The procedure for the activities of medical and social examination institutions. Institutions of medical and social examination

Topic 2. Organization of the institution’s activities civil service medical and social examination

1. Give the concept of temporary disability and its types.

2. What is the difference between the examination of temporary disability and the medical and social examination?

3. What is the procedure for organizing the examination of temporary disability?

4. What is the procedure for issuing documents certifying temporary disability of citizens due to illnesses and injuries? What is the legal significance of this document?

5. What is the procedure for issuing certificates of incapacity for work in other cases (except for illnesses and injuries)? What is the legal significance of this document?

6. What is the procedure for preparing documents certifying temporary disability?

7. What determines the amount of temporary disability benefits?

Main goals ITU institutions
Structure of ITU institutions. The procedure for their formation, reorganization and liquidation
Competencies of ITU institutions at different levels

Main tasks of ITU institutions

Medical and social examination is carried out by federal institutions of medical and social examination, subordinate to the authorized body determined by the Government Russian Federation. The procedure for the organization and activities of federal institutions of medical and social examination is determined by the authorized Government of the Russian Federation federal body executive power.

Federal medical and social examination institutions are responsible for:

1) establishing disability, its causes, timing, time of onset of disability, the disabled person’s need for various types social protection;

2) development individual programs rehabilitation of disabled people;

3) study of the level and causes of disability of the population;

4) participation in development comprehensive programs rehabilitation of disabled people, prevention of disability and social protection of disabled people;

5) determination of the degree of loss of professional ability to work;

6) determination of the cause of death of a disabled person in cases where the legislation of the Russian Federation provides for the provision of measures social support family of the deceased.

The decision of the institution of medical and social examination is mandatory for execution by the relevant authorities state power, local government bodies, as well as organizations regardless of organizational and legal forms and forms of ownership.

Currently, the clarification of the Ministry of Labor of the Russian Federation dated April 15, 2003 N 17 “On determining the causes of disability by federal state institutions for medical and social examination” is in effect.

According to this normative act Federal state institutions of medical and social examination determine the causes of disability using the following formulations provided for by the legislation of the Russian Federation:

Ø general disease;

Ø disabled since childhood;

Ø occupational disease;

Ø work injury;

Ø war trauma;

Ø disease acquired during military service;

Ø disease acquired while performing military service duties ( official duties) due to an accident at Chernobyl nuclear power plant;

Ø radiation-related disease, acquired while performing military service duties (official duties) in connection with the accident at the Chernobyl nuclear power plant;

Ø disease associated with the disaster at the Chernobyl nuclear power plant;

Ø a disease acquired during the performance of other military service duties (official duties) associated with the disaster at the Chernobyl nuclear power plant;

Ø illness associated with the accident at Mayak Production Association;

Ø an illness acquired during the performance of other military service duties (official duties) associated with the accident at the Mayak Production Association;

Ø disease associated with the consequences of radiation exposure;

Ø disease (trauma, mutilation, contusion, wound) received during the performance of military service duties (official duties), associated with direct participation in the actions of special risk units.

The main tasks of the federal government agencies medical and social examination are:

Ø carrying out rehabilitation expert diagnostics in order to determine rehabilitation potential, limitations in life activity, and the need for social protection measures;

Ø study of the causes, factors and conditions influencing the occurrence, development and outcome of disability, analysis of the prevalence and structure of disability.

Structure of ITU institutions. The procedure for their formation, reorganization and liquidation

Medical and social examination is carried out by federal institutions of medical and social examination. Only federal medical and social examination institutions are empowered to establish disability.

In Russia, about 3.5 million people are recognized as disabled annually, of which more than 1 million are diagnosed with disability for the first time. According to social forecasts, taking into account the annual dynamics of growth in the number of disabled people, in 2015 the number of disabled people may reach 24.2 million people.

Federal institutions of medical and social expertise include those under the jurisdiction of the Federal Medical and Biological Agency (FMBA):

Ø Federal Bureau of Medical and Social Expertise;

Ø main bureaus of medical and social examination for the relevant constituent entity of the Russian Federation;

Ø branches - bureaus of medical and social examination in cities and regions;

Ø the main bureau carrying out medical and social examination of employees of organizations in certain industries with special dangerous conditions labor and population of individual territories.

Currently, the Federal State Institution “Main Bureau of Medical and Social Expertise of the FMBA of Russia” and 20 of its branches operate. Specialists of the head office and its branches carry out their activities in close contact with the administration of enterprises in the corresponding region at the location of the branch. An important part of the bureau’s work is monitoring the rational employment of disabled people.

In addition, since May 2008, the FMBA of Russia has included 84 main bureaus of medical and social examination in the constituent entities of the Russian Federation.

In their activities, the above bodies are guided by Decree of the Government of the Russian Federation of December 16, 2004 N 805 “On the procedure for organizing and operating federal state institutions of medical and social expertise.” Based on the changes made to the commented article, after January 1, 2009, the Ministry of Health and Social Development of Russia will adopt a new regulatory legal act on the organization and activities of federal state institutions of medical and social examination.

The number of bureaus is determined based on the calculation, as a rule, 1 bureau per 70 - 90 thousand people, subject to the examination of 1.8-2 thousand people per year. "On the ground" bureaus are created taking into account the existing socio-demographic, geographical features regions based on a different calculation of the population and the number of citizens examined per year.

In their activities, ITU institutions interact with the relevant institutions of the Ministry of Health and Social Development of Russia, health care institutions of the constituent entities of the Russian Federation and local governments.

Currently, the state of the material and technical base of ITU institutions leaves much to be desired. The Agency has prepared a Model Agreement with the administration of the constituent entities of the Russian Federation, in mandatory including issues of transferring into federal ownership the buildings and structures on which ITU institutions are currently located, and financing their reconstruction. Based on limited physical capabilities disabled people, these institutions should be located primarily on the first floors of buildings, have convenient entrances, ramps, and the necessary set of premises.

Example. At the beginning of 2008, a medical and social examination bureau (MSE) was opened in the city of Zelenogorsk, Krasnoyarsk Territory, where it applies A complex approach to the problems of disabled people. According to the head of the FMBA V. Uib, the new Zelenogorsk bureau “is the only bureau of this level in Russia. Previously ITU Bureau were only involved in issuing conclusions on assigning a disability group. Here... a person comes to an appointment, a case is opened against him, an examination is carried out to confirm his disability group, and then measures for social protection are determined and individual rehabilitation programs are developed.”

The Bureau carries out a medical and social examination, determines the presence of limitations in life activity and disability, their causes and the degree of loss of professional ability to work, and also determines measures for social protection and develops individual rehabilitation programs.

The office building is equipped with ramps to facilitate access for disabled people using wheelchairs. There is a corner for children. Reception is ongoing social worker, therapist, psychologist, surgeon, neurologist and rehabilitation specialist.

The branch office performs the functions, enshrined in paragraph 5 of Government Decree No. 805 of December 16, 2004 “On the procedure for organizing and operating federal state institutions of medical and social expertise.”

The Bureau: determines the structure and degree of disability of the persons being examined and their rehabilitation potential; establishes the fact of the presence of disability, determines the group, causes (circumstances and conditions of occurrence), timing and time of onset of disability; determines the degree of loss of professional ability (in percentage) of workers who have received injury, occupational disease or other health damage associated with the performance of their work duties, and the need to implement additional measures social protection; determines the causal relationship of the death of the injured person c work injury, occupational disease, time at the front and other circumstances in which the legislation of the Russian Federation provides for the provision of benefits to the family of the deceased; determines the need of disabled people for special vehicles; forms and adjusts individual rehabilitation programs for disabled people (determines the types, forms, timing and volumes of measures for medical, social and professional rehabilitation), and also monitors their implementation; provides comprehensive assistance to persons who have undergone medical and social examination, including in the form of consultations on legal issues, and assists in providing the necessary social protection for people with disabilities, including rehabilitation; forms a data bank on citizens who have passed a medical and social examination, carries out state statistical monitoring of the demographic composition of disabled people and submits the relevant information to the main bureau; takes part in the study of factors leading to disability and in the development of comprehensive disability prevention programs; provides information to the relevant military commissariats about all cases of recognition of persons liable for military service and persons of conscription age as disabled.

The main bureau performs the functions, enshrined in paragraph 6 of Government Decree No. 805 of December 16, 2004 “On the procedure for organizing and operating federal state institutions of medical and social expertise.”

Main Bureau: conducts a medical and social examination of persons who appealed the decisions of the bureau, and if these decisions are unfounded, changes them; conducts medical and social examination of citizens in accordance with the directions of the bureau in cases requiring the use of special methods examinations; forms and adjusts individual rehabilitation programs for disabled people in cases requiring the use of special examination methods, and also monitors their implementation; provides primary rehabilitation, psychological and career guidance assistance to citizens who have passed a medical and social examination; forms a data bank of a constituent entity of the Russian Federation about citizens who have passed a medical and social examination, carries out state statistical monitoring of the demographic composition of disabled people living on the territory of a constituent entity of the Russian Federation, and submits the relevant information to the social protection body of the population of a constituent entity of the Russian Federation; takes part in the study of factors leading to disability and in the development of comprehensive disability prevention programs; provides information to the relevant military commissariats on all cases of recognition of persons liable for military service and persons of conscription age as disabled; provides advisory assistance to medical experts and other specialists of the bureau; exercises control over the activities of the bureau.

The Federal Bureau of Medical and Social Expertise performs the functions, enshrined in paragraph 7 of Government Decree No. 805 of December 16, 2004 “On the procedure for organizing and operating federal state institutions of medical and social expertise.”

Institutions are created, reorganized and liquidated by decision of the executive authorities of the constituent entities of the Russian Federation in the manner established by law Russian Federation. Expenses for the maintenance of institutions are made from the budgets of the constituent entities of the Russian Federation.

The number of institutions, as well as their profiles and staffing, are established by the executive authorities of the constituent entities of the Russian Federation.

The formation of a network of bureaus is carried out based on the size of the population living in the territory of a constituent entity of the Russian Federation and the number of citizens examined per year at the rate, as a rule, of one institution per 70-90 thousand people, subject to examination of 1.8-2 thousand people per year . Taking into account the existing socio-demographic, geographical and other characteristics of the regions, bureaus can be created based on a different population size and the number of citizens certified per year.

Depending on the level, structure of morbidity and disability, bureaus of general profile and specialized profile are formed (to conduct medical and social examination of patients with various diseases, defects and consequences of injuries) and mixed profile. To conduct a medical and social examination of persons under the age of 18 years, specialized bureaus may be formed.

IN staffing standard bureau includes specialists who receive expert solution(3 doctors of various specialties), rehabilitation specialist, specialist in social work and psychologist. In addition, the staffing table provides for senior positions nurse, medical receptionist and driver. If necessary, pediatricians, specialists in functional diagnostics, in career guidance, ergonomics, labor physiology, teacher, sign language interpreter and other specialists.

The staffing standard of the main bureau includes several teams of specialists who make expert decisions, groups of specialists in functional diagnostics, career guidance and organization of work for people with disabilities, their social and environmental adaptation, as well as specialists from legal consulting services and information and statistical support. The specialists making the expert decision include at least 4 doctors of various specialties, rehabilitation specialists of various profiles (depending on the need for expert rehabilitation diagnostics), social work specialists and psychologists. If necessary, an inpatient department can be created at the main office.

The number of teams of specialists included in the staffing standards of the main bureau is determined depending on the number of bureaus operating in the territory of a constituent entity of the Russian Federation, based, as a rule, on 1 team of specialists for 4 bureaus. To conduct a medical and social examination of citizens, the main bureau may attract consultants on medical and social issues.

In order to exercise their powers, institutions have the right to: send persons undergoing medical and social examination for examination in order to clarify their clinical and functional diagnosis and professional capabilities to treatment and preventive institutions of the state and municipal systems healthcare, rehabilitation and other state and municipal institutions operating in the field of medical and social examination and rehabilitation of people with disabilities; request and receive from organizations of all forms of ownership information necessary for making decisions and performing other functions assigned to institutions; conduct control examinations of disabled people for dynamic observation for the implementation of activities provided for by individual rehabilitation programs for disabled people; send specialists to organizations of all forms of ownership in order to study the working conditions of disabled people, monitor the implementation rehabilitation measures and in other cases necessary to perform the functions assigned to the institutions.

1. List the main tasks of ITU

2. Which ITU institutions do you know and what determines their number and profile?

3. How is the network of ITU offices formed?

4. What is included in the staff standards of the ITU bureau?

5. What is included in the staff standards of the ITU main bureau?

6. What responsibilities in the field of ITU and rehabilitation are assigned to the ITU Bureau?

7. What are the differences in the competence of the main bureau and the ITU bureau?

1. General provisions

2. Conditions for recognizing a citizen as disabled

3. The procedure for sending a citizen for a medical and social examination

4. The procedure for conducting a medical and social examination of a citizen

5. The procedure for re-examination of a disabled person

6. The procedure for appealing decisions of the bureau, main bureau, Federal Bureau

The state has created an entire system of assistance for the social protection of those individuals who have persistent health problems, injuries, cannot work, and have limited opportunities for socialization. Its goal is to reduce the distance between a sick person and society. It consists of several components:

ITU - what is it

To resolve some of these issues for each specific person, requiring state support, and created a medical and social examination (MSE). Strictly speaking, ITU is a state examination designed to resolve the issue of establishing disability for a specific person.

Among the main tasks of carrying out MSA is determining the degree of damage to the basic functions of the body of a particular person, identifying possible ways rehabilitation, legal recognition of him as disabled.

ITU structure

For each specific person who needs to establish a disability, the examination is carried out at the ITU office at the place of residence. They are branches of the Main Bureaus located in the regions.

There are city and district branches of the Main Bureaus, where you should come with a referral and documents. A disabled person can apply to the ITU at his place of residence (this may be his place of residence) or at his location (if he has left the Russian Federation). For example, to conduct ITU in Moscow, you should contact one of the 95 branches of the “GB ITU in Moscow” (their addresses are posted on the official website of the Head Office).

In case of disagreement with the decision of the local branch, the person (or his guardian) can appeal it to the Head Office, as a rule, these are regional structures. Then the examination will be carried out here (in our example, this will be the ITU GB for Moscow).

The main structure is the Federal Bureau of ITU. At difficult situations, in case of disagreement with the decision of the Head Body, the examination is carried out here, its decision can be appealed in court.

The Federal Bureau of Medical and Social Expertise is subordinate to the Ministry of Labor of the Russian Federation.

Tasks and powers

One of the main functions of the ITU is to establish a disability group. This procedure is the actual overall assessment health status of the person contacting the bureau.

To conduct examinations of persons with various diseases, special expert groups have been created:

mixed-profile groups will examine patients with general diseases;
special groups are created to consider issues related to persons aged 18-1 years.

Specialized groups have also been created for examination:

patients with tuberculosis;
persons with mental disorders;
suffering from visual impairment.

The examination will be carried out by an expert group depending on the disease that the patient has.

At passing the ITU the issue of rehabilitation is also resolved and an individual rehabilitation program (IRP) is issued (or adjusted).

Place of examination

At the same time, in accordance with the Rules for recognizing a person as disabled (Resolution of the Government of the Russian Federation of February 20, 2006 No. 95), an examination is possible:

About disability groups and criteria for their establishment

The ITU examination involves determining the disability group (its extension) or refusing to establish it. All and there is also a category “disabled child”. The ITU Bureau can set disability for 1 or 2 years, 5 years or for life (this is determined by the relevant criteria of the Rules).

The group specification contains a detailed list of health disorders of the person being examined. These criteria form the basis for establishing the disability group by the examination.

For example, when persistent moderate impairments lead to a decrease in the ability to perform previously familiar professional duties or to a decrease in the volume or intensity of work, and also cause the inability to continue activities in the main profession, but at the same time the person remains able to perform duties of a lower qualification under standard conditions. This indicates the presence of 1st degree limitation of the main categories of life activity, and there are grounds for prescribing Group III disability.

If persistently expressed disorders of body functions occur that require labor activity special devices or creation specific conditions labor, any special technical. funds or assistance from outsiders, they qualify as the second degree of restriction. In this case, disability group II is assigned.

When persistently expressed health disorders are detected, leading to the impossibility (even contraindication) of work or absolute inability to do it, grade 3 occurs. These are signs of disability group I.

The purpose of the group depends on general condition health of the person undergoing the examination. Here, many factors are taken into account that limit the main categories of life. Among them will be his ability to self-care, orientation, communication, movement, ability to control himself and learning ability (which is very important for children and young people).

When all these factors are taken into account, the group will be established. The criteria themselves are approved specifically for each group and have uniform, very clear recommendations for all ITU branches of Russia.

About the possible purposes of the examination

In addition to the main goal - maximum adaptation of a disabled person into society - MSE also pursues more specific goals. These include:

determination of a person’s disability group (category “disabled child”);
establishing the degree of loss of professional skills and ability to work;
development (or its correction);
development (or its correction) of a rehabilitation program for the victim.

The commission may also be held to establish:

stages of loss of professional skills from an occupational disease or industrial accident;
the need for outside care of a close relative, a citizen undergoing military service;
signs of persistent health disorder for police officers and other structures.

How to get directions

To undergo the examination, you need to receive a referral (to the patient himself or his guardian). This can be done in the following ways:

Contact medical institution healthcare of the Russian Federation , where the person requiring testing is being observed or treated.
Apply to the Pension Fund office. Here you will need to provide the necessary medical documents certifying illness, injury or disfigurement.
Apply to the social protection authorities, and there must be signs of a person’s disability and his need for social protection.

The medical institution issues a referral in form No. 088/u-06. In which there will be information about the state of health of the person referred and the recovery capabilities of his health, about the rehabilitation measures taken, their results, and necessarily the purpose for which the person is sent to MSE (disability and group are not indicated in it).

Social protection authorities and the Pension Fund of the Russian Federation issue a referral in a form approved by order of the Ministry of Health and Social Development of the Russian Federation dated December 25, 2006 No. 874, which contains information about signs of disability (usually based on a fact established by them) and the need for social protection, the purpose of the referral.

If a person has been denied a referral by all of the listed institutions, he has the right to appeal directly to ITU branches .

What other documents are needed for examination?

Documents are attached to the received referral. Their list will depend on the purpose for which the referral is issued. And you can get it along with the direction.

Common to all types of examination will be:

a written application for an examination from the person who requires it;
Identity document of the disabled person and his guardian (if available). For children under 14 years of age, documents of one of the parents are required;
medical certificate confirming health problems.

Most likely, you will also need the following documents:

Who are the legal representatives

In some cases, a person who requires the establishment of disability is due to his illness and cannot be fully responsible for his actions or is physically unable to collect certificates and go to authorities. This will be the basis for their interests to be represented by legal representatives. They may be parents, children, other relatives, spouses or strangers guardians of a disabled person (in this case, a guardianship decision will be required).

When examining children under 14 years of age and adolescents under 18, their legal representatives will be their parents. The law provides for their mandatory participation in the process (without them the examination will not be carried out). If the child does not have parents, then guardians replace them.

In all these cases, legal representatives for the ITU are an important component of the process. They must present documents that certify kinship or marriage, and can carry out a number of actions for the patient. Yes, they collect necessary certificates, bring the patient for examination, arrange for the commission to go home if it is impossible to deliver him. In fact, they represent the interests of their ward at the ITU.

About the results

During the examination, a protocol is kept. Then an inspection report is drawn up, which consists of 2 parts. It is stored for 10 years. The person in respect of whom the examination was carried out is given:

Help. It indicates the disability group, the cause and the period for which the disability was established, and there must be a link to the examination report and its details.
Individual rehabilitation program.

An extract from the act, which must be drawn up, is sent to the regional branch of the Pension Fund no later than within 3 days.

If a person disagrees with the results of the examination, he must write a statement to the same regional or head office no later than 1 month from the date of receipt of the certificate. The period during which the re-examination must take place is 1 month.

If you disagree with the commission's conclusions, you can also go to court.

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INTRODUCTION

On modern stage development of society, carrying out a set of measures for the social integration of disabled people into society is one of the priority areas social policy states. The relevance of the problem is determined by the presence in society significant amount persons with signs of disability and imperfection of normative - legal framework regulating relations between disabled people and the state. According to the Ministry of Health and Social Development of the Russian Federation, every year the number of disabled people in the country increases by 1 million people; now almost every tenth Russian receives a disability pension.

In this regard, a state institution of medical and social examination was formed, to which citizens turn in case of loss of ability to work, where they determine the degree of lost function (in percentage) and issue certificates on the basis of which citizens of the Russian Federation receive benefits and allowances in institutions for social protection of the population and Pension Fund Russia.

The purpose of the course work is to study the characteristics of the activities of state institutions of medical and social examination in the Russian Federation.

Coursework objectives:

1) Expand the concept of medical and social expertise.

2) Study the regulatory framework governing this area;

3) Consider the main directions of activity of state institutions of medical and social examination;

4) Study the tasks and functions of these institutions.

5) Study the stages of development of ITU institutions.

The object of the study is social relations arising in the sphere of providing social assistance citizens in the Russian Federation.

The subject of the study is the functioning and implementation of the regulatory framework of the Russian Federation regulating the activities of state institutions of medical and social examination.

The structure of the course work includes an introduction, which reveals the relevance of the topic, the purpose and objectives of the course work, as well as the object and subject of the research. The main part, which includes two chapters reflecting research on the assigned tasks for the activities of state institutions of medical and social examination in the Russian Federation. Also a conclusion in which conclusions are drawn and summaries of the work performed. The course work contains a list of used sources, consisting of regulations, scientific and methodological literature and Internet resources.

examination medical social institution

CHAPTER 1. INSTITUTIONS FOR MEDICAL AND SOCIAL EXAMINATION

1.1 Medical and social examination. Basic concepts, directions

Medical and social examination (MSE) is one of the types of medical examination. Medical and social examination - definition in in the prescribed manner the needs of the examined person for social protection measures, including rehabilitation, based on an assessment of the limitations in life activity caused by a persistent disorder of body functions.

Institutions for medical and social expertise in the Russian Federation are under the jurisdiction of the Ministry of Labor and Social Protection, with the exception of the Main Bureau of Medical and Social Expertise of the Federal Medical and Biological Agency, which is subordinate to the corresponding agency within the Ministry of Health.

The procedure for organizing and operating institutions of medical and social expertise is regulated by Order of the Ministry of Labor of Russia dated October 11, 2012 No. 310n “On approval of the Procedure for organizing and operating federal state institutions of medical and social expertise.”

Institutions of medical and social expertise in established by law in order to conduct examinations of citizens in order to establish the disability group, determine the degree of loss of professional ability to work, and also study the prevalence and structure of disability, the causes, factors and conditions affecting the occurrence, development and outcome of disability.

Establishing a disability group is a determination of the needs of citizens for social protection measures (including rehabilitation) based on life limitations caused by a persistent disorder of body functions.

1.2 Objectives, functions and structure of ITU institutions

The main tasks of federal government institutions medical - social expertise are:

* establishing disability, its causes, timing, time of onset of disability, the need of a disabled person for various types of social protection;

* development of individual rehabilitation programs for disabled people;

* study of the level and causes of disability of the population;

* participation in the development of comprehensive programs for the rehabilitation of disabled people, disability prevention and social protection of disabled people;

* determination of the degree of loss of professional ability to work;

* determination of the cause of death of a disabled person in cases where legislation.

OBJECTIVES OF ITU HEAD OFFICE

* establishing the structure and degree of disability and determining the needs of the person being examined for various social protection measures, including rehabilitation;

* study of the causes, factors and conditions influencing the occurrence, development and outcome of disability, analysis of the prevalence and structure of disability.

FUNCTIONS OF THE MAIN BUREAU OF MEDICAL AND SOCIAL EXAMINATION:

* considers complaints from citizens undergoing examination about the decisions of the bureau and, if found to be justified, changes or cancels the decisions of the bureau;

* conducts, on its own initiative, a re-examination of citizens who have been examined by the bureau, and, if there are grounds, changes or cancels the decisions of the bureau;

* conducts examinations of citizens who have appealed the decisions of the bureau, as well as examinations directed by the bureau in cases requiring special types of examination or an advisory opinion from the expert composition of the main bureau;

* coordinates the activities of the bureau and summarizes the experience of their work in the serviced territory;

* in case of inspection:

Ш establishes the fact of the presence of disability, the group, causes, duration and time of onset of disability, and also develops and adjusts individual rehabilitation programs for disabled people, including determining the types, forms, timing and volumes of measures for medical, social and professional rehabilitation;

Ш determines the degree of loss of professional ability to work (as a percentage);

Ш determines the needs of victims of industrial accidents and occupational diseases in medical, social and professional rehabilitation, and also develops and adjusts rehabilitation programs for victims of industrial accidents and occupational diseases;

* determines the causes of death of a disabled person in cases where the legislation of the Russian Federation provides for the provision of social support measures to the family of the deceased.

FUNCTIONS OF THE BUREAU OF MEDICAL AND SOCIAL EXAMINATION:

* conducts examinations of citizens based on an assessment of life limitations caused by persistent disorders of body functions;

* develops and adjusts individual rehabilitation programs for disabled people, including determining the types, forms, timing and volumes of measures for medical, social and professional rehabilitation;

* establishes the fact of the presence of disability, the group, causes, duration and time of onset of disability;

* determines the degree of loss of professional ability to work (as a percentage);

* determines the need for medical, social and professional rehabilitation of victims of industrial accidents and occupational diseases;

* develops and adjusts rehabilitation programs for victims of industrial accidents and occupational diseases;

* determines the causes of death of a disabled person in cases where the legislation of the Russian Federation provides for the provision of social support measures to the family of the deceased;

* provides citizens undergoing examination with explanations on issues of medical and social examination;

* participates in the development of programs for the rehabilitation of disabled people, disability prevention and social protection of disabled people;

* forms a data bank about citizens living in the serviced territory who have passed a medical and social examination; carries out state statistical monitoring of the demographic composition of disabled people living in the serviced territory;

* submits information to military commissariats about all cases of recognition of persons liable for military service and citizens of military age as disabled. STRUCTURE. The structure of institutions of the ITU system of government institutions is quite multifaceted and consists of several levels. (see Attachment)

CHAPTER 2. STAGES OF DEVELOPMENT OF THE SYSTEM OF MEDICAL AND SOCIAL EXAMINATION

The modern history of medical and social examination institutions began on April 27, 1918, when the People's Commissariat of Public Contempt was transformed into the Commissariat social security, and the formation began medical labor commissions predecessors of modern institutions of medical and social examination. Thus, the system of medical and social examination of the Russian Federation turned 90 years old in 2008.

The development path traversed by medical and social expertise, starting with medical and labor expertise, the creation, formation and development of medical and social expertise throughout Russia can be divided into a number of stages determined by the peculiarities of its political and socio-economic state:

· The first stage is an examination of the working capacity of citizens in Russia before 1918.

· The second stage is the formation of medical labor examination (1918 - 1929).

At this stage, issues of the formation of medical labor expertise are resolved within the framework of the emerging system of state social security for workers.

· The third stage (1930 - 1940) - the development of medical labor examination.

The resolution of the Central Committee of the All-Union Communist Party of Bolsheviks of September 28, 1929 served as a powerful incentive to improve the work on medical labor examination in the early 30s. The composition of medical experts was reviewed, the composition of disabled people was checked and studied, and a decision was made to create research institutes.

· The fourth stage (1941 - 1955) - medical and labor examination in the war and early post-war years.

During the Great Patriotic War The contingent of disabled people has changed significantly due to the increase in people with the consequences of gunshot, mine-explosive wounds, and damage to the musculoskeletal system. Hospital VTECs were created, which played a major role in the timely and qualified care of military contingents discharged from the army due to illness or injury.

· Fifth stage (1956 - 1994) - improvement of medical labor examination. At this long stage, a system of medical labor examination was created and improved.

· The sixth stage (from 1995 to the present) - the formation of a system of medical and social examination and rehabilitation in modern Russia

In development of new approaches, in 1995 it was developed modern concept disability, which formed the basis of the Federal Law "On Social Protection of Disabled Persons in the Russian Federation" dated November 24, 1995 No. 181-FZ, and is enshrined in law social institution"medical and social examination".

The introduction of the Federal Law of November 24, 1995 No. 181-FZ “On the Social Protection of Disabled Persons in the Russian Federation,” which is still in force today, determined public policy in the field of social protection of disabled people in the Russian Federation, the purpose of which is to provide disabled people with equal opportunities with other citizens in the implementation of civil, economic, political and other rights and freedoms provided for by the Constitution of the Russian Federation, as well as in accordance with generally recognized principles and norms international law and international treaties of the Russian Federation.

In the Federal Law “On Social Protection of Disabled Persons in the Russian Federation”, a new concept of “disabled person” was defined, the basis for determining disability depending on the degree of impairment of body functions and disability, the concept of “rehabilitation of disabled people” and “individual rehabilitation program for disabled people”, as well as The functions of recognizing citizens as disabled are assigned to federal institutions of medical and social examination. In the new interpretation, “disabled person” is a person who has a health impairment with a persistent disorder of body functions, caused by diseases, consequences of injuries or defects, leading to limitation of life activity and necessitating his social protection.

Medical and social examination institutions are tasked not only with establishing the group, cause and timing of the onset of disability, but also with determining the needs of disabled people for rehabilitation measures and developing an individual rehabilitation program for a disabled person.

In order to implement the Federal Law “On the Social Protection of Disabled Persons in the Russian Federation”, Resolution of the Government of the Russian Federation of April 3, 1996 No. 392 “On the State Service of Medical and Social Expertise” was adopted. In accordance with which, in the constituent entities of the Russian Federation, the process of creating state service institutions for medical and social examination on the basis of medical and labor examinations has begun. Decree of the Government of the Russian Federation dated September 13, 1996. No. 965 “On the procedure for recognizing citizens as disabled”, the Regulations on recognizing a person as disabled and the Model Regulations on institutions of the state service of medical and social examination were approved, and a little later “Classifications and temporary criteria used in the implementation of medical and social examination of citizens by institutions of the state service of medical and social examinations" approved by the resolution of the Ministry of Labor and social development of the Russian Federation and the Ministry of Health and Medical Industry of the Russian Federation dated January 29, 1997 No. 1/30.

During 1996, work was carried out to abolish medical and labor expert commissions, and the creation of a civil service began medical and social examinations in the system of the Ministry of Social Protection of the Population of the Russian Federation. By 1998, in all subjects of the Russian Federation, the reorganization of medical and labor expert commissions was completed with their transformation into institutions of the state service of medical and social examination. As of January 1, 1999, there were 1,573 ITU bureaus and 274 ITU main bureaus operating in the country. The system existed in this status until 2005. Soon, all existing medical and labor expert commissions were reorganized into institutions of the state service of medical and social examination.

In 1998, with the goal of a uniform approach to application regulatory documents to establish disability and preserve the principles of continuity, the examination of the child population, which was previously carried out in medical institutions, was transferred to the institutions of the state service of medical and social examination. preventive institutions. The formation and development of a network of pediatric medical and social examination bureaus began.

Adopted in 1998 the federal law No. 125 - Federal Law "On compulsory social insurance against accidents at work and occupational diseases" assigned the responsibility to MSE institutions to develop a rehabilitation program for victims of an accident at work and occupational disease.

To establish the degree of loss of professional ability to work, the following have been introduced and are currently in force: Resolution of the Government of the Russian Federation dated October 16, 2000 No. 789 “On approval of the Rules for establishing the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases” and Resolution of the Ministry of Labor and Social Development of the Russian Federation dated 07/18/2001 No. 56 "On approval of temporary criteria for determining the degree of loss of professional ability as a result of industrial accidents and occupational diseases, the form of the rehabilitation program for victims of an industrial accident and occupational disease."

The year 2004 marked the beginning of the next stage in the development of the state service of medical and social examination. In order to implement the provisions of the Federal Law “On Social Protection of Disabled Persons in the Russian Federation”, the Government of the Russian Federation Decree No. 1646-r dated December 16, 2004 “On the creation of federal state institutions of medical and social examination” and the Government Decree of the Russian Federation dated December 16, 2004 No. 805 "On the procedure for the organization and activities of federal state institutions of medical and social examination" according to which it is determined that the institutions of the state service of medical and social examination in all subjects of the Russian Federation are reorganized into federal state institutions of medical and social examination "Main Bureaus of Medical and Social Examination" according to subjects of the Russian Federation. The Federal Bureau is under the jurisdiction of the Ministry of Health and Social Development of the Russian Federation, the main bureaus of medical and social examination, which have bureaus under the jurisdiction of the Federal Agency for Health Care and Social Development (since June 2008, under the jurisdiction of the Federal Medical and Biological Agency).

New regulatory and legal documents on medical and social examination have been introduced: Order of the Ministry of Health and Social Development of the Russian Federation dated August 22, 2005 No. 535 “On approval of classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination” and Decree of the Government of the Russian Federation dated February 20, 2006 No. 95 “On the procedure and conditions for recognizing a person as disabled,” which approved the Rules for recognizing a person as disabled, was approved by Order of the Government of the Russian Federation dated December 30, 2005 No. 2347-r Federal list of rehabilitation measures and services provided disabled person. By order of the Ministry of Health and Social Development dated November 29, 2004. No. 287, the form of the individual rehabilitation program for a disabled person (IPR) was approved (subsequently, in August 2008, new forms of IPR for a disabled person and IPR for a disabled child were approved and introduced from 01.10.2008).

Decree of the Government of the Russian Federation dated 04/07/2008. No. 247 "On amendments to the rules for recognizing a person as disabled" is determined new order establishing a disability group without specifying the period for re-examination (category of a child - disabled until reaching 18 years of age) and introducing a List of diseases, defects, irreversible morphological changes, violations of the functions of organs and systems of the body, in which the disability group without specifying the period for re-examination (the category “disabled child” before the citizen reaches the age of 18) is established for citizens no later than 2 years after the initial recognition as disabled (establishment of the category “disabled child”).

The last stage of the reorganization of medical and social examination institutions began in 2008, when, in accordance with the decree of the President of the Russian Federation dated May 12, 2008. No. 724 “Issues of the system and structure of Federal executive authorities” and Decree of the Government of the Russian Federation of June 2, 2008 No. 423 “On some issues of the activities of the Ministry of Health and Social Development of the Russian Federation and the Federal Medical and Biological Agency” Federal Agency for Health and Social Development (Roszdrav ) under the jurisdiction of medical and social examination institutions was liquidated. The functions of the abolished Roszdrav were transferred to the Federal Medical and Biological Agency (FMBA of Russia).

Regulations on the Federal Medical and Biological Agency (approved by Decree of the Government of the Russian Federation of April 11, 2005 No. 206 “On the Federal Medical and Biological Agency”), FMBA of Russia is a federal executive body that carries out the functions of providing public services and managing state property in in the field of healthcare and social development, including the organization of medical and social examinations.

Order of the Ministry of Health and Social Development of the Russian Federation dated November 17, 2009 No. 906-“On approval of the procedure for organizing and operating federal state institutions of medical and social expertise” defined the tasks and functions of federal state institutions of medical and social expertise.

By order of the Ministry of Health and Social Development of the Russian Federation dated April 11, 2011 No. 295n, the Administrative Regulations for conducting medical and social examinations were approved. The administrative regulations for conducting medical and social examination are a consolidated document that summarizes the entire regulatory framework for medical and social examination and prescribes general order operation of the ITU in a simple, clear and accessible language, which is very important for citizens who find it difficult to familiarize themselves with all the documents that the regulations include. With its help, a person will know which requirements are excessive. The administrative regulations provide a description of the sequence of actions not only of the citizen, but also of the specialists providing this public service. For the first time, the regulations clearly defined the terms for providing the service - after submitting an application, a maximum of 30 days was allocated for the examination. Specified full list necessary documents when submitting an application by a citizen, as well as requirements for the conditions and organization of services for persons sent for examination. In addition, filing applications, receiving referrals and receiving decisions from ITU federal government agencies can be carried out in in electronic format through the Unified Portal of State Services.

Currently, more than 10 thousand doctors and specialists work in federal government institutions of medical and social examination, almost half of whom have higher and first degrees. qualification categories. Carrying out tasks to determine the needs of people with disabilities for measures, means of rehabilitation and rehabilitation services, to develop IPR and evaluate the effectiveness of their implementation, ITU federal institutions closely interact with treatment and preventive institutions, the employment service, regional offices Fonda social insurance, prosthetic and orthopedic enterprises and other interested services.

Over its long history, VTEK/ITU institutions have been reorganized several times. In the time that has passed since the creation of the first medical labor expert commissions, the situation in medical and social examination in to a large extent changed in better side the status of medical and social examination institutions has been increased, their financing and the material and technical equipment of institutions have been improved.

CONCLUSION

This work examined the existing system of organizing the activities of state institutions of medical and social expertise, and also highlighted the stages of development of the system of medical and social expertise in Russia.

To study this topic, the goal was set: to study the features of the activities of state institutions of medical and social expertise in the Russian Federation, which was achieved by solving problems.

So: Medical and social examination is one of the types of medical examination. MSE - determination in the prescribed manner of the needs of the examined person for social protection measures, including rehabilitation, based on an assessment of the limitations in life activity caused by a persistent disorder of body functions.

This area of activity is regulated by Federal Law No. 181-FZ dated November 24, 1995 “On social protection of disabled people in the Russian Federation” (with latest changes Federal Law of November 25, 2013 N 312-FZ) in particular Art. 8, which reads: Medical and social examination is carried out by federal institutions of medical and social examination, subordinate to the authorized body determined by the Government of the Russian Federation. The procedure for organizing and operating federal institutions of medical and social expertise is determined by the federal executive body authorized by the Government of the Russian Federation.

Federal medical and social examination institutions are responsible for:

1) establishing disability, its causes, timing, time of onset of disability, the need of a disabled person for various types of social protection;

2) development of individual rehabilitation programs for disabled people;

3) study of the level and causes of disability of the population;

4) participation in the development of comprehensive programs for the rehabilitation of disabled people, disability prevention and social protection of disabled people;

5) determination of the degree of loss of professional ability to work;

6) determining the cause of death of a disabled person in cases where the legislation of the Russian Federation provides for the provision of social support measures to the family of the deceased.

The decision to establish a medical and social examination is mandatory for execution by the relevant government bodies, local government bodies, as well as organizations, regardless of organizational, legal forms and forms of ownership.

Thus, this article indicates the main provisions of the activities of state institutions of medical and social examination.

Also, the activities of ITU institutions are divided into several stages and trace their history back to 1918. In the time that has passed since the creation of the first medical and labor expert commissions, the situation in medical and social examination has changed significantly for the better; the status of medical and social examination institutions has been increased, their financing and the material and technical equipment of institutions have improved.

LIST OF SOURCES USED

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APPLICATION

STRUCTURE OF THE STATE INSTITUTION FOR MEDICAL AND SOCIAL EXAMINATION

Administrative apparatus:

* Head - chief expert in medical and social examination;

* Deputy head for expert work - doctor for medical and social expertise, specialist;

* Deputy head for organizational and methodological work, doctor for medical and social examination, specialist;

* Deputy Head of general issues activities of the institution;

* Chief Accountant;

* Chief nurse.

Departments of the institution:

* Planning and financial department;

* Organizational and methodological department;

* Human Resources Department;

* Department of information and statistical support;

* Legal department;

* Department for organizing work with documents;

* Department for general issues of the institution;

15 compositions of the Main Bureau of Medical and Social Expertise;

113 branches of the Bureau of Medical and Social Expertise;

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