Federal Institution of Medical and Social Expertise. ITU is a medical and social expertise

Topic 2. Organization of activities of the state service institution of medical and social expertise

Control questions and tasks.

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

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

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

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

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

7. What determines the amount of temporary disability benefits?

Main tasks of the ITU institutions
Structure of ITU institutions. The order of their formation, reorganization and liquidation
Competencies of ITU institutions at different levels

Main tasks of the ITU institutions

Medical and social expertise is carried out by federal institutions of medical and social expertise, 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 institutions of medical and social expertise are entrusted with:

1) establishment of disability, its causes, timing, time of onset of disability, the needs of a disabled person in various types of social protection;

2) development of individual programs for the rehabilitation of disabled people;

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

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

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 of social support to the family of the deceased.

The decision of the institution of medical and social expertise is binding on the relevant state authorities, local governments, as well as organizations, regardless of organizational and legal forms and forms of ownership.

Currently, there is an explanation of the Ministry of Labor of the Russian Federation dated April 15, 2003 N 17 "On the determination by federal state institutions of medical and social examination of the causes of disability."

According to this regulatory act, federal state institutions of medical and social expertise 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 labor injury;

Ø military trauma;

Ø disease acquired during military service;

Ø disease acquired in the performance of military service (duties) in connection with the accident at the Chernobyl nuclear power plant;

Ø a disease caused by radiation, received in the performance of military service duties (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 in the performance of other duties of military service (official duties) associated with the disaster at the Chernobyl nuclear power plant;

Ø disease associated with the accident at the Mayak plant;

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

Ø disease associated with the consequences of radiation exposure;

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

The main tasks of federal state institutions of medical and social expertise are:

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

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

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

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

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

The 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 the main bureaus of medical and social expertise in the relevant subject of the Russian Federation;

Ø branches - bureaus of medical and social expertise in cities and districts;

Ø the main bureau that carries out medical and social examination of employees of organizations in certain industries with especially dangerous working conditions and the population of certain territories.

At present, there are FGU "Main Bureau of Medical and Social Expertise of the FMBA of Russia" and 20 of its branches. The specialists of the head bureau and its branches carry out their activities in close contact with the administration of enterprises of the corresponding region at the location of the branch. An important section of the bureau's work is control over the rational employment of disabled people.

In addition, since May 2008, the FMBA of Russia has included 84 main bureaus of medical and social expertise 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 expertise.

The number of bureaus is determined based on the calculation, as a rule, 1 bureau for 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 prevailing socio-demographic, geographical features of the 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, healthcare institutions of the constituent entities of the Russian Federation and local governments.

At present, the state of the material and technical base of ITU institutions leaves much to be desired. The Agency has prepared a Standard Agreement with the administration of the constituent entities of the Russian Federation, which without fail includes the issues of transferring the buildings and structures on the basis of which ITU institutions are currently located to federal ownership, and financing their reconstruction. Based on the limited physical capabilities of the disabled, these institutions should be located mainly on the first floors of buildings, have convenient entrances, ramps, and the necessary set of premises.

Example. At the beginning of 2008, a Bureau of Medical and Social Expertise (MSE) was opened in the city of Zelenogorsk, Krasnoyarsk Territory, where an integrated approach to the problems of people with disabilities is applied. According to the head of the FMBA V. Uyba, the new bureau of Zelenogorsk is “the only bureau of this level in Russia. Previously, the ITU bureaus were engaged only in issuing conclusions on assigning a disability group. disability groups, 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 disabilities and disabilities, 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. Equipped with a corner for children. Reception is conducted by a social worker, therapist, psychologist, surgeon, neurologist and rehabilitation specialist.

The bureau branch performs the functions, enshrined in clause 5 of Decree of the Government of December 16, 2004 N 805 "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 examined persons and their rehabilitation potential; establishes the fact of the presence of disability, determines the group, causes (circumstances and conditions of occurrence), the timing and time of the onset of disability; determines the degree of loss of professional ability to work (in percent) of employees who have been injured, an occupational disease or other damage to health associated with the performance of their work duties, and the need for additional social protection measures; determines the causal relationship of the death of the injured person with an industrial injury, occupational disease, stay at the front and with 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 for disabled people in special vehicles; forms and corrects individual programs for the rehabilitation of disabled people (determines the types, forms, terms and volumes of measures for medical, social and professional rehabilitation), and also controls their implementation; provides comprehensive assistance to persons who have undergone medical and social expertise, including in the form of legal advice, and assists in providing the necessary social protection for disabled people, 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 the disabled and submits relevant information to the main bureau; takes part in the study of factors leading to disability and in the development of comprehensive programs for the prevention of disability; submits to the relevant military commissariats information on all cases of recognition of persons liable for military service and persons of military age as disabled.

The main office performs the functions, enshrined in paragraph 6 of the Decree of the Government of December 16, 2004 N 805 "On the procedure for the organization and activities of federal state institutions of medical and social expertise."

Main Bureau: conducts a medical and social examination of persons who have appealed against the decisions of the bureau, and in case of unfoundedness of these decisions, changes them; conducts medical and social examination of citizens in the direction of the bureau in cases requiring the use of special examination methods; forms and corrects individual programs for the rehabilitation of disabled people in cases requiring the use of special examination methods, and also controls their implementation; provides primary rehabilitation, psychological and career guidance assistance to citizens who have passed medical and social examination; forms a data bank of the constituent entity of the Russian Federation on citizens who have passed a medical and social examination, carries out state statistical monitoring of the demographic composition of disabled people living in the territory of the constituent entity of the Russian Federation, and submits relevant information to the social protection authority of the population of the constituent entity of the Russian Federation; takes part in the study of factors leading to disability and in the development of comprehensive programs for the prevention of disability; submits to the relevant military commissariats information on all cases of recognition of persons liable for military service and persons of military age as disabled; provides advisory assistance to medical experts and other specialists of the bureau; supervises the activities of the bureau.

The Federal Bureau of Medical and Social Expertise performs the functions, enshrined in paragraph 7 of the Decree of the Government of December 16, 2004 N 805 "On the procedure for the organization and activities of 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 prescribed by the legislation of the Russian Federation. Expenses for the maintenance of institutions are made at the expense of the budgets of the constituent entities of the Russian Federation.

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

The bureau network is formed based on the population living in the territory of the subject of the Russian Federation, and the number of citizens examined per year, as a rule, one institution for 70-90 thousand people, subject to the examination of 1.8-2 thousand people per year . Taking into account the prevailing 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, a general profile bureau, a specialized bureau (for conducting a medical and social examination of patients with various diseases, defects and consequences of injuries) and a mixed profile are formed. To conduct a medical and social examination of persons under the age of 18, specialized bureaus may be formed.

The staff standard of the bureau includes specialists who make an expert decision (3 doctors of various specialties), a rehabilitation specialist, a social work specialist and a psychologist. In addition, the staffing table provides for the positions of a senior nurse, a medical registrar and a driver. If necessary, pediatricians, specialists in functional diagnostics, career guidance, ergonomics, labor physiology, a teacher, a sign language interpreter and other specialists can be included in the staff standard of the bureau.

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 disabled people, their social and environmental adaptation, as well as specialists in legal consulting services and information and statistical support. The specialists who make 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, a stationary department can be created at the main office.

The number of staff of specialists included in the staffing standard of the main bureau is determined depending on the number of bureaus operating in the territory of the constituent entity of the Russian Federation, as a rule, at the rate of 1 staff of specialists for 4 bureaus. To conduct a medical and social examination of citizens, the main bureau may involve consultants on medical and social issues.

In order to exercise their powers, institutions have the right to: send persons undergoing a medical and social examination for examination in order to clarify their clinical and functional diagnosis and professional capabilities in medical and preventive institutions of the state and municipal health care systems, rehabilitation and other state and municipal institutions that carry out activities in the field of medical and social expertise and rehabilitation of disabled people; to request and receive from organizations of all forms of ownership the information necessary for making a decision and performing other functions assigned to institutions; conduct control examinations of disabled people for dynamic monitoring of the implementation of measures provided for by individual programs for the rehabilitation of 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 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 staffing standard of the ITU bureau?

5. What is included in the staffing standard of the main bureau of the ITU?

6. What are the ITU and rehabilitation responsibilities of 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 to 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 against decisions of the bureau, the main bureau, the Federal Bureau

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

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 Expertise"

With changes and additions from:

The procedure for the organization and activities of the Federal State Institution of Medical and Social Expertise (ITU) 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 - the ITU bureaus in cities and regions.

FGU ITU 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 that affect the occurrence, development and outcome of disability, analyze its prevalence and structure.

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

The FGU has the right to send citizens undergoing ITU for examination at medical organizations providing medical and preventive care, as well as to scientific and practical centers of ITU and rehabilitation of the disabled. The goal is to clarify the clinical and functional diagnosis, professional opportunities, and conduct expert rehabilitation diagnostics.

Decisions of the bureau can be appealed to higher authorities or in court.

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

The structure and staffing of the FGU ITU 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 authority in charge of the institution.

The state has created a whole system of assistance for the social protection of those people who have persistent health disorders, injuries, cannot work, 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 in relation to each specific person requiring state support, they created a medical and social expertise (MSE). Strictly speaking, ITU is a state examination designed to resolve the issue of establishing disability for a particular person.

Among the main tasks of the MSE is to determine the degree of damage to the basic functions of the body of a particular person, identify possible ways of rehabilitation, and legally recognize him as a disabled person.

ITU structure

For each specific person who needs to establish a disability, an 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 the place of residence (this may be the place of his stay) or at the location (if he left the Russian Federation). For example, to conduct ITU Moscow, one should contact one of the 95 branches of the ITU GB 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, a 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, it will be the ITU Headquarters for Moscow).

The main structure is the Federal Bureau of ITU. In 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 the establishment of a disability group. This procedure is an actual general assessment of the state of health of the person who applied to the bureau.

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

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

And also specialized groups have been created for examination:

tuberculosis patients;
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.

When passing the ITU, the issue of rehabilitation is also resolved and an individual rehabilitation program (IPR) is issued (or adjusted).

Place of examination

At the same time, in accordance with the Rules for Recognizing a Person as a Disabled Person (Decree of the Government of the Russian Federation of February 20, 2006 No. 95), an examination is possible:

On disability groups and criteria for their establishment

The ITU survey implies the definition of a disability group (its extension) or the refusal to establish it. All and also there is a category "disabled child". Bureau ITU 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 specification of groups has a detailed list of health disorders of the examined person. These criteria underlie the establishment of a disability group by an examination.

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

If there are persistently expressed disorders of body functions that require special adaptations or the creation of specific working conditions for the performance of labor activity, any special technical equipment. funds or assistance from outsiders, they qualify as the second degree of restriction. In this case, the second group of disability is assigned.

When fixing persistently expressed health disorders, leading to the impossibility (even contraindications) of labor activity or unconditional inability to it, there is a 3rd degree. These are signs of the I group of disability.

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

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

About the possible purposes of the examination

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

identification of a person with a disability group (category "disabled child");
determination of the degree of loss of professional skills and ability to work;
development (or its correction);
development (or its correction) of the program of rehabilitation of the victim.

And also the commission can be held in order to establish:

stages of loss of professional skills due to occupational disease or accident at work;
the need for extraneous care of a close relative, a citizen undergoing military service;
signs of a persistent health disorder for police officers and other structures.

How to get a referral

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

Contact a medical institution of healthcare of the Russian Federation , where the person requiring examination is observed or treated.
Apply to the branch of the Pension Fund. Here you will need to submit the necessary medical documents certifying the disease, injury or disability.
Come with an appeal to the social protection authorities, and there must be signs of a person's life restriction and his need for social protection.

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

The social protection authorities and the Pension Fund of the Russian Federation issue a referral in the form approved by the order of the Ministry of Health and Social Development of the Russian Federation of December 25, 2006 No. 874, which contains information about the signs of limited life activity (as a rule, on the basis of a fact established by them) and the need for social protection, the purpose of the referral.

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

What other documents are required for examination

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

Common to all types of expertise will be:

a written application for an examination from a person who needs it;
a document proving the identity of the disabled person and his guardian (if any). For children under 14, documents of one of the parents are required;
medical certificate confirming health disorders.

You will most likely need the following documents:

Who are legal representatives

In a number of cases, a person who requires the establishment of a disability, due to his illness, cannot be fully responsible for his actions or is physically unable to collect certificates and go to the authorities. This will be the basis for their interests to be represented by legal representatives. They can be parents, children, other relatives, spouses or strangers who are 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 parents will be their legal representatives. The law provides for their mandatory participation in the process (the examination is not carried out without them). If the child does not have parents, they are replaced by guardians.

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

About results

A protocol is kept during the examination. Then an inspection report is drawn up, which consists of 2 parts. It is kept for 10 years. On the hands of the person in respect of whom the examination was carried out, they issue:

Help. It indicates the group of disability, the reason and the period for which the disability was established, there must be a link to the examination certificate 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 3 days.

If a person does not agree with the results of the examination, it is necessary to write an application 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.

In case of disagreement with the conclusions of the commission, you can also apply to the court.

Medical and social expertise - determination in accordance with the established procedure of the needs of the examined person in measures of social protection, including rehabilitation, based on an assessment of life limitations caused by a persistent disorder of body functions.

Medical and social expertise is carried out on the basis of a comprehensive assessment of the state of the organism based on an analysis of clinical, functional, social, professional, labor, 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 for medical and social expertise

The classifications used in the implementation of the medical and social examination of citizens by federal state institutions of medical and social examination determine the main types of violations of the functions of the human body due to diseases, the consequences of injuries or defects, and the degree of their severity; the main categories of human life and the severity of the restrictions 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 expertise

Medical and social expertise carried out by federal institutions of medical and social expertise, 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 expertise, having branches - a bureau of medical and social expertise in cities and regions (bureau).

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 expertise 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 expertise:

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

study of the causes, factors and conditions affecting the onset, development and outcome of disability, analysis of the prevalence and structure of disability.

Functions of federal institutions of medical and social expertise:

establishment of disability, its causes, timing, time of onset of disability, the needs of a disabled person in various types of social protection;

development of individual programs rehabilitation of the disabled;

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

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

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

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 of social support to the family of the deceased.