There are people who work at MSE. Medical and social examination is torture for disabled people. What documents are issued after the examination?

Disability can be registered if there is:

health impairment with persistent impairment of body functions caused by diseases, consequences of injuries or defects;
limitation of life activity (complete or partial loss by a citizen of the ability or ability to provide self-care, move independently, navigate, communicate, control one’s behavior, study or engage in work);
the need for social protection measures, including rehabilitation and habilitation.

The decision to recognize a person as disabled is made based on the results of a medical and social examination (MSE).

Depending on their health status, adults are assigned disability group I, II or III, and children under 18 years of age are assigned the category “disabled child.”

2. How to get a referral to the Bureau of Medical and Social Expertise?

Referrals for medical and social examination are issued by medical organizations (the legal form of the medical organization and your place of residence do not matter).

When determining whether you have signs of disability, your doctor must rely on diagnostic tests, treatment, rehabilitation, and habilitation results. Therefore, it is best to contact your attending physician for a referral to MSA. But you can also go, for example, to the chief doctor of the medical organization where you are being treated.

By Decree of the Government of the Russian Federation dated February 20, 2006 No. 95 “On the procedure and conditions for recognizing a person as disabled.”

"> according to the law, if a person needs social protection, social protection authorities and pension authorities can also issue a referral to MSE, but only if they have medical documents that confirm impairment of body functions due to diseases, consequences of injuries or defects. In practice, this means that you will still have to contact a medical organization.

If you are denied a referral, request that you receive a written refusal. With this certificate, you have the right to contact the ITU office yourself. In this case, the staff of the ITU bureau will prescribe an examination for you, and based on its results they will determine whether there is a need for a medical and social examination.

After you receive the referral, you will be scheduled for a medical and social examination at the ITU office.

3. What documents are needed to register a child for ITU?

To register your child for a medical and social examination, you will need:

application (children over 14 years of age fill out and sign the application on their own; for children under 14 years of age this must be done by legal representatives);
identification document (for children under 14 years old - birth certificate, for children over 14 years old - passport);
medical documents indicating the citizen’s state of health (outpatient card, hospital extracts, consultants’ reports, examination results - usually issued by the doctor who issued the referral for medical examination);
SNILS;
passport of the parent or guardian;
to the guardian (representative of the guardianship and trusteeship authority) - a document establishing guardianship.

4. What documents do adults need to register for ITU?

To sign up for a medical and social examination, you will need:

application (can be filled out by both the citizen himself and his representative);
identity document (original and copy);
referral to medical examination issued by the attending physician;
work book (original and copy);
professional and production characteristics from the place of work - for working citizens;
medical or military medical documents indicating the citizen’s state of health (outpatient card, hospital extracts, consultant reports, examination results, Red Army or military record book, certificate of injury, etc.);
SNILS;
if the documents are submitted by a representative - a power of attorney for the representative and his passport.

In some cases it may be necessary Additional documents (depending on the specific case):

act on an industrial accident in form N-1 (certified copy);
act on occupational disease (certified copy);
conclusion of the interdepartmental expert council on the causal relationship of the disease, disability with exposure to radioactive factors (certified copy, original presented in person);
ID of a participant in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant or living in the exclusion or resettlement zone (copy, original presented in person);
for foreign citizens and stateless persons permanently residing on the territory of the Russian Federation - a residence permit;
for refugees - a refugee certificate (to be presented in person);
for nonresident citizens - a certificate of registration at the place of residence;
for those discharged from military service - a certificate of illness drawn up by the Military Military Commission (a certified copy, the original must be presented in person).

">additional documents.

An application for a medical and social examination can be considered up to one month from the date of submission of the application.

5. Which ITU office should I contact?

Medical and social examination is carried out at the ITU office at the place of residence. In some cases, MSE may be carried out:

in the ITU Main Bureau - in case of appeal against the bureau's decision, as well as in the direction of the bureau in cases requiring special types of examination;
in the ITU Federal Bureau - in case of appeal against the decision of the ITU Main Bureau, as well as in the direction of the ITU Main Bureau in cases requiring particularly complex special types of examination;
at home - if a citizen cannot come to the bureau (ITU Main Bureau, ITU Federal Bureau) for health reasons, as confirmed by the conclusion of a medical organization, or in a hospital where the citizen is being treated, or in absentia by decision of the relevant bureau.

6. How is the examination carried out?

During the examination, the bureau’s specialists will study the documents you submitted and analyze social, professional, labor, psychological and other data.

In some cases, ITU specialists may prescribe additional examination for you. You can refuse it. In this case, the decision to recognize you as disabled or to refuse to recognize you as disabled will be made based only on the data you provide. Your refusal will be reflected in the ITU protocol, which is maintained during the examination.

Representatives of state extra-budgetary funds, the Federal Service for Labor and Employment, as well as specialists of the relevant profile (consultants) can participate in the medical and social examination at the invitation of the head of the bureau with the right of an advisory vote. You also have the right to invite any specialist with his consent, he will have the right to an advisory vote.

The decision to recognize a person as disabled or to refuse to recognize him as a disabled person 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 the medical and social examination.

Based on the results, a medical and social examination report is drawn up. You have the right to request copies of both the act and the protocol.

In addition, the bureau’s specialists, after conducting a medical and social examination, will prepare an individual rehabilitation and habilitation program (IPRA) for you.

7. What documents are issued after the examination?

A citizen recognized as disabled is issued:

a certificate confirming the fact of disability, indicating the disability group;
individual rehabilitation or habilitation program (IPRA).

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

If it is necessary to make changes (new personal data, technical errors) to the IPRA or if it is necessary to clarify the characteristics of previously recommended types of rehabilitation and (or) habilitation measures, there is no need to undergo a new medical and social examination. It is enough to write an application to the ITU bureau that issued the document. You will be given a new IPRA.

The date of determination of disability is the day the bureau receives an application for medical examination. Disability is established until the 1st day of the month following the month for which the next ITU (re-examination) is scheduled.

8. How to get re-examined?

Re-examination of disabled people of group I is carried out once every 2 years, disabled people of groups II and III - once a year, and disabled children - once during the period for which the category “disabled child” is established for the child.

Re-examination can be carried out in advance, but no more than 2 months before the expiration of the established period of disability.

If disability is established without specifying the period for re-examination, or if re-examination needs to be carried out earlier than the established period, it can be carried out:

at the personal request of a disabled person (or his legal or authorized representative);
in the direction of a medical organization due to a change in health status;

Hello! A doctor from the Moscow ITU Bureau is writing to you. Everyone, of course, knows what an atmosphere of evil rumors, and sometimes outright lies, has developed around doctors working in this department. Like, you sell disability groups, and take bribes, and the like. It’s a shame to hear this for medical experts who have devoted their years to the cause of medical and social rehabilitation and helping sick people. There is no need to talk about the meager salary: Everyone knows how ridiculous it is. I would like to talk about something else, namely about our leaders. Why should honest workers experience constant humiliation from their superiors? For example, why can Oleg Aleksandrovich Vasiliev, a lawyer at the FKU GB ITU in Moscow, afford to accuse almost everyone working in this system of corruption? Why does Oleg Aleksandrovich allow himself to speak inappropriately, if not rudely, with people who are much older than him? Has Oleg Aleksandrovich, a lawyer, really forgotten that there is such a thing as the presumption of innocence, and in this case he himself can be accused of libel? It’s simply pointless and useless to talk to our higher authorities: he has one answer to everything: “I don’t like it, no one is holding you!” And they leave. People who have devoted decades to helping the sick are leaving! It has even reached the point that, using their own funds from their meager salaries, MTU workers are forced to purchase office equipment necessary for their work! "There is no money!" - our leadership has one answer to everything. In addition, in 20 17 the management loaded the ITU bureau with overwhelming work! Not only do the branches receive many more people every day than are provided for in the plan! Doctors were given the task of entering into the computer database all disabled people who had been examined since 2005 in a new database, the so-called FRI. And so older people are forced to sit literally until the night, doing something that is essentially unusual for doctors! Need I say that no compensation is provided for extracurricular time? And they gave me the task of manually entering several hundred thousand people! People working at a computer around the clock lose their sight and health, and all because the management, having decided to save on paying IT workers, entrusted doctors with a task unusual for them! Given this attitude, there are fears that almost all doctors will leave the system of medical and social examination! But then socially vulnerable people will suffer first of all! But the management probably needs to collapse the system, it feels like this is where everything is heading.
There is more than enough evidence for this. So, since 2016, the FKU GB MSE has been headed by a certain Sergey Petrovich Zapariy from Omsk. It is not known by what means Sergei Petrovich was appointed to this position, but there are suspicions that it was not entirely honest. It is known that for some of his actions Sergei Petrovich was taken under the increased control of journalists in Omsk,

Which hasn't been filmed yet.
With his arrival, unfounded accusations of corruption, systematic humiliation of expert doctors, both those working in the ITU MAIN BUREAU and in regional divisions, unjustified dismissals of employees without explanation and other illegal actions began with renewed vigor.

It is also known that Sergei Petrovich’s daughter, Natalya Sergeevna Zapariy, works at the Federal State Budgetary Institution FB ITU of the Russian Ministry of Labor. From a legality point of view, I think this is doubtful.
And the last thing: this is how Sergei Petrovich parks at the building of the FKU GB MSE. How can a wheelchair user get there? Do you think that this is also a manifestation of disrespect for sick people?

With sincere respect, Vitaly Sedov. Honored Doctor of the Russian Federation

On October 16, 2017, the hotline of the Public Chamber of the Russian Federation on issues related to the activities of medical and social examination, Izvestia, will begin operating in Russia. Russians who have problems passing the ITU, for example, with establishing or confirming a disability group, can go there. This hotline will operate for 3 months.

Currently, the work of medical and social examinations raises many criticisms. The prosecutor's office, courts, and various public organizations are literally inundated with citizens' complaints about the work of the MTU system. The Civic Chamber of the Russian Federation plans to collect such complaints, systematize them and prepare recommendations for improving medical and social examination. The management of the Federal Bureau of ITU agreed to cooperate on this issue with the Public Chamber.

This project has several objectives. The main task is to advise citizens on issues related to the examination procedure, registration of disability, establishment or confirmation of disability group, provision of rehabilitation means, etc. In addition, the hotline will help conduct public monitoring of the work of the MSE system and its interaction with healthcare institutions, the Social Insurance Fund, the Compulsory Medical Insurance Fund and other structures.

Instructions:

How can people with disabilities prepare for the ITU?

“The Public Chamber will perform the functions of a dispatcher,” explained Ekaterina Kurbangaleeva, deputy chairman of the RF OP Commission on Social Policy. – We will begin to record problems and contacts. Then, if necessary, request the necessary documents from the applicant - for example, certificates of denial of disability. Next we plan to resolve the issue with the help of the Federal Bureau of ITU of the Russian Ministry of Labor.”

MINISTRY OF LABOR AND SOCIAL PROTECTION OF THE RUSSIAN FEDERATION
(MINISTRY OF LABOR OF THE RUSSIA)
DEPUTY MINISTER
Ilyinka street, 21, Moscow, GSP-4, 127994 tel.: 8 (495) 606-00-60, fax: 8 (495) 606-18-76
1 2 APR 2013

On the implementation of Decree of the President of the Russian Federation of May 7, 2012 No. 597 regarding the gradual improvement of the remuneration system for doctors, other medical and social workers of federal government institutions of medical and social expertise

To the heads of federal government institutions of medical and social expertise in the constituent entities of the Russian Federation of the Ministry of Labor and Social Protection of the Russian Federation
(by list, email distribution)

In accordance with Decree of the President of the Russian Federation dated May 7, 2012 No. 597 “On measures for the implementation of state social policy” (hereinafter referred to as the Decree), the average salary of doctors, employees of medical organizations with higher medical (pharmaceutical) or other higher education, providing medical services (providing medical services), by 2018 should reach 200% of the average salary in the corresponding region; social workers, junior medical personnel, paramedical personnel (personnel providing conditions for the provision of medical services) - up to 100% of the average salary in the corresponding region.

Since medical and social examination institutions, in accordance with the Federal Law of November 21, 2011 No. 323-FE “On the fundamentals of protecting the health of citizens of the Russian Federation,” are classified as medical organizations, the provisions of the Decree apply to the above-mentioned medical and social examination employees.
In pursuance of the Decree, the Ministry of Labor of Russia issued order No. 138 dated April 4, 2013 “On approval of the Action Plan for the implementation of road maps of changes in sectors of the social sphere aimed at increasing the efficiency of healthcare, education and science, social services for the population in 2013-2018 in the federal state institutions subordinate to the Ministry of Labor of Russia" (hereinafter referred to as the "road map").
In accordance with the road map, wage increases should be carried out gradually, starting in 2013.
The corresponding budgetary allocations are provided to the Russian Ministry of Labor by the Russian Ministry of Finance.

According to the order of the Government of the Russian Federation dated November 26, 2012 No. 2190-r on the approval of the “Program for the gradual improvement of the remuneration system in state (municipal) institutions for 2012-2018”, the source of financial support for employees of state-owned institutions is exclusively budgetary allocations of the corresponding budgets of the budget system Russian Federation.
Decree of the Government of the Russian Federation dated December 28, 2012 No. 1454 approved the “Rules for the use in 2013 of budgetary allocations provided for by the Ministry of Health of the Russian Federation, the Ministry of Labor and Social Protection of the Russian Federation, the Ministry of Education and Science of the Russian Federation and the Ministry of Culture of the Russian Federation in order to implement subparagraphs “a” and “e” of paragraph 1 of the Decree” (hereinafter referred to as the Rules).

In accordance with clause 7 of the Rules, the conditions for the provision of appropriate additional amounts of financial resources are:
a) the federal government institution has an action plan to improve the efficiency of the institution’s activities in terms of providing public services (performing work) based on the institution’s performance targets, improving the remuneration system, including measures to increase the remuneration of relevant categories of employees, optimization measures;
b) introducing changes to the regulations on remuneration of employees of a federal government institution in terms of implementing the provisions of the Decree and using additional funds for incentive payments to employees in accordance with the indicators and criteria of employee performance;
c) concluding an additional agreement to the employment contract with the head of a federal state institution, which establishes his responsibilities regarding the need to achieve in 2013 the indicators of the ratio of the average wage of workers of the relevant categories employed in the federal state institution and the average wage in the corresponding subject of the Russian Federation.

Thus, in accordance with subparagraph “a” of paragraph 7 of the Rules, part of the funds should be generated by optimizing the number of employees of institutions with the subsequent redistribution of wages.
Additionally, I inform you that in accordance with the “road map” in 2013, it is envisaged to bring the ratio of the average salary of employees of medical and social examination institutions by category of medical personnel to the average salary in the economy in the corresponding constituent entity of the Russian Federation, as follows: doctors - no less than 86 ,9 %; nursing staff - at least 53.7%; junior medical personnel - at least 35.0%.

Last year, the administration of the President of the Russian Federation received more than 130 thousand complaints about the work of medical and social examination: about the incompetence and bias of specialists, about corruption and frequent mistakes. Every week, the Public Chambers of the regions register dozens of citizens’ appeals.

The situation in the ITU system is out of control, according to Vladimir Slepak, Chairman of the Commission on Social Policy, Labor Relations and Quality of Life of the OPRF. The head of the Interregional Center for Independent Medical and Social Expertise, Doctor of Medical Sciences Svetlana Danilova, agrees with this. Before the interview, Svetlana Grigorievna sent a letter to the editor from a young disabled woman talking about her trip to the next commission. She showed that journalists understood what people with disabilities face. There are no generalizations or analysis of problems, but there is resentment, frankness, and just real life... We immediately contacted the author: is it possible to publish? “Why not? “I don’t mind,” answered wheelchair user from Bashkiria Lyudmila Simonova.

“Grandma is disabled, she has diabetes, and she’s been in line for 7 hours...”

“I have been disabled group I since 2008. Trauma to the cervical spine, dysfunction of the pelvic organs, explains Lyudmila Simonova. — I live in a village. I recently went to see my doctor and got tested. He wrote a messenger letter and sent it to the city to a urologist, neurologist, and so on.

I’m going to the city of Beloretsk, a hundred kilometers away. Doctors see you at different times and on different days - depending on who is lucky enough to make an appointment. I had to live in the city for a week to get around everyone. I couldn’t find a proctologist, so I went to the next city – Magnitogorsk. Another hundred kilometers... The building is not suitable for wheelchair users, the room is old, the plaster is falling off, it’s damp and cold inside. People wait in line for hours. From one o'clock in the afternoon until seven in the evening we sat with the thought: “When will we be invited?” One grandmother came at 11 and left eight hours later. She said: “I plowed my shift.” Another was crying, begging to be accepted. The old woman is disabled, she has diabetes, she wanted to eat, but she stood in line for 7 hours. ITU workers walked by with stone faces and pretended not to notice anything.

Recently, there is no ITU in Beloretsk; experts from Ufa come to us on certain days. I had to live in Beloretsk and wait for the specialists to arrive. Well, my relatives let me in, and it’s good that I have a friend who dragged me to the 3rd floor. Otherwise, I can’t imagine how long it would take to travel from village to city on off-road roads (we don’t have asphalt), and hire a car, because our buses are not equipped for wheelchairs.

This time, workers from ITU Bureau No. 6 in Ufa came to us. According to my ideas, I should have been invited to the office at the appointed time. Ask what problems I have, give advice and recommendations on the entire list of technical rehabilitation means that would make life easier and help me adapt. It’s not for nothing that the word “habilitation” was added to the individual rehabilitation program. I thought that ITU should work for people with disabilities, but I was mistaken. I sat in line, they called me in, looked at me and said: “If we are redoing the IPR, then we will remove half of what you have written in; according to the new rules, you are not allowed to do this. Better leave the old program and go home.”

How do they clean it? By what law? It turned out that I was not eligible for an electric wheelchair, but I am a “neck” and my hands don’t work well. Yes, I use an active stroller around the house, it’s easy to put it in the trunk, take me up the steps to the third floor when I’m visiting my sister in the city, but for walking around my village without asphalt with holes and bumps, I need an electric stroller. And in 2012 it was added to my program. Now they said: “We don’t care where you live.”

The experts did not agree with many of the decisions of the attending physicians and ignored their recommendations. They treated me and other disabled people as if we had come to them to beg, they were rude. The commission gave a friend a disability group, and then called her to Ufa for a re-examination. I was given a month to appeal the decision to the main bureau of the region. But this will be a huge problem - you will have to travel not a hundred, but three hundred kilometers, spending your money by renting a car. This is how people with disabilities are helped to live in our country, everything is for them.”

“When I first heard that disability group II costs 450 thousand rubles, I didn’t believe it”

We are talking with the head of the Interregional Center for Independent Medical and Social Expertise, Doctor of Medical Sciences Svetlana Danilova .

— Svetlana Grigorievna, is everything that Lyudmila Simonova writes about true?

- Certainly. Russian disabled people overcome so many obstacles to pass a commission, obtain a status, or receive preferential medications that mother, don’t worry. Nowadays it’s impossible to get an appointment with a specialist without going through a therapist—he gives referrals. First you go to him, then to the doctors, then again to him with the results. A disabled person travels 100 kilometers to one city, another hundred kilometers to another. And, in theory, he should be examined and receive help at his place of residence. The task of the ITU is not to challenge the diagnoses established by clinicians, but to determine the limitations of life activity. In our country, experts change diagnoses, cancel doctors’ recommendations, and say: “The patient has no obvious disorders.”

In the Federal Law of November 24, 1995 No. 181-FZ “On the social protection of disabled people in the Russian Federation,” disability is interpreted as “social insufficiency due to health impairment with a persistent disorder of body functions, leading to limitation of life activity and the need for social protection.” In accordance with this, in addition to expert examination, ITU institutions are entrusted with the responsibility for developing individual rehabilitation programs for people with disabilities and determining their needs for social protection measures.

- This is according to the law, but as in life ?

— And in life, the main problem of medical and social examination is the duration and complexity of obtaining a disability group and rehabilitation services for citizens with disabilities through the examination procedure at ITU institutions. Currently, people with disabilities often refuse to go through bureaucratic procedures and solve problems at their own expense. The legal rights of people with disabilities are violated. ITU forces people to undergo unnecessary examinations, collect unnecessary tests, arguing that they are supposedly disciplining a disabled person: “At least once a year he undergoes a medical commission, otherwise you won’t be forced to do so.” But, in fact, the ITU bureau today is a complex bureaucratic apparatus that creates various obstacles and problems for people with disabilities.

The entry into force of the Order of the Ministry of Labor of Russia dated October 11, 2012 No. 310n “On approval of the Procedure for the organization and activities of federal state institutions of medical and social expertise” called into question the need for the existence of the ITU itself as a separate structure.

According to paragraph 4 of this law, a necessary condition for the formation of the bureau is the presence of at least one medical specialist. However, the doctor’s specialty is not indicated...

— Is there really only one doctor included in the bureau, and who are the rest of the experts? Officials?..

— When there were VTEK, there were three doctors on the commission. Then we tried to include 5 specialists. There are currently three experts working, one of them on medical and social issues. Moreover, clarifications about the doctor’s specialization were removed from the documentation. Specialists do not apply to the ITU because it is impossible to obtain a category; it is not taken into account.

General ITU bureaus examine citizens with a wide variety of diseases, and no matter how competent a doctor is in ITU, it is almost impossible to navigate well in all nosological forms. And the psychologist and rehabilitation specialist who are part of the bureau are not at all competent in the matter of establishing disability.

In addition, according to the rules approved by Decree of the Government of the Russian Federation of February 20, 2006 No. 95, the decision to recognize a citizen as disabled or to refuse is made by a majority vote of the specialists who conducted the MSA. If there is one doctor for medical and social examination, the objectivity of such a vote is questionable - the main condition for recognizing a person as disabled to this day remains the type and severity of impaired body functions, which can only be determined by a doctor according to the medical examination (with the exception of mental functions).

In other words, the ITU bureau is turning into a bureau for issuing disability certificates, which significantly increases the corruption component and significantly reduces the objectivity of the decision made.

— Disabled people complain about the low professional level of ITU specialists in the regions. They say that they even confuse the diagnoses. The mother of a child with a serious illness recently showed a copy of a document in which experts call adrenogenital syndrome... diabetes mellitus. Where are they prepared?

— In Russia, experts are trained in internships in St. Petersburg - there is an institute for advanced training of doctors. And in the federal bureau of ITU. The level is really low. There are few professionals: and the leaders are weak, sometimes it is embarrassing to listen to them - they do not know regulatory documents, are poorly versed in the legislation, and experts in the regions lack the knowledge and competencies to understand and implement the orders of the Ministry of Labor of the Russian Federation. This is sad because the ITU system is an absolute monopoly. Its decisions cannot be challenged. In the pre-trial procedure, an appeal is carried out in the service itself: one team, another and then need to contact the federal bureau, where often the sent documents are not opened at all. I defended my candidate’s and doctor’s thesis there and repeatedly saw how meetings were held, how the experts did not see the patient, did not study the documentation, but immediately took the decisions of the main bureau of the region as a basis. Decisions change extremely rarely. Sometimes courts, when considering claims of disabled people, rule: undergo an examination in any region of your choice. Which region will change its decision after the federal bureau?

No independent expert can approach the service, since by law there is no independent ITU - the license is given only to federal institutions. Therefore, no matter how objective and fair the independent expert’s conclusion is, it will not affect the change in the decision of the ITU federal institution.

— The Public Chamber of the Russian Federation proposes to consider “the mistakes of the ITU from the point of view of the Criminal Code of Russia” and gives examples of corruption in the Ulyanovsk and Volgograd regions...

— And there is corruption, and, unfortunately, the regions have their own stakes. I’ll probably put the tariffs on the card soon - there are a lot of complaints from people with disabilities. I remember when they first told me that in Vorkuta, group II disability costs 450 thousand rubles, I didn’t believe it. And then people confirmed it. In the same Vorkuta, a surgeon was caught red-handed. It’s especially scary when they extort money from real disabled people. Alas, this is also part of the system. It needs to be changed, but I no longer believe the talk about reorganizing the ITU. Three years ago, this question was already raised; the Ministry of Economic Development of the Russian Federation was asked to calculate how much the reforms would cost. They counted a lot, wrote a lot, and didn’t offer anything concrete.

No reorganization of the ITU at this stage will be able to solve the problem. Examples are the largest regions, such as the Krasnodar Territory and Rostov-on-Don. The managers were removed several years ago, and the local specialists from the primary bureaus continued to work and continue to work. Nothing has changed in the service. The monopoly was and remains.

I believe that the determination of disability groups can be carried out by a medical commission of a medical organization on the recommendation of the attending physician on the basis of data from primary medical documentation, without filling out a referral for medical examination. Currently, the attending physician submits to a medical commission a patient with a temporary disability, a disabled person with a deteriorating condition, for the purpose of prescribing and correcting treatment, therapeutic and diagnostic measures. Therefore, the chairman of the commission is usually aware of the peculiarities of the course of the disease of such patients. And specialists from the ITU bureau determine the disability group without knowing anything about the patient (unless we are talking about re-examination) and rely only on the submitted medical documents and a one-time examination of the patient within a few minutes.

I consider it advisable to abolish the MSA service, and to entrust the conduct of MSA to the medical commissions of healthcare organizations, especially since most of the functions are currently performed by the medical commission to one degree or another. Reform will require changing the procedure for medical institutions to conduct examinations of disability, revising the functional responsibilities of medical commissions of primary care medical organizations. But it will shorten the route of travel for citizens with disabilities, simplify the examination procedure, improve the quality and expand the scope of medical and social rehabilitation services provided to disabled people.

The liquidation of the ITU service by transferring its functions to medical commissions of medical organizations will allow:

reduce social tension among disabled people and citizens initially sent to MTU (the long procedure of filling out referrals to MTU and subsequent examination at the bureau will be eliminated);

reduce federal budget expenses for maintaining the ITU service;

reduce the burden on specialists of the medical commission and doctors of the medical organization by eliminating the need to fill out a referral for medical examination;

increase the availability of examination for the population, because medical commissions exist in all medical organizations, while the ITU bureau is created at the rate of 1 bureau per 90,000 people, and citizens of small settlements are forced to travel considerable distances at their own expense to get to the ITU bureau;

eliminate the corruption component on the part of ITU bureau specialists;

legislatively approve an independent ITU.