Federal Institution for Medical and Social Expertise. ITU is a 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 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 tasks of 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 regulatory act, federal state medical and social examination institutions 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, disability, needs 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 that carries out medical and social examination of employees of organizations in certain industries with special hazardous 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 bureau of Zelenogorsk “is the only bureau of this level in Russia. Previously, the ITU bureaus 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 disability groups, and then social protection measures 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 population size living in the territory of a constituent entity of the Russian Federation and the number of citizens examined per year, based, as a rule, on 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 of 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

Application. The procedure for the organization and activities of federal state institutions of medical and social examination

Order of the Ministry of Labor and Social Protection of the Russian Federation of October 11, 2012 N 310n
"On approval of the Procedure for the organization and activities of federal state institutions of medical and social examination"

With changes and additions from:

The procedure for organizing and operating the Federal State Institution of Medical and Social Expertise (MSE) has been established.

This network of institutions includes the ITU Federal Bureau, the main ITU bureaus subordinate to the Russian Ministry of Labor and other federal departments, as well as their branches - ITU bureaus in cities and regions.

FGU MSE establish the structure and degree of disability, determine the need of the examined person for various social protection measures, including rehabilitation. They also study the causes, factors and conditions influencing the occurrence, development and outcome of disability, analyze its prevalence and structure.

The bureau consists of at least 3 specialists. These are medical specialists, psychologists, and rehabilitation specialists. If necessary, a social work specialist is involved.

Federal State Institutions have the right to refer citizens undergoing medical examination to medical organizations providing medical and preventive care, as well as to scientific and practical centers MSE and rehabilitation of disabled people. The goal is to clarify the clinical and functional diagnosis, professional capabilities, and conduct expert rehabilitation diagnostics.

Bureau decisions can be appealed to higher authorities or in court.

If the decision is not canceled or changed, it is binding for execution by the relevant authorities and organizations.

Structure and staffing table FGU MSE are established by the head of the institution.

The head of the FGU ITU is appointed to the position and dismissed from it by the head of the government body under whose jurisdiction the institution is located.

The state for the social protection of those persons who have persistent health disorders, injuries, cannot work, have limited opportunities socialization, created a whole system of assistance. 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 rating 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”. ITU Bureau disability can be established for 1 or 2 years, for 5 years and 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 occupational disease or an accident at work;
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 department Pension Fund. 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. Which will contain information about the state of health of the person being sent and the recovery capabilities of his health, about the rehabilitation activities, their results and necessarily the purpose for which the person is sent to the ITU (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 regional office PF no later than 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.

Medical and social examination - determination in the prescribed manner of the needs of the person being examined for social protection measures, including rehabilitation, based on an assessment of disability caused by a persistent disorder of body functions.

Medical and social examination is carried out on the basis of a comprehensive assessment of the state of the body based on the analysis of clinical, functional, social, professional, labor, and psychological data of the person being examined using classifications and criteria developed and approved in the manner determined by the Government of the Russian Federation.

Classifications and criteria of medical and social examination

The classifications used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination determine the main types of dysfunctions of the human body caused by diseases, consequences of injuries or defects, and the degree of their severity; the main categories of human life and the severity of the limitations of these categories.

The criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination determine the conditions for establishing the degree of limitation of the ability to work and disability groups (category “disabled child”).

Federal institutions of medical and social examination

Medical and social examination carried out by federal institutions of medical and social examination subordinate to the authorized body determined by the Government of the Russian Federation.

Federal state institutions of medical and social expertise include Federal Bureau of Medical and Social Expertise (Federal Bureau) and the main bureaus of medical and social examination, having branches - bureaus of medical and social examination in cities and regions (bureaus).

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 that have bureaus are under the jurisdiction of the Federal Agency for Health and Social Development.

Tasks of federal state institutions of medical and social examination:

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

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 federal institutions of medical and social examination:

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 programs rehabilitation of 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;

determining the degree of loss of professional ability to work;

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.