E-hospitals: how to get and pay - a guide for entrepreneurs

Since January 1, 2023, the entire healthcare sector in Ukraine has switched to the system of electronic sick leaves. However, despite the innovations introduced last year, there are still many questions about how such sick leaves are paid and what are the legal deadlines for sick leave payments in 2024?

Where should the employer start?

The employer has only 10 days to allocate financial assistance for temporary incapacity. The countdown starts only 7 days after the e-sick leave is closed, not from the moment it is issued.

Previously, the employer coordinated this issue with the company's social insurance commission, which calculated and paid the financial support in accordance with this Regulation. However, the updated Law № 1105 no longer requires the employer to establish such a body in the company. Thus, the responsibility for the decision to grant or deny e-sick leave payments lies with the company’s management.

The Ministry of Health oversees the payment of sick leaves during martial law. In this regard, the state administration constantly amends the order № 1066. Thanks to the ministry’s prompt response to current circumstances, issues related to the formation, issuance, and payment of electronic sick leaves are resolved fairly quickly.

Thus, since its inception, the Electronic Registry has helped enterprises:

• simplify the process of certifying temporary incapacity;

• accelerate the allocation and payment of financial assistance;

• reduce cases of sick leave forgery;

• minimize fines due to errors previously common when processing incapacity certificates.

How to obtain an electronic sick leave extract?

All incapacity certificates are formed in the Electronic Registry. The presence of such a document in the system confirms that the insured person is temporarily unable to perform their work duties.

To obtain an extract, the employee must register a personal account on the Pension Fund website. However, the employer can also access the document through the insurer's electronic account.

How has the procedure for assigning sick leave payments changed?

Let us remind you that the new procedure for assigning temporary incapacity benefits is formed by the Social Insurance Fund (SIF).

To enable the employee to receive the funds, the employer must do the following:

• assign temporary incapacity benefits;

• formalize the assistance and submit a claim-calculation to the pension fund.

Since the system operates remotely, employees no longer need to print forms or collect signatures or stamps.

Stages of reviewing and paying e-sick leave in the company

The electronic sick leave follows this process:

1. The e-sick leave is automatically generated based on the corresponding medical conclusion.

2. The employer receives a notification about the opening of the temporary incapacity certificate in the insurer's cabinet on the Pension Fund portal.

3. The generated electronic document can be viewed immediately after its creation.

4. Documents related to e-sick leave financial support can be prepared only after its status changes to "Ready for payment," which happens 7 days after the sick leave is closed.

5. The employer independently decides whether to print the document or keep it in electronic form.

6. The HR department must determine the insured worker’s seniority, benefits eligibility, and the number of days of incapacity. The financial assistance will be paid for each of those days.

7. The employer or an authorized person decides whether to grant or deny financial assistance. The corresponding order is passed to the payroll department for calculating the payment amount.

8. The accounting department calculates the payment based on the e-sick leave and the company’s decision.

9. The claim-calculation is submitted to the Pension Fund office at the company’s registration location in paper or electronic form via the portal of electronic services.

10. The claim-calculation must be submitted to the Pension Fund within 5 days from the time the company’s management decided on the financial assistance.

11. The employer receives the assistance amount from the Social Insurance Fund to a special account and pays it to the employee.

How to pay two e-sick leaves with the same insurance case number?

Imagine a situation where a worker received two sick leaves for the periods from 07/14 to 07/16 and from 07/17 to 07/24. Both documents are closed but have the same insurance case number for temporary incapacity.

According to the law, such sick leaves must be paid starting from the 6th day of temporary incapacity. At the same time, the accounting department must calculate the employee’s average daily wage.

However, there is another side to this issue. For example, in Order № 1066, it is stated that the worker or their employer can request the doctor to generate a new sick leave with the correct number. This can only be done before the document acquires the status of "ready for payment."

How to pay an e-sick leave for a part-time employee?

Employees working part-time are entitled to electronic sick leave payments only if they have been denied payment at their primary workplace. In all other cases, there are no differences in sick leave payments compared to full-time employees.

The basis for paying the sick leave will be the availability of a copy of the incapacity certificate. However, the document must be certified with the manager’s signature and stamp at the primary workplace.

How to pay an e-sick leave for a worker under a civil contract?

Such individuals are entitled to financial support if they obtain a sick leave. However, the employer pays the assistance only if:

• the worker obtained the sick leave during the contract period;

• due to temporary incapacity, the worker did not receive a portion of their income or salary;

• the individual is not simultaneously working for another company under an employment contract.

If all conditions are met, the employer must submit a claim-calculation and pay the financial assistance to the part-time worker.

Who is authorized to pay sick leave?

While we have clarified the situation for enterprises in the article, it remains to explain how sole proprietors (Sole Proprietorships) should act.

A sole proprietor may delegate such authority to trusted individuals, but they can also manage sick leaves and decide on payments independently. Additionally, a sole proprietor must:

• ensure the correct calculation and timely payment of funds for e-sick leave;

• decide on granting or denying insurance payments;

• verify the accuracy of documents based on which payments may be calculated.

The amount of assistance depends on the worker's insurance experience.

When are sick leaves paid?

As soon as the Social Insurance Fund transfers the funds to the employer’s bank account, the employer must pay financial assistance to the employee for temporary incapacity, namely:

• on the next scheduled payday;

• within 10 days from the allocation of assistance for an employee under a civil contract.

Can sick leave be unpaid?

If an employee opens an e-sick leave but continues to perform their work, the employer may choose not to pay for the temporary incapacity leave. However, the manager must ensure accurate recording of working hours for their employees. Such information must be reflected in the timesheet. In this case, the employee will receive only their salary without sick leave compensation.

The employer may refuse to assign sick leave payments based on Law №1105, citing the absence of lost earnings or income by the employee.