Is an employer required to pay compensation to an employee injured at work? Five mandatory steps to receive compensation What is a work injury.

An industrial injury is a consequence of an accident that occurred at work with an employee.

This is always unpleasant for both parties to the employment relationship. In Art. 5 of Federal Law No. 125-FZ of July 24, 1998 “On compulsory social insurance against industrial accidents and occupational diseases” states that every employee who works under an employment contract is subject to compulsory accident insurance.

This means that in the event of a work-related injury, the employer is obliged to pay compensation to the employee if the latter was injured in the course of performing his work functions.

Recognition of an industrial injury

In order for the injury to be recognized as a work-related injury, and for the employee who received it to be able to count on all the payments and benefits due, several important steps must be taken. This must be done on the day of injury:

• call a doctor, go to a medical center or call an ambulance to provide first aid to the victim;
• The application must be completed in accordance with all the rules. This needs to be monitored. If the victim himself is unable to do so, someone else must do it;
• call the head of the structural unit to the place where the accident occurred. If there is such a possibility, then you need to call the head of the enterprise himself;
• the victim must have witnesses who will confirm the fact that he received the injury exactly at this place and during working hours.

Regardless of how severe the injury is, you first need to fix it, and only then go to the hospital. This is a big disadvantage in recognizing a work injury. If there is no fact of proper recording of the injury received by medical personnel, or there are no witnesses to its receipt, it will be quite difficult to recognize it as industrial. But if there is at least some evidence or one witness, it is necessary to contact the employer with a written statement recognizing the fact of injury at work. The employer is obliged to order an appropriate investigation in accordance with Art. 229 - 231 Labor Code of the Russian Federation. If he does not do this, then the victim has the right to file a complaint with the labor inspectorate or file a claim in court to recognize this fact and assign appropriate payments to him.

Payments for an industrial injury are equal to the amount of paid sick leave, if the employee needed one, and compensation for his medical expenses. This is indicated in Article 184 of the Labor Code of the Russian Federation.

First, the employer pays compensation to his injured employee, and then he reports to the Social Insurance Fund, providing sick leave and other documents. In addition to sick leave, rehabilitation of the injured employee is also carried out at the expense of the Social Insurance Fund. The need for rehabilitation, as well as the severity of the harm caused, is assessed by a medical and social examination, which must be passed if serious harm has been caused to one’s health, and we are talking about assigning the victim one or another degree of disability. In order to make such payments, it must be established that the injury received is a work-related injury.

Such an injury is recognized not only as an injury received at the workplace, but also as an injury received while the employee was traveling to work or home from work using the employer’s transport.

If the employee used his own car, then the employment contract must stipulate that the employee has the right to use a personal car to perform his work functions or official purposes. The severity of the injury is determined by the medical institution where the victim went for help. The duration of the investigation, which is conducted by a specially created commission, also depends on this.

If the injury at work is minor, then the commission can complete the investigation in 3 days, but if the injury is severe or fatal, then the investigation period increases to 15 days. Not only the duration of the investigation, but also the amount of compensation payments depends on the severity of the injury to health. That is, a medical and social examination establishes the severity of harm as a percentage.
Exactly in these percentages, the employer must reimburse the employee for medications and medical care. Sick leave, in any case, is paid in the amount of 100% of earnings.

Actions of the employer and employee in the event of a work injury

In order for an injury to be recognized as a work-related injury, the correct procedure is required, both on the part of the employee and the employer:

• it is necessary to call a doctor or any other medical professional who will record the injury itself. Without this fact, no payments will be made. Therefore, even if the victim’s condition is critical, you first need to record the fact of the injury, and only then go to the hospital;
• the employer must be present at the fact of recording. If the employer himself cannot (especially in large enterprises where there are production and other departments), his deputy or the head of the structural unit in which the victim works must be present;
• it is necessary to draw up an act that will be signed by the employer and witnesses to the incident;
• An investigation into what happened is immediately organized. If damage to health is caused, the investigation is carried out at his expense;
• the investigation commission must consist of at least 3 people. The number of commission members must be odd. It may include:
  • labor protection worker, or the person who is responsible for labor protection at the enterprise;
  • an employee who is a representative of the employer or the employer himself, if possible;
  • a representative of a trade union or other body that is a representative of workers.

The employer's responsibilities in the event of a work injury are as follows:

• he must provide the victim with all necessary assistance. If hospitalization is required, the employer must ensure that an ambulance takes the employee to the hospital. If the team was not called, but decided to go to the hospital on their own, then the employer must provide transport;
• conduct a thorough investigation of what happened;
• make all necessary payments to the injured employee;
• must comply with the guidelines for drawing up an accident report. If the injury is minor, then the report is drawn up within 3 days. The degree of “lightness” or “severity” is determined based on the medical opinion;
• even if the injury occurred through the fault of the employee, compensation is paid, but in a smaller amount.

Types of payments

There are several types of payments that are assigned to a victim who has received an industrial injury:

• sick leave payments. These payments are made from the funds that the employer contributes to insurance against accidents and occupational diseases. Regardless of length of service, sick leave is paid in the amount of 100% of the average earnings of this employee. This value is calculated based on the employee’s earnings for the last year. The basis for calculating payments is a certificate of incapacity for work, duly issued in the medical institution where the victim received treatment.
• lump sum payment. Its size depends on the degree of disability of the victim. It is paid in the amounts established by the Social Insurance Fund. In 2016, the maximum amount of such payment is 80534.8 rubles;
• monthly payment. It is paid to the employee until he fully recovers. The amount of the payment is equal to the average earnings of the injured employee over the last year. It is indexed every year. Its maximum value in 2016 was 61,920 rubles per month. This limit is established by clause 12 of Art. 12 of Law No. 125 - Federal Law;
• additional expenses. Such payments include compensation by the employer for expenses for:
  • provision of qualified paid medical care to the victim;
  • purchase of medicines;
  • purchase of special equipment necessary for careful care of the victim;
  • payment for the services of the necessary equipment or transport for its transportation.
These payments are made at the discretion of the employer and are not reimbursed from the Social Insurance Fund. An exception is payment for additional leave necessary for the rehabilitation of the victim.
• compensation for moral damage. If there were not only material costs, but also moral suffering, the victim can file a claim in court for compensation for moral damage.

If the commission determines that the employee has suffered minor health damage, then all compensation payments will be made not at the expense of the Social Insurance Fund, but at the expense of the employer.

The employee also has the right to compensation for moral damages. Its value can be determined by agreement of both parties. If the employee is not satisfied with the amount of damages to be compensated, he can file a claim in court at the location of the defendant.

In addition to mandatory payments in case of injury at work, the employer has the right to pay additional compensation. It can be issued at a time by order of the employer, or it can be specified in an employment or collective agreement.

Compensation for lost earnings

In Art. 184 of the Labor Code of the Russian Federation states that if an employee is injured at work, the employer is obliged to compensate him for the earnings not received for these days. But there are several features when recovering lost earnings in favor of an employee.
It is worth understanding that “lost earnings due to forced absence” and “lost earnings due to a work injury” are different concepts. These are different types of compensation for harm in favor of an employee, to which different calculation methods are applied.

Law No. 125-FZ states that an injured employee has the right to compensation for harm caused to his life and health. While he is on sick leave, he does not receive wages. Even after returning from sick leave, the injured employee cannot always work at full capacity. Sometimes it takes time for long-term rehabilitation.
Consequently, the earnings that he does not receive all this time are subject to compensation. First of all, you need to determine from what point it is necessary to compensate for lost earnings.

The victim receives sick leave benefits in the amount of 100% of his average earnings for the last year. But in Art. 1085 of the Civil Code of the Russian Federation states that he has the right to receive the entire amount of earnings lost during this period. It is recovered from the employer as from the tortfeasor. The amount of compensation is 100% of earnings for these days.

How to receive payments

To receive all due payments, the employee must bring sick leave and other documents that confirm his medical expenses. To receive disability benefits, you do not need to write additional applications. And to receive compensation for medications and other expenses, you must write an application addressed to the employer with a request to pay him the specified amounts. All necessary documents and receipts are attached to the application.

Part of the payments is made at the expense of the employer, and part - at the expense of the Social Insurance Fund. For example, compensation for medications is at the expense of the employer, and compensation for additional leave is at the expense of the fund.
Within 10 days after writing the application, it is reviewed by a representative of the FSS. He also decides on payment of compensation. The decision is made after the specified period. The one-time benefit is transferred to the applicant’s account immediately after a positive decision is made by a fund employee.

If the employer refuses to make payments or does not do so in full, it is necessary to contact the labor inspectorate with a complaint about the employer’s illegal actions. The complaint will be investigated.
Filing a complaint to the labor inspectorate does not deprive the injured citizen of the right to self-defense of his labor rights. That is, he can go to court with a claim for reimbursement of expenses incurred for treatment.

There is no insurance against accidents, but if this incident occurred at work, it is possible to receive compensation for a work injury.

Related materials:

The popular term " work injury“is a legacy of Soviet times and is now nothing more than a colloquial expression. The legally correct term is “ industrial accident».

Injuries and occupational diseases

If you think you have had an accident at work, you must first qualify it. Not every bump received at work can be regarded as a corresponding injury. A splinter in the finger is not a reason to register an accident. What kind of injury is this if you do not need to take sick leave or sick leave for at least a day (Article 230 of the Labor Code of the Russian Federation)? To confirm a work injury, a doctor's report is required.

An industrial accident is considered to be events that occurred during the working day at the place where work assigned by the employer was performed, including during breaks and during overtime work. Work injuries include injuries received “while traveling to or from work in a vehicle provided by the employer, or on a personal vehicle in the case of using a personal vehicle for official purposes at the order of the employer,” as well as during business trips and business trips. (Article 227 of the Labor Code of the Russian Federation).

Order No. 160 of the Ministry of Health and Social Development of the Russian Federation clarifies which workplace injuries are considered minor and which are considered severe.

Accounting and investigation

In accordance with Art. 227 of the Labor Code of the Russian Federation, industrial accidents are subject to recording and investigation. Industrial accident investigation applies to all persons participating in the employer’s production activities, and not just to employees performing their functions under a contract of employment. It also applies to trainees, prisoners, and persons involved in performing socially useful work and eliminating the consequences of accidents.

Cases that resulted in the following are subject to investigation:

• bodily injuries, including those caused by another person;
• heatstroke;
• burn;
• frostbite;
• drowning;
• electric shock, lightning, radiation;
• bites and other bodily injuries caused by animals and insects;
• damage due to accidents.

Responsibilities of the employer in case of an accident Art. 228 Labor Code of the Russian Federation:

• immediately provide first aid and transport to a medical facility, if necessary;
• prevent the possible development of an accident;
• leave the scene of the accident “as it was” at the time of the accident until an investigation begins (if this does not endanger other employees);
• if it is impossible to preserve the situation, draw up diagrams, take photographs or videotape);
• immediately inform the state labor inspectorate in Moscow, the prosecutor's office at the scene of the accident, the compulsory social insurance insurer, the organization that referred the victim, the relevant trade union body, as well as the victim's relatives about the accident.

In case of acute poisoning, the employer must inform the territorial department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Moscow.

The employer is also required to keep a log to register accidents (Article 230.1 of the Labor Code of the Russian Federation). When accounting for an accident, it is important to remember that the fact that timely medical care was provided does not affect the assessment of the severity of the injury.

The investigation of injuries at work is legally assigned to state labor inspectors.

The procedure for preparing materials for the investigation is specified in Art. 230 Labor Code of the Russian Federation. It is required to draw up an industrial accident report in two copies in form N-1 (in case of a group accident, separate ones are drawn up for each victim). Upon completion of the investigation, they are signed by the inspectors who conducted the investigation, certified by the signature of the head and the seal of the organization.

The forms of materials are approved by order of the Ministry of Social Development of the Russian Federation No. 275 "".

The employer is obliged to ensure safe working conditions (). If during the investigation it is proven that the employer is guilty of non-compliance with occupational safety regulations, he will face a fine. An individual entrepreneur will get off with an administrative fine of one to five thousand rubles. The amount of the fine for a legal entity will be between thirty and fifty thousand rubles. Punishment for a legal entity can be not only a fine, but also administrative suspension of activities (Article 5.27 of the Administrative Code).

Benefit

All employees are subject to compulsory social insurance and this is the responsibility of the employer (Article 6 of the Federal Law “On the Basics of Compulsory Social Insurance”).

If the victim works part-time in several organizations, he has the right to demand compensation from all places of work. This is explained in the letter of the Ministry of Health and Social Development of the Russian Federation N3311-LG “”. For requirement temporary disability benefits You must provide a copy of the accident report.

Paid to the victim for the entire period of illness.

To calculate benefits for temporary disability, it is necessary to calculate the insurance length of work of the victim. The length of service includes the period of work under an employment contract and “periods of other activities during which the citizen was subject to compulsory social insurance” (Article 16 of the Federal Law “On the provision of benefits for temporary disability, pregnancy and childbirth to citizens subject to compulsory social insurance”). Experience is calculated in calendar order.

The amount of the benefit is calculated in accordance with the length of service of the victim (Article 7 of the Federal Law “On the provision of benefits ...”). A benefit of 100% of average earnings (calculated for 12 months) is due to an employee with more than 8 years of experience, 80% to an employee with 5-8 years of experience, and 60% to an employee who has not worked for five years. If disability occurred within 30 calendar days after termination of work, the benefit amount will be 60% of average earnings.

Compensation benefits are not taxed (Article 217 of the Tax Code of the Russian Federation).

It often happens that the employer and his employee do not want to “dig” through the paperwork and agree on benefits without drawing up acts and other documents. In this case, the employee injured in the accident is deprived of legislative support in the event of complications or subsequent refusal of compensation by the employer.

Labor legislation obliges the employer to provide safe working conditions. Article 212 of the Labor Code provides for certification of workplaces, which is carried out in order to assess working conditions at workplaces and identify harmful and hazardous production factors. The results of certification make it possible to develop and implement measures to bring working conditions into compliance with state regulatory requirements for labor protection. The procedure for certification of workplaces is set out in the Order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2011 No. 342n “On approval of the Procedure for certification of workplaces based on working conditions.”

But, unfortunately, workplaces do not always comply with legal requirements. In addition, an employee may be injured as a result of subjective reasons. For example, fatigue, dizziness, inattention, unstable emotional background - all these reasons can be a source of industrial injury.

Naturally, first of all, the injured employee makes a claim to the employer to pay him compensation, since the injury was received during the performance of work duties.

Let's figure out what payments are due to employees in such cases and who is obliged to make them, in which cases the employer is obliged to make compensation payments to employees injured at work. The employer must also know whether these payments are subject to taxes and insurance premiums.

What regulations should an employer follow if an accident occurs at the enterprise?

The main document regulating the actions of the employer in the event of an accident at work is the Labor Code of the Russian Federation.
The procedure is defined in Article 228 of the Labor Code of the Russian Federation.

Firstly, the employer is obliged to organize the provision of first aid to the victim and his delivery to a medical facility.

Secondly, report the incident to the appropriate authorities.

Thirdly, take the necessary measures to organize and ensure a proper and timely investigation of the accident and registration of investigation materials.

These are the main duties that an employer must perform when an accident occurs.

The next group of documents defines the procedure for assigning and paying compensation to injured workers. Such documents include Federal Law No. 125-FZ of July 24, 1998 “On compulsory social insurance against accidents at work and occupational diseases” (hereinafter referred to as Law 125-FZ).

In some industries, industry agreements provide for the payment of one-time compensation in connection with loss of productivity.
For example, an industry agreement on the mechanical engineering complex of the Russian Federation for 2011–2013 (approved by the Association of Mechanical Engineering Trade Unions of Russia, the Trade Union of Automotive and Agricultural Engineering Workers of the Russian Federation, the Trade Union of Mechanical Engineers of the Russian Federation, the Public Association "All-Russian Electric Trade Union", the All-Russian Industrial Association of Employers "Union of Russian Mechanical Engineers" 01.03 .2011) compensation for loss of ability to work has been established. Its size depends on the degree of disability and is established by local regulations.
Consequently, if the employing organization belongs to those industries in which industrial agreements have been adopted, it is obliged to pay the employee the compensation due to him. Payments are made in addition to those enshrined in Law 125-FZ.

What event is considered an industrial accident?

Insurance payments in accordance with Law 125-FZ are provided only to those employees who were injured as a result of an accident. Therefore, you need to have a clear understanding of what an industrial accident is.

An event is recognized as an industrial accident if it entailed the need to transfer the employee to another job, led to temporary or permanent disability or death of the employee (paragraph 10, article 3 of Law 125-FZ).

The need to transfer an employee to another job must be confirmed by a medical certificate issued in accordance with the law.
Such a conclusion is a Certificate of the final diagnosis of a victim of an industrial accident (Appendix No. 2 to Order of the Ministry of Health and Social Development of Russia dated April 15, 2005 No. 275).

In this case, the duration of the sick leave must be at least one day (Part 1 of Article 230 of the Labor Code of the Russian Federation).
For example, an employee got into an accident during a work trip and only suffered abrasions. He did not go to a medical facility and went to work the next day.

This case cannot be classified as an industrial accident, since it did not cause serious damage. The injured employee has no right to claim social benefits.

Industrial accidents also do not include those cases when an employee was injured due to alcohol intoxication or committing criminal acts (Part 6 of Article 229.2 of the Labor Code of the Russian Federation). Such situations are classified as accidents not related to production. It is clear that in such situations, workers lose the right to receive social benefits.

Therefore, the employer’s task is to document the incident in a timely and correct manner, since the presence of industrial accidents inevitably leads to an increase in the rates of insurance premiums for compulsory insurance against industrial accidents and occupational diseases (Article 22 of Law 125-FZ).

Which employees are entitled to receive compensation if they are injured while performing their work duties?

Compensation payments are assigned only to an employee who has lost his professional ability to work. A medical and social examination has the right to make a conclusion about loss of ability to work (Clause 1, Article 10 of the Law).

If the examination recognizes the employee as not having lost his professional ability to work, he has no right to apply for compensation.

What types of benefits are provided in case of injury at work?

Workers who have lost their ability to work as a result of an injury at work have the right to receive two types of compensation payments - one-time and monthly.

One-time payments are determined in accordance with the degree of loss of professional ability of the insured based on the maximum amount established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year. For 2013, the amount set is 76,699.8 rubles.

Let me remind you that the degree of disability is determined by a medical and social examination in its conclusion. The procedure for conducting the examination is determined by Decree of the Government of the Russian Federation of October 16, 2000 No. 789 “On approval of the Rules for determining the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases.”

Monthly insurance payments are paid to the insured employee throughout the entire period of his permanent loss of professional ability to work from the day from which the institution of medical and social examination established the fact of its loss, excluding the period for which temporary disability benefits were assigned.

By virtue of paragraph 1 of Art. 12 of Law No. 125-FZ, the amount of the monthly insurance payment is determined as the share of the employee’s average monthly earnings, calculated in accordance with the degree of disability.
Thus, if the employee never recovers and is unable to return to full-time work, he will receive insurance benefits for the rest of his life.
The maximum amount of insurance payment is established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year (Clause 12, Article 12 of Law No. 125-FZ).
For 2013, the specified limit is RUB 58,970.00. (Clause 2, Part 1, Article 6 of the Federal Law of December 3, 2012 No. 219-FZ).

In addition, monthly insurance payments are subject to indexation in the manner and amount established by the Government of the Russian Federation (paragraph 2, paragraph 11, article 12 of Law No. 125-FZ).

Which body pays one-time and monthly compensation for loss of ability to work?

If an employee has a medical and social examination report on loss of ability to work, then in this case he has the right to receive a one-time compensation. But the obligation to pay it lies not with the employer, but with the territorial body of the Social Insurance Fund at the place of registration of the employer, since it is the insurer. According to paragraph 7 of Art. 15 of the Law, it is the insurer, and not the employer, who is obliged to pay insurance payments.

The employer, being the insurer, is only obliged to pay the employee temporary disability benefits on the basis of the sick leave provided (clause 1, clause 1, article 8, clause 7, article 15 of Law No. 125-FZ).

Amount of temporary disability benefit due to an industrial accident

Temporary disability benefits due to an industrial accident and occupational disease are paid in the amount of 100% of the employee’s average earnings and do not depend on the employee’s insurance length (Article 9 of Law No. 125-FZ, Clause 2 of Article 1, Article 14 of Law No. 255-FZ).

At the same time, Federal Law No. 36-FZ dated 04/05/2013 establishes the maximum amount of insurance payment, which cannot exceed four times the maximum monthly insurance payment.

The maximum amount of insurance payment is established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year (Clause 12, Article 12 of Law No. 125-FZ).

In 2013, this limit is RUB 58,970.00. (Clause 2, Part 1, Article 6 of the Federal Law of December 3, 2012 No. 219-FZ). Consequently, the maximum amount of disability benefits due to an occupational injury or illness per full calendar month will be RUB 235,880.00. (Article 1 of Law No. 36-FZ, paragraph 12 of Article 12 of Law No. 125-FZ, paragraph 2 of Part 1 of Article 6 of Law No. 219-FZ).

What documents must be submitted to receive a lump sum payment?

If the conclusion of a medical and social examination indicates that the employee has lost his ability to work as a result of an accident, then he has the right to apply to the Social Insurance Fund to receive a one-time benefit. The benefit is assigned based on the application of the insured person. Since the insured person is the employee, the application must be submitted on his behalf.

Moreover, the application must be submitted to the territorial body of the Social Insurance Fund at the place of registration of the policyholder, that is, the employer.

The application is accompanied by documents in accordance with the list established by the FSS for each specific case (Clause 4 of Article 15 of the Law).

Such documents include:

• act on an industrial accident or act on an occupational disease;
• a certificate of the average monthly earnings of the insured for the period chosen by him to calculate monthly insurance payments in accordance with this Law;
• conclusion of a medical and social examination institution on the degree of loss of professional ability of the insured;
• conclusion of a medical and social examination institution on the necessary types of social, medical and professional rehabilitation of the insured;
• a copy of the work record book or other document confirming that the victim is in an employment relationship with the insured;
• notification of a medical institution about the establishment of a final diagnosis of an acute or chronic occupational disease;
• conclusion of the center of occupational pathology on the presence of an occupational disease;
• documents confirming the costs of carrying out, according to the conclusion of the medical and social examination institution, the social, medical and professional rehabilitation of the insured person, provided for in subsection. 3 p. 1 art. 8 of this Federal Law;
• rehabilitation program for the victim.

The list of documents may differ, since the FSS authorities request the relevant documents for each specific case.

It should be noted that an insured employee who has the right to receive insurance payments has the right to contact the insurer, that is, the Social Insurance Fund, with an application to receive insurance coverage, regardless of the statute of limitations of the insured event.

When applying for an appointment to pay monthly insurance coverage, after three years from the moment the right to receive it arises, payments are made for the past time for no more than three years preceding the application.

Time limit for consideration of an application by an injured employee at the territorial body of the Social Insurance Fund

The decision to assign a payment or refuse is made by the Federal Social Insurance Fund of the Russian Federation within 10 days from the date of submission of the application and relevant documents. Payments to the insured employee are made by the Federal Social Insurance Fund of the Russian Federation within one month from the moment a positive decision is made (clauses 4, 7, Article 15 of the Law).

Can an employer file documents for its employee?

Getting injured is always stressful for anyone. And even after treatment, he is not always able to independently collect all the documents and submit them to the territorial body of the Social Insurance Fund. Typically, employees have a very superficial understanding of the social insurance system and the rights they have, since these issues are usually decided for them by the employer.

And in this situation, first of all, the employer must explain to the employee what payments he is entitled to receive from the Social Insurance Fund and provide him with all the necessary documents in a timely manner.

In addition, the organization can help the employee by independently completing the documents specified in the list and submitting them to the Federal Social Insurance Fund of the Russian Federation. Law 125-FZ allows for the possibility of filing an application through a proxy, therefore, the organization has the right to submit documents for the employee (paragraph 1, clause 4, article 15 of Law 125-FZ).

Can an employer provide financial assistance to an injured employee?

From the analysis of the Law, it is clear that the employing organization is obliged to pay only temporary disability benefits to an employee who has received an industrial injury. One-time and monthly social payments are made by the Social Insurance Fund.

But the employer can, on its own initiative or on the basis of an employee’s application, pay the employee financial assistance in order to compensate for the costs of treatment and rehabilitation, and the amount of this assistance is not limited by the legislation of the Russian Federation.

It must be remembered that financial assistance in the amount of 4 thousand rubles is not subject to insurance contributions (clause 11, part 1, article 9, part 1, article 10, part 2, article 12, part 2, article 62 of the Law No. 212-FZ, paragraph 12, clause 1, article 20.2 of Law No. 125-FZ, Letters of the Ministry of Health and Social Development dated May 17, 2010 No. 1212-19, dated March 1, 2010 No. 426-19). Personal income tax is also not withheld from this amount (Article 216, paragraph 4, paragraph 28, Article 217 of the Tax Code of the Russian Federation).

In addition, the employer has the right to pay his employee the cost of treatment and medical care from the funds remaining after paying income tax. In this case, the income received by the employee is not subject to personal income tax (Clause 10, Article 217 of the Tax Code of the Russian Federation).

Thus, if an accident occurs in your organization and the injured employee turns to you to receive compensation payments, you must remember that the employer is obliged to pay his employee only temporary disability benefits. It must be remembered that an accident not related to production (for example, due to alcohol intoxication), but occurring at the workplace, is paid based on the minimum wage (clause 2, article 8 of the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity").

One-time and monthly insurance payments are assigned and paid to the employee by the territorial bodies of the Social Insurance Fund based on the employee’s application, so the employer can only help his employee prepare a package of documents for submission to the Social Insurance Fund.

In addition, the employer can provide the injured employee with financial assistance or pay for his treatment and purchase of medicines.

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Employee's procedure

What a person who has suffered at work and suffered a work-related injury should never do is leave the company without notifying anyone about what happened. There is every reason to believe that ultimately the injury will be considered a domestic injury, and the employee who left his workplace will be recognized as absentee.

This is not just a warning, it is reality. Management is unlikely to want the injury rate at the enterprise to increase.

Attention! How to behave if you are injured at work:

• First of all, call the charge nurse. She will not only provide first aid and call a doctor, but will also assess the extent of the injury;
• receive the act. The document is drawn up by a commission based on the results of an inspection of the incident;
• go to a medical facility and issue a sick leave certificate.

If the injury is considered moderate or severe, contact the Social Insurance Fund. There you can make additional payments.

ATTENTION! Look at the completed sample report on an industrial accident:

Statute of limitations

Current labor legislation regulates the procedure, conditions and timing of investigations into the causes of an employee’s injury at work.

Notice! So in Art. 229.1 of the Labor Code of the Russian Federation states the following:

• if the employee received a minor injury, the commission will investigate the incident within 3 days from the day it happened;
• If serious injuries are sustained or a person is killed as a result of the accident, the investigation lasts for 15 days. If there is a need for additional medical examination, the duration of the investigation is increased by another 15 days;
• if additional examinations, which are carried out in specialized institutions, are unavoidable, the time for investigating the causes of the incident, by agreement of the management of the enterprise and the commission, is extended for the required period;
• Sometimes it takes some time before it becomes known that an employee has suffered a work injury. In this case, the injured employee writes a corresponding statement. In this situation, the investigation lasts for 30 calendar days from the date of filing the application.

All other cases of injury at work will not be investigated, because it is impossible to prove that the injury was not sustained at home.

Payments and compensation for work injuries in 2018

The employer is obliged to compensate for damage suffered by an employee at work. Considering the fact that for each employee contributions are made to the Social Insurance Fund, which includes insurance against industrial accidents, the employer’s costs are reimbursed from the Social Insurance Fund.

Please note! Employees of an enterprise who are injured at work can count on receiving the following mandatory insurance payments:

• a lump sum payment in case of injury at work as a result of an accident. This payment is made to the Social Insurance Fund. You can receive it after a personal application to this Fund or through an employer. In 2018, citizens can receive no more than 97,778 rubles from the Social Insurance Fund as a one-time compensation and payment for an injury sustained at work. It should be noted that such a payment occurs only if a person completely loses his ability to work and cannot restore it within 4 months;
• monthly benefit assigned in connection with the onset of temporary disability. This type of benefit is issued in exactly the same way as sick leave. Although there are some differences that are important to know not only for the injured employee, but also for the employer. For example, if benefits are paid due to an industrial injury that led to temporary disability, a person on sick leave receives payments in the amount of 100% of the average salary. If the amount of payments is less, this is a violation of labor laws. Payments can last up to 4 months. How long a person will be on sick leave depends on the decision of the specialists of the medical institution where he went. Please note that the amount of payments cannot exceed 300,728 rubles for 4 months. By the way, sick leave is issued for a maximum of 4 months.

The listed payments will be transferred to the victim of the accident, regardless of who is to blame for the incident.

Thus, even if the employee received an industrial injury through his own fault, and not through the fault of the employer or other employees, he will receive the benefits provided by law. There are no restrictions on the payment of compensation to the victim.

The benefits mentioned earlier are transferred to the employee by the employer based on the application of the victim on the day of payment of the next salary.

The injured employee has the right to contact the Social Insurance Fund himself. This happens, for example, in the event of liquidation of the company, or if additional medical expenses arise that require compensation.

In some cases, in addition to the above payments, the employee receives additional payments. But these compensations are not mandatory.

Attention! Our qualified lawyers will assist you free of charge and around the clock on any issues.

In this case we are talking about:

• compensation for material damage. An employee who is injured in an accident and his property is damaged has the right to compensation for direct material damage. Note! Compensation for material damage is possible in the event that the investigation proves the employer’s guilt. If third parties are found guilty, responsibility for compensation for material damage rests with them;
• compensation for moral damage. When a person receives a work injury, he is entitled to compensation not only for material, but also for moral damage. Typically, moral damages are compensated by the guilty party. But often the decision on such compensation is made by the court. There are examples from judicial practice when an employer is held liable for an accident and is required to pay compensation if it is not his fault. This happens, for example, when the culprits are third parties who did not warn the employee about some of the nuances of his activities or possible dangers;
• compensation for lost earnings. Sometimes it happens that sick leave payments are lower than the employee’s average monthly earnings or salary. In such a situation, the employer will have to compensate the difference between the actual payments received and the average monthly earnings. This will only happen if the full or partial fault of the employer in the accident is proven. The decision to recover the specified difference in payments is made by the court or made in pre-trial proceedings. Also, the difference between the payments stipulated by law and the payments actually received is paid in the case when compensation for sick leave is less than the average earnings due to the maximum value being reached;
• reimbursement of costs for the purchase of medications, rehabilitation in a sanatorium and medical procedures. You can receive such compensation from your employer or from the Social Insurance Fund. To receive the specified payment, a medical examination conclusion and confirmation of the fact that all of the listed appointments are necessary for the victim are required;
• payment of financial assistance. It should be noted that such payments are not mandatory, since they are not defined by regulations or any documents. The employer can take the initiative and provide the victim with financial assistance. In addition, a provision on the provision of financial assistance to employees who have suffered a work-related injury can be officially included in the internal regulations of the enterprise itself, in a collective or labor agreement concluded with an employee upon hiring. Thus, if a resolution on the payment of financial assistance to employees is in the above documents, this action is mandatory, and the employer is obliged to fulfill it. But, we repeat once again that in most cases this payment is made at the initiative of the enterprise management. The employer must understand that financial assistance from the Social Insurance Fund is not compensated. But it is not subject to taxes (if it does not exceed 4 thousand rubles).

If an employee dies as a result of an accident or work injury, his relatives will receive compensation. This payment is fixed and equals 1 million rubles.

The primary right to receive compensation in the event of the death of a person is his children, parents, spouses and dependents of the deceased who became disabled within 5 years after his death.

Payments are not due to other relatives of the deceased employee. In this situation, the procedure for paying compensation does not correspond to the procedure for inheriting property after the death of the testator. Payments are made within 2 months from the date of death of the person.

Watch the video. Work injury: workers' rights and employer's responsibilities

Procedure for processing documents

Payments to the victim are made upon presentation of certain documents.

Attention! These include:

• application for payment;
• an act drawn up by a special commission based on the results of an investigation into the causes of the accident;
• expert opinion;
• employment contract (copy);
• employee work book (copy);
• income certificate (period indicated by the insurance company);
• sick leave received as a result of injury;
• certificate of receipt of disability (if necessary).

If a person died as a result of an accident, you will need to provide a death certificate, a medical report on the cause of death, a certificate of funeral expenses, a certificate of the deceased’s salary, and a certificate of the presence of dependents.

ATTENTION! View a completed sample application for benefits after a work injury:

Types of work injuries

Injuries at work are incidents as a result of which the employee received various injuries (Article 227 of the Labor Code of the Russian Federation).

Notice! These include:

• fractures, bruises, cuts, and other injuries to body parts. This also includes injuries sustained from exposure of the employee to other persons;
• various types of burns;
• sun or heatstroke;
• drowning;
• frostbite;
• injuries received from exposure to radiation, lightning, electric current;
• animal bites or other problems associated with human exposure to insects or animals;
• injuries received during the destruction of buildings, structures, accidents, explosions, injuries caused by natural disasters, earthquakes and other emergencies.

The above list is not complete. Work-related injuries also include injuries that occur as a result of exposure to external factors that cause the worker to become temporarily or permanently disabled or die.

What injuries will not be considered work-related?

An injury will not be classified as work-related, even when it was received by an employee at his place of work, if:

• the employee was injured during active actions (inaction) that were criminal in nature - when the appropriate qualifications were established by representatives of law enforcement agencies;
• injury (death of an employee) occurred as a result of a person being in a state of intoxication (alcohol, drugs, toxic) or poisoning, if the occurrence of such consequences is not related to the technological processes in production where the technology is used. alcohol and substances with various properties (toxic, narcotic, aromatic);
• if the cause of death of the employee was a general disease;
• in cases of suicide.

The listed facts are reflected without fail by medical experts, bodies of inquiry, investigation, and court in the documents they prepare in the manner prescribed by law.

As in the case of an industrial injury to an employee, the above cases are considered by a specially created commission, which is obliged to conduct an investigation into the fact.

Classification of injuries at work

Notice! Depending on the severity of the harm caused to the employee, injuries at work can be divided into the following types:

• mild - such injuries do not require seeking medical help and do not lead to serious consequences for the human body. Such injuries include bruises, abrasions, various scratches, etc. In such situations, outpatient treatment is limited;
• medium - after causing such damage, there is a need to consult a doctor. Requires hospital treatment. Sick leave is issued in cases of injury at work for a period of 10-30 days. Such injuries include: burn injuries, bone fractures, sprains, frostbite, etc.;
• severe - this type of damage is characterized by the seriousness of the consequences (sometimes irreversible). As a result of their occurrence, functional disruptions occur in the body, they directly lead to incapacity for work (including the appearance of disability) for a period of more than 30 days. For example, these could be: serious fractures, TBI (traumatic brain injury), mental disorders, severe blood loss, severe burns, etc.

A separate point should be noted about another type of injury at work: prof. disease - when, under the influence of constant harmful factors, the functions of the body are disrupted, upon detection of which the employer makes a forced decision to remove the employee from performing his work duties on a permanent basis or for a certain period.

Employer actions and responsibilities

It happens that in the course of performing his duties, an employee is injured, and the employer must find a new position for him or provide other working conditions that comply with medical conditions. indications.

Attention! According to labor legislation, if an employee refuses the proposed new working conditions, the employer acts in two directions:

• if it is necessary to transfer to another position for a period of no more than 4 months, the employer’s obligation is to protect the employee from performing his work while maintaining his job. The general rule says that during the period of suspension the employee is not entitled to wages, however, the internal regulations of the organization may also provide for deviations from it;
• if it is necessary to transfer an employee to another position for a period of more than 4 months or on permanent terms, the employer has every right to dismiss the employee in accordance with paragraph 8 of Article 77. Reasons - the employee’s refusal to transfer to a position more acceptable for medical reasons or the absence of a corresponding position in the organization . In the event of an accident in the organization, however, provided the employer complies with all necessary labor safety measures, he will not bear liability beyond the scope of standard payments. However, if a case of occupational injury is concealed or the conditions for ensuring labor safety are violated, liability arises in full.

Please note! Common violations committed when it is discovered that workers have been injured at work include:

• the employer deliberately hides information about the fact that an employee (employees) have suffered work-related injuries in the organization;
• the employer organized an investigation into injuries at work, but performed its duties improperly;
• a deliberate attempt to pass off an industrial injury as an ordinary domestic injury, in order to avoid associated liability and material costs;
• the amount of compensation due to the employee is underestimated;
• the employee is denied compensation for damages.

In case of incidents at work, the guilty employer will be held accountable, first of all, within the framework of administrative legislation - under Article 5.27 of the Code of Administrative Offences.

Responsibility for injuries to employees working in the organization, if such cases occur during the production period, rests with the employer and responsible officials.

Punishment in such cases is provided not only by administrative, but also by criminal standards. As a result, the violator may be given either a regular fine or imprisonment. Let's consider administrative sanctions.

The employer, together with the employees responsible for the emergency, may be punished under both Article 5.27 (parts 1, 2) and Article 5.27.1 of the Code.

Attention! When the requirements for regulatory documentation and standards for protecting the professional activities of employees are not met, sanctions are provided in the form of fines (under Part 1 of Article 5.27 of the Code):

• in the amount of 1 to 5 thousand rubles (if the official is guilty);
• in the amount of 1 to 5 thousand rubles (if the culprit is an individual entrepreneur);
• in the amount of 30 to 50 thousand rubles (if a legal entity is responsible).

When the law is not observed again, and the culprit again commits similar violations, the punishment will be as follows (under Part 2 of Article 5.27 of the Code):

• in the amount of 10 to 20 thousand rubles/disqualification for up to 3 years (if the violator is an employee);
• in the amount of 10 to 20 thousand rubles (if the violator is an individual entrepreneur);
• in the amount of 50 to 70 thousand rubles (for legal entities - violators).

Liability for an accident that occurred at work according to the Criminal Code of the Russian Federation

A company that is guilty of cases of industrial injuries to its workers may incur criminal liability under a number of articles from the Criminal Code of the Russian Federation.

Notice! In case of unintentional harm, characterized by a severe degree of damage caused to the health of an employee in the process of non-compliance by the employer with the standards for ensuring the protection of labor activities of employees, liability arises under Article 143 of the Criminal Code of the Russian Federation (clause 1):

• payments in the form of a fine in the amount of up to 400 thousand rubles, wages (other income) of the culprit received for 1.5 years;
• legally required work lasting from 180 to 240 hours;
• corrected labor for up to 2 years;
• forced labor for up to a year;
• deprivation of the right to freedom with imprisonment for up to a year, with deprivation of the right to hold office for the same period (or without limitation).

If the employer fails to comply with the standards for ensuring the safety of industrial work activities, and if there is an obligation to take such measures in the event of the death of an employee, criminal liability arises (under paragraph 2 of Article 143 of the Criminal Code of the Russian Federation).

Causing harm to the health of a worker or employee as a result of an industrial accident, resulting in: the need to transfer the employee to another job, temporary or permanent loss of the employee’s ability to work, the death of the employee.

An industrial injury is considered to be damage that an employee received during working hours on the territory of the enterprise or while carrying out instructions from management outside it. In addition, an industrial injury is considered to be damage received during breaks, overtime, preparation for the start of work, as well as work trips established by the employment contract.

According to Article 5 of Federal Law No. 125-FZ of July 24, 1998 “On compulsory social insurance against industrial accidents and occupational diseases,” individuals performing work on the basis of an employment agreement (contract) concluded with the insured (employer) are subject to compulsory social insurance insurance against industrial accidents and occupational diseases.

An accident can occur both on the territory of the insured and outside it, or while traveling to or returning from work using transport provided by the insured.

Note. Accidents that occur with students undergoing practical training with an employer, or persons involved in performing socially useful work, are also subject to investigation and recording.

An industrial injury in the workplace, even if it is not very severe, is always a nuisance for both the employee and the employer.
What to do if an accident does occur?

Industrial injuries sustained during working hours.

Labor legislation obliges employers to provide employees with safe conditions and labor protection in the organization.

But, if you do get injured at work, first of all, of course, you need to call a doctor. Then you should call your immediate superior and ask witnesses to the incident to tell about what happened. After the fact of injury is recorded, you can go to the hospital.

The employer, in turn, is obliged to organize assistance to the victim, and, if necessary, take him to a medical center. Also, the head of the organization must initiate the drawing up of a protocol, where all the circumstances of the incident must be recorded.

All work-related injuries received by employees while performing work duties or performing work on the instructions of the employer that occurred at the workplace, including a break, on the way to or from work are recorded and investigated (Articles 227, 230 of the Labor Code of the Russian Federation). There are no special features in the investigation of injuries and payment of compensation to victims for office workers; these issues are also regulated by labor legislation.

An injury received during working hours can also be classified as an accident not related to production: by decision of the accident investigation commission, state labor inspector or court. For example, injuries the sole cause of which was alcohol or drug intoxication, or injuries that were received when the victim committed actions qualified by law enforcement agencies as a criminal offense (Article 229.2 of the Labor Code of the Russian Federation).

If an office worker was injured not on the territory of the enterprise, but during working hours (had an accident while delivering reports on the instructions of the employer to the tax office on public transport or on foot), then such an injury is an industrial injury (clause 3 of the Regulations on the Peculiarities of Accident Investigation in production in certain industries and organizations, approved by Resolution of the Ministry of Labor of Russia dated October 24, 2002 No. 73).

On the way to work
An injury is considered work-related if the employee traveled to (from work) using the employer’s transport and was injured. If in his own car - only if the employee used his own car by order of the employer or the use of the employee’s car for business purposes was stipulated in the employment contract (Articles 227, 230 of the Labor Code of the Russian Federation).

An accident cannot be considered production-related if the employee was traveling by public transport, driving his own car (without agreement with the employer) or walking.

If an employee at the end of the working day went on errands, for example, submitted reports, and then, without stopping at the office, went home and was injured on the way, then in this case the employee fulfilled the employer’s instructions to submit reports and from that moment stopped fulfilling his work obligations. responsibilities. Consequently, an injury received by an employee on the way home (unless he was traveling home in the employer’s transport) is not considered work-related.

Commission of Inquiry into Work Injury.

The employer is obliged to create a commission of at least 3 people to investigate an industrial injury (Article 229 of the Labor Code of the Russian Federation). The commission includes representatives of the enterprise management, the state labor inspectorate, labor protection organizations, law enforcement agencies and doctors. If an accident results in the death of an employee at work, an employee of the prosecutor's office must be involved in the investigation.

The commission determines the degree of guilt of the victim based on witness testimony, studying the nature of the injury, examination results and details of the incident. The amount of payments to the victim and the possibility of paying for his treatment at the expense of the Social Insurance Fund depend on these circumstances. If, for example, you violated safety regulations, your chances of receiving treatment compensation from your employer are greatly reduced.

The length of the investigation depends on the severity of the injury. In case of light damage, the commission gives an opinion within three days, and in case of severe damage, the work of the commission can last 15 days from the moment of the incident. If the injury was considered minor but later turns out to be severe, the employer must notify all panel members within three days.

Payments for work injuries.

Let us remind you that the employee has the right to receive social benefits in the event of temporary disability (including injury) in any case. This is provided for in Art. 5 of the Federal Law of December 29, 2006 N 255-FZ.

If the employee’s health is damaged, the wages lost due to an industrial injury and expenses for medical, social and professional rehabilitation must be compensated (Article 184 of the Labor Code of the Russian Federation).
At the expense of the Social Insurance Fund (FSS RF), temporary disability benefits are reimbursed in the amount of 100% of earnings (Articles 8, 9 of the Federal Law of July 24, 1998 No. 125-FZ “On compulsory social insurance against industrial accidents and occupational diseases ").

The employee is paid a one-time and monthly insurance payments, the amount of which depends on the degree of loss of professional ability to work. It is determined by the establishment of a medical and social examination (Articles 8, 10, 11, 12 of the Federal Law of July 24, 1998 No. 125-FZ).
The rehabilitation of the victim is also carried out at the expense of the Social Insurance Fund (clause 2 of Article 8 125-FZ).
In addition to mandatory payments, the company has the right to provide other compensation or payments in a larger volume. Such guarantees may be enshrined in an industry tariff agreement. If the organization has signed this agreement, then it is obliged to pay increased security to employees.
And moral damages must be paid by the one who is to blame for causing an industrial injury (Clause 3, Article 8 No. 125-FZ).

The severity of health damage.

The degree of loss of professional ability in percentage is established by the institution of medical and social examination (Article 3, paragraph 3 of Article 11 No. 125-FZ). The amount of lump sum and insurance payments depends on it (Article 10 No. 125-FZ).
According to the severity of health damage, accidents are divided into severe and mild. The amount of payment for the treatment of the victim depends on this. The severity of the health injury is determined by the medical organization where the injured employee first sought help.
The List, approved by Order of the Ministry of Health and Social Development of Russia dated February 24, 2005 No. 160, lists health injuries in which an industrial accident is considered severe. If the accident is considered serious, additional costs for treatment and rehabilitation of the injured employee immediately after this accident (in a hospital, clinic, sanatorium) are paid from the Social Insurance Fund (clause 3, clause 1, article 8 No. 125-FZ).

In case of minor accidents, treatment costs are paid not by the Social Insurance Fund, but by the employer, who is obliged to compensate for harm caused to employees in connection with the performance of their work duties (Article 22 of the Labor Code of the Russian Federation).

Moral damage and statute of limitations.

The employer must compensate the employee for moral damages (Articles 21, 22 of the Labor Code of the Russian Federation, paragraph 3 of Article 8 No. 125-FZ). Its value can be determined by agreement of the parties. If the employee does not agree with the amount of compensation offered by the employer, then it will be determined by the court (Article 237 of the Labor Code of the Russian Federation) depending on the fault of the employer and the degree of physical and moral suffering of the employee (Article 151 of the Civil Code of the Russian Federation).

There is no statute of limitations for investigating an accident involving an employee.
Upon the statement of the victim (his relatives) that the accident was hidden by the employer or was investigated with violations, the state labor inspector, regardless of the statute of limitations, conducts an additional investigation of the accident (clause 25 of the Regulations). In practice, there are many cases when, after several years from the moment of injury, workers (former workers) who were injured at work contact the competent authorities in order to establish the fact of an accident at work.
If the organization where the accident occurred has already ceased to exist by that time, the Rostrudinspektsiya, together with the Social Insurance Fund and the territorial trade union, conducts an investigation on its own. The labor inspector examines the scene of the incident, interviews eyewitnesses and officials, studies internal documents of the employing organization and, based on the collected investigation materials, qualifies the accident as production-related or unrelated.

Record everything.

To obtain the compensation you are entitled to, you may need to prove a causal link between your work injury and the harm that occurred to your body. To prove this connection, you will need a doctor's report.
If the injury is severe and requires surgery, ask your doctor to also confirm that the surgery is related to the work-related injury. Otherwise, your employer may refuse to pay you for all of your medical expenses.

After the commission issues a conclusion, the employer is obliged to compensate the victim for all costs, pay for treatment, and pay wages during the period of incapacity. The employee's salary should not be lower than what he received in a healthy state. Compensation payments are made monthly.