIONAL DISEASES

In accordance with the Federal Law “On Compulsory Social Insurance against Industrial Accidents and Occupational Diseases” (Collected Legislation of the Russian Federation, 1998, No. 31, Art. 3803), the Government of the Russian Federation decides:

1. Approve the attached Rules for determining the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases.

2. The Ministry of Labor and Social Development of the Russian Federation, in agreement with the Ministry of Health of the Russian Federation and the Social Insurance Fund of the Russian Federation, approve:

criteria for determining the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases;

form of a rehabilitation program for a victim as a result of an accident at work and an occupational disease.

3. The Ministry of Labor and Social Development of the Russian Federation and the Ministry of Health of the Russian Federation provide the necessary clarifications on issues related to the application of the Rules approved by this resolution.

4. Recognize as invalid Resolution of the Government of the Russian Federation of April 23, 1994 N 392 “On approval of the Regulations on the procedure for establishing by medical and labor expert commissions the degree of loss of professional ability in percentage to workers who have received injury, occupational disease or other damage to health associated with the performance of their labor duties" (Collected Legislation of the Russian Federation, 1994, No. 2, Art. 101).

Chairman of the Government of the Russian Federation M. KASYANOV

Often a person finds himself in situations as a result of which he cannot fulfill the obligations assigned to him. The loss of an employee’s professional ability to work carries with it the consequences and amount of compensation payments. In our article we will consider the types of disability, the procedure for conducting an examination and other nuances relating to receiving payments.

Types of disability

The following types of disability are defined:

• General - performing simple functions that do not require qualifications.
• Professional - ability to work (the right of a subject to qualified activity in a certain profession).
• Special - a person’s qualification in a “narrow” specialty.
• Temporary - loss of ability to work occurs as a result of illness and injury that can be treated. It is divided into partial and complete.
• Persistent - a situation where the resulting injuries and injuries (or their consequences) cannot be completely cured.

Establishing the degree

Establishing the degree of loss of professional disability (LUC) as a percentage is carried out for persons who have suffered health damage as a result of an accident, a work-related injury or as a result of an occupational disease. For citizens who were injured while not performing their job duties, the level of UPT is established by MSEC institutions.

The degree of loss of professional performance is determined during a medical and social examination (MSE) based on the received documentation and information, personal examination of the citizen, based on the consequences of harm to health as a result of an industrial accident. Moreover, they take into account the professional abilities of the victim, his psychophysiological capabilities and work qualities, which allow him to further carry out work activities that precede an industrial injury and occupational disease, of the same content and in the same volume. Or taking into account a reduction in qualifications, a reduction in the volume of work performed and the severity of labor in ordinary, specially available production or other conditions. Expressed as a percentage and set between 10 and 100.

Criteria

The basic principle of establishing the degree of loss of professional ability of the victim is a combined analysis of medical and social criteria.

The first include a timely, complete clinical diagnosis, taking into account the severity of morphological changes, the nature and severity of the disease, the presence of decompensation and its stage, various complications, and the determination of long-term and short-term prognosis.

Social criteria include everything related to the professional activity of the victim: the characteristics of neuropsychic or physical stress, the organization, rhythm and frequency of work, the load on individual internal organs and systems, the presence of unfavorable working conditions.

Procedure

The examination of the victim at the ITU institution is carried out on the basis of the following regulatory framework:

It is carried out on the basis of an application from an employer, an insurance company, as determined by a judicial authority, or upon an independent application of the victim or his representative upon presentation of a report on an industrial accident, or a supporting document on an occupational disease.

The examination is carried out:

• at the ITU institution at the victim’s place of residence;
• at home, if the person, due to health reasons, is unable to come to the ITU institution or moves with the help of technical means (crutches, wheelchair, etc.);
• in the hospital where the citizen is being treated.

The victim is referred to a medical examination to determine the degree of UPT by the organization providing assistance after rehabilitation, diagnostic and therapeutic measures. In this case, a persistent violation of body functions in the event of an accident at work or occupational disease must be established.

In some situations, before signs of permanent loss of professional ability are identified, i.e. during the period of treatment, the citizen is sent for an examination to determine the need for certain types of rehabilitation.

Expertise

The percentage of loss of general ability to work is measured relative to the persistent consequences of the damage caused. To calculate this indicator, a forensic medical examination is carried out on the basis of regulatory documentation, namely the table of permanent loss of general ability to work as a percentage, which is an appendix to Order No. 194n. It establishes criteria for approving the extent and severity of harm that caused harm to human health. Based on it, a specialist who determines the percentage of loss of general ability to work identifies the damage caused to human health and the corresponding amount of loss.

Serious harm to health includes injuries, illnesses, as well as pathological conditions that entailed a significant permanent loss of general ability to work by at least 1/3 (insignificant - in the amount of 5%).

An examination to determine the percentage of loss of general ability to work is carried out only by court determination. During these activities, the specialist takes into account all the materials of the case. The duration of the ITU is 3 working days, when completing an additional examination - no more than 45 working days.

Compensation and benefits

Disability benefits are compensation to an employee for earnings that he lost due to illness or other reasons.

Subjects who, due to an injury or acquired occupational disease, are unable to perform work activities can count on compensation. They have the right to receive cash payments at their place of work for 30 days from the date of loss of ability to work.

The amount of the benefit depends on the time worked. Its maximum value is 100% of wages.

Disability and degree of disability

In each specific case, disability, or permanent loss of ability to work, may appear due to:

• general illness;
• occupational disease;
• work injury;
• disability since childhood.

If, within one year from the moment of the accident, an irreversible deterioration in the mental or physical condition of the insured (disability) occurs as a result, then he is paid compensation in the form of a certain amount, the amount of which depends on the degree of disability. Disability is determined by a doctor within 3 months after a year after the accident, which must be declared to the insurance company in the prescribed manner.

An experienced lawyer will help restore violated rights and achieve benefits provided by law. The specialist will contact the employer or the judicial authority directly. On our portal you can get reliable information about the amount and procedure for compensation. To do this, you should report your problem and get advice online or by phone.

The activities of the Social Insurance Fund are of absolute importance for any resident of our country. This organization will come to the rescue in case of illness, pregnancy, injury at work and in other situations.

The activities of the Social Insurance Fund are of absolute importance for any resident of our country. This organization will come to the rescue in case of illness, pregnancy, injury at work and in other situations. In short, a state non-budgetary institution was created for the purpose of mandatory social protection of citizens.

The organization has been operating since January 1, 1991. Its work is regulated by the federal law “On the Fundamentals of Compulsory Social Insurance”. We are talking with the director of branch No. 6 of the State institution - the Chelyabinsk regional branch of the Social Insurance Fund of the Russian Federation Natalya Tkacheva.

Natalya Yuryevna, some townspeople do not clearly understand what the Social Insurance Fund does. What are its functions?

The main functions of the organization are: payment of social benefits, provision of social insurance for certain categories of citizens, payment of birth certificates. The Fund's funds are generated from insurance contributions from employers and income from investing temporarily available Fund funds.

Insurance payments are made as follows: temporary disability benefits (sick leave); maternity benefits; a one-time benefit at the birth of a child and a monthly allowance for caring for him up to one and a half years. We also pay one-time insurance payments and monthly insurance payments for loss of professional disability in accordance with its degree.

Let's look at two areas of the Foundation's activities. So, in what cases does the law guarantee compensation for a work injury or occupational disease?

Everyone who works under employment contracts is insured in the system of compulsory social insurance against accidents at work and occupational diseases. That is, a person, when working somewhere, must remember that he is protected by an employment contract concluded with the employer. If there is no employment contract - say, a person works under a contract, provision of services or other civil law contract under which insurance contributions to the Social Insurance Fund are not paid, then, unfortunately, the employee is not insured. And if an accident occurs, such a victim will be left without compensation payments and other support measures, alone with his problems.

People should be aware of this and insist on concluding an employment contract in accordance with the law. After all, if an insured person has a serious work injury, by law the Fund assumes the obligation to pay all costs associated with treatment, and it can be very expensive - for example, if high-tech medical care is required. Today there are cases of payment for treatment in amounts of 200, 300, 400 thousand rubles.

When we say “work accident,” we immediately imagine an industrial enterprise, a factory. What if, say, an office worker was injured - he twisted his leg or fell down the stairs?

An important sign by which an injury is recognized as an industrial accident: if the damage to health occurred while the person was performing work duties in accordance with a contract or instructions from the employer. And the latter is obliged to take all measures to, first of all, provide medical assistance - deliver the employee to a medical facility, call an ambulance or help get to the clinic.

Keep in mind an important point: when the doctor asks what happened, to indicate in the medical documentation, it must be emphasized that the person was performing his job duties at the time of the injury. This will be one of the confirmations of an industrial accident. If there is a report on an accident at work, sick leave is paid in the amount of 100 percent of the average earnings of the injured employee, regardless of length of service. This is one of the additional guarantees.

If, despite treatment and rehabilitation, a person has a permanent loss of professional ability to work, what can he expect?

If the medical and social examination body (MSE) determines that a person has a permanent loss of professional ability to work (it depends on the severity of the injury), then the victim needs to contact the employer with such a conclusion or directly to the branch of the regional branch of the Social Insurance Fund at the place of residence (if the enterprise is liquidated) . At the place of work, a set of documents required by law is drawn up, and the employer sends them to the Social Insurance Fund so that the person is assigned compensation payments. In addition, ITU is drawing up a Rehabilitation Program for the victim. In accordance with this program, a person can receive free medicines, vouchers to a sanatorium, prosthetic products and other technical means of rehabilitation.

Natalya Yuryevna, let’s now talk about another area of ​​the Foundation’s activities. What are “birth certificates”?

For nine years, the Social Insurance Fund has been carrying out the function of paying for medical services provided under contracts by medical institutions to women during pregnancy and childbirth, as well as for dispensary observation of a child during the first year of life within the framework of the national project “Health”. In Kopeisk, such agreements have been concluded with city hospital No. 1 (which includes a maternity hospital) and the city children's clinic. A birth certificate is issued to a woman at 30 weeks of pregnancy, when she goes on maternity leave.

- Have payments for maternity benefits and child care increased?

Yes, since the new year the state has indexed these social payments. Firstly, according to the law, women who work at domestic enterprises, as well as full-time undergraduate and graduate students at Russian universities, have the right to receive a one-time maternity benefit. In addition, women who register in the early stages of pregnancy receive a one-time benefit in the amount of 625.22 rubles.

Maternity benefits (on sick leave) are paid in the amount of 100 percent of the average earnings of the expectant mother. The period for which benefits are paid is in most cases 140 days: 70 calendar days before childbirth and 70 days after. The maximum average daily earnings for maternity benefit payments in 2014 was 1,479.45 rubles; in 2015 it will be 1,632.88 rubles. Accordingly, the total amount of benefits for 140 days could be a maximum of 207,123 rubles in 2014; in 2015 it would be 228,603.2 rubles. The maternity benefit for female students is equal to 100 percent of the scholarship and is paid at the place of study.

A working mother's monthly childcare benefit until she reaches the age of one and a half years is 40 percent of her average earnings. What is the minimum guaranteed amount of such a benefit?

The law establishes the minimum monthly care allowance, in 2015 they are as follows: for the first child - 3,126.09 rubles, for the second - 6,252.17 rubles. Young mothers-students are paid such benefits by the social protection authority at their place of residence. Also, according to the law, any working family member, including father and grandmother, can take parental leave to care for a baby, if, of course, she continued to work before the birth of her grandson or granddaughter.

- In what cases is care allowance issued directly through the Social Insurance Fund?

The law provides that in some cases monthly payments can be received through the Social Insurance Fund. Until now, the Fund assumed this responsibility only if the mother worked at a bankrupt enterprise (that is, there was a lack of funds in the employer’s bank accounts from which money could be written off to pay benefits), or if the enterprise was liquidated. From this year, the Social Insurance Fund is obliged to help mothers even in cases where the location of the employer is unknown. Thus, women who found themselves working in shell companies now received additional protection.

In these cases, it is better to submit an application to the Social Insurance Fund for child care benefits immediately after the birth of the baby, the deadline is no later than six months after the child reaches one and a half years. Otherwise, payment may be refused. True, the law provides for exceptions to the general rule: if the applicant can prove that he violated the terms of application for a good reason. According to the order of the Ministry of Labor, this could be a force majeure, a natural disaster (earthquake, hurricane or flood), a long-term illness of the applicant, or a family moving to another city.

An accident at work or an acquired disease can have negative consequences for a person’s well-being. In particular, the result may be loss of ability to work and subsequent inability to perform work duties partially or in full. The type and degree of damage received are determined in accordance with established standards during a specialized examination.

The essence of the concept of “work ability”

The ability of a citizen to work professionally implies the ability of a person to perform the duties established by the instructions for a specific position held by him. The quality and timeliness of the work done plays a special role.

In situations where there is a dysfunction of the body resulting from an accident or illness acquired in the process of activity, they speak of loss of ability to work. This means that the citizen is no longer able to carry out the actions and responsibilities assigned to him.

Types of Disability

Disability is classified according to various parameters. The main criteria are:

• the degree of likelihood of recovery of health indicators and return to work in the future;
• level of maintaining the ability to work;
• professional sphere.

According to the specified parameters, the loss of the opportunity to use one’s professional skills and, in general, carry out any useful actions can be of several types.

Types of disability may be as follows:

1. Temporary loss of ability to work. In this case, it is implied that the ability to use labor skills is lost until the moment when health is restored. This type is recorded without establishing disability.
2. Permanent or permanent disability. In other words, a person can no longer work because there is no chance of a complete cure, for example, with amputation of limbs. In this case, any . However, it can also be removed if there is an improvement in physical performance.
3. Partial degree of preservation of the ability to engage in professional activities. This refers to restrictions imposed on a person that do not allow them to perform work to the fullest or allow easier working conditions.
4. Complete loss of ability to work. When such status is fixed, a person can no longer and should not work, since from now on he must live according to a regime corresponding to his state of health.
5. Restriction on work in a certain professional field. In other words, a citizen is prohibited from engaging in activities in any area due to inconsistency in health indicators, for example, a ban is imposed on working in a hot shop.
6. General loss of ability to work precludes employment in any type of work, both due to the unsatisfactory condition of the citizen and due to the risk of illness of other people. For example, if we are talking about a viral infection.

As already mentioned, loss of ability to work can be recorded as a result of illness or injury at work, illness, the need to care for a bedridden patient, and for other reasons.

How is the degree of disability determined?

The degree of loss of ability to work is determined by specialized commissions, most often, the State Service of the Medical Examination (Medical and Social Examination) or employees of the medical and forensic department.

The last case is due to the fact that going to court makes it possible to more accurately identify the type of restriction in the use of a citizen’s professional skills. This is especially true if the disability is permanent, that is, the person can no longer work and provide for himself.

Forensic medical examination is required in case of industrial injury, serious accident at the place of work, when it is necessary to assess the damage caused to human health. On the basis of which the amount of compensation for damage will be calculated in the future and the amount of additional payments will be determined.

The commission includes:

• therapist;
• ophthalmologist;
• surgeon;
• neurologist;
• traumatologist and others.

If we are talking about (medical labor commission), the group of specialists includes social security workers. Members of the commission carefully and comprehensively study how much the body’s functions are impaired, assess the real capabilities of a person to perform this or that work.

The final identification of the degree of loss occurs by calculating the damage caused to health as a percentage of the conditional criterion of the general ability to work. In order to obtain the most accurate result, tables with fixed values ​​are used.

Percentages

According to the Resolution of the Ministry of Labor, No. 56, it is customary to use the following indicators to determine the degree of disability:

• in case of complete loss of the ability to work in any professional field, even in the presence of specially created conditions, 100% loss of ability to work is established;
• opportunity to work in specialized conditions – 70-90%;
• the ability to engage in professional activities under normal conditions, but either with a decrease in qualifications or with a decrease in the volume of work - 40-60%.

There is another, milder indicator of the degree of disability, ranging from 10 to 30 percent. In this case, a person can engage in the following activities:

• work in unchanged production conditions with a slight reduction in qualifications;
• activities subject to a light amount of work;
• performing duties when working conditions change, but at the same time with a decrease in salary.

In any case, each situation submitted for consideration by the commission is studied individually. Therefore, the indicated values ​​should be taken conditionally, for reference. The final and exact decision one way or another remains with the experts.

Loss of ability to work due to injury or occupational disease necessarily requires an appropriate examination in order to identify the degree of loss of the ability to work. Depending on the obtained indicator, the type of disability is determined and monetary payments are assigned.

In addition to state benefits, if a disability category has been assigned, a citizen can count on compensation for harm in court. The last case concerns situations where an injury was sustained at work, and its consequences actually caused serious damage to a person’s health.

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How to correctly calculate lost earnings?

This section discusses the issue of calculating lost earnings subject to recovery in connection with injury to health and the occurrence of disability.

According to paragraph 1 of Article 1085 of the Civil Code of the Russian Federation, if a citizen is injured or otherwise damaged his health, the victim’s lost earnings (income) that he had or could definitely have are subject to compensation.

Determination of earnings (income) lost as a result of damage to health is carried out in the manner prescribed by Art. 1086 of the Civil Code of the Russian Federation.

1. The amount of earnings (income) lost by the victim to be compensated is determined as a percentage of his average monthly earnings (income) before injury or other damage to health or until he lost his ability to work, corresponding to the degree of loss of professional ability by the victim, and in the absence of professional ability - the degree of loss of general ability to work.

2. The composition of the lost earnings (income) of the victim includes all types of payment for his work under employment and civil contracts, both at the place of his main job and part-time work, subject to income tax. One-time payments are not taken into account, in particular compensation for unused vacation and severance pay upon dismissal. During the period of temporary disability or maternity leave, the benefits paid are taken into account. Income from business activities, as well as royalties, are included in lost earnings, while income from business activities is included based on data from the tax office.All types of earnings (income) are taken into account in amounts accrued before taxes are withheld.

3. The average monthly earnings (income) of the victim is calculated by dividing the total amount of his earnings (income) for the twelve months of work preceding the injury by twelve. In the case where the victim had been working for less than twelve months at the time of the injury, the average monthly earnings (income) is calculated by dividing the total amount of earnings (income) for the number of months actually worked prior to the injury by the number of these months.

4. Months not fully worked by the victim are, at his request, replaced by previous fully worked months or excluded from the calculation if it is impossible to replace them.

5. In the case where the victim was not working at the time of the harm, at his request, his earnings before dismissal or the usual amount of remuneration for an employee of his qualifications in the given area are taken into account, but not less than the minimum subsistence level established in accordance with the law for the working-age population as a whole in the Russian Federation .

6. If in the earnings (income) of the victim, before the injury or other damage to health was caused, lasting changes occurred that improved his financial situation (the salary for his position was increased, he was transferred to a higher-paying job, he entered work after receiving full-time education and in other cases when the stability of the change or the possibility of changing the victim’s wages has been proven), when determining his average monthly earnings (income), only the earnings (income) that he received or should have received after the corresponding change are taken into account.

Let me give you an example of calculating lost earnings:

Let’s assume that the injury was caused on October 29, 2012.

In the period from 10/30/2012 to 12/31/2012, from 01/01/2013 to 08/19/2013, the victim was on sick leave, and accordingly was completely unable to work (100% loss of ability to work).

At the time of the injury, the average salary of the victim was 15,326.44 rubles (calculated in accordance with clause 3 of Article 1086 of the Civil Code of the Russian Federation).

The amount of lost earnings during the period of total disability in 2012.

October – 15,326.44/23 working days×2 (number of days of incapacity for work (unpaid working days) = 1332 rubles 74 kopecks.

November – 15,326 rubles 44 kopecks.

December – 15,326 rubles 44 kopecks.

The plaintiff’s total lost earnings during the period of total disability in 2012 amounted to: 31,985 rubles 62 kopecks.

The amount of lost earnings of the plaintiff during the period of total disability in 2013.

From 01/01/2013 to 07/31/2013 – 107,285 rubles 08 kopecks.

August – 15,326.44/22 working days×13 (number of unpaid working days) – 90 56 rubles 58 kopecks.

The plaintiff’s total lost earnings during the period of total disability in 2013 amounted to: 116,341 rubles 66 kopecks.

The total amount of lost earnings during the period of total incapacity for work amounted to 148,327 rubles 28 kopecks.

Calculation of lost earnings due to permanent disability (if any).

For example, in accordance with the expert’s opinion, the victim was found to have a permanent loss of 25 percent of his overall ability to work due to the injury he received.

Taking into account a certain permanent loss of ability to work in the amount of 25%, the lost earnings of the victim amount to 3,831 rubles 61 kopecks monthly (15,326.44 earnings/100% × 25 percentage of permanent loss of ability to work).

According to Art. 1091 of the Civil Code of the Russian Federation, the amount of compensation paid to citizens for harm caused to the life or health of the victim is subject to change in proportion to the increase in the minimum subsistence level per capita established in accordance with the law in the corresponding subject of the Russian Federation at the place of residence of the victim.

Thus, the amount of lost earnings should be indexed in proportion to the increase in the cost of living.

The amount of lost earnings due to permanent loss of general ability to work:

2012– loss of ability to work 100% (from 10/30/2012 to 12/31/2012).

2013– loss of ability to work 100% (from 01/01/2013 to 08/19/2013).

August 2013 (from 08/20/2013 to 08/31/2013) 9 working days. Amount of lost earnings 4,354.61/22 working days×9= 1781.43 rubles.

September-December 2013 = (4,354.61×4) = 17,418 rubles 44 kopecks.

Total amount of lost earnings for 2013 = 19,199.87 rubles.

2014

January-March 2014 = 4,663.78×3 = 13,991.34 rubles.

April-June 2014 = 4,937.08×3 = 14,811.24 rubles.

July-September 2014 = 4,937.08×3 = 14,811.24 rubles.

October-December 2014 = 5,113.33×3 = 15,339.99 rubles.

Total amount of lost earnings for 2014 = 58,953.81 rubles.

Thus, the calculation of lost earnings is made in connection with a permanent loss of general ability to work (if it is established).

It should be taken into account that, according to the provisions of Article 1092 of the Civil Code of the Russian Federation, the court, taking into account the capabilities of the tortfeasor, has the right to recover payments for the future in a lump sum, but not more than for three years. Such a collection procedure is permissible at the request of the victim if there are good reasons (for example, when the debtor is expected to leave the Russian Federation for permanent residence, when the execution of a court decision becomes impossible or difficult, as well as in the difficult financial situation of the victim, who has dependent children and is in need in receiving a lump sum to cover necessary expenses (clause 39 of the Resolution of the Plenum of the Supreme Court of the Russian Federation of January 26, 2010 No. 1 “On the application by courts of civil legislation regulating relations under obligations resulting from harm to the life or health of a citizen”).

Interim conclusion:

This article discusses issues related to the calculation of lost earnings subject to recovery in connection with injury to health and the occurrence of disability (calculation of lost earnings in connection with total disability, permanent disability), as well as the procedure for indexing lost earnings in proportion to the increase in the cost of living.