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

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

MSE is carried out by the State Service of MSE, which is part of the system (structure) of social protection bodies of the Russian Federation. The decision of the public service body of the ITU is mandatory for execution by the relevant state authorities, local governments, as well as organizations, regardless of organizational, legal forms and forms of ownership.

ITU civil service institutions: structure, organization of activities

According to the Law “On Social Protection of Disabled Persons in the Russian Federation” (1995) and “Model Regulations on Institutions of the State Service for Medical and Social Expertise” (1996), the MSE service is entrusted with the following tasks and functions:

- establishing the fact of the presence of disability, determining the group, cause (circumstances and conditions of occurrence), timing and time of onset of disability;

Determining the needs of disabled people for social protection measures, including measures of medical, professional and social rehabilitation and developing individual rehabilitation programs (IRP), monitoring their implementation;

Assistance in the implementation of social protection measures for people with disabilities, including their rehabilitation, and assessment of the effectiveness of these measures;

Determination of the degree of loss of professional ability (in percentage) of workers who received injury, occupational disease or other health damage associated with the performance of their work duties, the need for additional measures of their social protection and rehabilitation;

Determining the need of disabled people for special vehicles;

Determining the causal relationship of the death of the injured person with a work injury, occupational disease, time 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;

Formation of data from the state system of registration of disabled people, study of the status, dynamics of disability and factors leading to it;

Participation in the development of comprehensive programs in the field of disability prevention, medical and social examination, rehabilitation and social protection of disabled people.

ITU civil service institutions to carry out their functions they have a right:

To refer persons undergoing examination for examination to health care institutions, rehabilitation and other state and municipal institutions operating in the field of medical assistance and rehabilitation of the disabled;

Request and receive from organizations of all forms of ownership information necessary for making decisions and performing other functions assigned to institutions;

Conduct control examinations of disabled people for dynamic monitoring of the implementation of measures provided for by the IPR;

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 ITU institutions.

ITU institutions are created, reorganized and liquidated by decision of the executive authority of the constituent entity of the Russian Federation, which also establishes the number of institutions, profiles and staff.

The primary link in the system of public service institutions of the ITU, providing expert services to the adult and child population, is ITU Bureau. Depending on the level, structure of morbidity and disability, ITU bureaus of general profile, specialized (cardiology, psychiatric, traumatology; pediatric - for examination of persons under the age of 18 years) and mixed type are formed. The staffing standard of the ITU bureau includes 3 doctors of various specialties, a rehabilitation specialist, a social work specialist and a psychologist; If necessary, other specialists can be introduced.

For organizational and methodological management of the activities of primary ITU bureaus as part of the public service ITU of a constituent entity of the Russian Federation, a ITU main office. The staffing standards of the ITU main bureau include several groups of specialists who make expert decisions; they may include groups of specialists in functional diagnostics, career guidance and organization of work for people with disabilities, their social and environmental adaptation, as well as specialists from legal consulting services and information and statistical support. The specialists of the ITU main bureau include at least 4 doctors of various specialties, rehabilitation specialists, social work specialists and psychologists.

The ITU Main Bureau conducts an examination of persons who have appealed the decisions of the bureau; conducts examinations of citizens in difficult cases, and also forms and adjusts the IPR of disabled people if it is necessary to use special examination methods - according to the directions of the bureau; provides advisory assistance to medical experts and other bureau specialists; exercises control over the activities of the ITU Bureau; forms a data bank and carries out state statistical monitoring of the composition of disabled people on the territory of a constituent entity of the Russian Federation; participates in the development and implementation of regional comprehensive programs for disability prevention and rehabilitation.

ITU institutions carry out their activities in cooperation with bodies and institutions of social protection of the population, healthcare, education, employment services, public organizations of disabled people; may involve consultants on medical and social issues. Specialists of the MSE Bureau provide advisory assistance to doctors of health care facilities, introduce them to regulatory and methodological materials, and participate in joint meetings and seminars on issues of MSE and rehabilitation of the disabled.

The procedure for referral for medical and social examination: citizens are referred to MSE by a health care institution or social protection authority. In the event of a refusal by a health care institution or a social welfare authority to refer the patient to an ITU, a citizen has the right to contact the ITU bureau independently, submitting the necessary medical documents.

The basis for referral to medical examination is: the presence of signs of disability or loss of professional ability, the end of the period of disability, early re-examination of the disabled person due to worsening of the condition, the presence of indications for providing the disabled person with special transport, the need for an in-person consultation. The health care institution refers the patient to medical examination after carrying out the necessary diagnostic, therapeutic and rehabilitation measures. Medical services when registering patients for examination at ITU institutions are financed from compulsory medical insurance funds. Based on the results of the activities carried out, the health care institution issues the patient a “Referral for a medical and social examination” form No. 088/u-97 (for persons over 18 years of age) or form 080/u-97 (for persons under 18 years of age). It contains information about the development of the disease, the course, frequency and duration of temporary disability, clinical examination data, diagnosis, nature and degree of impairment of basic body functions, category and degree of disability, treatment, preventive and rehabilitation measures taken. The referral is signed by the chairman of the KEC and members of the commission, sealed with the seal of the medical institution.

The procedure for conducting the ITU has been determined“Regulations on recognizing a person as disabled”, approved by the Decree of the Government of the Russian Federation (1996). The examination is carried out at the ITU office at the patient’s place of residence or at the place of attachment to a health care institution. It can be carried out either in person at the ITU office, at home or in a hospital where the patient is being treated, or (with the consent of the patient) in absentia based on an analysis of the submitted medical documents.

ITU is carried out upon a written application from the patient (or his legal representative) addressed to the head of the ITU bureau. The application is accompanied by: a referral to medical examination, issued by a health care institution or social protection body, medical documents confirming the patient’s health impairment, as well as documents necessary to make a decision on the cause of disability, the degree of loss of professional ability, and on other examination issues.

The composition of the bureau's specialists who make expert decisions is appointed by the head. The patient has the right to involve any specialist in the examination with the right of an advisory vote at his own expense. Specialists conducting MSE review the information provided (clinical-functional, social-domestic, professional-labor, psychological and other data), conduct a personal examination of the patient, assess the degree of limitation of his life activity and collectively discuss the results obtained.

If the patient is recognized as disabled, an ITU certificate is issued confirming the fact of disability, and the head of the ITU bureau announces an expert decision to the patient. For a patient sent to the ITU with a certificate of incapacity for work, the ITU Bureau indicates on the certificate of incapacity the date of commencement of the examination (the date the patient’s application with the attached documents was received by the ITU Bureau), the date of its completion, as well as the expert decision made: “Recognized as disabled I (II or III) groups,” or “Not recognized as disabled.” The date of determination of disability is the day the ITU bureau receives the patient’s application with the accompanying documents. If the patient is recognized as disabled, the medical institution closes the certificate of incapacity for work that day. If the patient is recognized as able to work, all days of the examination are counted, and from the next day he is discharged to work. If further treatment is necessary, the certificate of incapacity for work is extended in the usual manner.

Based on the results of the examination, a “Notification of health care facilities on the conclusion of the public health service institution” (for persons over 18 years of age) or a “Tear-off coupon” (for persons under 18 years of age) is also issued, which indicates the diagnosis, the degree of dysfunction and disability, group, reason disability (and for persons under 18 years of age - a decision to recognize the child as disabled), the period for which the disability was established, the date of the next re-examination; recommendations are made for the medical, professional and social rehabilitation of a disabled person.

A person who is not recognized as disabled may, at his request, be issued a free-form certificate on the results of the examination.

The procedure for appealing decisions of the ITU Bureau: a citizen (or his legal representative) can appeal the decision of the ITU bureau by filing an application to the main ITU bureau, or to the relevant social protection authority. The decision of the ITU main bureau can be appealed within a month to the social protection body of the population of a constituent entity of the Russian Federation, which can entrust the examination to any group of specialists of the required profile. The decision of the ITU establishment can also be appealed to the court.

citizen examination

20. A medical and social examination of a citizen is carried out in the bureau at the place of residence (at the place of stay, at the location of the pension file of a disabled person who has left for permanent residence outside the Russian Federation).

21. At the main bureau, a medical and social examination of a citizen is carried out if he appeals the decision of the bureau, as well as upon referral from the bureau in cases requiring special types of examination.

22. In the Federal Bureau, a medical and social examination of a citizen is carried out in the event of an appeal against the decision of the main bureau, as well as in the direction of the main bureau in cases requiring particularly complex special types of examination.

23. A medical and social examination can be carried out at home if a citizen cannot appear at the bureau (main bureau, Federal Bureau) for health reasons, which is confirmed by the conclusion of the medical commission of a medical organization, or at the citizen’s location in a medical organization providing medical care. assistance in an inpatient setting, in a social service organization that provides social services in an inpatient setting, in a correctional institution, or in absentia by decision of the relevant bureau.

A medical and social examination of a citizen who is undergoing treatment in a hospital in connection with an operation for amputation (reamputation) of a limb(s), who has the defects provided for in paragraphs 14 and (or) the appendix to these Rules, and who requires primary prosthetics, is carried out on time, not exceeding 3 working days from the date of receipt of the relevant referral for medical and social examination by the bureau.

For citizens with diseases, defects, irreversible morphological changes, dysfunctions of organs and systems of the body, provided for in Section IV of the Appendix to these Rules, disability is established during an absentee examination.

Also, a medical and social examination can be carried out in absentia if there are no positive results of rehabilitation or habilitation measures carried out in relation to a disabled person.

When a bureau (main bureau, Federal Bureau) decides to examine a citizen in absentia, the following conditions are taken into account:

residence of a citizen in a remote and (or) inaccessible area, or in an area with complex transport infrastructure, or in the absence of regular transport links;

severe general condition of the citizen, preventing his transportation.

24. A medical and social examination is carried out upon a referral for a medical and social examination received from a medical organization, a body providing pensions, or a social protection body, as well as upon an application for a medical and social examination submitted by a citizen (his legal or authorized representative) in the bureau, in cases provided for in paragraphs 19 and these Rules.

The bureau organizes the registration of received referrals for medical and social examination and applications from citizens for a medical and social examination.

Based on the results of reviewing the received documents, the bureau (main bureau, Federal Bureau) makes a decision on the location of the medical and social examination or on its implementation in absentia, and also determines the date for the medical and social examination and sends an invitation to the citizen to conduct a medical and social examination. If a citizen submits an application for a medical and social examination in electronic form using the federal state information system "Unified Portal of State and Municipal Services (Functions)", an invitation to conduct a medical and social examination is sent to the citizen using the specified information system.

Medical and social examination is carried out with the written consent of the citizen (his legal or authorized representative).

The citizen’s consent form for conducting a medical and social examination is approved by the Ministry of Labor and Social Protection of the Russian Federation.

Medical and social examination is carried out in accordance with the stated goals.

(see text in the previous edition)

24(1). The goals of conducting a medical and social examination may be:

a) establishing a disability group;

b) establishing the category “disabled child”;

c) establishing the causes of disability;

d) establishing the time of onset of disability;

e) establishing the period of disability;

f) determination of the degree of loss of professional ability as a percentage;

g) determination of permanent disability of an employee of the internal affairs body of the Russian Federation;

h) determining the need for health reasons for constant outside care (assistance, supervision) of the father, mother, wife, sibling, grandfather, grandmother or adoptive parent of a citizen called up for military service (a military serviceman undergoing military service under a contract);

ConsultantPlus: note.

When conducting a medical and social examination for the purposes specified in paragraphs. “i”, “m”, “n”, referral from a medical organization is not required (Letter of the Federal State Budgetary Institution FB ITU of the Ministry of Labor of Russia dated November 28, 2018 N 42905/2018).

I) determination of the cause of death of a disabled person, as well as a person injured as a result of an industrial accident, occupational disease, disaster at the Chernobyl nuclear power plant and other radiation or man-made disasters, or as a result of injury, concussion, injury or disease received during military service, in cases where the legislation of the Russian Federation provides for the provision of social support measures to the family of the deceased;

j) development of an individual rehabilitation or habilitation program for a disabled person (disabled child);

k) development of a rehabilitation program for a person injured as a result of an industrial accident or occupational disease;

M) issuance of a duplicate certificate confirming the fact of disability, the degree of loss of professional ability in percentage;

H) issuance of a new certificate confirming the fact of disability, in the event of a change in the last name, first name, patronymic, or date of birth of a citizen;

o) other purposes established by the legislation of the Russian Federation.

25. Medical and social examination is carried out by specialists of the bureau (main bureau, Federal Bureau) by examining the citizen, studying the documents submitted by him, analyzing the social, professional, labor, psychological and other data of the citizen.

27. Representatives of state extra-budgetary funds, the Federal Service for Labor and Employment, as well as specialists of the relevant profile (hereinafter referred to as consultants) can participate in conducting a medical and social examination of a citizen at the invitation of the head of the bureau (main bureau, Federal Bureau).

27(1). A citizen (his legal or authorized representative) has the right to invite any specialist, with his consent, to participate in a medical and social examination with the right of an advisory vote.

28. The decision to recognize a citizen as disabled or to refuse to recognize him as disabled is made by a simple majority of votes of the specialists who conducted the medical and social examination, based on a discussion of the results of his medical and social examination.

The decision is announced to the citizen who underwent the medical and social examination (his legal or authorized representative), in the presence of all the specialists who conducted the medical and social examination, who, if necessary, give explanations on it.

(see text in the previous edition)

29. Based on the results of the medical and social examination of the citizen, an act is drawn up, which is signed by the head of the relevant bureau (main bureau, Federal Bureau) and the specialists who made the decision, and then certified with a seal.

The conclusions of consultants involved in conducting a medical and social examination, a list of documents and basic information that served as the basis for making a decision are entered into the act of a medical and social examination of a citizen or attached to it.

(as amended by Decree of the Government of the Russian Federation dated September 4, 2012 N 882)

(see text in the previous edition)

(see text in the previous edition)

29(1). An act of medical and social examination of a citizen, a protocol for conducting a medical and social examination of a citizen, an individual rehabilitation or habilitation program for a citizen are formed into the file of a medical and social examination of a citizen.

A citizen (his legal or authorized representative) has the right to familiarize himself with the act of the medical and social examination of the citizen and the protocol of the medical and social examination of the citizen.

Upon application of a citizen (his legal or authorized representative), submitted to the bureau on paper, on the day of filing the said application, he is given copies of the medical and social examination report of the citizen certified by the head of the bureau (main bureau, Federal Bureau) or an official authorized by him in the prescribed manner and a protocol for conducting a medical and social examination of a citizen.

(see text in the previous edition)

Documents generated during and based on the results of a medical and social examination, in the form of electronic documents, are signed with an enhanced qualified electronic signature of the head of the bureau (main bureau, Federal Bureau) or with an enhanced qualified electronic signature of an official authorized by him.

30. When conducting a medical and social examination of a citizen in the main bureau, the case of the medical and social examination of the citizen with the attachment of all available documents is sent to the main bureau within 3 days from the date of the medical and social examination in the bureau.

(see text in the previous edition)

When conducting a medical and social examination of a citizen at the Federal Bureau, the case of the medical and social examination of the citizen, with all available documents attached, is sent to the Federal Bureau within 3 days from the date of the medical and social examination at the main bureau.

(see text in the previous edition)

31. In cases that require special types of examination of a citizen in order to establish the structure and degree of disability, rehabilitation potential, as well as obtain other additional information, an additional examination program can be drawn up, which is approved by the head of the relevant bureau (main bureau, Federal Bureau). This program is brought to the attention of the citizen undergoing a medical and social examination in a form accessible to him.

(see text in the previous edition)

The additional examination program may include conducting the necessary additional examination in a medical organization, an organization engaged in rehabilitation, habilitation of the disabled, obtaining an opinion from the main bureau or the Federal Bureau, requesting the necessary information, conducting a survey of the conditions and nature of professional activity, the social and living situation of the citizen, and others Events.

(see text in the previous edition)

32. After receiving the data provided for by the additional examination program, specialists from the relevant bureau (main bureau, Federal Bureau) make a decision to recognize the citizen as disabled or to refuse to recognize him as disabled.

33. If a citizen (his legal or authorized representative) refuses an additional examination and provides the necessary documents, the decision to recognize the citizen as disabled or to refuse to recognize him as disabled is made on the basis of available data, about which a corresponding note is made in the protocol of the medical and social examination citizen in the federal state institution of medical and social examination.

(see text in the previous edition)

34. For a citizen recognized as disabled, specialists from the bureau (main bureau, Federal Bureau), who conducted a medical and social examination, develop an individual rehabilitation or habilitation program.

If it is necessary to make corrections to an individual rehabilitation or habilitation program in connection with a change in the personal, anthropometric data of a disabled person (disabled child), the need to clarify the characteristics of previously recommended types of rehabilitation and (or) habilitation measures, as well as in order to eliminate technical errors (misprint, typo , grammatical or arithmetic error or a similar error) for a disabled person (disabled child), at his or her application or at the request of a legal or authorized representative of the disabled person (disabled child), a new individual rehabilitation or habilitation program is drawn up in place of the previously issued one without issuing a new referral for a medical and social examination disabled person (disabled child).

(see text in the previous edition)

In this case, changes to other information specified in the previously issued individual rehabilitation or habilitation program are not carried out.

If it is necessary to include in an individual rehabilitation or habilitation program for a disabled child recommendations on goods and services intended for social adaptation and integration into society of disabled children, for the purchase of which funds (part of the funds) of maternal (family) capital are allocated (hereinafter referred to as goods and services ), for a disabled child, at his or her application or at the request of a legal or authorized representative of a disabled child, a new individual rehabilitation or habilitation program for a disabled child is drawn up instead of the previously issued one, without issuing a new referral for a medical and social examination.

Medical and social examination (MSE)

What is a medical and social examination?

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

Why is a medical and social examination carried out?

Medical and social examination is carried out in order to legally recognize a person as disabled and determine the extent of damage to his health. It involves a comprehensive assessment of the condition of the disabled person’s body.

Medical and social examination is carried out free of charge, at the expense of funds allocated within the framework of the basic program of compulsory health insurance for citizens of the Russian Federation.

Who conducts the medical and social examination?

Medical and social examination is carried out:

Federal Bureau of Medical and Social Expertise	Carried out in case of appeal against the decision of the main bureau, as well as in the direction of the main bureau in cases requiring particularly complex special types of examination
Main bureaus of medical and social examination	Carried out in case of appeal against the decision of the bureau, as well as in the direction of the bureau in cases requiring special types of examination
Bureau of Medical and Social Expertise	The bureau is carried out in cities and regions that are branches of the main bureaus, as a rule, in the bureau at the place of residence (at the place of stay, at the location of the pension file of a disabled person who has left for permanent residence outside the Russian Federation)

Medical and social examination can be carried out at home in the event that a citizen cannot appear at the bureau (main bureau, Federal Bureau) for health reasons, which is confirmed by the conclusion of the organization providing medical and preventive care, or in the hospital where the citizen is being treated, or in absentia by decision of the relevant bureau.

Where and how to get a referral for a medical and social examination?

A referral for a medical and social examination can be obtained:

in a healthcare institution (polyclinic or other organization where a person receives medical and preventive care);

in the social protection authority;

in the body or branch of the Pension Fund of the Russian Federation.

Since referrals can be obtained from various authorities, several situations should be considered.

A health care institution sends a citizen for a medical and social examination:	Social protection authorities or the Pension Fund of the Russian Federation send a citizen for medical and social examination:
If there is evidence confirming persistent impairment of body functions caused by diseases, consequences of injuries or defects;	Having signs of disability and in need of social protection;
After carrying out the necessary diagnostic, therapeutic and rehabilitation measures	If the citizen has medical documents confirming impairment of body functions due to diseases, consequences of injuries or defects

Healthcare institution specialists themselves determine a specific list of diagnostic, therapeutic and rehabilitation measures.

A citizen who has received the appropriate referral independently applies to the medical and social examination bureau. If the referral is issued to a child, then his interests are represented by a legal representative (parent, guardian, trustee or adoptive parent).

What does a referral for a medical and social examination look like?

The referral is filled out by the organization sending the citizen for examination. Organizations and bodies issuing a referral are responsible for the accuracy and completeness of the information specified in it.

The direction indicates the name of the medical and social examination bureau, where the citizen should apply (usually at his place of residence).

Referral issued by a healthcare institution (form No. 088/у-06)	Referral issued by social security authorities or the Pension Fund of the Russian Federation
Data on the citizen’s health status are indicated, reflecting the degree of dysfunction of organs and systems, the state of the body’s compensatory capabilities, as well as the results of rehabilitation measures taken, the purpose of the referral	The signs of disability that cause the need for social protection measures are indicated, the purpose of the referral

If a healthcare institution or social security authorities or the Pension Fund of the Russian Federation denied a citizen a referral for a medical and social examination, then he is issued a certificate, on the basis of which the citizen (his legal representative) has the right to apply to the bureau of medical and social examination independently.

What documents are provided for medical and social examination?

The following documents must be provided for the medical and social examination:

a written application for an examination;

referral for examination;

medical documents confirming health impairment.

Example. If a citizen only has a certificate of refusal to send him for a medical and social examination, then the bureau specialists conduct an examination of the citizen and, based on its results, draw up a program for additional examination of the citizen and rehabilitation measures, after which they consider the question of whether he has a disability.

How is a medical and social examination carried out?

Medical and social examination is carried out by specialists of the bureau (main bureau, Federal Bureau) by:

citizen examinations;

studying the documents submitted by the citizen;

analysis of social, everyday, professional, labor, psychological and other data of a citizen.

When conducting a medical and social examination of a citizen, a protocol is kept.

Representatives of state extra-budgetary funds, the Federal Service for Labor and Employment, as well as specialists of the relevant profile (hereinafter referred to as consultants) can participate in conducting a medical and social examination of a citizen at the invitation of the head of the bureau (main bureau, Federal Bureau).

Before conducting a medical and social examination, a disabled person must be familiar with the procedure and conditions for its conduct. Familiarization must be carried out in a form accessible to the disabled person, and the disabled person has the right to ask the bureau specialist any questions of interest in this area.

How is the decision of the medical and social examination made?

Step 1. The decision to recognize a citizen as disabled or to refuse to recognize him as disabled is made by a simple majority vote of the specialists who conducted the medical and social examination, based on a discussion of the results of his medical and social examination.

Step 2. Based on the results of the medical and social examination of the citizen, an act is drawn up, which is signed by the head of the relevant bureau (main bureau, Federal Bureau) and the specialists who made the decision, and then certified with a seal.

The conclusions of consultants involved in conducting a medical and social examination, a list of documents and basic information that served as the basis for making a decision are entered into the act of a medical and social examination of a citizen or attached to it.

Step 3. The decision is announced to the citizen who underwent the medical and social examination (his legal representative), in the presence of all the specialists who conducted the medical and social examination, who, if necessary, give explanations on it.

An extract from the medical and social examination report of a citizen recognized as disabled is sent by the relevant bureau to the body providing his pension within 3 days from the date of the decision to recognize the citizen as disabled.

Step 4. If the issue of determining disability requires additional types of examination or the bureau does not have the necessary equipment, or special examination methods cannot be used, then an additional examination program can be drawn up for the disabled person and then the examination period is increased. This program is brought to the attention of the citizen undergoing a medical and social examination in a form accessible to him.

Step 5. After receiving the data provided for by the additional examination program, specialists from the relevant bureau make a decision to recognize the citizen as disabled or to refuse to recognize him as disabled.

If you are not recognized as disabled

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

Decree of the Government of the Russian Federation of February 20, 2006 No. 95 “On the procedure and conditions for recognizing a person as disabled” approves the attached Rules for recognizing a person as disabled. The website contains the latest version of the document dated April 16, 2012 N 318.

Federal Law of November 24, 1995 N 181-FZ On the social protection of disabled people in the Russian Federation ((as amended on November 30, 2011, as amended and supplemented, coming into force on February 1, 2012)

Order of the Ministry of Health and Social Development of the Russian Federation of December 23, 2009 No. 1013n “On approval of classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination”

Shashkova O. V. Disabled people. Rights, benefits, support. - M.: Eksmo, 2012. - 128 p.

Important information update!

The Pension Fund and Social Security can issue a referral to the ITU in accordance with Order of the Ministry of Health and Social Development No. 874. If all of the listed organizations refuse to send a person, he can file a complaint with the ITU office.

The next step in the examination procedure is. Moreover, a list of them is most often issued along with the referral. This list includes:

Then, you need to write to the bureau and register it along with all the necessary papers. Registration of such an appeal is made on the day it is written.

Reference! If a person has not provided all the necessary documents to the bureau, he is given 10 days to bring them. If he managed to provide them within the given period, then the disability fee will be charged from the date of the first application.

After ITU bureau staff have examined all the documents, they will set a time for the examination and send an invitation to the applicant. He is sent within 24 hours after the decision on the date of the examination. Such an invitation must indicate the date, time and address of the organization that will conduct the examination.

After receiving an invitation from the bureau, the person needs to appear at the place of examination. If the applicant cannot come for the examination himself for health reasons, then the organization’s employees can come to his home or hospital. Besides, in some cases, a decision can be made even without the presence of a person, based on the documents provided.

During the ITU, a person wishing to formally register a disability undergoes an examination. When conducting such an examination, bureau employees evaluate and study a person’s everyday, labor, psychological and social abilities. Everything that happens during the examination must be recorded in the protocol.

Making an expert decision

After carrying out all the necessary examinations and studying documents, the commission begins to make a decision. This procedure takes place in the form of discussion and voting. The members of the commission make their decision by a majority vote.

After this, it is announced in the presence of the person who underwent the ITU, and all the specialists who took part in the examination. This must be made no later than 30 days after the date of application.

Statement of results

So, what kind of certificate is this and where can I get it? A citizen receives such a document after undergoing an examination at the ITU bureau. It contains information about the examination and a professional verdict. Such a certificate is issued to all people who are recognized as disabled. In addition, such an act indicates the degree of ability to work that was awarded to the person, as well as whether he needs to be transferred to easier work.

Important! Such a document is issued immediately after the decision is made. The ITU certificate is given to the person who has undergone this examination, and the extract is sent to the social security department or the Pension Fund.

Document requirements

This certificate must contain:

1. Number and series of the certificate.
2. Full name, date of birth and place of residence of the person to whom the certificate was issued.
3. Date of disability determination.
4. Disability group, degree of disability and cause of disability.
5. The date until which the disability is valid.
6. Seal of the ITU Bureau and signature of its head.

This is what a blank certificate of passing the ITU looks like in the photo:

The act is a document that contains the following data:

This act is sent to the Social Security authorities or the Pension Fund.

The bureau can also issue sick leave, which is also called a certificate of incapacity for work. It is issued if a person is not recognized as disabled and he can still work. The duration of such a sheet is at least 30 days. Also, its validity period may last until the next disability examination.

If a person needs to obtain official disability status, this is a prerequisite. There is no need to be afraid of such a procedure; the most important thing in this matter is to collect everything that is listed in the article.

If you find an error, please highlight a piece of text and click Ctrl+Enter.

A commission with the abbreviation ITU (its decoding: medical and social examination) is a set of measures during a medical examination aimed at identifying the needs of an individual for social protection and rehabilitation as a result of a serious violation of the basic processes in the human body. The result of the ITU is a decision to recognize a citizen as disabled with a degree of severity, or recognition of full physical capacity.

Classification and criteria in medicine

In its activities, ITU is guided by criteria for determining the degree of disability:

1. First degree assigned to citizens (including disabled people from birth) who have persistent impairments of body functions on a scale from 90 to 100%. Disabled people of the 1st group cannot take care of themselves or engage in any type of income-generating activity.
2. Second degree disability among citizens with pronounced health problems ranges from 70 to 80%. Patients of the 2nd group can partially take care of themselves and are exempt from fulfilling most work obligations.
3. Third group disability as a result of MSE is assigned to citizens with partial loss of ability to work caused by persistent impairment of the body's activity by 40-60%. Disabled citizens of the 3rd group can take care of themselves and engage in labor activities on preferential terms.

The degree of disability is assigned as a result of an ITU examination. Citizens can challenge the decision of medical experts by filing a complaint with the Federal Bureau of Medical and Social Expertise. The ITU classification is the identification of the main categories of life activity and the determination of the degree of their impairment as a result of injuries or illnesses (at work or at birth).

• self-service;
• ability to move independently;
• orientation in space;
• adequate communication;
• behavior control;
• learning ability;
• ability to work.

Reference: One of the main criteria is self-care - during the MSE, experts check a citizen’s ability to take care of himself by performing the most important actions: bending, lifting limbs, changing clothes, free access to all parts of the body.

Types, activities, tasks of the organization

In the Russian Federation, the activities of ITU bodies are regulated by Federal Law No. 181-FZ dated November 24, 1995 “On social protection of disabled people in the Russian Federation” and Order of the Ministry of Health and Social Development of Russia dated November 17, 2009 No. 906 n.g. “On approval of the Procedure for the organization and activities of federal state institutions of medical and social examination.”

According to the Order, there are several types of ITU:

The tasks of ITU are:

• A decision to assign a degree of disability when citizens apply during a medical examination or a refusal based on the results of an analysis of the submitted medical history (injury) and examination.
• Analysis of healthcare in the region, identifying the reasons for the increase in the number of disabled people and the deterioration of working conditions.

We talked in more detail about the purpose of the ITU, goals and objectives, as well as the structure of the institution in.

What is meant by the term “expert commission”?

When citizens turn to the ITU for a decision on determining the degree of harm to the body, a medical and social expert commission, or MSEC (this is its decoding in medicine), is appointed. Medical experts conduct a personal examination of the patient, study the submitted documents, the history of the injury or the development of the disease.

After all the procedures, the expert commission, outside the patient (or his representative), makes a decision to recognize the citizen as disabled or to refuse to receive a certificate of incapacity for work (incapacity - the day of minor citizens or disabled children).

What does the abbreviation VTEC stand for and what is it?

ITU came into being after the law was passed in 1995. Previously, recognition of limited ability to work or its complete loss due to disability was issued by a service with the abbreviation VTEC (its decoding accepted in medicine is the medical labor expert commission). The activities of VTEK covered only employees - children who had not reached legal age or were recognized as incompetent at birth were not subject to this examination.

ITU covers all citizens who are going to undergo examination at a medical institution to determine the degree of disability and existing impairments in the functionality of the body. VTEC considered mainly injuries and progressive diseases identified in the working population. The principle of establishing disability for citizens by ITU and VTEC is practically the same.

IPR and PRP

According to the Decree of the Government of the Russian Federation of April 7, 2008 No. 240 “On the procedure for providing disabled people with technical means of rehabilitation and certain categories of citizens from among veterans with prosthetics (except dentures), prosthetic and orthopedic products,” and Federal Law dated November 24, 1995 No. 181- Federal Law “On Social Protection of Disabled Persons in the Russian Federation”, IPR (now IPRA) is an individual program for the rehabilitation (or habilitation) of disabled people, which includes measures to provide citizens with limited ability to work with special medical care, provision of medicines and rehabilitation means with exemption from payment.

Participation in the IPR is optional; a disabled person has the right to refuse the provision of certain medical benefits or services, in whole or in part.

During an individual rehabilitation program, disabled people can receive prosthetic and orthopedic products free of charge. Attention:

the list of products and prostheses that are provided to disabled people free of charge is limited. It does not include dental products such as dentures.

PRP is a rehabilitation program for victims at work. During the program, the victim undergoes a medical examination to determine the severity of the injury or progression of the disease resulting from long-term work in a position with “harmful” working conditions. The results of the examination reveal the degree of harm caused to the body and the measures necessary to eliminate the threat to health or eliminate the consequences. Under the rehabilitation program for victims, an employee may be relieved from his position for a period of time

if injury or illness prevents him from engaging in this type of activity.

According to the PRP, the employee is entitled to compensation for damage and payment for necessary treatment, purchase of medicines and (if necessary) prosthetic products. The difference between the IPR and the PRP is that under the IPR, compensation and payment for treatment are handled by the state, while under the PRP, the employer is responsible.

In what cases is judicial ITU used?

The activities of forensic medical and social examination services are regulated by the Federal Law of May 31, 2011. No. 73-FZ (as amended on November 25, 2013) “On State Forensic Expert Activities in the Russian Federation.” Judicial MSA are activities within the framework of judicial production activities carried out to obtain a decision based on the results of the MSA.

The initiator of the ITU from the court can be any government representative, including a lawyer.

ITU: determination of the degree of severity of harm to the victim as a result of the employer’s failure to comply with technical requirements for occupational safety at work. During the judicial medical examination, a representative of the government has the right to receive from the doctor or medical institution in which the patient was observed or treated all the necessary documents for analyzing the state of health.

The decision on the identified severity of harm to the body is made by forensic medical experts. During this event, the patient may also be issued a certificate indicating the need to be assigned a disability or limited ability to work or work.

Terms and cost of a medical commission for registration of disability

Passing a medical examination about the required social support of a patient is free, but the process may entail additional costs. The main costs are associated with:

• Passing the examination. We are talking about paid tests that cannot be obtained at municipal medical institutions.

  Minimum expenses– from 100 rubles, the maximum cost is unlimited.

• Transporting a patient(if necessary). Sometimes a special taxi is required - a medical one, the services of which cost 500-1500 rubles more than a regular taxi.
• Notary services. Seriously ill patients are allowed to submit an application through a representative whose powers are secured by a notary (the cost of the service is 1500-2500 rubles).

The decision on the status of a disabled person or refusal in the disability group upon application is made within 24 hours after a personal examination by an expert commission.

Walkthrough: brief instructions

• Patient's full name and passport details.
• Name of the medical institution that issued the document.
• The date of the examination (you will find out how the dates of sending to the ITU bureau and the days of passing the commission for examination are paid).
• Validity period of the document (temporary disability or permanent disability).
• Grounds for recognizing a patient as disabled (or refusing such a decision) - diagnoses, certificates and decisions of specialists are prescribed.

The document must be certified by the seal of the institution and the signatures of authorized medical experts. If an official representative acts on behalf of the patient (appointed by a notary and holding a document on the ability to conduct MSA for another citizen), the certificate states that the document is issued to a third party with the permission of the person being examined.

In what cases is a re-pass required?

Re-passing the MSA is required if the commission of medical experts has disagreements regarding the decision to assign a disability to the patient.

There are many reasons for doubt:

• unclear medical history;
• patient behavior inappropriate to the disease;
• lack of documentation or errors in its preparation.

An exception is the re-examination by the decision of the citizen himself, if he is not satisfied with the refusal issued by the specialists (or the degree of severity).

Additionally, an examination may be appointed to make a decision on the duration of assignment of limited ability to work: depending on the severity of the illness, the patient may be recognized as disabled for life or for a limited period (followed by mandatory re-examination by the ITU). We wrote about what documents need to be collected to re-pass the ITU.

What are the differences for adults and children, characteristics for students

Not only adults, but also children can take the ITU. The difference lies in the presence of a certificate from a general education institution instead of a reference from work and production activities. The student’s certificate for ITU must state: appeal the examination.

Important: The deadline for filing a complaint against ITU is no later than one month from the date of the previous decision. You should apply for an appeal to the Main or Federal Bureau of the ITU - they supervise the activities of local examinations.

To submit an appeal, you must collect all documents confirming the limitation of health, a statement indicating the reason for disagreement, an extract and a previous decision.

At the request of the client, a re-examination may be scheduled. The patient has the right to refuse a re-examination, but it is not recommended to show a categorical attitude towards the actions of higher authorities - the loyalty of the authorities also depends on the assessment of the citizen’s mental state. A categorical refusal can be regarded as an unwillingness to cooperate, an attempt to falsify data about one’s health.

On the contrary, assistance to medical experts, fulfillment of the requirements for additional analysis of health status, collection of new certificates in 73% of cases brings positive results. If the decision of the Federal (or Main) Bureau also does not suit the client, he can appeal to the court.

ITU is responsible for making a decision on assigning a degree of disability. Both the patient himself and his representative can contact the authority. Based on the results of the examination, the client is assigned a degree of activity limitation or is issued a certificate of refusal to recognize the citizen as disabled.