❶ How To Fill Out A Certificate Of Incapacity For Work

A certificate of incapacity for work is a document confirming temporary release from work. The social security fund pays for it. If inaccurate data is entered, then such a document will not be paid. Location: Location: 1

The stamp of the hospital with its name and address is placed in the upper right corner. Additionally, the title can be typed or handwritten.

In the upper right and lower right corners, there is also a stamp for sick leaves.

In some cases, additional seals must be affixed. In the first case, when a person does not have registration at the place of illness (for visitors, business travelers, who are on vacation in a given area). In the second case, when examining citizens who were sent for a medical examination. The seal is placed next to the signature of the head confirming the conclusion.

Mismatch of the seal in the upper corner and in the lower one is allowed when a patient is redirected to another medical institution. All seals must be clear without smears and streaks. Some types of seals may not be named after the institution. These are psychiatric clinics, drug addiction, infectious diseases, AIDS centers.

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The certificate of incapacity for work must be filled out without blots with a pen or printer.

On the front side it is indicated whether the sick leave was issued initially, or this is a continuation of the previously issued one, the date, month (in words), year of issue, surname, name, patronymic of the patient, age (number of full years), gender, full name of the organization where the patient works. It is also indicated whether a sick leave was issued at the main place of work, or at the place of part-time work.

The corresponding columns indicate the disease or other reason (for pregnancy and childbirth), the treatment regimen, notes on the violation of the regimen, from which and by what date the regimen was violated.

In the column "Exemption from work", the date of issue or (if necessary) the date of the next extension is entered in Arabic numerals. The doctor puts a personal signature and seal.

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If the decision is made by the medical commission, then the signature of the chairman of the commission is additionally put.

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In the line "Get started" the date is written in words.

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If the patient continues to be ill, a corresponding entry is made. In the old sheet, they write that a new one has been issued, and put its number, date of issue and the doctor's signature.

If a disability is established, the sick leave is closed and an appropriate entry is made.

If the sick leave is lost, a duplicate is issued.