The severity of the accident is determined. Occupational injury - at the workplace and on the way to work
3.7. DETERMINING THE SEVERITY OF INDUSTRIAL ACCIDENTS
Based on severity, industrial accidents are divided into two categories - severe and mild.
Signs of the severity of an industrial accident are:
. the nature of the injuries received and complications associated with these injuries, as well as the aggravation of existing and development of chronic diseases;
. duration of health disorder (temporary loss of ability to work);
. consequences of injuries received (permanent loss of ability to work, degree of loss of professional ability to work).
The presence of one of the above signs is sufficient to establish the category of severity of an industrial accident.
Signs of a serious industrial accident also include injuries that threaten the life of the victim.
Preventing death as a result of medical care does not affect the assessment of injury severity.
Severe ones include industrial accidents, which in the acute period are accompanied by:
. shock of any severity and any origin;
. coma of various etiologies;
. significant (up to 20%) blood loss;
. acute cardiac or vascular failure, collapse, severe cerebrovascular accident;
. acute renal or liver failure;
. acute respiratory failure;
. disorder of regional and organ circulation, leading to infarction of internal organs, gangrene of the extremities, embolism (gas and fat) of cerebral vessels, thromboembolism;
. acute mental disorders.
. penetrating wounds of the skull;
. fracture of the skull and facial bones;
. severe or moderate brain contusion;
. intracranial injury of severe or moderate severity;
. injuries penetrating the lumen of the pharynx, larynx, trachea, esophagus, as well as damage to the thyroid and thymus glands;
. penetrating spinal injuries;
. fractures or dislocations of the bodies and bilateral fractures of the arches of the 1st and 2nd cervical vertebrae, including without dysfunction of the spinal cord;
. dislocations (including subluxations) of the cervical vertebrae;
. closed injuries of the cervical spinal cord;
. fractures or dislocations of one or more thoracic and lumbar vertebrae with impaired spinal cord function;
. wounds of the chest penetrating into the pleural cavity, pericardial cavity or mediastinal tissue, including without damage to internal organs;
. abdominal wounds penetrating into the peritoneal cavity;
. wounds penetrating the bladder cavity or intestines;
. open wounds of the retroperitoneal organs (kidneys, adrenal glands, pancreas);
. rupture of an internal organ of the thoracic or abdominal cavity or pelvic cavity, retroperitoneal space, diaphragm, prostate gland, ureter, membranous part of the urethra;
. bilateral fractures of the posterior semi-ring of the pelvis with rupture of the iliosacral joint and disruption of the continuity of the pelvic ring or double fractures of the pelvic ring in the anterior and posterior parts with disruption of its continuity;
. open fractures of long tubular bones: humerus, femur and tibia, open injuries of the hip and knee joints;
. damage to a large blood vessel: aorta, carotid, subclavian, brachial, femoral, popliteal arteries or accompanying veins;
. thermal (chemical) burns of III-IV degree with an affected area exceeding 15% of the body surface;
. third degree burns with an affected area of more than 20% of the body surface;
. second degree burns with an affected area of more than 30% of the body surface;
. burns of the respiratory tract, face and scalp;
. radiation injuries of moderate (12...20 Gy) and severe (20 Gy or more) severity;
. abortion.
Serious industrial accidents include injuries that do not directly threaten the life of the victim, but have serious consequences:
. loss of vision, hearing or speech;
. loss of any organ or loss of its function by an organ (in this case, the loss of the most functionally important part of a limb (hand or foot) is equivalent to the loss of an arm or leg);
. mental disorders;
. loss of ability to reproduce and bear children;
. permanent facial disfigurement.
Serious industrial accidents also include:
. long-term health disorders with temporary disability (lasting 60 days or more);
. permanent loss of ability to work (disability);
. loss of professional ability to work by 20% or more.
Minor accidents at work include:
. health disorders with temporary disability lasting up to 60 days;
. loss of professional ability to work by less than 20%.
Ambulance and emergency doctors, as well as any other medical workers providing first aid to the victim, do not give an opinion on the severity of the injury.
Their competence includes determining the nature of further treatment of the victim (outpatient or inpatient), as well as determining the death outcome.
An opinion on the severity of an industrial injury is given at the request of the employer or the chairman of the commission for investigating an industrial accident by the clinical expert commissions (CEC) of the medical institution where the victim is being treated, within three days from the receipt of the request. This conclusion must also be documented in the discharge summary, regardless of the nature of the treatment performed.
The degree of loss of professional ability to work is determined in accordance with the Regulations “On the procedure for establishing by medical-labor expert commissions the degree of loss of professional ability to work as a percentage of workers who have received injury, occupational disease or other damage to health associated with the performance of their work duties”, approved by the Decree of the Government of the Russian Federation dated April 23, 1994 No. 392.
MINISTRY ORDER
HEALTH AND SOCIAL DEVELOPMENT
RUSSIAN FEDERATION
dated February 24, 2005 N 160
ABOUT DETERMINING THE DEGREE
SEVERITY OF HEALTH DAMAGE IN ACCIDENTS
INCIDENTS AT PRODUCTION
In accordance with paragraph 5.2.101 of the Regulations on the Ministry of Health and Social Development of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 30, 2004 N 321 (Collection of Legislation of the Russian Federation, 2004, N 28, Art. 2898), I order:
1. Establish that the determination of the severity of health damage in industrial accidents is carried out in accordance with the attached Scheme for determining the severity of health damage in industrial accidents.
2. Recognize as invalid the Order of the Ministry of Health of Russia of August 17, 1999 N 322 “On approval of the scheme for determining the severity of accidents at work.”
Minister M.Yu. ZURABOV
Application
to the Order
Ministry of Health
and social development
Russian Federation
SCHEME
DETERMINING THE SEVERITY OF HEALTH INJURY
IN THE EVENT OF ACCIDENTS AT PRODUCTION
1. Industrial accidents are divided into 2 categories according to the severity of health damage: severe and mild.
2. Qualifying signs of the severity of health damage in an industrial accident are:
The nature of the health injuries received and complications associated with these injuries, as well as the development and aggravation of existing chronic diseases in connection with the injury;
Consequences of received health injuries (permanent loss of ability to work).
The presence of one of the qualifying characteristics is sufficient to establish the category of severity of an industrial accident.
Signs of a serious industrial accident also include health damage that threatens the life of the victim. Prevention of death as a result of medical care does not affect the assessment of the severity of the injury.
3. Serious industrial accidents include:
1) health damage, the acute period of which is accompanied by:
Blood loss (more than 20%);
Embolism;
Acute failure of the functions of vital organs and systems (central nervous system, cardiac, vascular, respiratory, renal, hepatic and (or) a combination thereof);
2) health injuries qualified during the initial examination of the victim by doctors at a hospital, trauma center or other health care organizations as:
Penetrating wounds of the skull;
Fracture of the skull and facial bones;
Brain contusion;
Intracranial injury;
Injuries penetrating into the lumen of the pharynx, trachea, esophagus, as well as damage to the thyroid and thymus glands;
Penetrating spinal injuries;
Fracture dislocations and fractures of the bodies or bilateral fractures of the arches of the I and II cervical vertebrae, including without dysfunction of the spinal cord;
Dislocations (including subluxations) of the cervical vertebrae;
Closed injuries of the cervical spinal cord;
Fracture or fracture-dislocation of one or more thoracic or lumbar vertebrae, including without dysfunction of the spinal cord;
Injuries of the chest penetrating into the pleural cavity, pericardial cavity or mediastinal tissue, including without damage to internal organs;
Abdominal wounds penetrating into the peritoneal cavity;
Injuries penetrating the bladder cavity or intestines;
Open wounds of the retroperitoneal organs (kidneys, adrenal glands, pancreas);
Rupture of an internal organ of the thoracic or abdominal cavity or pelvic cavity, retroperitoneal space, rupture of the diaphragm, rupture of the prostate gland, rupture of the ureter, rupture of the membranous part of the urethra;
Bilateral fractures of the posterior semi-ring of the pelvis with rupture of the iliosacral joint and disruption of the continuity of the pelvic ring or double fractures of the pelvic ring in the anterior and posterior parts with disruption of its continuity;
Open fractures of long tubular bones - humerus, femur and tibia, open injuries of the hip and knee joints;
Damage to the main blood vessel: aorta, carotid (common, internal, external), subclavian, brachial, femoral, popliteal arteries or accompanying veins, nerves;
Thermal (chemical) burns:
III - IV degrees with a lesion area exceeding 15% of the body surface;
III degree with an affected area of more than 20% of the body surface;
II degree with an affected area of more than 30% of the body surface;
respiratory tract, face and scalp;
Radiation injuries of moderate (from 12 Gy) severity and higher;
Abortion;
3) damage that does not directly threaten the life of the victim, but has serious consequences:
Loss of vision, hearing, speech;
The loss of any organ or the complete loss of its function by an organ (in this case, the loss of the most functionally important part of a limb (hand or foot) is equated to the loss of an arm or leg);
Mental disorders;
Loss of reproductive function and ability to bear children;
Permanent facial disfigurement.
4. Minor accidents at work include damage that is not included in paragraph 3 of this Scheme.
APPROVED
Ministry of Health of the USSR
SCHEME FOR DETERMINING THE SEVERITY OF OCCUPATIONAL INJURIES
An opinion on the severity of an industrial injury is given by doctors of medical and preventive institutions where the victims are treated. It is issued at the request of the administration of the enterprise, institution, organization, state farm, collective farm in which this accident occurred, as soon as possible (no more than 3 days from the date of receipt of the request).
When determining the severity of an industrial injury, the nature and location of existing injuries and their danger to the life and health of the victim are taken into account.
Severe industrial injuries of various locations include:
1. Mechanical damage
1.1. Head, face, neck
1.1.1. Open and closed fractures of the bones of the vault and base of the skull.
1.1.2. Fractures of the upper and lower jaw.
1.1.3. Traumatic intracranial hemorrhages, injuries, bruises and concussions.
1.1.4. Penetrating wounds and bruises of the eyeball, accompanied by visual impairment.
1.1.5. Injuries of large main vessels of the neck, penetrating wounds of the pharynx, esophagus, trachea.
1.1.6. Extensive injuries to the head, face, neck with possible subsequent disfigurement of these areas.
1.2. Torso
1.2.1. Closed and open injuries to the organs of the thoracic and abdominal cavities, retroperitoneal space, and pelvis.
1.2.2. Fractures of the ribs with damage to the pleura and lung, fracture of the sternum, compression of the chest.
1.2.3. Fractures of the bodies, arches and articular processes of the vertebrae, two or more spinous or transverse processes of the vertebrae.
1.2.4. Dislocations and fracture-dislocations of the vertebrae with or without damage to the spinal cord.
1.2.5. Fractures of the pelvic bones with disruption of the integrity of the pelvis, ruptures of the sacroiliac and pubic joints of the pelvis.
1.3.1. Dislocations and fracture-dislocations in large joints of the limbs.
1.3.2. Closed and open fractures of long tubular bones of the limbs, patella, neck of the scapula.
1.3.3. Multiple fractures of the metacarpal and metatarsal bones, isolated and multiple fractures of the carpal and tarsal bones.
1.3.4. Crushing of the hand, foot and their parts.
1.3.5. Damage to the tendons of the deep and superficial flexors of the hand, biceps brachii, Achilles tendon, ligaments of the knee and ankle joints.
1.3.6. Traumatic amputation of the upper or lower limb.
1.3.7. Damage to large main vessels and nerve trunks of the extremities.
1.3.8. Compression of the soft tissues of the extremities with crush syndrome.
2.1. Thermal and chemical burns of I-II degree with an area of more than 20% of the body surface, III degree with an area of more than 1% of the body surface, IV degree burns, radiation burns.
2.2. Frostbite of the III-IV degree, general cooling of the body.
2.3. Exposure to electric current, accompanied by impaired consciousness, respiratory distress and cardiovascular activity.
2.4. Foreign bodies of the pharynx, esophagus and respiratory tract requiring emergency resuscitation.
Other injuries are not considered serious work-related injuries.
METHODOLOGICAL INSTRUCTIONS FOR THE APPLICATION OF THE "SCHEME FOR DETERMINING THE SEVERITY OF OCCUPATIONAL INJURIES"
Basic principles for determining severity
industrial injuries
In all cases of industrial injuries, the victim is provided with the necessary assistance at the scene of the incident, after which, if necessary, he is sent for qualified treatment to a medical and preventive institution.
If an injury occurs at work, the administration and trade union organization of each enterprise, institution, organization, state farm or collective farm are obliged to investigate its causes within 24 hours.
The results of the investigation are documented in the “Workplace Accident Report”. If the injury is severe, then the investigation into the causes of its occurrence is carried out in a special manner and is documented in a special investigation report, which is drawn up by the technical inspector of the trade union within 7 days from the moment of its occurrence.
The issue of the severity of an industrial injury is decided by the doctors of the medical and preventive institution in which the victim is treated, in accordance with the “Scheme for determining the severity of industrial injuries.”
The basis for determining the severity of industrial injuries is the principle of taking into account the nature of anatomical damage to organs and systems, the danger of existing damage to the life and health of the victim, and the real possibility of restoring functions lost as a result of injury.
Solving the issue of the severity of an industrial injury requires doctors at a treatment and preventive institution to have appropriate knowledge and experience not only in treatment, but also in determining the possible prognosis for various types of injuries. When a victim is admitted to a medical and preventive institution, the doctor must identify all the injuries he has, assess the function of the vital systems of the body, determine the danger of the injuries to the life and health of the victim (prognosis of the outcome), as well as the possibility of restoring the function of damaged organs.
When deciding on the severity of an industrial injury, one should be guided by the “Scheme for determining the severity of industrial injuries,” approved by the USSR Ministry of Health on September 22, 1980.
Use in practice of the "Scheme for determining severity
industrial injuries"
1. Mechanical damage
1.1. Head, face, neck
1.1.1. This includes all open and closed fractures of the bones of the vault and base of the skull, without exception, regardless of the general condition of the victim. The diagnosis of skull fractures must be confirmed by the results of a clinical and x-ray examination of the victim in a medical institution. In the absence of convincing radiological evidence indicating the presence of fractures (especially the bones of the base of the skull), clinical data and the mechanism of injury are of leading importance. This group of injuries also includes fractures of the nasal bones, accompanied by massive bleeding and damage to the sinuses of the main bone. A fracture of the outer plate of the cranial vault in the presence of general cerebral and focal neurological symptoms should also be classified as a severe industrial injury.
1.1.2. This includes all fractures of the upper and lower jaw, excluding fractures of the coronoid process of the lower jaw, avulsions of its cortical layer, as well as damage to the crowns of individual teeth.
1.1.3. Includes extradural, subdural, subarachnoid and other intracranial hemorrhages of traumatic etiology, as well as any nature and location of damage to the brain substance, including bruises. These injuries, as a rule, are accompanied by a severe general condition of the victim, severe cerebral and focal neurological symptoms, and often respiratory and cardiovascular disorders. In the presence of clinically detectable general cerebral and focal neurological symptoms, this group of severe industrial injuries also includes concussions.
1.1.4. This group of severe industrial injuries includes damage and foreign bodies to the eyeball, in which there is a real danger of impairment or loss of vision. Signs of these injuries are pain and acute visual disturbances in the damaged eye, hemorrhages in the membranes and chambers of the eye. With penetrating wounds, chamber fluid leaks out and eyeball tissue falls into the wound.
1.1.5. The most typical signs of this group of injuries are: massive bleeding from wounds in the neck, bleeding from the pharynx, its presence in the sputum during expectoration, disturbance of external respiration and the act of swallowing. Injuries to the large main vessels of the neck are accompanied by acute anemia of the brain and pose a serious danger to the life of the victim. Penetrating wounds of the pharynx, esophagus and larynx are fraught with the risk of subsequent development of inflammatory complications in the mediastinum.
1.1.6. As a rule, extensive wounds lead to severe disfigurement of the head, face, and neck. Wounds in which it is not possible to count on primary healing without plastic replacement of defects should be considered extensive. Injuries to the face with damage to the facial nerve and its large branches, loss of part of the nose, one or two ears should also be classified as severe industrial injuries.
1.2. Torso
1.2.1. Injuries to the organs of the thoracic and abdominal cavities, pelvis and retroperitoneal space are characterized by: clinical picture of shock, internal bleeding, acute peritonitis, pneumo- or hemothorax, hematuria. The severe general condition of the victim, the presence of the above symptom complexes, taking into account the mechanism of injury, are the basis for classifying the existing industrial injury as severe.
1.2.2. Multiple, bilateral and double rib fractures without clinical signs of pleural damage, but accompanied by severe respiratory distress, should also be classified in this group of severe industrial injuries. Signs of dysfunction of the heart and lungs - difficulty in external breathing, unstable blood pressure, congestion in the pulmonary circulation after the chest is released from compression - indicate that this industrial injury is a serious one.
1.2.3., 1.2.4. Of all spinal injuries, only uncomplicated fractures of the sacrum and coccyx without displacement of fragments, as well as an isolated fracture of the transverse or spinous processes of the vertebrae, can be classified as mild.
1.2.5. Injuries in this group should also include fractures of the wings of the iliac bones if they are accompanied by a state of shock and massive interstitial bleeding.
1.3. Upper and lower limbs
1.3.1. The large joints of the limbs include: the shoulder, elbow and wrist joints of the upper limb; hip, knee, ankle and tarsal joints of the lower limb. A habitual shoulder dislocation that occurs in the victim while performing work duties is not considered a serious work-related injury.
1.3.2. The long tubular bones include: clavicle, humerus, radius and ulna of the upper limb, femur and tibia of the lower limb. Intra-articular fractures of the epiphyses of the humerus, femur, tibia, ulna (excluding fractures of the styloid process) and radius, fractures of the patella and neck of the scapula should be classified in this group of severe industrial injuries. Avulsion extra-articular fractures of long tubular bones and fractures of the body of the scapula, which do not threaten limb function after treatment, are not considered severe industrial injuries.
1.3.3. Multiple fractures of the bones of the metatarsus and metacarpus should be considered open and closed fractures of two or more bones or one bone with the presence of two or more fracture planes. Avulsion fractures of individual bones of the metatarsus and tarsus, metacarpus and wrists, isolated fractures of individual phalanges of the fingers, and fractures of the sesamoid bones do not belong to the group of severe industrial injuries.
1.3.4. Crushing of the hand, foot and their parts is considered to be damage to several different tissues that form them (bone, muscle, tendon, blood vessels and nerves). When deciding on the severity of this group of injuries, the possibility of restoring the anatomical integrity and functional ability of injuries to the hand or foot is taken into account. Crushing of the hand, threatening the loss of the terminal phalanx of the first finger, two phalanges of each of the other fingers or three phalanges (in total) of the II-V fingers, one hand, as well as two or more toes of one foot, should be classified as a serious industrial injury. Extensive scalp wounds of the soft tissues of the foot and hand, requiring plastic replacement of defects during treatment, also belong to the group of severe industrial injuries.
1.3.5. Open and closed injuries of more than half of the anatomical volume of the patellar ligament, the quadriceps femoris tendon, the lateral ligaments of the knee and ankle joints, as well as complete rupture of the cruciate ligaments of the knee and deltoid ligament of the ankle joint should be considered to be classified as severe. Isolated and partial injuries of the tendons of the superficial flexors of the hand, the extensor tendons of the toes and hands, which do not threaten subsequent impairment of finger function, are not classified as severe industrial injuries.
1.3.6. Traumatic amputation is the complete separation of part of a limb as a result of injury. A severe industrial injury is considered to be amputation of the upper limb above the level of the II-V metacarpophalangeal joints, of the lower limb - above the level of the distal third of the fiafyses of the metatarsal bones. The group of severe industrial injuries should also include amputation of one or more phalanges of the first finger, two or more phalanges of each of the other fingers, three or more phalanges (in total) of the II-V fingers of one hand, two or more toes above the level of the metatarsophalangeal joints .
1.3.7. The main signs of injuries in this group are massive bleeding from the wound, if present, severe circulatory disorders of the distal limb, loss of function of the damaged nerve trunks of the limbs. The large main vessels and nerves of the upper limb include: subclavian, axillary and brachial (to the level of its division into radial and ulnar) arteries; axillary and main (up to the level of the lower third of the shoulder) veins; brachial plexus, radial, ulnar and median nerves throughout. The large main vessels and nerves of the lower extremity include: femoral, popliteal and posterior tibial (up to the level of the upper third of the leg) arteries; deep vein of the thigh and popliteal vein; sciatic and tibial nerves along their entire length, peroneal nerve to the level of the upper third of the leg.
1.3.8. The basis for classifying severe work-related injuries into this group is mainly the mechanism of injury; During a clinical examination of the victim, the possibility of developing general autointoxication of the body with subsequent dysfunction of the cardiovascular, nervous and urinary systems is taken into account.
2. Other damage (thermal, chemical, electrical, radiation, foreign bodies)
2.1. This group of severe industrial injuries includes thermal and chemical burns of the fourth degree, regardless of the area of damage, thermal and chemical burns of the eyeball in the presence of clinically pronounced signs of visual impairment. Thermal and chemical burns of the pharynx, esophagus, and respiratory tract with clinically pronounced symptoms of swallowing and breathing disorders should also be classified as severe industrial injuries. Severe industrial injuries also include radiation burns, regardless of the degree and area of damage.
2.2. Extensive frostbite of the third degree and frostbite of the fourth degree, regardless of size, are considered severe industrial injuries. Frequently occurring limited frostbite of the I-II degree of the face, fingers, feet and hands, which usually ends with the complete recovery of the victim, does not belong to the group of severe industrial injuries. A clinically pronounced disturbance in the general condition of the victim is lethargy, lethargy, adynamia, a decrease in body temperature by more than 1 degree. C - with general cooling of the body, this is the basis for classifying this condition as a group of severe industrial injuries.
2.3. Any deviations in the function of the cardiovascular system, disturbances in external respiration or consciousness at the time of exposure to electric current, as well as during the examination of the victim in a medical institution, regardless of their severity, are grounds for classifying electrical injury as a group of severe industrial injuries. In all cases, it is necessary to take into account the path of electric current to assess the possibility of further development of adverse consequences of its influence.
2.4. This group of severe industrial injuries also includes the consequences of asphyxia as a result of immersion in water or other liquid media.
The combination of these severe industrial injuries with other injuries, as well as with each other, is the basis for classifying this injury as a group of severe industrial injuries based on the leading injury.
Severe industrial injuries also include extensive wounds of various locations to the skin and underlying tissues, often accompanied by profuse bleeding, blood loss, and shock. Damages in which it is not possible to expect healing without plastic replacement of the defect should be considered extensive. Such injuries include extensive scalp wounds of the extremities, perineum, torso, lower leg and face.
Issuance procedure
medical and preventive detention facility
about the severity of the work injury
A conclusion on the severity of an industrial injury is issued by a medical and preventive institution in which outpatient or inpatient treatment of the victim is carried out, at the request of the enterprise, institution, organization, state farm or collective farm where the accident occurred.
It indicates the surname, first name, patronymic of the victim, age, position held, date and time of admission (application) to this medical and preventive institution, provides a full diagnosis indicating the nature and location of the injury and a conclusion about whether the existing injury relates or does not apply to group of severe industrial injuries.
The issued report on the severity of the injury must bear the stamp and seal of the medical institution, the signature of the attending physician and the head of the department (or chief physician), and the date of issue.
An approximate diagram of a conclusion on the severity of an industrial injury is attached.
A conclusion on the severity of an industrial injury can be issued by a medical institution on the form “Extract from the medical history of an outpatient, inpatient (underline) patient” (registration form No. 27, approved by the USSR Ministry of Health 10/111 1956). In this case, it is necessary to comply with the above requirements for drawing up the conclusion.
The attending physician makes a corresponding entry about the issued conclusion in the medical history (individual outpatient card), indicating the severity of the existing injuries and the date of issue of the conclusion.
The period for issuing the conclusion should be as short as possible and not exceed 3 days from the moment the medical institution receives a request from the enterprise, institution, organization, state farm or collective farm in which the accident occurred.
Ambulance and emergency doctors, medical workers who provide only first aid or transport the victim to a medical facility do not give conclusions about the severity of the work injury.
Application
to the Methodological Instructions
by application
"Schemes for determining severity
industrial injuries"
CONCLUSION ON THE SEVERITY OF WORK INJURY
Name of medical institution
(stamp)
Issued by _________________________________________________________________
(name of enterprise, institution, organization, state farm,
Collective farm, upon whose request a conclusion is issued)
is that the victim __________________________________________
(last name, first name, patronymic, age)
__________________________________________________________________
(position held)
entered _______________________________________________________
(name of hospital department, clinic)
__________________________________________________________________
(date and hour)
Diagnosis __________________________________________________________
(indicating the nature and location of the damage)
According to the Scheme for Determining the Severity of Work Injuries,
approved by the USSR Ministry of Health on September 22, 1980, the indicated damage is _____
__________________________________________________________________
(applies, does not apply - write out)
to the number of severe work-related injuries.
Head department
(or chief physician) ___________ ______________________________
(signature) (last name, first name, patronymic)
Attending doctor ___________ ______________________________
An industrial injury on the way to (from work) or directly at work is a fairly common case. In order to dispel all doubts, illusions and contradictions regarding this event, the Labor Code of the Russian Federation in its articles provided clear explanations on this issue. Let us also figure this out, translating dry legal language into simple language that everyone can understand.
Not every scratch, bruise or bump is an injury.
Legislation defines injury as harm caused to health, as a result of which the employee lost the ability to perform his work, was forced to undergo treatment, was transferred to lighter work, became disabled, or died.
If the incident happened at the workplace, during working hours and resulted in a deterioration in health, the incident is not considered industrial. And it doesn’t matter whose fault it happened.
Classification of injuries
What to do if a work injury occurs?
There is a certain algorithm of actions when attacking accident resulting in harm to health. It is defined by law (Article 228 of the Labor Code of the Russian Federation), and any manager of an enterprise must know it:
- It is necessary to immediately provide all possible medical assistance on the spot and call doctors or ensure the delivery of the victim to the hospital.
- In accordance with the situation, eliminate the causes of the incident - turn off the power, turn off the water, stop the production line, etc.
- If there is no further threat, leave the scene undisturbed.
- If such a threat cannot be excluded, document the situation at the scene of the incident: video filming, photography, diagram.
- Provide information about the incident to the relatives of the victim, the state labor inspectorate, insurers, trade unions, etc.
- Enter the relevant information into the emergency incident log available at the enterprise.
You can download a sample work injury report ->
Determining the severity of a work injury
Further, the Labor Code regulates: after all the above actions, a commission is created to investigate the incident. She carries out the procedure for registering a work injury. The size and composition of the commission depends on the complexity of the investigation. It consists of three or more people, it includes: the employer or his authorized representative, state labor inspector, representatives of the trade union, law enforcement agencies, medical workers, representatives of the prosecutor's office.
Investigating the incident by collecting information and witness testimony, this commission determines whose fault the incident occurred. The amount of payments to the victim and who will make these payments depends on this. The commission is also obliged to classify the harm. So, for example, if an incident was recorded at the workplace, during working hours, but the injured employee was intoxicated, then the injury will be defined as an accident.
Determining the severity of an industrial injury falls on the shoulders of the medical and social commission. It determines the nature of the injury: mild or severe. This also affects the size and source of payments.
Investigating the fact that occurred, this commission documents the occupational injury and draws up a report. An example of the act is given below.
The commission's work period ranges from three to fifteen days, depending on the complexity of the situation.
Injury at work - payments
In the event of an accident, one-time and monthly monetary compensation, sick leave and rehabilitation measures are paid. The amount of payment and the source of these payments depend on the classification and severity of the injury.
If the commission determines that the employee himself is to blame for the incident, then the amount of compensation will be significantly lower.
Also, the amount of monetary compensation depends on the severity of the injury. The degree of severity is determined by a medical and social commission. According to the severity of injuries, they are divided into severe and minor. Payment for severe work-related injuries is significantly higher than for mild ones.
If the work injury is classified as mild, then the payment of monetary compensation is made by the employer himself. If the severity of the injury is severe, then payment comes from the Social Insurance Fund.
Payment of sick leave for a work-related injury occurs in accordance with the Labor Code of the Russian Federation.
In addition to the basic payments provided for by Russian law, an injured worker may request payment of moral damages. As a rule, the employer and employee agree on the amount of damage independently. If the parties cannot come to an agreement, the court will help resolve the dispute.
There is no statute of limitations for this requirement.
A work injury is a situation that is unpleasant for both the employer and the employee. Sometimes, trying to avoid publicity and bureaucratic delays, the parties resolve the issue through a verbal agreement. In this case, if the contract is violated, it will be very difficult to prove anything and protect your rights.
Not every severe injury is accompanied by unbearable pain, just as not every minor injury is painless. The resulting bodily injuries are assessed not by the degree of pain, but by the consequences and reaction of the body. That is why a classification of industrial accidents has been developed for a competent investigation.
Terminology
In order to conduct an investigation in the proper manner, you should refer to the order of the Ministry of Health of the Russian Federation No. 160 of 2005. According to its provisions, absolutely all injuries, regardless of the cause of the accident at work, are classified into light and severe. And they are distinguished by the complexity of the damage, as well as by the duration of disability over time.
In most cases, a forensic medical examination establishes that an injury is 100% severe if the victim experiences the development of its consequences, the appearance of chronic diseases against this background, permanent disability or death. Severe injuries have 3 degrees of severity.
Also in this order, the concept of “classification of industrial accidents” is clearly defined and a three-stage scheme is provided, which indicates possible bodily injuries and their relationship with degrees of severity.
First degree of severity
The first stage of the scheme is characterized by health damage, which was initially accompanied by the patient with heavy blood loss, shock, problems with the functioning of the cardiovascular system, central nervous system, kidneys, liver, and lungs. Even if these health problems exist for a short period of time, when an injury occurs, the latter will always be considered severe.
Second degree of severity
The second stage, unlike the first, may not appear immediately, but upon admission for an initial examination upon arrival at a healthcare organization (usually an emergency room or intensive care unit). Only a doctor can determine the presence of the following injuries during a qualified examination using medical equipment.
The classification of industrial accidents provides for the classification of injury to the second degree of severity if the following damage is revealed during the examination:
- penetrating injury to the skull;
- fractures of the bones of the face and skull;
- brain injuries;
- penetrating wounds in the pharynx, trachea, esophagus, thyroid gland;
- spinal column injury (vertebral dislocations and fractures);
- chest injury with or without damage to the pleural cavity, heart muscles;
- penetrating injury to the abdomen with damage to the gastrointestinal tract and genitourinary system;
- organ rupture;
- fractures of the pelvic bones, humerus, femur, tibia;
- open joint injuries;
- injuries to large blood vessels;
- burns of thermal and chemical nature with an affected area of more than 15% of the body, as well as burns of the face, respiratory tract, and groin area;
- spontaneous termination of pregnancy (miscarriage).
Third degree of severity
The classification of industrial accidents identifies a separate group of severity of injuries that cannot threaten the life of the victim, but are recognized as having grave consequences:
- loss of vision (in one or both eyes);
- loss of the ability to speak and hear;
- loss of an organ or cessation of its functioning;
- mental disorders;
- facial disfigurement.
Special cases
The Ministry of Health classifies some types of industrial accidents as severe, not because the injury is on one of the lists, but because it can aggravate the course of chronic diseases, and sometimes become a catalyst for irreversible processes leading to death.
One of these special cases was the injury of Anna German, a Soviet singer. In 1967, she was in a car accident, suffering multiple broken bones. For fifteen years, the singer took strong painkillers and struggled with thrombophlebitis and sarcoma, a bone cancer. All these fatal damages appeared after the accident. A forensic examination has proven that pain, manifestations of new diseases and complications of chronic ones are sure signs of serious injury.
More often, there are situations when the conclusion indicates that the injury is mild, but subsequent medical examinations and monitoring of the victim’s condition require reclassification as severe. Here the investigation is carried out directly by representatives of the Labor Inspectorate.
For example, a welder is injured by an electric arc while working. After several days in the hospital, he feels improvement and informs the doctor that he has regained his ability to work. After some time, it turns out that when injured, the welder’s reproductive system was so damaged that it will no longer function. Such an accident should be immediately classified as serious.
Sometimes minor injuries can cause death, as Ministry of Health Order No. 160 warns about. In such cases, not only the general classification comes to the rescue. The investigation of industrial accidents in this situation is carried out jointly by the Labor Inspectorate and the Prosecutor's Office.
For example, if an employee suffers a fracture of the lower leg, the attending physician first issues a certificate of minor injury. During the fracture, adipose tissue from the bone marrow enters the bloodstream, and a fat embolism develops. Death occurs within two days. It would seem like a minor injury, but its consequences are fatal.
General classification of all NS
Before proceeding with the investigation, it is necessary to make sure that the injury is directly related to the production process, and when contacting a medical institution, the patient reported this, and the doctor entered code “04” on the sick leave sheet - industrial injury.
All NS can be divided into industrial and household (those that do not fall under the definition of industrial).
Production NS
The Labor Code of the Russian Federation provides a classification of industrial accidents. Thus, these include injuries received by an employee during working hours on or outside the employer’s territory, while performing official duties, as well as when traveling to and from the place of work on official transport. Also included in this category are injuries that an employee receives while performing overtime work or responding to emergency situations.
There is also a classification of the causes of accidents at work. It was determined by Order of Rostrud No. 21 of 2005:
- By source of injury: this includes 19 causes, some of which relate to the employer, and others to the employee. Each reason is assigned a unique code.
- Based on the type of incident, all causes are divided into several groups and subgroups:
2.1. On transport (8 subgroups).
2.2. Fall from a height (4 subgroups).
2.3. Collapse (4 subgroups).
2.4. Injury from moving, rotating or flying parts, elements, materials (5 subgroups).
2.5. Foreign bodies (3 subgroups).
2.6. Physical overload (3 subgroups).
2.7. Electric shock (1 subgroup).
2.8. Radiations (5 subgroups).
2.9. Extreme temperatures and natural factors (5 subgroups).
2.10. Fire and smoke (4 subgroups).
2.11. Harmful substances (2 subgroups).
2.12. Nervous overload.
2.13. Contact with dangerous animals and plants (3 subgroups).
2.14. Contact with water (2 subgroups).
2.15. Illegal actions of third parties.
2.16. Intentional self-harm.
2.17. Emergency (4 subgroups).
2.18. Other reasons.
Household pumps
If an accident occurs with an employee outside the employer’s territory during non-working hours, on the employer’s territory, but not in the performance of official duties (for example, a turner is injured in the process of turning parts for personal needs), if the employee was in a state of alcohol, drugs or other toxic intoxication, then the injury is recognized as not related to production - domestic.
Thus, the official classification of industrial accidents makes it possible to determine not only the cause of the injury, but also its source.
