How to open and close a compulsory medical insurance and VMI in 2026: step-by-step instructions

In 2026, the system of registration of sick leave in Russia will retain the general order, but the rules for working with electronic disability certificates (ELS) will be clarified. The circle of citizens who receive medical treatment will expand, and medical organizations will receive additional regulation of procedures for opening and closing hospitals. Details can be found in the Izvestia article.

What has changed in the rules of registration of sick leave in 2026

In 2026, the basic procedure for issuing disability certificates will remain in place, but a number of procedures related to electronic sick leave will be clarified. At the federal level, the transition to a fully digital document management model in healthcare continues, which requires updating regulations and technical interaction between medical organizations, employers and the Social Insurance Fund (Social Insurance Fund).

According to the leading expert of Kontur.Externa" by Elena Kulakova, there will be no global changes in the rules for issuing disability certificates in 2026, but the procedure for working with electronic hospital records will be expanded and clarified.

One of the key innovations will be the expansion of the category of citizens for whom electronic disability certificates (ELS) are generated. The Ministry of Justice is approving a document providing for the registration of an EIT for persons who have lost their ability to work during the suspension of an employment contract after military service.

These adjustments should ensure a unified approach to accounting for temporary disability, regardless of the citizen's status and the circumstances under which medical release from work became necessary.

How to open a medical leave for compulsory medical insurance and VMI

The procedure for opening sick leave in 2026 remains the same for both public clinics for compulsory medical insurance and private medical centers operating in the VMI system. There are no fundamental differences between them. The only requirement is that the medical organization has a license that includes an examination of temporary disability.

The procedure begins with the initial admission of the patient. The doctor collects an anamnesis, evaluates complaints, conducts a visual examination and prescribes the necessary diagnostic tests. Only after that, a decision is made to issue a disability certificate. As noted by Elena Kulakova, it remains mandatory for a medical professional to establish a diagnosis of the disease and its severity based on the collection of medical history and complaints, a general examination of the citizen and the results of diagnostic measures.

All data is recorded either in the patient's electronic medical record during outpatient follow-up, or in the medical history during inpatient treatment.

In order to receive an ELN, the patient must present an identity card and SNILS. Data is transferred to the FSS system automatically, and it is enough for a citizen to inform the employer of the number of the issued electronic form. This eliminates paper media and minimizes the risk of errors.

How to extend and close sick leave

The rules for extending and closing sick leave are also retained in the previous version. The extension is issued by the doctor upon re-examination of the patient, if his health condition does not allow him to return to work duties. The medical organization records changes in the patient's condition and forwards the updated ELN to the FSS system.

In a number of situations, automatic closure of the disability certificate is provided. This applies, for example, in cases where the patient does not show up for a repeat appointment.

"For example, in case of acute respiratory viral infections, a doctor opens a sick leave for 7 days. If the patient does not come to the appointment, it is considered that he has recovered, and the medical center is closed," the expert explained.

This procedure applies to common diseases with a short predicted recovery period.

If the patient shows up for an appointment, the doctor re-evaluates his condition and decides on an extension. The electronic sick leave system allows you to record all changes in real time, ensuring transparency and access of the employer to up-to-date information about the status of the medical institution.