Determining the degree of disability resistance. Temporary disability, its types and forms of social welfare Examination of the resistance of disability in ITU

The date: 05.03.2020

Examination of ability to work - This is the type of examination, which is to determine the causes, duration, degree of temporary or resistant disability of a person in connection with the disease, an injury or another cause, as well as determining the patient's needs in the types of medical care and social protection measures.

Naturally, the question arises, what should be understood under the work of man?

Ability - This is the condition of the human body, in which the set of physical and spiritual possibilities allows you to perform the work of a certain amount and quality. Medical worker on the basis of these comprehensive medical examination should establish the presence or absence of a disease in a particular person. Disability has medical and social criteria.

Medical workbay criteriaincludes a timely prescribed clinical diagnosis, taking into account the severity of morphological changes, the severity and nature of the course of the disease, the presence of decompensation and its stage, complications, the definition of the nearest and long-term forecast of the development of the disease.

However, not always a sick person is disabled. For example, two people suffer from the same disease - Panaritis. One of them is a teacher, another cook. A teacher with Panaritis can fulfill his professional duties - it is able-bodied, and the cook - no, that is, is disabled. In addition, the cause of disability is not always in the disease of the patient itself. For example, the same cook itself can be healthy, but in his family someone fell ill with viral hepatitis, as a result of which the cook cannot fulfill his professional duties, that is, to do cooking, since he has contact with a patient with viral hepatitis. Consequently, the disease

and the disability is not identical. In the presence of a disease, a person can be able-bodied if the disease does not interfere with the performance of professional duties, and disabled, if their execution is difficult or impossible.

Social cooking criteriadetermine the labor forecast with a specific disease and the conditions of its labor, reflect everything related to the professional activity of the patient: the characteristic of the prevailing voltage (physical or neuropsychic), the frequency and rhythm of work, the load on individual systems and organs, the presence of adverse working conditions and professional harm.

Using medical and social disability criteria, an examination is carried out by a medical professional, in the course of which the patient's disability can be established. Under disability it is necessary to understand the condition caused by the disease, injury, its consequences or other reasons when professional labor is impossible in whole or in part for a limited time or constantly. Disability may be temporary and resistant.

13.2. Examination temporary

Disability

If the changes in the patient's health is temporary, reversible, and in the near future, recovery or improvement is expected, as well as disability, this type of disability is considered temporary. Temporary disability (VN)- This is the condition of the human body caused by the disease, injury and other reasons, in which violations of functions are accompanied by the impossibility of performing professional labor under normal production conditions for a certain period of time, that is, they are reversible.

Distinguish complete and partial temporary disability.

Full temporary disability - This is the impossibility of performing any work for a certain period, accompanied by the need to create a special mode and treatment.

Partial temporary disability comes in a person in relation to its usual professional activities

save the ability to perform another job with a different lightweight mode or reduced volume.

The establishment of temporary disability is carried out on the basis of an examination and has important legal and economic importance, as it guarantees a citizen exemption from work and receiving benefits at the expense of state social insurance. The timely liberation of illness from work is one of the effective preventive measures to prevent the complications of diseases, their chronic.

Thus, examination of temporary disabilityit is one of the types of medical examination, the main purpose of which is an assessment of the health of the patient, the quality and effectiveness of the treatment, the ability to carry out professional activities, as well as determining the degree and timing of temporary disability.

Examination of temporary disability is made in state, municipal and private health organizations.

The incidence of temporary disability reflects the incidence of the working population, therefore, in addition to the medical and social, it has a large economic value.

A document certifying temporary disability of citizens and confirming their temporary exemption from work, serves disability sheetwhich is issued:

For diseases;

In injuries, poisoning and other states associated with temporary disability;

For the period of fake in sanatorium-resort institutions;

If necessary, care for a sick family member;

For a period of quarantine;

At the time of prosthetics under hospital conditions;

For the period of pregnancy and childbirth;

When adopting a child.

There are two ways to issue disability leaves: centralized and decentralized. Centralized wayit is often used in large polyclinics, where disability sheets are made in the registry or in specialized cabinets of centralized issuance of hospital leaves.

A medical sister working in this office should be able to properly fill in the passport part of the disability sheet and items relating to exemption from work. For decentralized methodthe disability sheet is issued and issued by the attending physician itself, a medical sister helps him in filling in the passport part.

The disability sheet, in addition to the attending physician, can issue a paramedic and dentist medical organizations to solve the health authority of the subject of the Russian Federation agreed with the regional branch of the Social Insurance Fund of the Russian Federation.

Do not issue disability leaves Medical workers of the following health care facilities:

Emergency medical institutions;

Blood transfusion institutions;

Adoptive departments of hospital institutions;

Medical and physical dispensaries;

Balneological hospitals and mud;

Health care institutions (medical prevention centers, disaster medicine, forensic examination bureau);

Health care institutions to supervise consumer rights and human well-being.

The issuance of disability leaves is carried out upon presentation of a passport or document replacing it. In the event that a citizen works in several employers, several disability leaves are issued for each place of work.

Control over the observance of the procedure for issuing disability sheets by medical workers is carried out by the Federal Service for Supervision of Health and Social Development in conjunction with the Social Insurance Fund of the Russian Federation.

Resistant disability- Long-term or constant loss of ability to work or a significant disability caused by chronic disease (injury, anatomical defect), leading to a pronounced violation of the functions of the body. Depending on the degree of disability, disability is established by conducting MES.

Medical and social expertise- Determination of the needs of an examined person in measures of social protection based on the assessment of the limitations of the vital activity caused by the resistant disorder of the body's function. Russia has created a three-stage system of federal state institutions ITU, which includes the Federal Bureau of ITU, the main ITU Bureau, as well as the ITU Bureau, which are branches of the main bureaus. Currently in the Russian Federation there are the Federal Bureau of MES (Moscow), the main ITU Bureau in all constituent entities of the Russian Federation and the ITU Bureau in all municipalities.

Citizens are sent to ITU, having persistent limitations of life and ability to work and need social protection, to conclusted the medical commission at:

An obvious unfavorable clinical and labor forecast regardless of temporary disability, but no later than 4 months from the day of its start;

A favorable clinical and labor forecast for temporary disability, ongoing over 10 months (in some cases - a state after injuries and reconstructive operations, in the treatment of tuberculosis - over 12 months);

The need to change the program of professional rehabilitation of working disabled in case of deterioration of clinical and labor forecast, regardless of the group of disability and temporary disability.

A citizen is heading for ITU by the organization providing him with medical and preventive assistance (a body that implements pension provision, social protection authority), after the necessary diagnostic, medical and rehabilitation measures in the presence of data confirming persistent violation of the functions of the body, due to diseases, the effects of injuries or defects. At the same time, in the "direction of medical and social expertise" (f. 088 / U-06), data on the state of health of the citizen, reflecting the degree of violation of the functions of organs and systems, the state of the compensatory capacity of the body, as well as the results of the rehabilitation activities carried out are indicated.

In the event that an organization providing medical and preventive assistance refused to a citizen in the direction of ITU, he is issued a certificate, on the basis of which he has the right to contact the Bureau on its own. Specialists of the Bureau conduct an examination of a citizen and according to its results, make up a program of additional examination and rehabilitation activities, after which they consider the issue of the presence of life restrictions.

ITU is held at the Bureau at the place of residence. The ITU main bureau is held in the event of an appeal of a citizen of the Bureau's decision, as well as in the direction of the Bureau in cases requiring special types of surveys. The Federal Bureau of ITU is held in the event of an appeal of a citizen of the decision of the Main Bureau, as well as in the direction of the Main Bureau in cases requiring particularly complex special types of surveys. ITU can be held at home if a citizen cannot appear at the Bureau for Health, which is confirmed by the conclusion of an organization providing medical and preventive care, or in a hospital where a citizen is in treatment, or in absentia by decision of the relevant bureau. The examination is held at the request of a citizen who is submitted to the Bureau in writing with the application "Directions on the Medical and Social Examination" issued by the Organization providing medical and prophylactic assistance (a body that implements the Pension Provision, the Social Protection Authority), and medical documents confirming Violation of health. ITU is held by the Bureau experts by examining a citizen, studying the documents submitted by them, analysis

socio-household, professional labor, psychological and other citizen data. The decision to recognize a citizen with disabilities or a refusal to recognize him with disabilities is made by a simple majority of experts who conducted ITU, based on the discussion of the results of its ITU. The decision is declared a citizen held by ITU, in the presence of all specialists who conducted ITU, which, if necessary, give an explanation on it. According to the results of ITU, the Citizen is drawn up. In cases that require special types of examination of a citizen in order to establish a degree of restriction of life (including the degree of restriction of the ability to work), rehabilitation capacity, as well as obtaining other additional information, a program of an additional survey may be approved, which is approved by the head of the relevant bureau. This program is communicated to a citizen undergoing ITU in an accessible form.

After receiving the data provided for by the Additional Survey Program, specialists of the relevant Bureau decide on the recognition of a citizen with disabilities or a refusal to recognize it with disabilities. In case of refusal of a citizen from an additional examination, such a decision is made by experts on the basis of available data, which the corresponding entry is made in the ITU Act of the Citizen.

Extract from an ITU Act of a citizen recognized by disabled person is sent to the body exercising its pension provision, within three days from the date of the decision to recognize it with disabilities.

A citizen recognized as disabled is a certificate confirming the fact of the establishment of disability, indicating the disability group and the degree of restriction (or without limitation) of the ability to work, as well as the individual rehabilitation program.

A citizen who is not recognized as disabled, at his request, is issued a certificate of ITU results.

A citizen may appeal the decision of the Bureau, submitting a written application to the higher authorities: to the Main Bureau or Federal Bureau of ITU. Also decisions taken at the ITU Bureau (three instances), a citizen can appeal in court in the procedure established by the legislation of the Russian Federation.

TEST QUESTIONS

1. What is customary to understand under work?

2. List medical disability criteria.

3. What social disability criteria do you know?

4. What is temporary disability? What kinds of her do you know?

5. List the functions of the attending physician during the examination of temporary disability.

6. What tasks is the medical commission solve?

7. What is a document certifying temporary disability?

8. What are the basic functions of disability?

9. What methods of issuing disability leaves exist in health organizations?

12. Open the procedure for issuing a sheet of disability for diseases, injuries, poisoning, as well as some other consequences of exposure to external reasons.

13. What is the procedure for issuing a sheet of disability to care for a sick family member?

14. How is a sheet of disability in cases of pregnancy and childbirth?

15. How is the issuance of a disability sheet for a period of sanatorium-resort treatment, prosthetics and quarantine?

16. What should be understood under resistant disability?

17. Give the ITU definition.

18. In which cases, patients on the conclusion of the medical commission are sent to ITU?

19. What is the procedure for the direction of citizens at ITU?

Resistant disability is a long-term or constant disability or a significant disability limitation caused by chronic disease (injury, an anatomical defect) with a significant impairment of the body functions. Depending on the degree of disability, disability is established.

Under disabilities (lat. Invalidus - weak, weak) understand the persistent, long disability. The concept of "disability" has medical, legal and social aspects.

According to WHO, not less than 25% of the total population can be attributed to the category of patients, people with disabilities are 10% of the total population of the globe. In England, this figure is 8%, in the US - 10%, in Canada - 20%. The concept of "disability" in its development has passed a long way from the absolutization of biological factors of its formation, when the focus was on anatomophysiological violations, to the "social environment" systematization based on the transfer of attention to the relationship between human and society.

The impact of the socio-economic conditions for disability is higher in those territories where there are less average monthly wages, small cash incomes per capita, a high proportion of workers engaged in manual labor working in harmful working conditions, where unsatisfactory living conditions (provision of housing) and life, Bad conditions for rest. The level and quality of therapeutic and prophylactic assistance is disability higher in those territories where there is less security of LPU beds, low staffedness of medical personnel, low coverage of patient dispensarization, poor equipment with diagnostic equipment. The activities of the State Service ITU more often disability acts as a reason, and the ITU Bureau Indicators are as a result. At the same time, the disability is lower in those territories where treatment is more often extended.

The environmental situation and working conditions according to WHO, the state of the environment introduces a 25 -30% "contribution" to the health of each person. Over the past 10 years in Russia, there has been a constant deterioration of the state of the environment, working conditions, the living standards of the population and its health. More than 75% of production wastes have one or another degree of toxicity for the environment and human health. About 47% of total emissions taken into account of harmful substances make up motor transport. It becomes one of the main reasons for the development of acute and chronic respiratory diseases. Chronic forms of eco-dependent pathology in children over time are the cause of the emergence of FMR, IBS, an early form of atherosclerosis, chronic nonspecific diseases of the lungs, etc. The proportion of enterprises with unsatisfactory working conditions reached 45%, with extremely unsatisfactory - 42%.

A distinctive feature of occupational diseases is a high degree of disability during them (more than 50%) and long-term disability (10-20 years or more), while overall working capacity is often preserved, with the only criterion for establishing disability is the impossibility of continuing work in contact with professionality . This is evidenced by the high level of persons with disabilities of the Group III among patients (more than 80%), while among all the disabled it does not exceed 30%. The disability is higher in those territories where there are more discharges of polluted wastewater, emissions of solid and gaseous substances into the atmosphere, where many mineral fertilizers are made, where capital investments on environmental protection and working conditions. Wars and armed conflicts, natural and man-made disasters, road accidents have a significant impact on the state of disability.

A disabled person - a person who has a violation of health with a resistant disorder of the body functions, due to diseases, the consequences of injuries or defects, leading to the restriction of life and the necessity of its social protection (FZ "On the social protection of persons with disabilities in the Russian Federation" No. 181 -fz from 24. 11 . 1995)

The classification of violations of the basic functions of the human body (Order of the Ministry of Health and the Code of the Russian Federation No. 535 of 22. 08. 2005) - disorders of mental functions (perception, attention, memory, thinking, intelligence, emotions, will, consciousness, behavior, psychomotor functions); - violations of linguistic and speech functions (violations of oral (rinolalia, dysarthria, stuttering, alaria, aphasia) and written (disgrave, dyslexia), verbal and non-verbal speech, violation of voice formation, etc.); - disorders of sensory functions (vision, hearing, smell, tanging, tactile, pain, temperature and other types of sensitivity); - disorders of statitional functions (motor functions of the head, torso, limbs, static, coordination of movements); - disorders of blood circulation, respiration, digestion, isolation, blood formation, metabolism and energy, internal secretion, immunity; - Violations caused by physical ugliness (deformities of the face, head, torso, limbs leading to external deformations, abnormal openings of digestive, urinary, respiratory tracts, body size).

Classification of violations of the body functions according to severity: 1 degree - minor violations of functions; 2 degree - moderate disorders of functions; 3 degree - pronounced violations of functions; 4 Degree - significantly pronounced violations of functions. Resistant disorder of the body's function is considered if it cannot be restored during a period of temporary disability.

Temporary disability is limited to 10 months, and in some cases - 12 months. (injuries, states after reconstructive operations, tuberculosis). Order of the Ministry of Health and Social Development No. 514 of 01. 08. 2007 "On the procedure for issuing medical institutions of disability"

Recommendations for the heads of medical and prophylactic institutions and doctoring doctors, specialists of the executive bodies of the Social Insurance Fund of the Russian Federation "The estimated time limits of temporary disability for the most common diseases and injuries" (in accordance with the ICD-10) (utensils. Ministry of Health of the Russian Federation and the Social Insurance Fund Of the Russian Federation dated August 21, 2000 N 2510/9362 -34, 02 -08/10 -1977 P) Approximate terms of temporary disability are a recommendatory nature. However, a significant increase in the orientability time of temporary disability (30 or more percent) should serve as a reason for the examination of temporary disability by the head of the department, the medical commission (VC) with the assessment of the volume, quality and effectiveness of medical care, the use of modern medical technologies, the timeliness of attraction To therapeutic process of other specialists or medical institutions in order to identify objective or subjective factors and adequate measures.

The direction of patients on the IECE (medical and social expert commission) is carried out by medical institutions. For the passage of the IECE, 3 documents are presented: the messenger sheet, passport and disability sheet.

Direction to the medical and social expertise (f. 088 / U-06), in use of the called "Messenger Sheet", is issued to a citizen (his legal representative) or an organization providing medical infiltrate assistance (any legal form), or by the pension authority Provision (department of the Department of the Pension Fund of the Russian Federation), or the social protection authority (the Office of Social Protection of the Municipal Education Population).

This direction (f. 088 / U-06) is filled in the clinic at the place of residence of a citizen after the necessary diagnostic, medical and rehabilitation measures in the presence of data confirming the resistant violation of the functions of the body of a citizen, due to diseases, consequences of injuries or defects.

The Medical and Social Expert Commission is an authority exerting the examination with a long and constant (resistant) disability. MCEC is an important stage in the system of medical and social rehabilitation of persons with disabilities, predetermines the paths and forms of involvement of persons with disabilities into socially useful work.

The main functions of MCEC in accordance with the Model Regulations are: 1. Determination of the state of disability, constant (resistant) or long loss; 2. Establishment of a group of disability for the first time or during re-informing; 3. Determination of the cause of disability resistivity; 4. Determining the time of the actual occurrence of disabilities; 5. Establishing the degree of disability due to industrial accident (in%);

6. The definition for disabled conditions and types of labor, works and professions available to them for health states, as well as conditions and methods with which disturbed disability can be restored or improved; 7. Direction for retraining; 8. Checking the correctness of the use of persons with disabilities at work in accordance with the conclusions of the Commission; 9. Facilitating the health promotion, disability prevention (validation of trolics during temporary disability 10 (12) months in a year, participation in preventive programs); 10. Studying with health authorities, enterprises, institutions, organizations and trade union bodies causes disability in case of disability and participation in the development of disability prevention activities and disability.

Documents at a raft loss of ability to work are: 1. Act of examination at MSEK 2. Statistical coupon 3. Conclusion for a medical institutional institution 4. Lime for the company 5. Extract to the social security department or to the social protection department. 6. Help on the decision of MCEC

The grounds for the Direction on IEC on the Medical and Social Examination are citizens who have signs of persistent restriction of life and disability and in need of social protection: with an obvious unfavorable clinical and labor forecast, regardless of time disability, but no later than 4 months from the date of its start. ; With a favorable clinical and labor forecast for temporary disability, ongoing over 10 months (in some cases: States after injury and reconstructive operations, in the treatment of tuberculosis - over 12 months); If it is necessary to change the professional rehabilitation program with working disabled in case of deterioration of clinical and labor forecast, regardless of the group of disability and temporary disability. Doctors and VC (medical commissions) in state, municipal and private health organizations are engaged in issues of temporary disability of citizens in state, municipal and private organizations.

Classification of the main categories of life (Order of the Ministry of Health and CP of the Russian Federation No. 535 of 22. 08. 2005) 1. The ability to self-service - the ability of a person to independently carry out basic physiological needs, perform daily household activities, including personal hygiene skills. 2. The ability to independently move - the ability to move independently in space, maintain the balance of the body when moving, alone and change the body position, use public transport. 3. The ability to learn is the ability to perceive, memorizing, learning and reproducing knowledge (general education, professional, etc.), mastering skills and skills (professional, social, cultural, domestic).

4. The ability to work the ability to carry out labor activities in accordance with the requirements for content, volume, quality and conditions of work. 5. The ability to orientation is the ability to adequately perceive the environment, assessing the situation, the ability to define the time and location. 6. The ability to communicate is the ability to establish contacts between people by perception, processing and transmitting information. 7. The ability to control their behavior to the ability to realize itself and adequate behavior, taking into account the socio-legal and moral societies.

Classification according to the severity of restrictions of life categories I. Restricting self-service (independent movement, orientation, communication, control over their behavior): 1 degree - ability to self-service with a longer time of time, fragmentation of its implementation, reduction of volume, using, if necessary, auxiliary technical funds; 2 degree - self-catering ability with regular partial help of other persons using, if necessary, auxiliary technical means; 3 degree - inability to self-service, the need of permanent assistance and complete dependence on other persons; II. Limiting the ability to learn: 1 degree - the ability to learn, as well as to obtain education of a certain level within the framework of state educational standards in general-purpose educational institutions using special training methods, special training regime, with use of auxiliary technical means and technologies if necessary; 2 degree - ability to learn only in special (corrective) educational institutions for students, pupils with disabilities or at home for special programs using if necessary, auxiliary technical means and technologies; 3 degree - inability to learn;

Restriction of the ability to work with the criterion of establishing 1 degree of restriction of the ability to work to work with a persistent moderately pronounced disorder of the body functions due to diseases, consequences of injuries or defects, leading to a decrease in the qualifications, volume, severity and tension of work, the impossibility of continuing The main profession with the possibility of performing other types of work of lower qualifications under normal working conditions in the following cases: when performing work under normal working conditions under the main profession with a decrease in production activities for at least 2 times, a decrease in labor gravity by no less than two classes ; When transferring to another work of lower qualifications under normal working conditions due to the inability to continue to work on the main profession.

The criterion for establishing 2 degrees of restriction of the ability to work is a violation of health with a persistent pronounced disorder of the body's functions, due to diseases, consequences of injuries or defects, in which work is possible to carry out work activities in specially created working conditions, using auxiliary technical means and (or) Use other persons. The criterion for establishing 3 degrees of restriction of ability to work is a violation of health with a persistent significantly expressed disorder of the body functions, due to diseases, consequences of injuries or defects, leading to a complete inability to work activities, including in specially created conditions, or contraindicateness of work.

The criteria for establishing the first group of disability criterion to determine the first group of disability is a violation of human health with a persistent significantly expressed disorder of the body functions, due to diseases, the consequences of injuries or defects, leading to a limitation of one of the following categories of life or a combination and the necessity of its social protection self-service III degree; ability to move the III degree; ability to orientation of the III degree; ability to communicate III degree; The ability to control their behavior of the III degree.

Criteria for establishing a second group of disability criterion to establish a second group of disability is a violation of human health with a persistent pronounced disorder of the body functions, due to diseases, the consequences of injuries or defects, leading to the limitation of one of the following categories of livelihoods or their combination and the necessity of its social protection: the ability to self-service II degree; ability to move the II degree; ability to orientation of the II degree; ability to communicate II degree; ability to control their behavior of II degree; learning abilities III, II degrees; Ability to work activities III, II degrees.

The criteria for establishing the third group of disability criterion for determining the third group of disability is a violation of human health with a persistent moderately pronounced disorder of the body functions due to diseases, consequences of injuries or defects, leading to the restriction of the ability to work the I degree I or the restriction of the following livelihood categories in their various combinations and Caused by its social protection: the ability to self-service I degree; ability to move the I degree; ability to orientation of the I degree; ability to communicate I degree; ability to control their behavior of I degree; Ability to teach I degree.

Criteria for the establishment of a child-disabled child category category "Child-disabled" category is determined if there are restrictions on the livelihoods of any category and any of three degrees of severity (which are estimated in accordance with the age norm), causing the need for social protection.

The deadlines for the establishment of disability groups Category "Child-disabled" is set for 1 year, 2 years and until the child has been achieved by the 18-year-old age; I a group of disability is set for 2 years; II and III a group of disability is set for 1 year; The degree of restriction of ability to work (the lack of limitation of ability to work) is established for the same time as a group of disability. In the event that the causal relationship of disability is established with the implementation of work on the elimination of the consequences of the Chernobyl accident, the re-examination is made 1 time in 5 years, regardless of the group of disability (indication of the MSO RSFSR No. 1 -76 -U from 11. 09. 92); Without an indication of the period of re-examination, disability is established in these persons when reached the redundant age retirement (men - 50 years old, women are 45 years old). In the event of a citizen of a disabled person of disability, the day of receipt of a citizen on the conduct of medical and social expertise is considered to be received. Disability is established up to the 1st day of the month following the month, which is scheduled to hold another medical special examination of a citizen (re-examination).

The establishment of a group of disability is indefinite (Decree of the Government of the Russian Federation No. 247 of 07. 04. 2008) no later than 2 years after the initial recognition of disabled person (establishing a "child-disabled" category) a citizen, having diseases, defects, irreversible morphological changes, violations of organs of organs and the body systems on the list according to the application; No later than 4 years after the initial recognition of a citizen with disabilities (establishing a "child-disabled" category) in case of identifying the impossibility of eliminating or decreasing, during the implementation of rehabilitation measures, the degree of limiting the vital activity of a citizen caused by persistent irreversible morphological changes, defects and violations of the functions of organs and systems of the body ( Except as specified in the Appendix).

The dynamics of the first established disability of the children's population of the Russian Federation in different age groups of 1996-2007.

The decoration of the person's sick leave, directed to the examination of the ITU institution and having disability sheets should be examined as a priority (letter of the Ministry of Labor and Social Development of the Russian Federation No. 6070 -Ao from 09. 1999). When directed to ITU, the corresponding dates in the lines are indicated in the sheet of disability: "sent to the ITU Bureau", "Registration of documents at the ITU Bureau", "was examined at the ITU Bureau". In the Row "Conclusion of the ITU Bureau", an entry is made on the results of the survey and the signature of the ITU Bureau leader is set. In the "Starting" row, recording is made: "The degree of restriction of the ability to work is established" and the date of registration of documents at the ITU Bureau is specified. If the degree of restriction of the ability to work the ITU bureau is not established, the period of examination of one line is indicated in the graphs: "From what date" and "for what number inclusive" Table "Exemption from work".

When establishing disability with the degree of restriction of the ability to work on labor activity, the time of temporary disability is completed by the date directly preceding the day of registration of documents in the ITU facilitation. Temporarily disabled persons who have not been established by disability, including the determination of the degree of restriction of labor activities, a disability sheet may be issued to solving a medical commission before disability for a period of no more than 4 months after the date of registration of documents in the ITU facilities, with the frequency of issuance A sheet of disability by decision of the medical commission is no less often than 30 days later, or re-directions on ITU. If a citizen refuses to referrals to ITU or its late appearance on ITU in a disrespectful reason, a disability sheet is not extended from the date of refusal to send documents to ITU or the day of registration of documents in the ITU facilities, information about it is indicated in a disability sheet and in a medical card outpatient (stationary) patient.

Primary disability prevention - a system of state measures aimed at reducing morbidity and injuries, improving working conditions, an environmental situation; Secondary - early diagnosis and adequate treatment, prevention of the development of complications and consequences. This can be achieved by the distance of the disability occurrence or the establishment of disability less severe group; Tertiary - prevention of weighting disability.

1. Federal Law of 24.11.1995 No. 181-FZ "On Social Protection of Disabled in the Russian Federation" (as amended 2015)

2. Decision of the Government of the Russian Federation of 20.02.2006 No. 95 "On the procedure and conditions of recognition of persons with disabilities" (as amended 2016).

3. Order of the Ministry of Health and Social Development of Russia of January 31, 2007 No. 77 "On approval of the form of referral to the medical and social expertise by the Organization providing medical and preventive assistance" (as amended 2009).

4. Order of the Ministry of Health and Social Development of Russia dated December 25, 2006 No. 874 "On approval of the form of referral to the medical and social expertise issued by the authority carrying out pension provision, or a body of social protection" (as amended 2009).

5. A list of diseases, defects, irreversible morphological changes, violations of the functions of organs and systems of the body, in which a group of disability without specifying the period of re-examination (the category "Child-disabled" until a citizen of age is 18 years old) is established by citizens no later than 2 years after the primary recognition of disabled (establishment of a "child-disabled child" category). Annex to the "Rules of Facial Recognition by Disabled" (as amended by the Decree of the Government of the Russian Federation of 07.04.2008 No. 247).

6. Order of December 17, 2015 N 1024n "On the classifications and criteria used in the implementation of medical and social expertise citizens by federal government agencies of medical and social expertise" (as amended by the Order of the Ministry of Labor of Russia from 07.07.2016 N 346n)

7. Clarifications of the Ministry of Labor of Russia dated April 15, 2003 No. 1 "On the definition of disability by federal state institutions of medical and social expertise", approved by the Resolution of the Ministry of Labor of Russia dated April 15, 2003 No. 17 (as amended by the Order of the Ministry of Health and Social Development of Russia dated 29.04.2005 No. 317).

8. Order of July 31, 2015 N 528n on approval of the procedure for developing and implementing an individual program of rehabilitation or anticipation of a disabled person, an individual program of rehabilitation or having a disabled child issued by federal government agencies of medical and social expertise, and their forms (as amended 2016 d)

Didactic material

Recognition of persons with disabled person

I. General provisions

1. These Rules are determined in accordance with the Federal Law "On Social Protection of Disabled in the Russian Federation" The procedure and conditions for the recognition of the person with disabilities. Recognition of the face (hereinafter - citizen) disabled person is carried out by federal government agencies of medical and social expertise: the Federal Bureau of Medical and Social Expertise (hereinafter referred to as the Federal Bureau), the main bureaus of medical and social expertise (hereinafter - the main bureau), as well as the Bureau of Medical Social Expertise In cities and districts (hereinafter - the Bureau), which are branches of the main bureaus.

2. The recognition of a citizen with disabilities is carried out in conducting medical and social expertise on the basis of a comprehensive assessment of the state of the Citizen's body based on the analysis of its clinical and functional, social, professional, labor and psychological data using classifications and criteria approved by the Ministry of Health and Social Development of the Russian Federation.

3. Medical and social expertise is carried out to establish the structure and degree of limiting the vital activity of a citizen (including the degree of limitation of the ability to work) and its rehabilitation potential.

4. Specialists of the Bureau (Main Bureau, the Federal Bureau) are obliged to familiarize the citizen (his legal representative) with the procedure and conditions for the recognition of a citizen with disabilities, as well as to explain to citizens on issues related to the establishment of disability.

II. Conditions for recognition of a citizen with disabilities

5. The terms of recognition of a citizen with disabilities are:

a) violation of health with a resistant disorder of the functions of the body, due to diseases, consequences of injuries or defects;

b) restriction of vital activity (complete or partial loss by a citizen of the ability or opportunity to carry out self-service, independently move, orientate, communicate, control their behavior, to study or engage in labor activity);

c) the need for social protection measures, including rehabilitation.

6. The presence of one of these rules specified in paragraph 5 is not a basis sufficient to recognize a citizen with disabilities.

7. Depending on the degree of life limit, due to the resistant disorder of the body functions arising from diseases, the effects of injuries or defects, a citizen recognized as disabled I, II or III, a group of disability, and a citizen under the age of 18 - a category "Child -disabled".

8. When establishing a group of disability, a group of disability is simultaneously determined in accordance with the classifications and criteria provided for in paragraph 2 of these Rules, the degree of restriction of its ability to work (III, II or I, the degree of restriction) or a group of disability is established without limiting the ability to work.

9. The disability of the I Group is established for 2 years, II and III groups - for 1 year.

The degree of restriction of ability to work (the lack of limitation of ability to work) is established for the same time as a group of disability.

11. In case of recognition of a citizen with disabilities, the date of the disability is considered the day of receipt of a citizen of a citizen on conducting medical and social expertise.

12. Disability is established until the 1st day of the month following the month, which is scheduled for the next medical and social examination of a citizen (re-examination).

13. Citizens establishes a group of disability without indication of the period of re-examination, and citizens under the age of 18 are the category of "disabled child" until a citizen of age is 18 years old:

no later than 2 years after the primary recognition of disabled person (establishing a "child-disabled" category) a citizen of having diseases, defects, irreversible morphological changes, violation of the functions of organs and body systems on the list according to the application;

no later than 4 years after the initial recognition of a citizen with disabilities (establishing a "child-disabled" category) in case of identifying the impossibility of eliminating or decreasing, during the implementation of rehabilitation measures, the degree of limiting the vital activity of a citizen caused by persistent irreversible morphological changes, defects and violations of the functions of organs and systems of the body ( Except as specified in the Annex to this Regulation).

The establishment of a group of disability without specifying the period of re-examination (the category "Child-disabled" before the age of 18 years old) can be implemented in the primary recognition of a citizen with disabilities (establishing a "child-disabled child") on the grounds specified in the second and third paragraphs of this paragraph, In the absence of positive results of rehabilitation activities conducted by a citizen before its direction on the medical and social expertise. At the same time, it is necessary that in the direction of the medical and social expertise issued by a citizen by the organization providing him with medical and prophylactic assistance and sent it to medical and social expertise, or in medical documents in the event of a citizen's direction for medical and social expertise in accordance with paragraph 17 These Rules contained data on the absence of positive results of such rehabilitation activities.

Citizens who applied to the Bureau independently in accordance with paragraph 19 of these Rules, a disability group without an indication of the period of re-examination (the category of a "child-disabled child" until a citizen of age is 18 years old) can be established with the primary recognition of a citizen with disabilities (establish a "child-disabled child" In the absence of positive results assigned to him in accordance with the specified point of rehabilitation activities.

(p. 13 as amended. Decree of the Government of the Russian Federation of 07.04.2008 N 247)

13.1. Citizens who have established a "child-disabled" category, at the age of 18, are subject to re-evidence in the manner established by these Rules. At the same time, the calculation of the deadlines provided for by paragraphs by the second and third paragraph 13 of these Rules is carried out from the date of the provision of a group of disability for the first time after reaching the age of 18.

(p. 13.1 introduced by the Decree of the Government of the Russian Federation of 07.04.2008 N 247)

14. If a citizen is recognized as a disability as a reason for disability, general disease, labor injury, professional disease, disability from childhood, disability from childhood due to injury (contusion, injury) associated with combat actions during the Great Patriotic War, Military Injury, Disease obtained during military service, disabilities associated with a disaster at the Chernobyl NPP, the consequences of radiation impacts and direct participation in the activities of special risk units, as well as other reasons established by the legislation of the Russian Federation.

In the absence of documents confirming the fact of the vocational disease, labor injury, military injury or other circumstances provided for by the legislation of the Russian Federation, which caused disabilities, the general disease is indicated as the cause of disability. In this case, the citizen is assisted in obtaining these documents. When submitting relevant documents to the Bureau, the reason for disability changes from the date of submission of these documents without additional examination of the disabled person.

III. The order of the direction of a citizen

on medical and social expertise

15. A citizen is sent to the medical and social expertise by an organization providing medical and preventive assistance, regardless of its organizational and legal form, a body carrying out the pension provision, or by the social protection authority.

16. The organization providing medical and preventive assistance sends a citizen to medical and social expertise after the necessary diagnostic, medical and rehabilitation measures in the presence of data confirming the resistant violation of the functions of the body due to diseases, the effects of injuries or defects.

At the same time, in the direction of the medical and social expertise, the form of which is approved by the Ministry of Health and Social Development of the Russian Federation, indicate data on the state of the health of the citizen, reflecting the degree of violation of the functions of organs and systems, the state of the organism compensatory capabilities, as well as the results of the rehabilitation activities.

17. The authority that performs the pension provision, as well as the body of social protection of the population, is entitled to direct a citizen to the medical and social expertise, having signs of limiting livelihoods and in need of social protection, if he has medical documents confirming the violations of the body's functions due to diseases, the effects of injuries or Defects.

The form of the appropriate direction on the medical and social expertise issued by the authority by pension provision, or the social protection authority is approved by the Ministry of Health and Social Development of the Russian Federation.

18. Organizations providing medical and preventive assistance, authorities carrying out pension provision, as well as the social protection bodies of the population are responsible for the accuracy and completeness of information specified in the direction of medical and social expertise, in the manner prescribed by the legislation of the Russian Federation.

19. In the event that an organization providing medical and preventive assistance, a pension body or social protection authority refused to a citizen in the direction of medical and social expertise, it is a certificate, on the basis of which a citizen (his legal representative) has the right to apply to the bureau on their own.

The Bureau's specialists conduct an inspection of a citizen and, according to its results, make up a program of an additional examination of a citizen and holding rehabilitation activities, after the fulfillment of which there is a question of the presence of life restrictions.

IV. The procedure for conducting medical and social

examination of a citizen

20. Citizen's medical and social expertise is held at the place of residence (at the place of stay, at the place of finding a pension case, a disabled person who left for permanent residence outside the Russian Federation).

21. The Main Bureau of the Citizen's Medical and Social Examination is held in the event of an appeal of the Bureau's decision, as well as in the direction of the Bureau in cases requiring special types of surveys.

22. In the Federal Bureau, the Citizen's medical and social expertise is held in the event of the decision of the Main Bureau, as well as in the direction of the Main Bureau in cases requiring particularly complex special types of surveys.

23. Medical and social expertise can be held at home if a citizen cannot appear at the Bureau (Main Bureau, the Federal Bureau) for health, which is confirmed by the conclusion of an organization that provides medical and preventive care, or in a hospital where a citizen is on treatment, or in absentia by decision of the relevant bureau.

24. Medical and social expertise is held at the request of a citizen (his legal representative).

The application is submitted to the Bureau in writing with the application of the Direction on the medical and social expertise issued by the Organization providing medical and preventive assistance (a body that implements the pension provision, the body of social protection of the population), and medical documents confirming the violation of health.

25. Medical and social expertise is conducted by the Office of the Bureau (Main Bureau, the Federal Bureau) by examining a citizen, studying the documents submitted by them, the analysis of socio-domestic, professional labor, psychological and other citizen data.

26. When conducting medical and social expertise, a citizen is conducted.

27. In conducting a medical and social examination of a citizen at the invitation of the Head of the Bureau (Main Bureau, the Federal Bureau), representatives of state extrabudgetary funds, the Federal Service for Labor and Employment, as well as specialists of the relevant profile (hereinafter referred to as consultants) can participate with the right of advisory vote.

28. The decision to recognize a citizen with disabilities or a refusal to recognize him with disabilities is made by a simple majority of votes of specialists who conducted medical and social expertise, based on the discussion of the results of its medical and social expertise.

The decision is announced by a citizen who has held medical and social expertise (his legal representative), in the presence of all specialists who conducted medical and social expertise, which, if necessary, give an explanation on him.

29. According to the results of the medical and social expertise, a citizen is drawn up with an act, which is signed by the head of the relevant Bureau (Main Bureau, the Federal Bureau) and specialists who have made a decision and then assures printing.

The conclusions of consultants involved in the medical and social expertise, a list of documents and basic information that served as the basis for the decision-making is recorded in the act of medical and social examination of a citizen or joined it.

The procedure for the compilation and form of an act of medical and social examination of a citizen is approved by the Ministry of Health and Social Development of the Russian Federation.

The shelf life of a citizen's medical and social examination is 10 years.

30. When conducting a medical and social examination of a citizen at the General Bureau of the Act of Medical Social Expertise, a citizen with the application of all available documents is sent to the Main Bureau within 3 days from the day of the medical and social expertise in the Bureau.

When conducting a medical and social examination of a citizen in the Federal Bureau of the Act of Medical Social Expertise, a citizen with an application of all available documents is sent to the Federal Bureau of 3 days from the date of medical and social expertise in the main bureau.

31. In cases requiring special types of surveys of a citizen in order to establish the structure and degree of life limitation (including the degree of restriction of the ability to work), rehabilitation capacity, as well as obtaining other additional information, a program of an additional survey may be approved, which is approved by the head of the relevant Bureau (Main Bureau, federal bureau). This program is brought to the attention of a citizen passing by the medical and social expertise in the form available to it.

The additional examination program may provide for the necessary additional survey in a medical, rehabilitation organization, to obtain the conclusion of the Main Bureau or the Federal Bureau, the request for the necessary information, conducting the examination of the conditions and nature of professional activities, the social situation of the citizen and other events.

32. After receiving the data provided for by the Additional Survey Program, specialists of the relevant Bureau (Chief Bureau, the Federal Bureau) decide on the recognition of a citizen with disabilities or a refusal to recognize it with disabilities.

33. In case of a citizen's refusal (his legal representative) from an additional examination and providing the required documents, the decision to recognize a citizen with disabilities or refusal to recognize him with disabilities is made on the basis of available data, as appropriate entry in the act of medical and social expertise a citizen.

34. For a citizen recognized by disabled person, specialists of the Bureau (Main Bureau, the Federal Bureau), which conducted a medical and social expertise, a personal rehabilitation program is being developed, which is approved by the head of the relevant bureau.

35. Extract from the act of medical and social expertise a citizen recognized as disabled with disabilities is sent to the relevant Bureau (Main Bureau, the Federal Bureau) to the authority that makes its pension provision, within 3 days from the date of the decision to recognize the citizen with disabilities.

The procedure for compiling and form statements are approved by the Ministry of Health and Social Development of the Russian Federation.

Information about all cases of invalid recognition of military-ridicated or citizens are submitted by the Bureau (Main Bureau, the Federal Bureau) in the relevant military commissariats.

36. A citizen recognized as disabled is a certificate confirming the fact of the establishment of disability, indicating a group of disability and the degree of restriction of the ability to work or indicating a group of disabilities without limiting the ability to work, as well as an individual rehabilitation program.

The procedure for compiling and form of reference and the individual rehabilitation program are approved by the Ministry of Health and Social Development of the Russian Federation.

A citizen who is not recognized as disabled, at his request, is issued a certificate of the results of medical and social expertise.

37. A citizen who has a document on temporary disability and a recognized disabled person, a disability group and the date of its establishment are affixed in the specified document.

V. The procedure for re-evaluating the disabled

38. Realization of the disabled person is carried out in the manner prescribed by sections I - IV of these Rules.

39. Realization of persons with disabilities I group is held 1 time in 2 years, persons with disabilities II and III groups - 1 time per year, and children with disabilities - 1 time during the period for which the child has a child-disabled category.

The re-examination of a citizen, the disability of which is established without the indication of the period of re-examination, may be carried out on his personal statement (the statement of his legal representative), or in the direction of an organization providing medical and preventive assistance, due to a change in the state of health, or when implementing the Main Bureau, the Federal Bureau Controls for decisions taken by the Bureau, the main bureau.

40. Revitalization of the disabled person can be carried out in advance, but not more than 2 months before the expiration of the established period of disability.

41. The re-registration of the disabled person of the previously established period is carried out on his personal statement (the statement of his legal representative), or in the direction of an organization providing medical and preventive assistance, due to a change in the state of health, or when implementing the Main Bureau, the Federal Device Control Bureau adopted Accordingly, the Bureau, the Main Bureau.

Vi. The procedure for appealing the decision of the Bureau,

main Bureau, Federal Bureau

42. A citizen (his legal representative) may appeal the decision of the Bureau to the Main Bureau within a month on the basis of a written statement submitted to the Bureau, which conducted medical and social expertise, or to the Main Bureau.

The Bureau, who conducted a citizen's medical and social expertise, within 3 days from the date of receipt of the application sends it with all the available documents to the Main Bureau.

43. The Main Bureau No later than 1 month from the date of receipt of the statement of a citizen conducts its medical and social expertise and on the basis of the results obtained makes an appropriate decision.

44. In case of appealing by a citizen's decision of the Main Bureau, the chief expert on medical and social expertise on the relevant subject of the Russian Federation with the consent of a citizen may entrust its medical and social expertise to another composition of the Main Bureau specialists.

45. The decision of the Main Bureau may be appealed within the month term to the Federal Bureau on the basis of a statement submitted by a citizen (his legal representative) to the Main Bureau, which conducted medical and social expertise or to the Federal Bureau.

The Federal Bureau no later than 1 month from the date of receipt of the statement of a citizen conducts its medical and social expertise and on the basis of the results obtained makes the appropriate decision.

46. \u200b\u200bDecisions of the Bureau, the Main Bureau, the Federal Bureau can be appealed to the court by a citizen (his legal representative) in the manner prescribed by the legislation of the Russian Federation.

Medical and social criteria should always be clearly defined and reflected in the outpatient map of the patient of a person.

The medical criterion is leading in establishing a fact of disability.

Disabled personit is considered a person who has a violation of health with a resistant disorder of the functions of the body, due to diseases, the consequences of injuries or defects, which limits life and causes the need for its social protection.

The recognition of a person with disabilities is possible only with the medical and social expertise, which is carried out by federal government agencies - the Bureau of Medical and Social Expertise (ITU Bureau).

Resistant disability (disability)- This is a long or constant loss of working capacity or its significant limitation caused by a chronic disease (injury, an anatomical defect), which led to a pronounced violation of the functions of the body.

Depending on the degree of violation of the functions of the body and vital activity, three groups of disabilities are established:

I Group:resistant and significantly pronounced violations of the body functions that determine the need for permanent assistance, care or supervision. In some cases, people with disabilities of group I can perform certain types of labor in specially created conditions;

Group II:persistent pronounced functional disorders that do not cause the need for permanent assistance. Patients are completely and long disabled; In some cases, patients are allowed in specially created conditions or at home;

III Group:resistant and slightly pronounced disorders of the body functions, resulting in reduced disability. Such patients need to change the working conditions.

The main sources of information about the disability of the population are the data of departmental reporting (ministries of health, the Ministry of Labor and Social Development, the Ministry of Education, etc.).

In evaluating disability, it is used by statistical data on the total number of persons with disabilities among the population and the number of patients with the established disability (primary disabilities) in this year. Primary disability gives an idea of \u200b\u200bthe dynamics of disability. Of great importance is the study of the causes of disability. In terms of the level and structure of the causes of disability, the population needs reveal in various types of medical care, determines the size of public and state aid, privileges in labor, and material support. Disability statistics are under the jurisdiction of social security bodies and is drawn up on the basis of the conclusions and reports of the Medical and Social Expertise Bureau (ITU).

The following main indicators are calculated for the analysis of disability:

The initial disability of the working-age population;

Indicator of the primary disability of the children's population;

Indicator of the structure of primary disability due to diseases (age, social affiliation);

The indicator of the structure of the primary disability in groups of disability;

The indicator of the overall disability of the working-age population (the prevalence of disability);

The indicator of the common disability of the children's population (prevalence of child disability);

The proportion of persons first recognized as disabled;

An indicator of full medical and professional rehabilitation of persons with disabilities (allows you to evaluate the effectiveness of medical, psychological, pedagogical, socio-economic activities aimed at eliminating the loss of disability).

The statistical indicator of disability depends not only on the health of the nation and many social factors, but also from the methods of collecting information, the regulatory framework for disability.

In the structure of the primary disability of the adult population, the first place is occupied by diseases of the circulatory system, then malignant neoplasms, diseases of the musculoskeletal system and connective tissue, injuries of all localizations, mental disorders, which make up more than 80% in the structure of all causes of the primary disability of the population.

The scale of disability depends on the set of factors:

Health status of the nation (including the state of the gene pool);

Increased injuries (household, transport, production) and inadequate exit from the effects of injuries;

Untimely biological feasibility of the population; - development of the health system;

Socio-economic development affecting the quality of life;

Status of ecology, historical background;

The growth of social aggressiveness of society, political reasons, in particular the country's participation in wars and military conflicts.

The grounds for recognizing a citizen with disabilities are:

- violation of health with a resistant disorder of the functions of the body, due to diseases, consequences of injuries or defects;

Limiting vital activity;

The need to implement social protection measures of a citizen in connection with the availability of social failure.

The presence of one of these features is not a condition sufficient to recognize the person with disabilities.

Medical and Social Examination (ITU)- This is determined by the needs of an examined person in social protection measures based on the assessment of the livelihoods caused by a resistant disorder of the body's function.

Russia has created a three-stage system of federal state institutions ITUwhich includes: The Federal Bureau of Medical Social Expertise, the main bureaus of medical and social expertise, as well as the Bureau of Medical and Social Examination in Municipalities, which are branches of the Main Bureau.

Citizens are sent to ITU, having persistent limitations of life and ability to work and need social protection, to conclusted the medical commission at:

An obvious unfavorable clinical and labor forecast regardless of the timing of temporary disability, but no later than 4 months from the date of its start (early re-examination of the disabled person in connection with the weighing state, the end of the disability period);

A favorable clinical and labor forecast for temporary disability ongoing over 10 months (in some cases: states after injuries and reconstructive operations, in the treatment of tuberculosis - over 12 months) (the presence of signs of disability or loss of professional working capacity);

The need to change the professional rehabilitation program by working disabled in the event of a deterioration in clinical and labor forecast, regardless of the disability group and temporary disability (the need to conduct in full-time consultation and the availability of indications to ensure the disabled special transport).

Procedure for ITU:citizens are sent to ITU:

1. Healthcare institution,

2. The social protection authority (separation of the Pension Fund of the Russian Federation);

3. In case of refusal to establish a health care or social protection body in the ITU direction, a citizen has the right to contact the ITU Bureau independently, submitting the necessary medical documents.

The recognition of a citizen with disabilities is carried out by Federal State Institutions of ITU based on a comprehensive assessment of the body's condition, the analysis of clinical and functional, social and domestic, professional labor and psychological data using the classifications and criteria approved by the Ministry of Health and Social Development of Russia, with a persistent disorder of the functions of the body, due to diseases, consequences injuries or defects, which leads to a limitation of vital activity, i.e., a complete or partial loss of self-service ability or, for example, orientation in space, learning.
For each occasion of disability, the decision is made individually.

The following tasks and functions are assigned to ITU service:

Establishment of the fact of the availability of disability, the definition of a group, the causes (circumstances and conditions of occurrence), the timing and time of the occurrence of disabilities;

Determination of the need for disabled in social protection measures, including in measures of medical, professional and social rehabilitation and the development of individual rehabilitation programs (IPR), control over their implementation;

Assistance in the implementation of activities of social protection of persons with disabilities, including their rehabilitation, and evaluating the effectiveness of these events;

Determining the degree of loss of professional working capacity (as a percentage) of workers who have received injury, professional disease or other health damage related to the performance of labor duties, the need to exercise additional measures of their social protection and rehabilitation;

Determining the need of disabled in special vehicles;

Determination of the causal connection of the death of the affected person with a production injury, a professional disease, staying at the front and with other circumstances, under which the legislation of the Russian Federation provides for the provision of benefits to the family of the deceased;

The formation of data of the state system of accounting for persons with disabilities, the study of the state, the dynamics of disability and factors, leading to it;

Participation in the development of integrated programs in the field of disability prevention, medical and social expertise, rehabilitation and social protection of persons with disabilities.

I Level - ITU Bureau - Consideration of citizens, the result of which is the establishment of a group and the causes of disability, the degree of restriction of labor activities, participate in the development of rehabilitation programs.

II level -Main bureau - It has the authority not only to consider complaints of the survey in the bureau of citizens, but also to cancel or change the decision of the Bureau, to conduct in order of control, as well as on appeal, repeated, towards the bureau of the examination of citizens, coordinates the activities of the Bureau and analyzes their work. The main bureau is in the subject subject by the main organizational and methodological structure with controlling authority in the field of medical and social expertise.

III level - Federal Bureau - Controls the activities of the main bureaus, conducting the examination of citizens in the order of control and appeal.

The competence of medical and social expertise:

Establishment of the structure and degree of human life limit;

Determining the need of an examined person in various social protection measures, including rehabilitation;

Study of the causes, factors and conditions affecting the emergence, development and outcome of disabilities;

Analysis of the prevalence and structure of disability.

In addition, the ITU Bureau performs the following functions:

- conducts a survey of citizens based on the assessment of the vital limitations caused by the resistant disorder of the body functions;

- establishes the fact of disability, group, reasons, the time of the offensive and the term of disabilities;

- develops and adjusts individual rehabilitation programs, including determines the types, forms, deadlines and volumes of measures for medical, social and professional rehabilitation;

- determines the degree of loss of professional working capacity in percentage;

- determines the need of affected by industrial accidents and occupational diseases in medical, social and professional rehabilitation;

- develops and adjusts the programs for the rehabilitation of victims as a result of accidents at work and occupational diseases;

- determines the causes of death of persons with disabilities in cases where the legislation of the Russian Federation provides for the provision of a family of deceased social support;

- gives citizens passing by examination, explanations on medical and social expertise;

- participates in the development of disabled rehabilitation programs, disability prevention;

- forms a data bank on citizens who have passed medical and social expertise;

- Provides information on military-ridic and conscript citizens to military commissariats.

The Bureau of Medico-Social Expertise At least three doctors specialists in the medical and social expertise of various specialties, a psychologist or medical psychologist, a specialist in rehabilitation, either ITU specialist, as well as a specialist in social work. In addition, doctors are attracted here: ophthalmologist and psychiatrist.

Restriction of vital activity -full or partial loss of the face of the ability or ability to carry out self-service, to move independently, orientate, communicate, control your behavior, learn and engage in labor activity.

Violation of health- physical, mental and social disadvantage, associated with loss, anomaly, disorder of the psychological, physiological, anatomical structure and (or) function of the human body.

Classification of violations of the basic functions of the human body:
- disorders of mental functions (perception, memory, thinking, intelligence, higher cortical functions, emotions, will, consciousness, behavior, psychomotor functions);

Language and speech violations - violations of oral and written, verbal and non-verbal speech, not caused by mental disorders; violations of voice formation and form of speech (stuttering, dysarthria, etc.);

Disorders of sensory functions (vision, hearing, smell, touch, vestibular function, tactile, pain, temperature and other types of sensitivity; pain syndrome);

Violations of steel dynamic functions (motor functions of the head, torso, limbs, static, coordination of movements);

Visceral and metabolic disorders, nutrition disorders (blood circulation, breathing, digestion, isolation, blood formation, metabolism and energy, internal secretion, immunity);

Relievers (structural deformations of the face, head, body, limbs, pronounced external ugliness; abnormal openings of digestive, urinary, respiratory tracts; body sizes violation: giantism, dwarfishness, cachexia, overweight).
Classification of violations of the basic functions of the human body in terms of severity:

1 degree - minor violations of functions;

2 degree - moderate disorders of functions;

3 degree - pronounced violations of functions;

4 Degree - significantly pronounced violations of functions.

Social insufficiency -social implications of violation of health, leading to the restriction of human life and the need for its social protection or help. Social insufficiency is manifested in the disadvantage of a patient of a person compared to other people, in a complete or partial loss of the ability or opportunity to perform the usual (taking into account age, gender, level of education, etc.) role in society. Basic species of social insufficiency These are: inability to independent accommodation, to maintaining social relations, to social integration, to ensuring economic independence (independence).

The procedure for conducting ITU:

Examination is carried out at the ITU Bureau at the place of residence of the patient or at the place of attachment to the Healthcare Institution. It can be carried out as part of the ITU Bureau, at home or in the hospital, where the patient is in treatment and (with the consent of the patient) in absentia on the basis of the analysis of the presented medical documents.

The composition of the Bureau's specialists who take an expert decision is appointed by the head. The patient has the right to involve in conducting an examination with the right of the advisory voice of any specialist at the expense of its own funds.

Specialists conducting ITU consider the information presented (clinical and functional, socially domestic, professional labor, psychological and other data), conduct a personal inspection of the patient, assess the degree of restriction of its livelihoods and collegiates discuss the results obtained. The decision is made by a simple voting.

The procedure for appealing the decision of the ITU:

A citizen (or his legal representative) can appeal against the decision of the ITU Bureau, submitting an application to the ITU Main Bureau.

The decision of the MSU Main Bureau may be appealed within a month in the Federal Bureau of ITU.

The decision of the Federal ITU Bureau may be appealed in court.

Depending on the circumstances of the occurrence of disability, with medical and social expertise, the following causes of disability :

disability due to the general disease . The general disease serves the most common cause of disabilities, except for cases directly related to professional diseases, labor injury, military injury, etc.

disability in connection with "Labor injury . "Labor injury" as the cause of disability is established by citizens, the disability of which has come due to damage to the health associated with an accident in production.

disability due to a professional diseaseinstalled Citizens, the disability of which came due to sharp and chronic occupational diseases.

disability since childhood . A face under the age of 18, recognized by disabled person, establishes the status of a disabled child. Upon reaching the age of 18 and older than these persons, "disability from childhood" is established.

disability from former servicemen. It is established for diseases and injuries associated with the fulfillment of military duties.

disabilities due to radiation disasters . It is established to citizens whose disability has come due to the elimination of accidents at the Chernobyl NPP (on the "Mayak" and others).

Criteria for determining a disability group -depending on the degree of violation of the functions of the body and restrictions on the livelihood, the person recognized as disabled is established I, II or III a group of disability.