Electronic Sick Leave: How Does the System Operate Post-October 1, 2021?

Two months have passed since the full launch of e-sick leave certificates. Let's find out now if everything is working in practice and what changes have occurred during this time. We will also consider the situations that employees and employers face in practice.
Let us remind you that e-sick leave certificates became fully operational on October 1, 2021. Although this was supposed to happen on September 1. However, government officials issued MoH Order No. 1836 dated 28.08.2021, which postponed the start until October.

Will paper sick leave certificates be issued after October 1, 2021?

An interesting question! After all, one way or another, doctors were still allowed this possibility until 01.02.2022. The Social Insurance Fund (SIF) provided a list of specific cases when this is possible. There are only 4 of them:

1.  If a sick leave certificate issued before 01.10.2021 needs to be closed or extended.
2.  If 7 days have passed during which the doctor can make changes to the medical conclusion, and an error needs to be corrected.
3. If, due to technical reasons, it was not possible to generate a medical conclusion and an e-sick leave certificate within seven days after the sick leave certificate was closed.
4.  In case of adoption of a newborn child.
   Please note that separate application-calculations are submitted for paper and electronic sick leave certificates.

Status of e-sick leave certificate in the personal account

An e-sick leave certificate, which we see in the personal account on the PFU portal, can have the following status:

1. Closed – this status appears from the first day of incapacity for work, and, ideally, should be maintained until the end of the 7th day following the last day of incapacity for work.
2.  Ready for payment (issued) – appears on the 8th day following the last day of incapacity for work. But, be careful! This status can be seen in the account already on the day following the last day of incapacity for work. Exception – e-sick leave for pregnancy and childbirth. It becomes issued/ready for payment 7 days after its opening.
3.  Mistakenly generated - in the case when a doctor made an error in the medical conclusion, on the basis of which the e-sick leave certificate was generated, and creates a new correct medical conclusion and a new e-sick leave certificate, the previous sick leave certificate acquires the status "mistakenly generated".
4.  Invalid – an e-sick leave certificate usually receives this status under the "reduction rule" when several sick leave certificates are opened for one employee. What does this mean? For example, an employee was issued a sick leave certificate for a general illness, and during this time, the employee's child fell ill, and a sick leave certificate was opened for the child. Automatically, the sick leave certificate for the general illness becomes invalid.
5.  Paid.

Reduction Rule

E-sick leave certificates can interrupt each other according to the reduction rule. This rule applies when several medical conclusions are created for one insured person, and their periods of incapacity for work overlap. You can read about this in Procedure No. 1234.
Most often, the reasons for reduction are:

•  creation of a new medical conclusion within one case of incapacity for work – in this case, an extended e-sick leave certificate is created. The primary sick leave certificate becomes "invalid" on the date preceding the opening date of the extended e-sick leave certificate
•  creation of a new medical conclusion, unrelated to the previous one, certifying incapacity for work within the same category. – For example, an injury was sustained during a cold. Both general illnesses and injuries belong to the same category
•  creation of a new medical conclusion about another insured event from a different category of reasons for incapacity for work. For example, a sick leave certificate for a general illness interrupts a sick leave certificate for pregnancy and childbirth
• Establishment of a disability group.
  E-sick leave certificates are reduced automatically.

When is it recommended to pay for sick leave?

From October 1, an electronic sick leave certificate is considered issued and ready for payment 7 days after its closing date. This is stated in Procedure No. 1234. The seven-day period was determined so that the doctor could correct errors in the medical conclusion, if necessary.
In practice, it happens that the "Ready for payment" status may appear already on the day following the closing day. But this does not mean that changes will not be made within the next seven days. Practically, this is possible. Therefore, it is recommended to pay for sick leave when 7 days have passed from its closing date.

Extended e-sick leave certificate number

The unique e-sick leave certificate number has been extended. For the convenience of policyholders, the insurance event number has been added. It is immediately clear whether it is a primary or extended sick leave certificate.

Error in employee's full name

We all know that any inaccuracies in the data of the electronic healthcare system and the PFU data will most likely lead to errors, inability to generate a medical conclusion or e-sick leave certificate, and other problems.
What to do if there was an error in the full name. For example, when a declaration was concluded with a family doctor, the name Natalia was indicated, but in the PFU data, which is filled in by the employer, one letter was missed, and it was written Natalya. Since this error is not significant, the employer can submit an application-calculation for such a sick leave certificate.
The SIF explained that previously, due to such an error, the application-calculation could be rejected. But to prevent minor errors from causing inconvenience in work, the SIF made changes to the software.
If the error in the full name is more serious, for example, an employee changed their surname, fell ill, and came to a doctor's appointment. The doctor changed the data in the declaration. But the data in the PFU is not updated. In this case, the doctor will not be able to generate an e-sick leave certificate because the data in the healthcare system does not match the PFU data. The doctor issues a paper sick leave certificate, and the employee needs to submit a personal data change form in the account on the PFU website and inform the employer about the surname change.

No notification of medical conclusion creation received

A notification about the creation of a medical conclusion comes from E-health after a visit to the doctor.
However, the SMS may not arrive. Most often, this happens due to outdated data in the healthcare system, or in other words, in the Declaration concluded with the doctor. The surname or phone number has changed, or a paper passport has been replaced with an ID card, and other data.
What to do?

•  inform the doctor of the current data, which he will enter into the electronic healthcare system;
• check the availability of the medical conclusion and e-sick leave certificate on the PFU website, and at the same time, check personal data.

Also, ask the doctor what message was received in response to the creation of the medical conclusion. There are also such messages, for example, "Person is absent in the Register of Insured Persons" or "Insurer is absent".
If "Person is absent in the Register of Insured Persons", then most likely the passport data, full name in the electronic healthcare system, and the Register of Insured Persons differ.
If "Insurer is absent", then the error may be in the data submitted by the employer in the D5 Tax Calculation report.

E-sick leave certificate not displayed in the employer's account

The PFU explained why this might happen:

• the e-sick leave certificate may go to the previous employer if the employee recently changed jobs, and the Tax Calculation has not yet been submitted because it is submitted quarterly
• the e-sick leave certificate may go to the employer with whom the employee works concurrently
•  software malfunction.

Will the e-sick leave certificate be displayed in the Diia mobile application?

The MoH clarified that the e-sick leave certificate will not be displayed in the Diia mobile application. However, on the Diia website, it will be possible to check whether a medical conclusion was generated for a specific person. To do this, you will need to enter the medical conclusion number and the individual's data.
Note that this option is currently not available on the Diia website.

Well, services and software are being updated, the SIF and PFU are explaining new nuances of working with e-sick leave certificates, and employees and employers are figuring it all out in practice. So, we are moving forward and hoping for fewer innovations and faster improvement in working with e-sick leave certificates. We will keep you informed )

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