Sick Leave Over 120 Days: Payment Procedures, Extensions, and Referral to MSEC

Prolonged employee disability that exceeds the standard sick leave duration is complex from both medical and legal perspectives. It requires strict adherence to social insurance norms, proper documentation, and interaction among the doctor, employer, and social protection agencies. 

In today's conditions, when a significant portion of the population faces complicated health issues, the question of long sick leave, its payment, and further referral to medical and social expertise becomes particularly relevant.

Sick Leave Over 120 Days: Definition and Grounds

Sick leave for more than 120 days (if the sick leave exceeds 120 days) — is a period of temporary disability that surpasses standard treatment times and requires additional medical evaluation regarding the individual's further capacity to work. Such situations usually arise in cases of severe diseases, injuries, surgeries, or chronic conditions with prolonged recovery.

The basis for extending sick leave is the conclusion of the medical advisory commission (MAC), which assesses the patient's condition, treatment dynamics, and prognosis for recovery of work capacity. If recovery does not occur within the standard period, the commission decides on extending the sick leave or referring the patient for further expertise.

The nature of the illness is also taken into account: mental disorders, the consequences of injuries, oncological and neurological conditions most often become the grounds for prolonged sick leaves.

Who Has the Right to Long Sick Leave

All insured individuals who are in labor relations or engage in activities with mandatory social insurance have the right to obtain and extend sick leave beyond 120 days. This includes employees of enterprises, institutions, organizations, as well as individual entrepreneurs provided they pay contributions.

It is also important to consider categories of individuals with special conditions: patients after complex surgical interventions, individuals with debilitating illnesses, military personnel, and those affected by hostilities.

The decision to extend sick leave is not made automatically — it is based on a medical conclusion that confirms the impossibility of returning to work. In the case of long-term treatment, regular health re-evaluations are mandatory.

Procedure for Issuing Sick Leave Over 120 Days

The issuance of prolonged sick leave begins with the initial establishment of temporary disability by a doctor. The sick leave is then extended based on a decision by the MAC, which conducts periodic examinations of the patient.

If treatment continues for more than the specified term with no signs of full recovery of work capacity, the medical institution initiates the referral of the patient to the medical and social expert commission (MSEC or modern expert commissions, depending on the current disability assessment system).

Documents typically issued include: electronic or paper sick leave, extracts from the medical record, examination results, conclusions of specialists. The employer receives information through an electronic system that allows monitoring the employee's status without additional requests.

It is important that the extension of sick leave cannot be indefinite — after a certain period, the issue of establishing the degree of loss of work capacity must be reviewed.

Calculation of Payment for Sick Leave Lasting More Than 120 Days

Payment for prolonged sick leave is made from the system of mandatory state social insurance. The amount of payments depends on the employee's insurance experience and average salary.

The general calculation mechanism involves determining the average daily earnings for the previous calculation period and applying a payment percentage according to the duration of service (for example, 50%, 60%, 70%, or 100%).

In the case of prolonged sick leave, payments may be made in parts, depending on the extension of the sick leave. It is important that after 120 days, the issue of payment may be associated with transitioning to another status — for example, establishing disability, which changes the source and mechanism of funding.

The employer is involved in the process only at the initial stage (data transfer and confirmation of insurance experience), after which the main funding is provided by the relevant social funds.

Features of Extending Sick Leave Beyond 120 Days

Extending sick leave beyond 120 days is a procedure regulated by medical and legal norms and involves a clear sequence of actions by medical institutions. The main feature of such a process is the mandatory participation of the medical advisory commission, which assesses the dynamics of the disease and determines whether the patient has prospects for recovery of work capacity within a reasonable time frame.

As a rule, after the initial period of disability ends, the doctor cannot independently extend the sick leave for a long time without a collective decision. This is why the MAC acts as the key body confirming the need for treatment extension. The commission analyzes medical documentation, examination results, consultations with specialists, and the overall patient state.

If treatment does not bring consistent improvement or the patient's condition remains severe, the commission may decide to refer them for medical and social expertise. In this case, the issue of not only extending sick leave but also the possible establishment of disability or determining the degree of loss of work capacity is considered.

Another feature is the regularity of re-evaluations. In the case of long illnesses, the patient is not on sick leave without control — their condition is periodically assessed, allowing for the avoidance of unreasonable prolongation of incapacity to work.

Employee Rights During Prolonged Sick Leave

An employee on prolonged sick leave retains a number of social and labor rights that ensure their protection during temporary disability. Primarily, they have the right to receive material support in the form of benefits for temporary incapacity according to their insurance experience and current legislation.

The employee also has the right to retain their job. The employer cannot dismiss a person solely based on their sick leave status, except in cases of enterprise liquidation or other legally defined grounds.

Another right is access to information regarding their treatment and the status of the sick leave. The employee can obtain data about the continuation of the sick leave, the MAC's decisions, and referrals for examination.

In addition, the employee has the right to medical confidentiality — information about their health status cannot be disclosed by the employer or third parties without consent.

In the case of prolonged treatment, the individual also has the right to initiate additional medical consultations or inquiries with alternative specialists to clarify the diagnosis and treatment plan.

Employer's Duties During Sick Leave Over 120 Days

In the case of an employee's prolonged sick leave, the employer primarily performs administrative and accounting functions, ensuring proper documentation and interaction with the social insurance system.

The first duty is to timely obtain and process information about the sick leave in the electronic system. The employer must correctly input data into the enterprise's accounting systems and ensure accurate calculation of insurance experience.

Another important duty is to calculate and transfer documents for the payment of temporary incapacity benefits. In the case of prolonged sick leave, the employer does not make independent medical decisions but ensures the financial and administrative aspects of the process.

Additionally, the employer must preserve the employee's position for the entire duration of their incapacity. Any actions regarding the dismissal or replacement of the employee must be carried out exclusively within the legal framework.

Importantly, confidentiality must be maintained. Information about the employee's health status cannot be used for discrimination or disclosed to other employees.

In the case of referring the employee to a medical and social expertise, the employer must provide necessary documents about the working conditions, the nature of the duties performed, and other data that may be required for assessing work capacity.

Thus, the employer's role during prolonged sick leave lies in ensuring legal and organizational support for the employee without interfering in medical decisions.