Do you need sick leave after a stroke and how many days do you need to take it? Where and who issues it?

Grounds for extradition

Stroke in medical terminology refers to a group of clinical syndromes that develop as a result of a decrease or cessation of blood supply to the brain.

If an acute cerebrovascular accident (hereinafter - ACVA) caused a persistent neurological disorder, then it is classified as a stroke, and a working person who has suffered it needs a certificate of incapacity for work .

The need for a sick leave certificate in this case is obvious and the legal basis for its issuance is the simultaneous presence of the following factors:

• diagnosed by a doctor at a licensed medical institution, which resulted in a persistent neurological disorder (stroke);
• a person who has suffered a stroke is a party to labor relations as an employee in accordance with the Labor Code of the Russian Federation;
• the sick person is insured in the compulsory health insurance system.

Important! Stroke is one of the main causes of disability in the population: 70-80% of stroke survivors become disabled, and about 30% of them require constant care from others.

How many days do they stay on paid b/l?

The approximate deadlines for issuing a certificate of incapacity for various types of stroke are enshrined in the Recommendations of the Ministry of Health of Russia No. 2510/9362-34 dated August 20, 2000 and are:

The indicated periods of sick leave are approximate : the attending physician in each specific case takes an individual approach to determining the duration of the patient’s incapacity for work, guided by the time restrictions of Part 4 of Art. 59 of the Federal Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” (hereinafter referred to as the Federal Law of November 21, 2011 No. 323-FZ), according to which, in the event of an obvious unfavorable prognosis of the disease, no later than 4 months from the date of opening the bulletin, the patient is sent for passing the ITU, and if he refuses the prescribed assessment of disability, the certificate of incapacity for work must be closed.

Grounds for extending the certificate of incapacity for work

The period of sick leave is extended in case of pathologies discovered during the examination. If the patient complains of feeling unwell, but the complaints are not confirmed by the results of tests and other diagnostic methods, the certificate of incapacity for work is closed. Diagnostic methods depend on the type of disease. This could be x-rays, ultrasound, tests, palpation.

Sometimes the employer suspects that sick leave has become the basis for paid leave for the employee. However, these are unnecessary suspicions, since at the moment it is very difficult to obtain a certificate of incapacity for work without sufficient grounds. In most cases, private clinics do not issue certificates.

What affects the duration?

How long the period of disability after a stroke will last depends on many factors:

1. type of stroke;
2. severity of stroke;
3. speed of restoration of impaired functions;
4. general state of human health (primarily the cardiovascular system);
5. the patient's response to treatment;
6. the presence or absence of recurrent hemorrhage (in the case of hemorrhagic stroke) while on sick leave;
7. the presence or absence of repeated incoming cerebrovascular accidents;
8. the nature of the patient’s work activity.

It should be noted that in most cases, the patient’s condition after a stroke (except for all types of mild stroke and moderate subdural hemorrhage) indicates an unfavorable prognosis in terms of performance and the doctor, guided by Part 4 of Art. 59 of the Federal Law of November 21, 2011 No. 323-FZ, has the right to immediately refer the patient to receive disability.

How long can you stay on sick leave in 2019?

It is clear that then the health of the insured employee comes first, especially since he has every right to sick leave. Sick leave can be issued for temporary disability, but many are interested in the question: how long is it legal to remain on sick leave continuously in 2021? Legislation changes almost every year and is supplemented by a host of important rules and regulations; only an experienced lawyer can keep up with the process.

Back in 2012, a term was established that a regular therapist can indicate on sick leave - 15 days. After 15 days, the patient is obliged to come to the doctor for an appointment at the clinic and confirm the closure of the sheet (if the patient has recovered) or extend the sick leave for another 15 days, i.e. up to 1 month. If after a month the patient is still in unsatisfactory physical condition, a medical commission meets to decide what to do next. If before this the therapist whom the patient visited was seen in a private hospital, he is sent to a state institution for a commission.

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Grounds for extension and possible deadlines

The basis for extending sick leave is the patient’s slow recovery of lost functions and insufficient response to treatment. The specifics of the work of an employee on sick leave are of no small importance.

Attention! The advisability of extending the certificate of incapacity for work within the 4 months established by law is decided by a medical commission, taking into account the specified circumstances.

For patients with ongoing restoration of functions and stable positive dynamics, the decision is predominantly made to continue treatment simultaneously with being on sick leave; otherwise, the most likely decision is to refer them to medical examination to establish the disability group.

Sick leave period after stroke

The story is this: my mother-in-law had a stroke at the age of 54 (in theory she’s still working) with complications in her speech. Four months pass, and my speech has not fully recovered. Doctors force people to go to work, saying that the maximum period of sick leave according to the law in this case is 4 months. Tell me, is there any way to extend the sick leave for at least a month and a half, because my mother-in-law works as a teacher (it’s unrealistic to speak like that), and it’s also icy outside. There is no disability group. Is there anything that can be done?

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Medical and social examination of patients who have suffered a stroke; sick leave. All patients who have suffered a stroke are temporarily disabled. The length of time on sick leave depends on the severity of the stroke, its type, the speed of restoration of impaired functions, the general health of the patient, primarily the cardiovascular system, and the effectiveness of treatment. In case of mild or minor stroke, subarachnoid hemorrhage of non-aneurysmal etiology, the approximate time of stay on sick leave is 2.5-3 months, the duration of inpatient treatment is at least 25-30 days. For a moderate stroke, inpatient treatment is about a month, and the total duration of sick leave is 3-4 months. In the case of a severe stroke with a slow recovery of functions and an unfavorable work prognosis, it is possible to be referred to establish a BMSE disability group in 3-3.5 months. If the labor prognosis is favorable, after the expiration of the approximate period of stay on sick leave, the question of the advisability of continuing treatment on sick leave must be decided by a decision of the medical commission (MC). In these cases, the time spent on sick leave is determined taking into account the possibility of returning to work in full (or with restrictions on the recommendation of the Institution of Internal Affairs) or, if necessary, determining disability group III. Taking into account the effectiveness of rehabilitation measures and the prospect of restoring the ability to self-care, in some cases it is necessary to continue sick leave in order to determine disability group II. After subarachnoid hemorrhage due to congenital arterial aneurysm, the length of sick leave depends on the characteristics of the treatment. Non-operated patients usually have a sick leave of at least 4 months (inpatient treatment is 1.5-2 months), after which they are most often sent to BMSE to determine their disability group. In case of recurrence of hemorrhage, the period of stay on sick leave is extended by decision of the medical commission (MC) for another 2-3 months. In the absence of contraindicated factors in work in the specialty, and a good clinical prognosis, it is possible to extend the sick leave for up to 7-8 months with a return to work without a referral for medical examination (initially with restrictions on the recommendation of the medical commission - VK). Those operated on for an aneurysm are temporarily disabled with a note on the sick leave certificate for at least 4 months (depending on the duration of the operation after the hemorrhage). In patients with ongoing restoration of functions, it is advisable to continue treatment for disability while being on sick leave by the decision of the medical commission (MC).

Where and who issues a bill of lading?

All types of stroke are the result of severe brain damage , so the person who has suffered it undergoes treatment in a hospital setting, where he receives a certificate of incapacity for work.

Of course, opening a sick leave at a clinic is also possible, but in practice this is not so common.

In accordance with Order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n, licensed medical institutions have the right to issue certificates of incapacity for work . In addition to general information about the patient, the sick leave must include a two-digit code – “01”, indicating the disease as a general cause of disability.

The procedure for paying for time spent on sick leave is regulated by Federal Law No. 255-FZ of December 29, 2006. Three days of incapacity for work are paid by the employer, and all subsequent days by the Social Insurance Fund.

The amount that an employee will receive directly depends on his total insurance period - the period of employment during which the employer transferred insurance contributions to extra-budgetary funds for him. The longer the total insurance period, the larger the payments.

Note! An employee with less than 1 year of experience will receive the least - 30% of average earnings. An employee for whom contributions to insurance funds have been received for 8 or more years has the right to receive a payment in the amount of 100% of the average salary.

Stroke. How long are they in the hospital?

Poor blood circulation in the brain, in other words, stroke, treatment involves three stages:

• prehospital;
• stay in the intensive care unit;
• treatment in a general ward.

The length of stay of a patient in a hospital, according to treatment standards, is 21 days, provided the patient has no violations of vital functions, and 30 days in case of serious violations. When the length of a patient’s stay in a hospital is insufficient, a medical examination is carried out followed by the development of an individual course of rehabilitation.

The Yusupov Hospital employs highly qualified doctors, and after being treated by them, most of even the most severe patients return to a full life. The professionalism of doctors plays a huge role in the effectiveness of therapy and rehabilitation. Neurologists at the Yusupov Hospital develop an individual treatment plan for each patient.

Patients stay in the intensive care unit as long as they need to fully recover. During this period, doctors strictly monitor the patient’s vital functions in order to avoid serious complications caused by damage to brain tissue.

All patients diagnosed with stroke are subject to hospitalization. The length of stay in intensive care depends on a number of factors, including:

• depression of vital functions;
• degree of damage to brain tissue. With a major stroke, patients stay in intensive care longer;
• the need for constant monitoring if there is a high risk of recurrent stroke;
• severity of the clinical picture;
• level of depression of consciousness and others.