Is sick leave given for osteochondrosis and for how many days? Do they give sick leave for osteochondrosis of the cervical spine and for how long?

E. A. Yurova author of the article, Askon labor law consultant

Disability is one of the most common cases of abuse of rights by certain categories of workers. Such workers, having a history of a stable disease, carefully study all the signs of its exacerbation and go to various medical institutions, endlessly providing the employer with many certificates of incapacity for work. After receiving the next sick leave, the employer asks questions: can the employee actually perform work duties, how to stop the series of sick leaves, whether these documents are justifiably issued...

How to correctly simulate osteochondrosis for sick leave

Many people are interested in whether, in the absence of a disease, it is possible to simulate its symptoms (especially for cervical osteochondrosis) in order to get the desired sick leave.
Doctors say that it is easier to fake the symptoms of a cold or pancreatitis than osteochondrosis, but, nevertheless, we will describe all the ways to simulate this disease. Still from the film

1. When you enter the neurologist’s office, hold your lower back and wince in pain. When you sit on a chair, pretend that you are sitting on a stake. Your head should be tilted - your neck hurts very much. Symptoms that you need to tell your doctor about: pulling in the lumbar region, acute pain radiating to the side, this appeared after any physical work, for example, washing floors. The doctor may tap you with his fist on the back under the ribs. You should say: “It hurts when you knock.” Ideally, call a doctor at home. In this case, they won’t send you for an x-ray right away, and they’ll definitely give you sick leave, because the pain is so bad that you don’t have the strength to get to the hospital.
2. Tell the neurologist the following phrase: “When I bend, there is no pain, but straightening up is very painful in the lower back.” And show him this. If they don’t send you for an x-ray, they will give you sick leave. But even if you are sent for an x-ray and it is fine, you can tell the doctor that you have a pinched nerve. This cannot be seen on an x-ray.
3. Complain to the doctor about very severe pain in the tailbone, making it impossible to sit down and walk. This happens after the flu or bronchitis, a complication. They may not send you for an x-ray, but they will give you sick leave.
4. Simulation of cervicothoracic osteochondrosis. What you should tell the doctor: “I can’t turn my head to the right or left (you choose), there is a feeling of an electric shock to the brain, constant pain in the head, pain in the chest for a whole week (this excludes heart disease). This happened in the morning, after sleep, it was very difficult to get out of bed. I wrapped a woolen scarf around my neck and it seemed to feel better. Over time it gets a little better, but it’s just as difficult to turn your neck.”
5. X-ray forgery.
6. Bribe a doctor.
7. Call a doctor at home. When the doctor comes, you have to lie on Kuznetsov’s applicator, groaning. In front of the doctor, the head should be tilted to the side, as if there is a pinch in the neck and it is difficult to turn it. If the doctor begins to feel you, you should moan in pain. I must say that you can’t even dress yourself. They will give you sick leave and prescribe Diclofenac and Finalgon. Tests and x-rays may not be requested.

Remember - if you cannot correctly simulate osteochondrosis, then there will be no other chance.

The most important rule is if there is pain, go to the doctor, because the spine is not to be trifled with. Is sick leave given for osteochondrosis? Yes! If the doctor confirms that there is osteochondrosis, he will send you to sick leave for at least 7 days.

Situation 3: an employee went on sick leave on the day of dismissal

Is it possible to fire me in this case?

An employer cannot, on its own initiative, fire an employee who is on sick leave (Part 6 of Article 81 of the Labor Code of the Russian Federation). But if this is the initiative of the employee himself, there are no obstacles (Article 80 of the Labor Code of the Russian Federation). Rostrud specialists confirm this (explanation on one situation and a similar one).

How to calculate the payout

When calculating, two circumstances must be taken into account.

First: the amount of benefits depends on the length of insurance coverage. If the employee’s insurance coverage is 8 years, then sick leave is paid in the amount of 100% of average earnings (Clause 1, Part 1, Article 7 of Federal Law No. 255-FZ of December 29, 2006). On the day of dismissal, the employment contract is still in force, which means you calculate benefits as if the employee were still working for you.

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Second: if you first paid the employee, and then found out about sick leave, make sure that you do not pay for the same period twice. Sick leave compensates for the earnings that the employee lost due to illness. And if you have already paid him for this period as worked, it turns out that the earnings have already been received.

This position is confirmed by information from the official website of the FSS of the Russian Federation and judicial practice (Resolution of the Arbitration Court of the Ural District dated 08/15/2018 in case No. A76-27843/2017; Resolution of the Eighth Arbitration Court of Appeal dated 07/17/2019 in case No. A46-5081/2019). The court concluded that the day for which the salary was accrued is counted towards the three days for which the employer pays benefits.

When movement is limited

Very often, young people who experience the first minor pain in the lumbar or cervical region or stiffness of movement are in no hurry to go to the clinic. But even at a young age, a disease such as osteochondrosis, in order to avoid serious consequences, requires immediate treatment. If temporary disability occurs, sick leave can be issued to you for a period of 7 to 30 days, depending on the type of treatment prescribed.

But even a week in which to follow all the recommendations, visit exercise therapy, a massage room and, if necessary, a chiropractor and physiotherapeutic procedures, can stop the spread of the disease and create the necessary foundation on which you can work and be treated in the future. Therefore, if the doctor recommends that you open the sheet and go through all the necessary procedures, you must listen to his advice.

Amount of sick leave benefit during quarantine

The mechanism for issuing electronic certificates of incapacity for work by the Social Insurance Fund has been streamlined in almost all regions. This format was in effect previously, so there should be no problems with payments.

The benefit amount will be calculated as before; the rules for calculating sick leave for the majority remain the same. The only change concerns those whose income on sick leave may be extremely low due to short work experience or low salary. So, if the temporary disability benefit, calculated according to the general rules (based on the average daily earnings and work experience), calculated for a full calendar month is lower than the minimum wage (the minimum wage is now 12,130 rubles), then sick leave will be paid in the amount of the minimum wage calculated for a full calendar month.

The new rate of payments for sick leave is being introduced temporarily and will be in effect from April to December 2021.

What is needed to apply for sick leave?

In case of a severe course of the disease with persistent pain syndromes, after a medical examination the person is declared temporarily disabled for up to 4 months. If after this there is no improvement in the condition, you cannot return to work, a referral is given to the VTEK to resolve the issue of recognizing the person as disabled.

As a rule, after 1-2 years of treatment, disability is removed, many patients return to their previous lives, and there are no restrictions or contraindications to work.

What indications are needed to apply for sick leave:

• neurological complications causing pain;
• limitation of motor functions, the occurrence of protrusions, hernias;
• information about the place and conditions of work;
• treatment methods and duration, stay at home or in hospital;
• stage of pathology development.

Reasons for extending the BC and possible deadlines

When issuing a BC, the doctor schedules follow-up appointments to assess the dynamics of recovery. If the patient’s condition does not allow him to start work, the sick leave is extended.

In accordance with the order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n, the extension of BL can be carried out until a certain period:

• no more than 4 months with an unfavorable labor prognosis;
• no more than 10 months or no more than 12 months for reconstructive operations, if the prognosis for restoration of working capacity is favorable.

After the specified period, in case of inability to work, a referral is issued to the ITU to establish disability.

Complications from pathology

Cervical osteochondrosis is a dangerous, unfortunately common disease in which the spinal cord, nerve roots, and blood vessels are compressed. There is a disruption in the activity of the brain and vital processes located in it. If you do not seek help from specialists in time, you can cause serious harm to the body; advanced stages cause a number of complications.

Displacement of intervertebral discs leads to paralysis and often causes death. If one of the joints of the cervical spine changes its natural position, complications will have extremely serious consequences. Reducing the height of the discs due to degenerative changes in the spine leads to the fact that the nerves and blood vessels are further compressed. Such processes are fraught with disastrous consequences.

The appearance of osteophytes (bone growths). This complication occurs in 80% of patients. Growths form on the outside and inside the vertebra, causing irritation of muscle and nerve tissue. There is excessive stress on the vertebrae of the cervical spine, swelling and spasms.

Osteochondrosis of the cervical spine leads to negative consequences that affect the condition of blood vessels and changes in the brain. If you do not consult a doctor who will issue a sick leave and prescribe treatment, complications will soon affect the entire spine, which can lead to paralysis of the limbs and disruption of the functioning of all vital organs and systems.

How to diagnose the cause of back pain?

In most cases, a neurologist can name the cause of pain after examination, without additional examination. If the reason needs to be clarified, they resort to help^

• radiography,
• computed tomography,
• magnetic resonance imaging,
• electroneuromyography (recording of electrical impulses in nerves and muscles using special electrodes),
• Sometimes blood tests are necessary.

One of the simplest and fastest tests that helps assess the condition of the spinal column and detect pathologies is radiography. Usually photographs are taken in two projections - full face and profile. As a rule, 4–6 neighboring vertebrae are involved, in which the pathology presumably occurred.

X-ray of the spine helps to identify disorders of the vertebrae (their bodies, arches and processes), intervertebral discs and joints, injuries (fractures, vertebral subluxations), congenital anomalies, osteophytes (bone growths), osteoporosis and other changes.

In what cases do they not give a bulletin with osteochondrosis?

Although this disease can lead a person to disability, often establishing this diagnosis does not require issuing a certificate of incapacity for work. Signs of destruction of the surfaces of the vertebrae can be detected by X-ray in people after 30 years of age. The very fact that cartilage and bone tissue are hiddenly subject to destruction does not cancel the usual physical labor. The doctor prescribes medications that maintain the condition of the cartilaginous surfaces of bones, professional massage, preventive physiotherapy, and physical therapy.

Sick leave is given for osteochondrosis only when distinct symptoms develop that impair a person’s ability to work. Therefore, many people believe that with this pathology, the only way to avoid work is by being in hospital. It is impossible to completely correct the destruction of spinal tissue that has accumulated over the years in a short time, but you need to immediately begin to take measures so as not to subsequently lose mobility. This problem needs to be dealt with regardless of whether you have sick leave. No doctor can force a sick person to restore impaired health. The initiative from the patient himself to strengthen and maintain the functionality of his organs and systems is important.

You cannot self-medicate or perform work duties with severe pain. It is better to seek advice from specialists in order to get a few days of sick leave for examination and determination of the degree of osteochondrosis.

After the painful symptoms of the disease subside and the term of the bulletin ends, you should gradually try to strengthen your back muscles. Some types of physical exercise, swimming, and gymnastics are suitable for this. However, they need to be started gradually, without sudden loads on the spine. Specially designed physical therapy complexes under the supervision of specialists help best. Patients who are unable to attend the classes recommended by the doctor can spend more time walking than lying or sitting still.

How many days can you be on sick leave?

The duration of sick leave is determined by many factors: the intensity of the pain syndrome and its impact on a person’s ability to perform everyday and professional duties, the need for inpatient or sanatorium treatment, and the presence of associated complications. The average duration of sick leave for osteochondrosis ranges from 3 to 10 days. During this time, the patient will receive the necessary medication, hardware or physiotherapeutic treatment. If these measures are not enough, the patient will be offered hospitalization in a hospital (if necessary, a decision on the issue of preparation for surgical intervention).

When initially visiting a doctor about back pain and diagnosing osteochondrosis, the duration of sick leave rarely exceeds 1 week, since at this stage the pain syndrome is quite well and quickly relieved by the use of medications (anti-inflammatory drugs from the NSAID group, glucocorticoid hormones, non-narcotic analgesics, muscle relaxants) . If after treatment the patient does not follow the doctor’s recommendations on nutrition and regimen, the disease will become chronic, characterized by frequent relapses.

Mechanism of action of NSAIDs

When applying again, the duration of sick leave may be:

• with severe pain syndrome (including radicular and muscle pain) – up to 7-10 days;
• if hospital treatment is necessary – up to 2-3 weeks;
• if surgical intervention is necessary – up to 2-6 weeks (depending on the chosen method);
• in case of severe or numerous complications – up to 2-3 months;
• if long-term rehabilitation and sanatorium treatment is necessary - up to 4-6 months (it is possible to assign a temporary disability group).

Disability due to osteochondrosis
Surgical treatment of osteochondrosis may be indicated in the presence of serious complications, for example, an intervertebral hernia with a diameter of more than 5-6 mm (for the cervical spine, hernias of more than 3-4 mm are considered surgical pathology). The duration of sick leave after surgery depends on the state of the patient’s immune system, the individual speed of recovery and the characteristics of the chosen surgical method. For example, operations performed by endoscopic methods are low-traumatic surgical procedures, so in most cases, patients after such operations are able to return to light work within 10-14 days after treatment.

Intervertebral hernia

For how many days is leave from work issued?

The length of sick leave for back pain can vary widely. The period of release from work is influenced by the type of pathology, the nature of its course, and the effectiveness of the treatment provided.

With periarthritis of the cervical spine, people are released from work for a long period. This condition takes a long time to be treated. The doctor can write out a sick leave for 6-7 months.

In case of exacerbation of thoracic osteochondrosis, treatment continues from 15 to 18 days. In case of acute back pain or limited mobility of the spine, a person is given a release from work for up to two weeks. In severe cases, hospital treatment may be recommended.

When the vertebrae are damaged, a person loses ability to work from several days to a week. For diseases with severe radicular syndrome of the cervical zone, they are released from work for 18-20 days. Treatment can take place on an outpatient or inpatient basis.

Persons who have undergone surgery and need to rest in a sanatorium can receive a release from work for up to six months. Patients with numerous complications of osteochondrosis are usually given a certificate of incapacity for work for three months.

If a complex operation has been performed, the rehabilitation period is long, the person’s condition is serious and it is impossible to predict how soon he will become able to work, then a medical commission is convened.

Experts analyze the results of the patient’s examination and make a decision on extending sick leave or assigning disabled status.

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Grounds for issuing sick leave

The main reason for opening a temporary disability certificate for a working patient is radicular or myofascial pain, which can have both a chronic and acute course, intensifying during periods of exacerbations or when exposed to provoking factors. This is especially true for workers in heavy physical labor, professional athletes, and people forced to be in a static, anatomically and physiologically incorrect body position for a long period of time.

Grounds for issuing sick leave

When assessing the patient’s condition and deciding on the need to register a sick leave, the doctor (or medical commission) must be guided by the generally accepted scale. This scale takes into account not only the clinical picture of the disease and the characteristics of the medical history in each specific case, but also the presence of syndromes that allow an objective assessment of the patient’s condition and his ability to work.

Table. Clinical symptoms for an objective assessment of the condition of patients with osteochondrosis.

Data from visual and physical examination must be assessed in conjunction with the results of x-ray examination. If there is insufficient data or it is impossible to make a diagnosis after radiography, the patient is prescribed additional examinations: MRI, multislice computed tomography, electromyography, densitometry, etc. To exclude rheumatoid factors, serological diagnosis may be indicated.

Multislice computed tomography

Duration of sick leave

Osteochondrosis is a fairly common disease; it is diagnosed in 8 out of 10 cases after an X-ray examination. For this reason, changes in bone structure and problems with intervertebral discs themselves are not a reason to rest. The issuance of a sick leave certificate by a neurologist to a patient suffering from osteochondrosis is carried out only when an exacerbation of the disease begins, and it is accompanied by severe unbearable pain.

In the case where the patient was previously seen by a neurologist with a similar illness, and at the moment there is no doubt that an exacerbation has occurred, the doctor sends the person to sick leave. The doctor prescribes maintenance pain therapy.

When you first had to deal with the occurrence of acute pain, the doctor also advises you to take a break from work, but you will have to stay in the clinic for some time to conduct an X-ray examination of the pathological area and take the tests required to diagnose the disease.

If severe pain cannot be relieved with standard home treatment medications, the doctor may decide to hospitalize the patient. In such a situation, sick leave for osteochondrosis will be issued in the hospital, and it will be opened on the day of admission to the department.

A patient who has had this pathology for several years does not ask the question whether sick leave is issued to people with osteochondrosis - it is given and even in an urgent form, since it is better to start treating the disease in the early stages, and not to fight in the future with an advanced disease .

If pain occurs, it is recommended to take a break from work for a certain time rather than try to get rid of irreversible complications in the future.

The duration of sick leave during osteochondrosis is determined by a combination of symptoms:

• the strength and duration of pain that hinders movement (in the case where the pain is soon relieved as a result of therapy, the sick leave will last a standard number of days, if the treatment is long, the sick leave may be extended);
• the patient’s occupation (when the patient is engaged in heavy physical labor, in order to avoid secondary manifestations of the disease, he is advised to rest for a long time);
• specialist treatment plan and standards for the treatment of the diagnosed disease. With rapid pain relief, the patient should spend a standard number of days on sick leave. Otherwise, the clinic and the doctor may be fined by the insurance company.

Duration of sick leave depending on the type of disease:

1. The duration of sick leave for the treatment of osteochondrosis of the cervical region is 3-7 days, provided that the patient has been diagnosed with a mild form of the disease. If the disease is severe, the doctor may issue a certificate of incapacity for work for 21 days. If osteochondrosis is complicated by periarthritis, therapy and sick leave can last up to 7 months.
2. In case of thoracic osteochondrosis in the acute stage, the neuropathologist can extend sick leave to 18 days.
3. The duration of therapy for lumbar osteochondrosis is at least 7 days. If pain is not relieved for a long time, the patient is sent to hospitalization for serious treatment and a decision on surgical intervention. When transferring a patient for treatment in a hospital department, the clinic doctor closes the certificate of incapacity for work, and a new one is opened by hospital staff.

The duration of the certificate of incapacity for work during treatment of any illness is strictly controlled by the insurance company. If the standard duration of therapy is violated (both reduced in case of a quick cure, and increased despite accepted norms), employees of the insurance company conduct an inspection of the medical institution.

General requirements

The rules by which a document on illness is issued are approved by Order of the Ministry of Health of the Russian Federation dated September 1, 2020 No. 925N (hereinafter referred to as the Order). The Order states that only insured persons can receive a certificate of incapacity for work: citizens of the Russian Federation, foreigners and stateless persons permanently or temporarily residing in the Russian Federation, as well as foreign citizens and stateless persons temporarily staying in the Russian Federation. This procedure applies to:

• those working under an employment contract, including managers who are the only founders (the guarantees of the Labor Code of the Russian Federation do not apply to those working under GPC contracts);
• state civil servants, municipal employees;
• clergy;
• lawyers, individual entrepreneurs, members of peasant farms, notaries;
• women who were fired due to the liquidation of an enterprise and became pregnant within twelve months before being declared unemployed;
• unemployed citizens who are registered with the employment service, with temporary loss of ability to work.

Sick leave is issued only by attending physicians, paramedics and dentists in licensed medical institutions. The medical staff of blood transfusion services, ambulances, mud baths and balneological hospitals, the forensic medical examination bureau and other specialized institutions do not have the right to issue this document.

A paper certificate of incapacity for work is issued using an identification document. For electronic sick leave, you will additionally need SNILS. If, at the time of maternity leave or temporary disability, the sick person works for two or more employers and has worked for them for the previous two years, he is issued several paper sick leaves or one electronic sick leave number.

As a rule, opening and closing the disability form is done in one medical institution. If the patient was sent for treatment to another organization, a new form (continued) is issued there.

How to pretend to be sick to get sick leave?

In the medical unit at their plant they gave him sick leave once, immediately after he tore his back, then for a long time they refused to give him sick leave at all. claiming that this is not a reason. This year, he was still able to get sick leave only after undergoing an x-ray of his back, where a very serious diagnosis was made.

I slept on the floor all night... (he winces again and bends his right leg unnaturally) (D) - How long ago? (already with sympathy) (MB) - The second day... (swallowing saliva and taking a breath). The spare tire... That is, the tire... The car got flat... I started changing it...

I took the spare tire out of the trunk (wrinkling)... I just sat down in a place with it in my hands... then something shot in my butt... I couldn’t straighten up... so compassionate citizens brought me home with the spare tire... (D) - So why didn’t you go to the reception right away? (throwing up her hands... Zinochka, with her mouth open, watches what is happening) (MB) - I thought it would pass...

and you need to go to work (the word “work” is pronounced insinuatingly, but clearly) (D) - Stand up (you stand up yourself). You, frantically grabbing the back of the chair with one hand, leaning on the table with the other, while crumpling the post-mortem epicrisis, stand up with your face , full of universal suffering. Retreat: don’t jump up suddenly. The first ten massage sessions I was just climbing on the wall in pain, and the next ten I was just crazy and enjoying the massage. So calculate how long I was on sick leave. If we throw out all the non-working days (weekends), then I spent almost a month and a half at nm. But it really was an unbearable pain in my back!

If your back simply hurts and the doctor determines muscle tension and sees a limitation of the musculoskeletal system, then the maximum you can get a sick leave for is two weeks. You will be prescribed a course of injections and physiotherapy and on average it will last 10 - 14 days. Then they discharge you, even if you complain that you can’t fully bend yet. But if an MRI shows the presence of protrusions, then in a mild case the sick leave will be issued for 30 days, and if there are hernias, then the sick leave may be extended further. I was on sick leave for three months, my sister for more than six months.

Deadline for paying maternity benefits

Maternity benefits are paid from the Social Insurance Fund or the federal budget. If a woman expecting a child is officially employed, then she turns to her employer for benefits, but pays the money to the Social Insurance Fund. In this case, the payment period does not differ from the general rules for receiving compensation for sick days.

Material on the topic Rules for recording sick leave for external part-time workers Unemployed pregnant women apply for benefits to the social security authorities at their place of residence (stay or actual residence). Officials are given 10 days to review and assign a specific amount. Maternity leave must be issued directly no later than the 26th day of the month following the month of application and registration of the application with all the necessary documents.

The benefit is calculated based on average earnings. That is, a woman who provides sick leave for pregnancy and childbirth will receive 100% of the average earnings during the period of maternity leave. If an employee has worked for less than six months, her benefits will be calculated based on the minimum wage and regional coefficients (if applied). Unemployed expectant mothers will also be able to claim the minimum amount.

The benefit is paid in a total amount regardless of the number of days actually used by the pregnant woman before giving birth. The practice of not paying full maternity leave on the basis that a woman continued to work after 30 weeks of pregnancy is illegal.

What should I do to make the pain go away?

First of all, consult a doctor. For progressive pain syndrome, the doctor prescribes medications that quickly relieve pain. During exacerbations, when mobility is limited and accompanied by severe pain, the doctor will prescribe a drug blockade - drugs that relieve spasms are injected directly into the muscles.

During the recovery period, chondroprotectors are used to restore damaged cartilage tissue. It is impossible to completely restore damaged cartilage; this makes osteochondrosis dangerous.

The group's drugs prevent further destruction of tissue between the vertebrae. The substances contained in the preparations retain moisture in the tissues, nourish, and increase the regeneration processes.

In the future, when the attack of pain passes, you go through a recovery period, a set of exercises, medications prescribed by a doctor, it is useful to lead an active lifestyle. It is useful to use a horizontal bar for cervical osteochondrosis. To prevent the disease, it is enough to periodically hang on it.

The main thing when performing exercises is caution. Often patients decide to start a serious fight, go to the gym, and perform complex sets of exercises

Possible duration of sick leave

Of course, this question will remain unanswered until the patient visits the neurologist’s office, where a full examination will be performed and the stage of the disease will be revealed.

Since this neurological disease is often accompanied by complications, the doctor will insist on strict adherence to the regimen, medication and other mandatory procedures.

However, the number of days allotted for treatment will depend on the indicators of diagnostic measures:

• The doctor will find out how the pain manifests itself, what is the degree of limitation of movement in the patient;
• The patient will definitely be asked about the patient’s working conditions, its specific features; questions may arise regarding the length of the working day and rest schedule;
• The length of sick leave also depends on the duration of treatment that will be required to restore health.

A patient may be on sick leave for different periods of time, here are some examples:

1. If a diagnosis of cervical osteochondrosis is made, the number of sick days depends entirely on the location of the pathology and the degree of damage to bone structures or vertebrae. On average, a patient may not go to work for three to seven days. If a severe form of the disease, such as radicular syndrome, is diagnosed, then sick leave may last for three weeks. For periarthritis, the notice will last up to seven months.
2. Osteochondrosis of the thoracic part in an aggravated form should be treated for at least 18 days, for this period a permit for treatment in a hospital or at home will be issued.
3. A fairly common occurrence is lumbar osteochondrosis. Its treatment will require an average of up to seven days, but it all depends on the patient’s well-being and the severity of the pain. Often, in advanced stages of the disease, a person is prescribed treatment in a hospital setting, since at home there are no proper conditions for a full recovery. Often after such a therapeutic course and recovery period, the patient is strongly recommended to change work to an easier option.
4. There are cases when the disease requires surgical intervention. In this case, the operated patient receives sick leave for a treatment and rehabilitation course. The degree of complexity of the disease and surgery dictate the duration of sick leave.

Do they give sick leave for lower back pain?

httpv://www.youtube.com/watch?v=embed/KD1eXxLJzbU

If your local police officer is literate, then refer to acute pain in the lower back, again, do not get up from the bed and when asked to lie on your back, yell at the top of your voice, and when asked to raise your leg, do not raise it higher than ten cm, again ooh and ahh , as if you are being cut into pieces. The theme is the same here, sick leave for 3 weeks is guaranteed. They will prescribe ortofen, milgamma, and some diclofenac in the form of an ointment or voltaren.

The advantage of points 1 and 2 is that this is the competence of a neurologist, and a therapist will come to you, so they won’t really understand it. 3) If you have ever had sinusitis.

Complain of a headache, especially when palpating the forehead strictly above the bridge of the nose and eyebrows.

The diagnosis is recurrent sinusitis; Erespal or Augmentin will be prescribed. Again, call the local police officer to your home so that you are not sent for an x-ray. 4) Call a therapist again at home and complain about the temperature

How to go on sick leave?

If lower back pain occurs and a person has lost the ability to work, then the question arises of how to go on sick leave with a back problem. To open a certificate of incapacity for work, you should visit your local physician at your local clinic. The doctor will examine, interview the patient and refer him for examination and consultation to specialists.

Diagnostic procedures may include:

• blood analysis . Necessary to identify an infection that can cause pain in the spinal column;
• radiography . Shows the condition of bone tissue. Prescribed for suspected fracture or arthritis;
• magnetic resonance and computed tomography . They allow you to assess the condition of not only bones, but also soft tissues of the back (ligaments, muscles, nerves, blood vessels, intervertebral discs). MRI images are considered higher quality than CT images;
• bone scan . Used when a tumor or compression fracture is suspected;
• electromyography . Makes it possible to evaluate electrical impulses from nerves and the reaction of muscle tissue to them. Detects nerve compression due to spinal canal stenosis and intervertebral hernia.

Based on the results of these studies, the doctor will make a diagnosis and make a decision regarding the patient’s release from work.

Can they give sick leave for osteochondrosis?

The discs located between the vertebrae, consisting of fibrocartilaginous tissue, are affected. The patient feels attacks of pain, as a result of which one may lose motor activity.

In stages 2 and 3 of osteochondrosis, it is difficult to move; acute pain occurs during movement and in a quiet position. Such symptoms indicate the need for medical examination.

More often, sick leave is opened in a hospital. Therapy for osteochondrosis is carried out in courses aimed at stopping the progression of the disease.

• Stages of osteochondrosis and registration of disability due to illness
• Which doctor treats osteochondrosis?

How long can you be on sick leave without a break with your back?

Dear site visitors, good health to you! So, the decision has been made - let's go to the doctor to get sick leave. But what and how is it better to mow? There can be a lot of advice, different people quite successfully pretend to doctors in different ways and different diseases. It’s better to see a doctor on your back! How to mow your back, how to simulate pain in the back (lower back) - recommendations.

If a significant and sustainable result in treatment is not observed, then the patient’s condition is considered as permanent disability. In this case, it may be recommended to conduct a survey to establish a disability group.

However, part-time workers should clarify the procedure for accrual and payment under the document, since they depend on the specific situation. Those dismissed from work are issued a sick leave certificate if the illness or injury occurs within 30 calendar days after the termination of the employment contract.

There are different periods for sick leave due to back pain. In some cases, three days are enough for treatment, for others it may be extended after the course of treatment. So, if pain due to cervical osteochondrosis is relieved during the treatment period, then there is no point in extending the course.

Automatic release is an exceptional and urgent measure taken to ensure the proper functioning of the service.

If a medical commission gathers to assess the patient’s condition, it is necessary to provide the results of instrumental and general clinical studies. Sometimes additional diagnostic measures are required, for example, multislice computed tomography, electromyography, densitometry, serological tests to determine rheumatoid factor.

Such diseases are very common, even among young people they are not uncommon. Disability against their background can be not only temporary, but also permanent. Especially when the stage of the disease is conducive to this. My husband often has back problems because he tore it when he was young. In the medical unit at their plant they gave him sick leave once, immediately after he tore his back, then for a long time they refused to give him sick leave at all. claiming that this is not a reason. This year, he was still able to get sick leave only after undergoing an x-ray of his back, where a very serious diagnosis was made.

How is back pain treated?

In most cases, back pain is not caused by serious illnesses. An unpleasant symptom can be dealt with by:

• Non-steroidal anti-inflammatory drugs.
• Therapeutic gymnastics.
• Massage.
• Physiotherapy.
• Many people benefit from manual therapy.
• Some chronic back pain can be successfully treated with antidepressants.

Most often, diseases that lead to back pain are quite amenable to drug treatment. Surgeries are rarely necessary. Naturally, with a number of pathologies, the longer you postpone a visit to the doctor and the start of treatment, the more changes in the spine increase, and accordingly, the chances of ending up on the operating room table increase.

Don't expect your back pain to go away on its own. Do not self-medicate. A neurologist will understand the causes and prescribe effective treatment. Make an appointment with a neurologist, call +7 (495) 120-08-07

Do they provide a certificate of incapacity for work?

The main reason for opening a sick leave certificate for a working patient is radicular or muscle (myofascial) pain. It can be acute or chronic and intensifies during exacerbation.

Such painful manifestations are characteristic of manual workers, persons whose activities are associated with incorrect anatomical and physiological position of the body during the working day (stooping work, lifting weights).

Is sick leave given for osteochondrosis? Yes, if the patient:

• I am registered with a neurologist for this disease, and at the moment it has worsened. Therapy in this case involves a course of painkillers;
• I experienced acute pain for the first time. The doctor will prescribe an x-ray examination of the affected area and all necessary laboratory tests;
• home therapy did not bring positive changes - the pain does not go away and remains severe. In such a situation, the doctor may recommend continuing the examination in a hospital, where a sick leave certificate will be issued. Its discovery dates back to the moment the patient entered the hospital.

Symptoms characteristic of osteochondrosis help the doctor assess the patient’s condition and his ability to work:

• reflex-tonic syndrome. The main sign of the disorder is severe deformation of the spine (stooping, displacement of the vertebrae, increased thoracic kyphosis). In most cases it appears on one side of the body. In patients, stooping and gait disturbance can be visually observed;
• visceral pain syndrome. The cause of pain is a malfunction of one or another internal organ caused by a disruption of the innervation of the affected spinal motor segment of the spinal cord (a segment is the bodies of 2 adjacent vertebrae and everything that is between them). Symptoms: cardialgia, intercostal neuralgia, etc.;
• vascular syndromes. With prolonged muscle spasm, compression of the blood vessels occurs, which impairs blood circulation in the upper and lower extremities. The patient may be bothered by numbness of the arms and legs, changes in the sensitivity of the skin;
• tension syndrome. In this case, pain appears when bending and turning the body, flexing and extending the affected limbs.

The results of the physical examination and visual examination of the patient must be assessed in conjunction with the results of radiological data. If necessary, additional diagnostics may be prescribed: MRI, electromyography, computed tomography, etc.

Other factors that the doctor must take into account when issuing sick leave and determining its duration include:

• the ability for patients to move independently and take care of themselves fully. Some patients suffer from severe pain during an exacerbation and require outside help. The certificate of incapacity for work is extended for them until the acute symptoms disappear completely and motor skills are restored;
• existing complications or concomitant diseases. It happens that in-depth diagnostics aimed at identifying degenerative processes reveal concomitant pathologies that are complications of osteochondrosis. For example, kyphosis and radiculitis, spondylosis, spinal hernia and intervertebral disc protrusion. If these diseases require correction and may affect the dynamics of the main therapy, sick leave is extended in accordance with the diagnosis code according to the ICD;
• working conditions. If the patient’s professional activity is associated with physical strain, even moderate pain will be grounds for issuing a certificate of incapacity for work. In some cases, after the end of the sick leave, the employee cannot return to his main duties, since he has been recommended to have a lighter workload due to limited ability to work.

Back pain is one of the most common complaints when visiting a neurologist. Almost 70% of the total number of temporary disability certificates issued are for patients with various manifestations of osteochondrosis.

Errors in sick leave and FSS claims

Sergey Slesarev,

private practicing lawyer, expert

Every year, courts consider thousands of disputes related to errors in sick leave certificates: errors in sick leave can cause claims from inspectors and the employer will be required to reimburse expenses incurred to pay for sick leave or be denied credit for insurance premiums. The tension is heightened by the fact that even the slightest blot, say, a missed birthday when filing sick leave, can lead to such consequences. In such cases, does the organization have any hope of defending “justice” in the courts? What do the courts think about errors in sick leave certificates and under what conditions should an organization not be afraid of claims from inspectors?

Certificate of incapacity for work as confirmation of an insured event

Often, a sick leave is perceived simply as a kind of analogue of a sickness certificate to recognize a valid reason for absence from work.

And this is indeed true to a certain extent, primarily from the point of view of labor relations: for the employer, the only important thing is for what reason the employee was absent, and that he really had an objective reason to “miss” the performance of work duties.

But from the point of view of the compulsory social insurance system, the certificate of incapacity for work is a much more important document.

When we go on sick leave or maternity leave, the “gears” of the compulsory social insurance system are activated.

What sometimes seems to us to be just an ordinary social benefit is actually insurance coverage (insurance payment) in connection with the occurrence of an insured event under an insurance contract.

Moreover, the basis for the payment of such benefits is not the illness, injury or birth of a child per se, but a change in our situation as a result of the event.

This, in particular, is directly stated in Art. 1 of the Federal Law of July 16, 1999 No. 165-FZ “On the Basics of Compulsory Social Insurance” (hereinafter referred to as the Law on OSS): compulsory social insurance is part of the state system of social protection of the population, the specificity of which is the insurance of working citizens from possible change in financial and (or) social situation, including due to circumstances beyond their control.

Among the insurance risks are listed (Article 7 of the Law on OSS):

1) the need to receive medical care;

2) loss of earnings (payments, rewards in favor of the insured person) or other income by the insured person in connection with the occurrence of an insured event;

3) additional expenses of the insured person or his family members in connection with the occurrence of an insured event.

As we can see, the task of the OSS system is to support, first of all, the financial situation of a citizen, to help him in case of loss of earnings or the need for additional injuries.

Reaching retirement age, the birth of a child, illness, injury, etc. are only insured events that trigger the insurance risk and insurance protection.

They “signal” about the occurrence of an insurance risk (clause 1.1 of Article 7 of the Law on OSS, Article 9 of the Law of the Russian Federation of November 27, 1992 No. 4015-1 “On the organization of insurance business in the Russian Federation”).

Of course, after reading this, you can say: why this lecture about the OSS system and what do errors in sick leave and claims from inspectors have to do with it?

The fact is that a certificate of incapacity for work is not just a “certificate of illness”, but a document confirming the occurrence of an insured event and the “triggering” of the insurance risk.

A kind of analogue of the “Start” button for the OSS system, and if this button is defective, then questions arise about the correct operation of it.

And in case of disputes, the courts will look at whether the “button” was actually “working” and worked correctly; and the organization to which the claim is made must prepare to provide evidence of the occurrence of conditions for the “triggering” of insurance protection.

Let us turn to judicial practice for illustration and at the same time compile a small list of FSS claims for sick leave and the courts’ reactions to them.

Claim 1. Lost certificate of incapacity for work

The loss of a certificate of incapacity for work can happen for various reasons: from theft of documents to the negligence of employees and accidental damage to certificates.

In such a situation, the FSS considers the sick leave payments made to be unjustified, allegedly due to failure to confirm the fact of incapacity for work. But the courts look at the loss of sick leave differently.

Thus, the joint-stock company lost certificates of incapacity for work for 10 employees, which is why the Social Insurance Fund decided not to take into account the costs of paying benefits for temporary disability and in connection with maternity.

The joint-stock company challenged the decision in court, and all three authorities supported the company, pointing out that the mere fact of failure to submit certificates of incapacity for work in connection with their loss by the insured is not a sufficient basis for refusing to accept for offset the costs of paying insurance coverage in the presence of other documents confirming justification of the corresponding payments.

The basis for the appointment and payment of insurance coverage, in particular, maternity benefits or temporary disability, to the insured person is the occurrence of a documented insured event (Articles 8, 12 of the Law on OSS). Within the meaning of these norms, as well as Art. Art. 3, 2.3, 4.1, 13 of the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity”, the conditions necessary to reimburse the policyholder for the costs of compulsory social insurance are:

• the existence of an employment relationship between the policyholder and the insured person;
• documentary confirmation of the occurrence of an insured event and payment of benefits to the insured person, calculation and payment of insurance premiums.

The company applied to medical institutions with a request to confirm the issuance of certificates of incapacity for work to their employees, as well as to issue their duplicates. And to confirm the validity of the payments made, the JSC provided the Fund during the audit:

• pay slip for the disputed year;
• orders for hiring employees;
• calculations of temporary disability benefits for each employee;
• pay slips and other documents confirming the payment of benefits to employees;
• responses from medical institutions, which contain information about issued certificates of incapacity for work, indicating the series and numbers of certificates, surnames, first names and patronymics of employees and periods of their incapacity for work. The medical institution also provided copies of the spines of the leaflets.

The information contained in the submitted documents makes it possible to establish the existence of an employment relationship between the policyholder and the insured persons, the occurrence of insured events, periods of temporary disability of the insured persons and the incurrence of related expenses by the policyholder.

At the same time, the district court emphasized that the current legislation does not provide for the re-issuance of certificates of incapacity to replace lost ones, therefore the loss of sick leave is not a reason to “punish” the employer.

In the event of the loss of such certificates, the legality of the expenses incurred can be confirmed by other documents, including letters from medical institutions, which, together with the information contained therein, confirm that the lost certificates of incapacity for work were actually issued to the insured persons and presented for payment to the insured. (Resolution of the Arbitration Court of the North-Western District dated 06.06.2018 No. F07-5149/2018 in case No. A21-9220/2017).

The district court presented a similar position in another case, in which a college lost certificates of incapacity for work for 2021: the loss itself is not a reason for making decisions to refuse credit and additionally charge insurance premiums, penalties, and fines.

The occurrence of insured events and the issuance of certificates of incapacity for work were confirmed by medical organizations at the request of the court of first instance (Resolution of the Arbitration Court of the North-Western District of May 21, 2020 No. F07-2705/2020 in case No. A13-4806/2019).

Similar conclusions are found in another case: during the inspection, the LLC was unable to provide the original certificates of incapacity for work for one of the employees, which is why the Social Insurance Fund did not accept the corresponding expenses for offset.

The court rejected the Fund’s arguments, since the FSS did not deny the fact of the occurrence of insured events, and the absence of original certificates of incapacity for work in itself is not a basis for making a controversial decision (Resolution of the Arbitration Court of the East Siberian District dated August 13, 2019 No. F02-2281/2019 in case No. A19-20870/2018).

As we see from the examples, to remove the claims of the inspectors, it is enough to have evidence of the existence of an employment relationship and the fact of the occurrence of temporary disability.

The latter is confirmed by any evidence received from medical organizations, for example, upon request.

The request is written in free form, it indicates: the reason for the request (loss of certificates of incapacity for work and the need to confirm the occurrence of an insured event in order to pay benefits for temporary disability) and what information is needed (number, series, date of issue of the certificate of incapacity for work, full names of employees, periods of incapacity for work), the address where you want to send the response.

It is recommended, in order to reduce the risk of refusal on the grounds of maintaining “medical secrets,” to avoid formulations asking to confirm the fact of applying for medical care or receiving medical care, but only to ask to confirm the issuance of a certificate of incapacity for work.

If the medical organization for any reason refuses to do this, then copies of the correspondence are attached to the package of documents for the inspectors. You can also ask employees to obtain similar certificates from a medical organization themselves.

In the event of a trial, you can petition the court to send a judicial request to the medical organization.

The petition is formulated either in the text of the application itself to challenge the relevant decision of the inspectors or in the form of a separate document. In any case, a request and a “refusal” response from the medical organization are attached. (Part 4 of Article 66 of the Arbitration Procedure Code of the Russian Federation).

Claim 2. Errors in issuing and extending certificates of incapacity for work

Incorrect extension of the certificate of incapacity for work.

For example, medical organizations issued certificates of incapacity for work for additional days of maternity leave as primary, and not as an “extension”; because of this, the Social Insurance Fund refused to accept benefits paid to employees by PJSC.

Meanwhile, as the courts pointed out, the procedure for issuing sick leave certificates in force at the time of registration does not determine how sick leave for additional days should be issued - as a primary one or as a continuation, and does not establish that a sick leave certificate issued for an additional 16 days must necessarily be a continuation of the main one. maternity sick leave.

The Presidium of the Supreme Arbitration Court of the Russian Federation, in Resolution No. 10605/12 dated December 11, 2012, noted that the employer does not have the right to control the correctness of the sick leave certificate and compliance with the procedure for issuing it. Therefore, the Social Insurance Fund cannot refuse to offset (reimburse) the benefit amount to the employer if there are such violations in the sick leave certificate.

In such cases, the Fund has the right to demand reimbursement of expenses for payment of benefits from a medical institution that incorrectly filled out the form (Clause 6, Part 1, Article 4.2 of Law No. 255-FZ). (Resolution of the Arbitration Court of the Moscow District dated June 25, 2020 No. F05-7340/2020 in case No. A40-158982/2019).

In another case, a worker’s sick leave was extended, but, contrary to the rules for issuing sick leave, the first was “closed”, and the second was issued as a continuation of the first.

The FSS considered that in this case the payment of temporary disability benefits was unjustified and demanded that the company reimburse the expenses incurred by the FSS for the payment of benefits, since the payment of benefits was made within the framework of a pilot project directly by the Fund. The company challenged the decision in court.

The court came to the conclusion that the shortcomings made by the medical institution when issuing a certificate of incapacity for work cannot serve as a basis for reimbursement of expenses incurred excessively by the FSS by the applicant.

The institution did not provide evidence of the issuance of certificates of incapacity for work by medical institutions in the absence of medical indications.

The institution’s reference to the fact that the medical organization issued an incorrectly executed certificate of incapacity for work, where the section “to be filled out by a doctor of the medical organization” is drawn up using printing devices, and the controversial entries about the number of the “certificate of incapacity for work continued”, entries in the line “Other” code “31” and the line “a certificate of incapacity for work has been issued (continued)” is entered in black ink with a gel (or capillary) pen, does not indicate the unreliability of the information provided by the policyholder; The Foundation’s arguments that the certificate of incapacity for work was damaged by the applicant are based on assumptions and are neither documented nor refuted.

To recognize a payment made as unjustified, it is required that the Fund establish circumstances indicating that the policyholder’s actions were aimed at illegally receiving funds from the Social Insurance Fund, but such evidence was not provided to the court (Resolution of the Arbitration Court of the West Siberian District dated November 7, 2018 No. F04-4525/2018 on case No. A45-2304/2018, by Decision of the Supreme Court of the Russian Federation dated February 27, 2019 No. 304-ES19-275, the transfer of the case for review was refused).

Incorrect dates on sick leave or errors in dates.

Thus, the medical organization made a mistake in terms of entering the period of incapacity for work into the hospital: in two lines instead of one and indicating all periods of extension instead of the start and end dates of the period of incapacity for work.

And again the FSS refused to offset the contributions. The court recognized the Fund's position as unfounded: errors in the preparation of a duplicate sheet in themselves are not an unconditional basis for recognizing the resulting disability as a non-insurable event, excluding the payment of insurance coverage.

By virtue of clause 6, part 1, art. 4.2 of Law No. 255-FZ The Fund has the right to bring claims directly against medical organizations for reimbursement of the amount of expenses for insurance coverage for unreasonably issued or incorrectly executed certificates of incapacity for work, i.e. the negative consequences of medical institutions’ failure to comply with the requirements of the current legislation are assigned directly to them, and not on the policyholder, who is not entitled to control the correctness of registration and compliance with the procedure for issuing certificates of incapacity for work by medical organizations.

Since the Fund did not challenge the fact of incapacity for work and did not prove the direction of the institution’s actions as an insurer to create an artificial situation to receive funds from the Fund, its decision is illegal (Resolution of the Arbitration Court of the North Caucasus District dated August 10, 2017 No. F08-5574/2017 in case No. A63-8397 /2016).

Moreover, the courts in this case also referred to the position of the Supreme Arbitration Court of the Russian Federation that it is the medical organization that bears the risks for violating the rules for processing and issuing certificates of incapacity for work, for example, if it does not have a license to carry out medical activities (Resolution of the Presidium of the Supreme Arbitration Court of the Russian Federation dated December 11, 2012 No. 10605/12 in case No. A33-11561/2011).

Adheres to the same position on the responsibility of medical organizations and the Armed Forces of the Russian Federation (see, for example, Ruling of the Supreme Court of the Russian Federation dated February 13, 2018 No. 306-KG17-22369 in case No. A12-3283/2017).

In another dispute, employees of a medical organization incorrectly filled out the details of the sheets regarding the end dates of the period of incapacity for work, in particular, in one of the sheets the date of issue did not correspond to the date of discharge after hospital treatment, in the other the line “start to work...” was filled in incorrectly, etc.

All this served as the basis for the FSS’s refusal to accept expenses incurred for offset.

However, the court recognized that the FSS did not have legal grounds for making such a decision, since violations of the requirements for the procedure for filling out certificates of incapacity for work were committed directly by medical institutions, and the facts of incapacity for work themselves were not disputed by the persons participating in the case.

The Fund’s refusal to accept for offset the costs of paying insurance coverage does not change the legal nature of the benefits paid, since errors in the preparation of documents cannot be an absolute reason for recognizing the resulting disability as a non-insurance event, that is, not obliging to pay insurance coverage.

Such errors do not actually entail refusal to pay benefits for temporary disability (Decision of the Supreme Court of the Russian Federation dated December 16, 2014 No. 309-KG14-2606). (Resolution of the Arbitration Court of the North Caucasus District dated January 28, 2019 No. F08-11199/2018 in case No. A63-5252/2018).0-36992/2019).

A similar conclusion is found in other disputes:

• The medical organization incorrectly indicated the date of closure of the sick leave: the mere fact of issuing certificates of incapacity for work in violation of Procedure No. 624n, if there are conditions for the citizen to receive benefits for temporary disability, is not a basis for refusing to accept these expenses for offset (Resolution of the Arbitration Court of the Ural District dated 19.08 .2020 No. F09-4818/20 in case No. A50-36992/2019);

• in the continuation of the certificate of incapacity for work, the employees of the medical institution incorrectly indicated the start date of the period of incapacity for work. The court explained that not any violation of the procedure for issuing temporary disability certificates indicates the illegality of making social insurance payments.

The Fund did not dispute the fact of the occurrence of the insured event and did not provide evidence of the unreliability of the disputed certificate of incapacity for work (Resolution of the Arbitration Court of the East Siberian District dated February 20, 2019 No. F02-81/2019 in case No. A19-11796/2018).

There is no seal/stamp of the medical organization.

For example, temporary disability benefits were assigned on the basis of a certificate of incapacity for work without the seals of a medical organization.

The courts found that the violation committed by the company is remediable and does not indicate the illegality of the accrual and payment of benefits; the circumstances of the occurrence of an insured event in relation to employees by the Fund are not disputed.

The occurrence of insured events, the period of incapacity for work of the insured persons, and the incurrence of corresponding expenses by the insured are confirmed.

At the same time, the court imposed on the FSS the obligation to pay the state duty, and rejected the argument to exempt the Fund from this, since the LLC addressed the Fund with a statement, attaching the necessary documents, in which it asked to reconsider the Fund’s decision.

Meanwhile, the Fund has not considered this application on its merits; the society has not been informed of anything about the procedure for subsequent actions after receiving the necessary documents. Thus, the Foundation had the opportunity to resolve the current situation out of court, but did not take any measures in response to the company’s actions and did not respond to the submitted application.

The legislation does not provide for the exemption of state and municipal bodies from reimbursement of legal costs if the decision is not made in their favor (Resolution of the Arbitration Court of the East Siberian District dated October 4, 2018 No. F02-4308/2018 in case No. A19-22723/2017).

Putty corrections.

Thus, the following mistake was made on the certificate of incapacity for work: a new entry was made on the entry erased with “putty” in the “insurance period” field, instead of the required crossing out and making the correct entry on the reverse side of the certificate of incapacity for work.

Because of this, the FSS demanded that the institute (the employer) reimburse the excessively incurred expenses for paying sick leave.

Meanwhile, as the courts indicated, the Foundation did not provide evidence of the issuance of a certificate of incapacity for work by a medical institution in the absence of medical indications.

The Fund does not dispute the fact of the employee’s illness and the validity of issuing sick leave.

The targeted nature of spending the Fund's funds has not been violated.

Violation by the insured of the procedure for filling out a certificate of incapacity for work in the field “insurance period” does not indicate the absence of grounds for payment of benefits for temporary disability to the insured person (Resolution of the Arbitration Court of the Volga District of September 26, 2018 No. F06-37202/2018 in case No. A06-10422/2017) .