Important information update!
How to pass the commission: algorithm
Step 1
First you need to get it from a therapist based on the data entered in the outpatient card.
Step 3
During the examination itself, specialists first of all get acquainted with all the documentation, then they conduct an examination and conversation with the patient, and analyze his condition. All actions and conversations during the work of the commission are recorded.
Step 4
Step 5
Important! The decision made by the commission is communicated to the patient on the same day on which the examination took place. In case of a positive conclusion, the person is given the original certificate, as well as a scheme for future rehabilitation and treatment developed specifically for him.
Step 6
A citizen’s application with this very certificate to a pension fund or other social organization to receive a pension and other assistance. This must be done within three days after receiving the papers..
In total, in about two months you can actually successfully apply for disability.
However, this does not mean that you can forget about your visit to the ITU office. Depending on the assigned group, disabled people in Russia must confirm their status at certain intervals:
- first group - every two years;
- second and third – annually;
- disabled children - once during the validity of this status.
Before the deadline is also possible. If this is due to a noticeable deterioration in the citizen’s condition, then whenever, but if not, then the disability should be valid for no more than two more months.
Decree of the Government of the Russian Federation of February 20, 2006 N95 gives citizens the right to challenge the decision of the commission. A period of one month is allotted for the local ITU center in the main office. The same period applies for a complaint against a decision of the main bureau in the federal center.
In this case, you must bring documents for appeal to the bureau where you have already been examined. It is the government itself that is forced to transfer statements from dissatisfied citizens to higher authorities within no more than three days. The very last body to which one can turn in such proceedings, and whose decision is no longer subject to appeal, is the court.
Possible difficulties
- The patient himself is in a non-transportable condition or in intensive care. The doctors of the medical institution, his relatives and the company where the patient is employed are then required to collect the papers. His collected documents are transferred to the ITU bureau on the basis of a special certificate confirming the citizen’s inability to deal with everything personally.
- The clinic where the patient is located is a psychiatric clinic, and the situation is similar to the previous one, that is, the person’s condition is very serious. At such moments, a notarized power of attorney is usually drawn up, and his relatives have the right to act on behalf of the patient.
- The citizen is capable of independently registering disability, but the medical institution refused to issue him a referral. The solution to this problem is to require a form in the form
The nurse, like all participants in the process of medical and social examination, is in a difficult position: she often has to deal with patients with whom it is quite difficult to establish contact, whose personality traits have little to do with communication and make it difficult.
These features include: low level of education; defects in mental activity caused by illness; unfavorable personality traits (emotional instability, vulnerability, resentment, explosiveness, low self-esteem), which are aggravated in the examination situation (which is stressful for most patients). And yet, even when working with the most difficult contingent of those being examined, adherence to the principle of partnership, treating a person without prejudice, as an equal person, is the key to the effectiveness of the communication process.
It should be emphasized that optimization of the communication process is only possible if a person really wants to achieve this.
Simply memorizing communication techniques and techniques is ineffective.
Success depends on how committed the medical worker is to choosing the optimal methods of behavior in relation to persons who come for examination. The stability of such aspiration among individuals for whom working with people is their professional activity may turn out to be one of the most important conditions for the success of their activities. Communicative competence includes motivational, cognitive, personal and behavioral components. This is a person's ability to interact effectively with other people.
It includes: the ability to navigate social situations, the ability to correctly determine the psychological characteristics and emotional states of other people, the ability to choose and implement adequate methods of interaction.
Communication skills include: active listening skills, the ability to express one’s thoughts taking into account the partner’s level of understanding, reflective tracking of the communication process, conscious control of emotions. The communicative competence of a medical worker is manifested in mercy, tolerance, stress resistance, professional empathy, which helps alleviate suffering, rehabilitation, and restore the patient’s health.
Thus, the requirements for the personality of a nurse at an ITU institution are quite high; it must be remembered that we work for the patient and for the patient.
The peculiarity of communication in an examination situation is its short duration. In 10-15 minutes of communication, the nurse and the person being examined form an impression of each other.
It must be remembered that under no circumstances should the conflict be allowed to escalate. You need to behave calmly and kindly with the patient.
People with illnesses are extremely sensitive to the emotional climate in their environment. Therefore, you need to pay attention to your behavior and gestures. It is necessary to be respectful, try to be consistent and direct, maintain a friendly distance, take into account that the person is sick, and attribute the symptoms not to him, but to the disease. This tactic is based on basic common sense.
It is worth separately noting the peculiarities of communication with mentally ill people. There is no single correct line of behavior when dealing with mental patients. It all depends on the specific situation, setting and personality of the interlocutors.
Although the average person cannot accurately determine the degree of danger posed by a mentally ill person, he can recognize some of the symptoms of the disease and behave accordingly. If the interlocutor has difficulty concentrating, you should try to be brief and, if necessary, repeat what was said. If he is overexcited, a conversation with him will not work. You should limit the information, do not try to explain anything, speak briefly, and do not aggravate the discussion. “Uh-huh”, “yes”, “goodbye” - these are the tactics of the nurse.
It is necessary to be calm and open when communicating with patients. When speaking, remain calm, clear and direct. Remember that the patient may hear strange voices and see strange things, his thoughts are racing, and at the same time he is experiencing a wide variety of feelings. So long-winded emotional phrases are likely to confuse him, while short phrases and calm speech will be more understandable.
Let's say you were outraged by his behavior and expressed it very emotionally - most likely he simply will not hear you or will not remember what was discussed. And it is quite likely that next time he will behave in exactly the same way.
Mental illness seriously affects how a person thinks and behaves and what they are able to do. However, for those of us who associate with and love such people, it is vital to always remember that these are not just “mentally ill.” They still remain PEOPLE with their feelings, are very vulnerable, easily lose their individuality and therefore especially need those who love and understand them. Not realizing how much they could be given, others simply label them as mentally ill. Friends and families should resist this tendency by remembering to separate the person from the illness.
Nurses should not:
Laugh at the patient and his feelings;
Be frightened by his experiences;
Convince the patient of the unreality or insignificance of what he perceives;
Engage in a detailed discussion about the hallucinations or who he thinks they are coming from;
You should pay attention to your own emotional state. It must be remembered that fear and resentment are usually hidden behind external anger. It is easier to take control of the situation if you behave calmly and clearly. Often a soothing, confident voice makes it possible to quickly eliminate the irrational anger and fear that overwhelms the patient.
It is necessary to avoid any physical contact and not create a crowd around the patient. When communicating with a patient, even physical presence itself is important. The patient may lose his temper if he feels like he is cornered or trapped. Therefore, it may be a good idea to leave him free to leave the office or position himself so that he can move away if emotions become too intense.
It is worth being as attentive as possible to the reasons for the patient’s anxiety. Do not minimize or ignore the fact that the patient may be experiencing strong feelings. During an attack of anger, the most important thing is to help the patient focus on what can calm him down. It is necessary to study the reasons for his anger during a calmer period.
It is important to remember the boundaries of acceptable behavior. If in anger the patient screams, throws objects, disturbing other examinees and employees of the ITU institution, it is necessary to calmly but firmly make a remark. For example, say that if he does not stop, then you will be forced to report the current situation to the head of the bureau (expert staff).
If the person being examined in the process of communication assessed the nurse as a formal, hasty, indifferent person to his situation, then if the expectations of the examination are not met, the likelihood of filing a complaint with higher authorities about the rudeness and incompetence of doctors and nurses (even in the absence of an immediate reason for such accusations) increases, and vice versa, if the person being examined has gained confidence in the staff of the institution, has seen caring people trying to understand his problem and do everything to help him, then he will make a decision not in his favor more calmly, since he will feel objectivity.
The correct communication style will help reduce conflict in the examination procedure. Social psychology identifies a number of reasons that provoke interpersonal conflicts.
1. Personal characteristics of the parties.
Personal prerequisites for conflict
Such traits as intolerance to the shortcomings of others, reduced self-criticism, incontinence in feelings, as well as a tendency to aggressive behavior, power, selfishness, and selfishness can serve. The behavior of a nurse at an ITU institution should not be aimed at emphasizing her authority or importance in deciding the fate of another person. The authoritarian style of communication usually increases the aggressiveness of the conflict patient. You should not consider the patient from a subjective position, that is, see in each patient either the features of an acquaintance or relative and behave in proportion to this.
The nurse should be fairly self-confident, but not arrogant; fast and persistent, but not fussy; decisive and firm, but not stubborn; emotionally responsive, but reasonable. She must remain calm and sincerely involved, optimistic with a certain amount of skepticism. A balanced, harmonious personality of a nurse is an important factor in establishing optimal contact with the person being examined.
2. Barrier of negative emotions.
Emotions can influence the perception of a communication partner. When experiencing hostility, anger, and disgust, it is difficult to expect that you will be able to correctly evaluate and understand your communication partner.
3. Perception barrier.
There are a number of postures and gestures that cause a negative attitude from the interlocutor. Thus, crossed arms over the chest indicate alienation, some aggressiveness, and closedness to communication. Hands clenched into fists - an openly aggressive pose, etc. The first impression of a person creates an appropriate attitude towards relationships; it can be negative or positive.
It is necessary to distinguish between types of conflicts. Realistic (substantive) conflicts. They are caused by the dissatisfaction of the requirements and expectations of the participants, as well as the unfair, in their opinion, distribution of any responsibilities, advantages and are aimed at achieving specific goals. The reason for confrontation may be the behavior of medical personnel (rudeness, incivility), the nature of the procedure for registering a patient (negligence), the sanitary and hygienic conditions of the medical institution (film, noise, smell), errors in the preparation of expert documentation.
Pointless (unrealistic) conflicts. They have as their goal the open expression of accumulated negative emotions, grievances, and hostility, when acute conflict interaction becomes not a means of achieving a specific result, but an end in itself. This type of conflict is often caused by the biased attitude of the person being examined towards the medical service in general and a specific physician in particular.
The success of a contact is sometimes determined by seemingly insignificant factors. For example, excessively rich, fashionable clothes, an abundance of jewelry, and cosmetics can create a negative impression.
Openness to communication can be shown through eye contact, a slight smile, friendliness, and gentle manners and intonation. A slight tilt of the body, head towards the interlocutor, an interested and attentive facial expression, etc. is possible.
The pace of speech should be slow, calm, and the words should be clear. For the effective work of the nurse of the ITU Bureau and the expert teams of the Main Bureau, the ability to listen to the interlocutor is necessary.
The next stage of communication is leaving contact. The ability to leave contact is as important as entering it. The role of the last impression is as important as the first. The inability to contain one’s hostility leads to resentment, a negative impression of the examination procedure, and a feeling of dissatisfaction.
A good way to end a contact is the technique of “paraphrasing” (i.e., reformulating the interlocutor’s thoughts - “as I understood you...”, “in other words, you are saying...”) and summarizing - summing up the main ideas and feelings of the patient. The patient, making sure that he was understood correctly, leaves with a feeling of satisfaction and will even accept a negative decision for him more calmly.
In each office it is necessary to create an environment that would spare the psyche of patients and generate an atmosphere of trust. This can be achieved by proper organization of work and rest schedules, high employee culture and clear labor and professional discipline.
Already the first meeting at the reception should create an atmosphere of positive mood for the patient, an atmosphere of goodwill.
It is necessary to maintain order and cleanliness in the waiting room; there must be a stand in proper form indicating the work schedule of the bureau, the list of documents required during the examination, the procedure for appealing the decision of the ITU bureau, information about benefits for the disabled and other information relating to those being examined.
A patient's registration for examination must be done individually. Treatment of the patient during recording should be friendly and patient, since from the first moment the patient begins to form an opinion about the correctness and quality of the examination.
If the necessary documents are not available, the need to provide them should be patiently explained; any questions that arise (which are not within the competence of the nurse) should be resolved with the head of the bureau. After registering a patient, information about him is provided to the head of the bureau, who determines the priority of the examination procedure.
Social issues (housing, family relations, work activities, etc.) should be clarified delicately.
It is unacceptable to address each other first name in the presence of patients. If the specialist collecting the anamnesis is forced to be distracted, he should apologize to the patient.
Summarizing the above, it follows that in a disease with relatively rare seizures and minor personality changes, the ability to work is practically not affected.
Patients are able to work mainly with mild (absence seizures, simple partial, etc.) and rare seizures, without distinct mental disorders, with moderately expressed characterological characteristics, having the opportunity to continue working in their specialty with restrictions or changes in the profile of activity (mainly persons in the humanitarian professions, teachers etc.). Patients with long-term remission of seizures during maintenance therapy, without significant personality changes - with the possibility of employment in available professions.
Indications for referral to BMSE are contraindicated types and working conditions, the progressive course of the epileptic process (frequent, treatment-resistant seizures, mental disorders, personality changes), after insufficiently effective surgical treatment.
It should also be noted that the examination situation at the ITU institution is one of the potentially conflict-prone situations. If the work is carried out convincingly, competently, in compliance with all regulatory documents and ethical standards for fulfilling professional duties, conflict situations will not arise.
Thus, having considered the principles of organization, tasks, functions of medical and social examination, as well as the characteristics of disability in epilepsy and the participation of the nurse directly in the examination, we can conclude that the diagnosis of epilepsy does not necessarily mean disability, with relatively rare seizures and minor personality changes, working ability practically does not suffer.
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 wasn’t eligible for an electric wheelchair, but I’m a “collar” 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 hiring 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 activities 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 essence, 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 dated 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 there. 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 group, another, and then you have 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 experts did not see the patient, did not study the documentation, but immediately took 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.
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1. General provisions
1. GENERAL PROVISIONS
1.1. A medical and social examination doctor (hereinafter referred to as the “Worker”) is a specialist.
1.2. This job description defines the functional responsibilities, rights, duties, responsibilities, working conditions, relationships (positional connections) of the Employee, criteria for assessing his business qualities and work results when performing work in his specialty and directly at the workplace in "____________________" (hereinafter - " Employer").
1.3. An employee is appointed to a position and dismissed from a position by order of the Employer in the manner prescribed by current labor legislation.
1.4. The employee reports directly to ____________________.
1.5. The employee must know:
Constitution of the Russian Federation; laws and other regulatory legal acts of the Russian Federation in the field of healthcare, consumer protection and sanitary and epidemiological welfare of the population; theoretical foundations of the chosen specialty; modern methods of treatment, diagnosis and drug provision for patients; basics of medical and social examination; rules for action when a patient is detected with signs of particularly dangerous infections, HIV infection; the procedure for interaction with other medical specialists, services, organizations, including insurance companies, physician associations, etc.; the fundamentals of the functioning of budgetary insurance medicine and voluntary medical insurance, providing sanitary, preventive and medicinal care to the population; medical ethics; psychology of professional communication; basics of labor legislation; internal labor regulations; labor protection and fire safety regulations;
____________________.
1.6. The employee must meet the qualification requirements for the specialty "Medical and Social Expertise", established by Order of the Ministry of Health of Russia dated October 8, 2015 N 707n "On approval of the qualification requirements for medical and pharmaceutical workers with higher education in the field of training "Healthcare and Medical Sciences":
- Higher education - specialty in one of the specialties: “General Medicine”, “Pediatrics”;
- Residency training in the specialty "Medical and Social Expertise" or professional retraining in the specialty "Medical and Social Expertise" with training in internship/residency in one of the specialties: "Pediatric Surgery", "Neurology", "General Medical Practice (Family medicine)", "Oncology", "Otorhinolaryngology", "Ophthalmology", "Pediatrics", "Psychiatry", "Therapy", "Traumatology and Orthopedics", "Phthisiology", "Surgery", "Endocrinology";
- Advanced training at least once every 5 years throughout your career.
2. Job responsibilities
Worker:
conducts medical and social examination of citizens based on an assessment of life limitations caused by persistent disorders of body functions;
develops individual rehabilitation programs for disabled people, including determining the types, forms, terms and volumes of measures for medical, social and professional rehabilitation;
establishes the fact of the presence of disability, the group, causes, duration and time of onset of disability;
determines the degree of loss of professional ability to work (as a percentage);
determines permanent disability;
determines the need for medical, social and professional rehabilitation for victims of industrial accidents and occupational diseases and develops rehabilitation programs for victims of industrial accidents and occupational diseases;
determines the causes 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;
determines the need for health reasons for constant outside care (assistance, supervision) of a father, mother, wife, brother, sister, grandfather, grandmother or adoptive parent of citizens called up for military service (military personnel serving under a contract);
provides citizens undergoing medical and social examination with explanations on issues of medical and social examination;
participates in the development of programs for the rehabilitation of disabled people, disability prevention and social protection of disabled people;
creates a data bank about citizens living in the serviced territory who have undergone a medical and social examination; carries out state statistical monitoring of the demographic composition of disabled people living in the serviced territory;
submits to military commissariats information on all cases of recognition of persons liable for military service and citizens of military age as disabled.
3. Employee Rights
The employee has the right to:
providing him with work stipulated by the employment contract;
a workplace that complies with state regulatory requirements for labor protection and the conditions provided for by the collective agreement;
On October 1, the Public Chamber launched a “hotline” on issues of accessibility and quality of work of institutions of the medical and social examination system, press service of the RF OP. Citizens who are not satisfied with the work of the MTU system can contact it. You can call the hotline from any region of Russia, all calls are free.
“The hotline will not act as a help desk,” said Ekaterina Kurbangaleeva, deputy chairman of the RF OP commission on social policy, labor relations, interaction with trade unions and support for veterans, “we collect all the necessary information on the appeal, analyze it, try to solve it, but if If we don’t resolve the issue at the level of our legal and organizational support, then we transfer it to ITU.”
Let us recall that on March 29, 2018, the Russian government adopted Resolution No. 339, which significantly simplified the methods of examination and re-examination of people with disabilities. A specific list of diagnoses has appeared for which disability is given during the initial examination before the age of 14 or 18. Previously, children with disabilities had to prove their status every year. The changes also affected the individual rehabilitation and habilitation program (IPRA). “If a person, for example, needs to change the size of diapers, for this he does not need to go through the entire lengthy procedure - from doctors to the ITU, which sometimes lasts for two months, now you can simply come to the ITU and make changes to the IPRA,” explained Kurbangaleeva.
