The procedure for conducting MSE in the bureau. How and where to pass the MSE (vtek): passing the commission, obtaining a certificate, as well as the role of the act and sick leave. The list of diseases for disability has been expanded
People with physical disabilities have the right to count on support from the state in the form of various benefits, subsidies and benefits. However, in order to use the privileges, you first need to confirm and document your status. The examination is carried out by a commission on disability, consisting of specialists from various fields. In order not to get confused at the moment of the process, it is worthwhile to figure out in advance what it is, and what algorithm of the procedure is provided for by law.
What is ITU
According to the text of federal law No. 181-FZ, chapter 2, paragraph 7, a medical and social examination (MSE) is an examination procedure aimed at establishing the fact of disability in relation to a person who has physical pathologies of varying severity.
The list of the main functions of the ITU includes:
- identification of the causes of disability, the establishment of its terms;
- clarification of a person's need for social protection and assistance in obtaining it;
- development of rehabilitation projects;
- determination of the degree of loss of ability to work.
According to the results of the commission, a citizen is also assigned a disability group corresponding to his physical indicators. This applies to cases when a person is being examined for the first time.
The re-examination is also aimed at checking the condition of the disabled person, but in this case, the subject of the procedure is the improvement or deterioration of physical indicators.
At the end of such systematic checks, a verdict is issued that no changes are observed, as a result of which the disability group is confirmed. Another option is to improve the condition of a person and remove the status.
What is the basis for the committee's decision?
Examination in the ITU process is a comprehensive analysis of the functions of the human body. This is also stated in clause 7 of Law No. 181.
During the examination, monitoring is carried out in the following areas:
- clinical and functional indicators;
- professional labor criteria;
- social and household data;
- psychological condition.
Simply put, in addition to the medical commission, a person will need to talk with a psychologist and a social worker. Other specialists may be appointed depending on individual characteristics.
Are there any differences between VTEC and ITU
For a better understanding, it is worth clarifying whether there are differences between the two abbreviations - ITU and VTEK (medical labor expert commission). The latter type of examination was previously used to address issues of disability among the working population, and people with disabilities from childhood were not within the competence of specialists.
In fact, the procedure revealed whether a person had lost his ability to work or whether he could continue to work in full or using a simplified schedule. At the same time, not only health indicators were studied, but also working conditions and its characteristics.
As for the ITU or medical and social expertise, this name has been used since 1995 on the basis of federal legal act No. 181-FZ. The process is a more advanced version of the verification. The commission accepts all disabled people, including children, for examination.
In other words, the concepts of ITU and VTEC are identical. And when it comes to examining the physical condition of a person with the aim of assigning a disability or confirming an existing group, both formulations can be used. The essence of this will not change.
However, there are still differences. These consist in the technical equipment of the activities carried out during the survey. And there is nothing surprising here, because progress does not linger on the spot, which is reflected both in the development of medicine and in the improvement of legal support for the disabled, their rehabilitation and inclusion in the system of social relations.
Where is the examination
Examination is carried out in the Bureau of Medical and Social Expertise located in the regions. It is in the territorial offices that you should apply for disability registration.
The actions of city and regional ITU are coordinated by similar structures, but located in large federal subjects. They analyze the activities of territorial branches and, if necessary, make decisions in various situations.
The Federal Bureau of Medical and Social Expertise, functioning on the basis of the Ministry of Labor and Social Protection of the Russian Federation, manages the above authorities. Located in Moscow.
ITU passing algorithm
The ITU procedure itself is quite complex and energy-intensive. A person will need to go through several instances, collect documents, communicate with various specialists and, in general, undergo a series of studies.
The process is especially problematic for people whose physical or mental abnormalities can be classified as severe. Therefore, in any case, you will need to be patient and follow the already proven algorithm.
The procedure for establishing disability involves the following steps:
- getting a referral to ITU;
- preparation of documentation;
- passing the examination procedure;
- announcement of the decision on the results of the commission and receipt of a certificate.
It happens that experts disagree and cannot come to a unanimous decision. In such cases, a re-examination is ordered.
How to get a referral
To obtain a document, you should contact a specialized medical institution at the place of observation of a person. Directly to your doctor.
In some cases, the Pension Fund of the Russian Federation or social security can provide paper. At the same time, a direct appeal to the ITU bureau is also allowed, if he was refused in the indicated structures.
The most common option is to receive paper from a doctor with whom the patient is registered. At the reception, you will need to announce the desire to apply for disability and ask for a referral to the ITU.
The doctor prepares a document, fixing the information in the patient's outpatient record, and then directs the person to go through narrow specialists. Passing through specialists, it is worth telling about all injuries, illnesses, symptoms and other points related to health. This data is recorded in the card, it also includes information about the methods and techniques of treatment.
A referral can only be issued if there are regular visits to the doctor, which must be noted in the medical record.
In the absence of observation, patient visits and information about treatment methods, the applicant will be denied not only the assignment of a disability group, but also the referral to the commission itself.
If the paper is received, it is necessary to make sure that it bears the seal of the medical institution and the signature of the head physician.
Commission Application
Once the referral is issued, you can begin to draw up an application for certification and.
Required information includes:
- name of the healthcare organization;
- information about the applicant;
- a request for an examination in order to register a disability;
- date of submission of the request.
The paper is certified by the signature of the applicant, as well as the acceptance note affixed to the office of the ITU bureau.
Paper package
It is necessary to inquire about what kind of documents you need to prepare from the attending physician. The list may change depending on the disease, its severity and related factors.
The standard package of papers includes:
- direction;
- passport of the examined person;
- statement;
- a copy of the work book;
- patient's medical record;
- test and analysis results;
- SNILS;
- originals, as well as copies of extracts from the medical history, certificates and other papers requested from clinics and hospitals where the applicant was examined and treated;
- letters of recommendation from the place of employment (in some cases);
- an act on the presence of an occupational injury (if any) in the form H-1;
- if the commission is repeated, you will need to have a copy of the disability certificate issued earlier.
It is allowed to submit documentation, both by the interested person himself, and by his representative under the law (parent, guardian).
Since ITU is also for children, an application can also be submitted on behalf of a minor child.
In this case, the package of papers should be supplemented with the following documents:
- birth certificate;
- parents' passports;
- referral from a children's clinic;
- conclusion of a psychologist;
- documents from an educational or educational institution (characteristics, diploma, certificate of education).
After submitting the documents, an invitation is sent to the applicant, and the time of the examination is determined. After that, an entry takes place on a specific date, but no later than 30 days from the date of application.
ITU procedure
On the appointed day, the citizen must appear at the ITU bureau for direct examination. It is also allowed to carry out the procedure at home, for example, if the patient is bedridden or in absentia in a hospital.
Usually the commission consists of a leader, a secretary, a number of specialists in narrowly professional areas. The process consists of several stages:
- Study of the provided documentation on the patient. References, extracts, acts, a map - all this is carefully studied by all members of the council.
- Inspection of a person if necessary.
- Interview in the form of questions from members of the commission (psychologist, doctors, social worker) and answers to them from the patient. In addition to topics related to health, living conditions, social skills and other points may be affected.
Throughout the process, the chairman of the commission and its members analyze the behavior and condition of the person. The patient is advised to behave calmly, confidently, not to raise his voice. Wherein the presence of relatives is usually not allowed. The exception is minors and patients who are unable to move independently.
At the end of the examination, a closed meeting is held, where a decision is made by voting on registration or refusal to assign the status. With a positive result, the applicant is assigned the appropriate disability group, an official certificate and a rehabilitation program are issued.
The maximum term for making a decision on a specific person is 6 days, although usually the verdict is announced on the day of the ITU. The applicant is notified of the results by phone or by mail.
What to do if a disability is confirmed
After receiving the certificate, it will need to be transferred within 3 days to the Pension Fund for the appointment of pension payments and benefits.
In addition, do not forget that the status of "disabled" is not assigned for life. Periodically, it needs to be confirmed through the next survey. At the same time, each disability group has its own period.
Group 1 passes ITU once every 2 years. 2 and 3 categories every year. Disabled children visit the ITU bureau 1 time during the validity of the status.
The process of registration of disability is carried out by passing a medical and social examination. The procedure is quite complicated, partly because it requires a lot of effort to collect documents. At the same time, members of the commission can behave quite harshly, therefore, before the meeting, it is recommended to set yourself up psychologically correctly, calm down and realize that if the fact of having physical health limitations has already been established, then the commission will be convinced of this. Otherwise, its decision is quite realistic to challenge in court.
Free question to a lawyer
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Medical assistance to the disabled and persons with disabilities is provided by medical organizations of the state health care system of the city of Moscow, providing primary health care.
To carry out activities approved by Decree of the Government of Moscow dated September 6, 2011 No. 420-PP “On the state program “Social support for residents of the city of Moscow for 2012-2016”, according to section 6 “Formation of a barrier-free environment for the disabled and other low-mobility groups of the population”, allocated target budget funds.
In order to ensure the rights and legitimate interests of people with disabilities and people with limited mobility in medical organizations of the state healthcare system of the city of Moscow that provide primary health care, work is underway to install railings, handrails, repair ramps, entrance groups of buildings, expand doorways, modernize elevators, ways of movement inside buildings, equipment of sanitary rooms.
As part of the interaction of the Moscow City Health Department with public organizations of the disabled in Moscow, from 2014 to the present, representatives of the Moscow city organization of the All-Russian Society of the Disabled and public inspectors of the Public Inspectorate for the Affairs of the Disabled in the City of Moscow have been participating in surveys on the accessibility of medical organizations for disabled people, in the preparation of recommendations for the adaptation of objects of medical organizations for the disabled.
Medical care at home for the disabled is carried out by general practitioners of the centralized house call service and local general practitioners (patronage). By appointment of a general practitioner and a district general practitioner, consultations are carried out, including at home by specialist doctors (neurologist, surgeon, ophthalmologist, etc.) and the necessary studies and procedures are carried out.
In addition, a planned medical examination is carried out with the involvement of all necessary specialist doctors for consultation.
Registration of a disability group
The decision to recognize a person as a disabled person or to refuse to recognize him as a disabled person is made based on the results of passing a medical and social examination. Referral for medical and social examination is carried out in the presence of signs of disability:
- health disorder with a persistent disorder of body functions due to diseases, consequences of injuries or defects;
- limitation of life activity (complete or partial loss by a citizen of the ability or ability to carry out self-service, move independently, navigate, communicate, control their behavior, study or engage in work activities);
- the need for social protection measures, including rehabilitation and habilitation.
Make an appointment with a doctor
The procedure for registering a disability must begin with a visit to the attending physician at the clinic at the place of attachment. Please note that in order to attach to the clinic, you must have a compulsory medical insurance policy (CHI).
The attending physician at the clinic at the place of attachment must record the presence of prerequisites for obtaining a disability group. If there are such prerequisites, you will be given a referral to the Bureau of Medical and Social Expertise for examination (form No. 088/у-06).
Prepare documents
After you receive a referral from a doctor to undergo a medical and social examination (MSE), prepare a package of documents:
- an application for examination (re-examination) on behalf of a citizen (if he is over 14 years old) or his representative (if the child is under 14 years old);
- an identity document (for children under 14 years old - a birth certificate, for children over 14 years old - a passport);
- medical documents evidencing the state of health of a citizen (outpatient card, extracts from hospitals, consultants' conclusions, examination results);
- passport of the parent or guardian;
- guardian (representative of the body of guardianship and guardianship) - a document on the establishment of guardianship.
adult
- application for examination (re-examination) on behalf of a citizen or his representative;
- identity document;
- referral to ITU issued by the attending physician;
- a copy of the work book;
- professional and production characteristics from the last place of work (according to the approved form);
- medical or military medical documents evidencing the state of health of a citizen (outpatient card, extracts from hospitals, consultants' conclusions, examination results, Red Army or military book, certificate of injury, etc.);
- if the documents will be submitted by a representative - a power of attorney for the representative and his passport.
Additional documents (depending on the specific case):
- act on an accident at work in the form of H-1 (certified copy);
- act on occupational disease (certified copy);
- the conclusion of the interdepartmental expert council on the causal relationship of the disease, disability with exposure to radioactive factors (certified copy, the original is presented in person);
- certificate 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 (a copy, the original is 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 (presented in person);
- for non-resident citizens - a certificate of registration at the place of residence;
- for those discharged from military service - a certificate of illness drawn up by the VVK (a certified copy, the original is presented in person).
Contact the ITU Bureau
The prepared package of documents must be submitted to the Bureau of Medical and Social Expertise.
Medico-social examination (MSE) is carried out in the bureau at the place of residence. In some cases, ITU may be conducted:
- In the main bureau - in case of an appeal against the decision of the bureau, as well as in the direction of the bureau in cases requiring special types of examination.
- In the Federal Bureau - 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.
- At home - in the event that a citizen cannot come to the bureau (main bureau, Federal Bureau) for health reasons, as evidenced 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.
An application for a medical and social examination may be considered up to one month from the date of submission of the application.
Conducting a medical and social examination
In the course of the examination, the specialists of the bureau study the submitted documents, analyze the social, professional, labor, psychological and other data of the citizen.
Representatives of state non-budgetary funds, the Federal Service for Labor and Employment, as well as specialists of the relevant profile (consultants) may participate in the conduct of a medical and social examination at the invitation of the head of the bureau with an advisory vote.
A citizen (his legal or authorized representative) also has the right to invite any specialist with his consent to participate in the medical and social examination with an advisory vote.
When conducting a medical and social examination, a protocol is kept.
Outcome of the ITU
The decision to recognize as disabled or to refuse to recognize as disabled is made by a simple majority of votes of the experts who conducted the medical and social examination. The decision is announced in the presence of all specialists who, if necessary, provide explanations on it.
Based on the results of the examination, an act is drawn up. The conclusions of consultants involved in the medical and social examination, a list of documents and basic information that served as the basis for making a decision are entered there.
A citizen (his legal or authorized representative) has the right to familiarize himself with the act and protocol of the medical and social examination. Copies of the act and protocol, certified by the head of the bureau, may be issued upon a written application of a citizen or his representative.
Additional examinations in special cases
Special cases
In cases requiring special types of examination to establish the structure and degree of disability, rehabilitation potential, as well as obtaining other additional information, an additional examination program may be drawn up, which is approved by the head of the relevant bureau. The specified program is brought to the attention of a citizen undergoing a medical and social examination in a form accessible to him.
After receiving the data provided for by the additional examination program, the specialists of the bureau make a decision to recognize the citizen as disabled or to refuse to recognize him as disabled.
In the event that a citizen (his legal or authorized representative) refuses to undergo an additional examination and provide 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 the available data, which is noted in the protocol of the medical and social examination of the citizen in federal state institution of medical and social expertise.
Individual rehabilitation program
For a citizen recognized as disabled, the specialists of the bureau who conducted the medical and social examination develop an individual program of rehabilitation or habilitation *.
Thus, a citizen recognized as disabled is issued:
- a certificate confirming the fact of the establishment of disability, indicating the group of disability;
- individual program of rehabilitation or habilitation.
A citizen who is not recognized as a disabled person, at his request, is issued a certificate of the results of a medical and social examination.
*If it is necessary to make corrections to the individual program of rehabilitation or habilitation 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 (typo, typo, grammatical or arithmetic error or similar error) to a disabled person (child with a disability), at his request or at the request of a legal or authorized representative of a disabled person (child with a disability), a new individual rehabilitation or habilitation program is drawn up instead of the previously issued one without additional examination of the disabled person (child with a disability). disabled person).
Disability can be issued if:
- health disorder with a persistent disorder of body functions due to diseases, consequences of injuries or defects;
- limitation of life activity (complete or partial loss by a citizen of the ability or ability to carry out self-service, move independently, navigate, communicate, control their behavior, study or engage in work activities);
- the need for social protection measures, including rehabilitation and habilitation.
The decision on recognition as a disabled person is made based on the results of a medical and social examination (MSE).
Depending on the state of health, adults are assigned I, II or III disability groups, children under 18 years of age - 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, the doctor should rely on diagnostic tests, the results of treatment, rehabilitation and habilitation. Therefore, for a referral to ITU, it is best to contact your doctor. But you can also go, for example, to the chief physician of the medical organization in which you are undergoing treatment.
By Decree of the Government of the Russian Federation of February 20, 2006 No. 95 “On the procedure and conditions for recognizing a person as a disabled person”.
"> the law, if a person needs social protection, social security authorities and pension provision authorities can also issue a referral to the ITU, but only if they have medical documents that confirm violations of body functions due to diseases, consequences of injuries or defects. In practice, this means that you still have to contact a medical organization.If you are denied a referral, ask for a written denial. With this certificate, you have the right to apply to the ITU bureau on your own. In this case, the examination will be assigned to you by the employees of the ITU bureau, and based on its results, they will determine whether there is a need for a medical and social examination.
After you receive a referral, you will be recorded for a medical and social examination at the ITU bureau.
3. What documents are needed to enroll a child in ITU?
To register a 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);
- an identity document (for children under 14 years old - a birth certificate, for children over 14 years old - a passport);
- medical documents evidencing the state of health of a citizen (outpatient card, extracts from hospitals, conclusions of consultants, examination results - usually issued by a doctor who issued a referral to the ITU);
- SNILS;
- passport of the parent or guardian;
- guardian (representative of the body of guardianship and guardianship) - a document on the establishment of 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 in by the citizen himself or by his representative);
- identity document (original and copy);
- referral to ITU 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 evidencing the state of health of a citizen (outpatient card, extracts from hospitals, consultants' conclusions, examination results, Red Army or military book, certificate of injury, etc.);
- SNILS;
- if the documents will be submitted by a representative - a power of attorney for the representative and his passport.
In some cases, you may need Additional documents (depending on the specific case):
- act on an accident at work in the form of H-1 (certified copy);
- act on occupational disease (certified copy);
- the conclusion of the interdepartmental expert council on the causal relationship of the disease, disability with exposure to radioactive factors (certified copy, the original is presented in person);
- certificate 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 (a copy, the original is 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 (presented in person);
- for non-resident citizens - a certificate of registration at the place of residence;
- for those discharged from military service - a certificate of illness drawn up by the VVK (a certified copy, the original is presented in person).
An application for a medical and social examination may 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 in the ITU office at the place of residence. In some cases, ITU may be conducted:
- at the ITU Main Bureau - in case of appeal against the decision of the bureau, as well as by direction of the bureau in cases requiring special types of examination;
- in the Federal Bureau of the ITU - in case of appealing against the decision of the Main Bureau of the ITU, as well as in the direction of the Main Bureau of the ITU in cases requiring particularly complex special types of survey;
- at home - if a citizen cannot come to the bureau (ITU Main Bureau, ITU Federal Bureau) for health reasons, which is confirmed by the conclusion of a medical organization, or in a hospital where a citizen is being treated, or in absentia by decision of the relevant bureau.
6. How is the examination carried out?
During the examination, the specialists of the bureau will study the documents submitted by you, analyze social, professional, labor, psychological and other data.
In some cases, ITU bureau specialists may prescribe you an additional examination. You can refuse it. In this case, the decision to recognize you as a disabled person or to refuse to recognize you as a disabled person will be made based only on the data you provide. Your refusal will be reflected in the ITU protocol, which is kept during the examination.
Representatives of state non-budgetary funds, the Federal Service for Labor and Employment, as well as specialists of the relevant profile (consultants) may participate in the conduct of a medical and social examination at the invitation of the head of the bureau with an advisory vote. You also have the right to invite any specialist with his consent, he will have an advisory vote.
The decision to recognize as disabled or to refuse to recognize 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 the medical and social examination.
Based on the results, an act of medical and social examination is drawn up. You have the right to request copies of both the act and the protocol.
In addition, after the medical and social examination, the specialists of the bureau will prepare for you an individual rehabilitation and habilitation program (IPRA).
7. What documents are issued after the examination?
A citizen recognized as disabled is issued:
- a certificate confirming the fact of the establishment of disability, indicating the group of disability;
- individual program of rehabilitation or habilitation (IPRA).
A citizen who is not recognized as a disabled person, 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 necessary, clarify the characteristics of previously recommended types of rehabilitation and (or) habilitation measures, it is not necessary 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 establishment of disability is the day of receipt by the Bureau of the application for the ITU. Disability is established before the 1st day of the month following the month for which the next MSE (re-examination) is scheduled.
8. How to get re-certified?
Re-examination of disabled people of group I is carried out 1 time in 2 years, disabled people of II and III groups - 1 time per year, and disabled children - 1 time 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 the disability is established without specifying the period of re-examination, or if the re-examination must be carried out earlier than the established date, 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 in connection with a change in the state of health; . More information about the work of the ITU Bureau can be found on the website
This is the result of a medical examination, indicating the degree of working capacity and limited capabilities of a person. Simply put, it is established whether a citizen is disabled or not and how much he needs social support. This also includes such a thing as the category of "disabled child".
Also, medical and social expertise is studying the causes of disability, the prevalence of the latter, as well as the factors under the influence of which it may occur.
Where can I get a disability check?
The examination takes place in one of the ITU bureaus - territorial, federal or main. For this it should be:
- a referral from the municipality, also from the clinic or hospital where the candidate has recently received treatment;
- the court's decision;
- the citizen's own decision.
The last point means that a person can apply to the branch of the bureau on his own initiative. There is only one condition - you must have all the medical papers and conclusions confirming the permanent loss of working capacity. To do this, you need to write an application.
A citizen writes it himself, or he can entrust this procedure to an authorized person (a notarized power of attorney is required).
In addition to the actual statement, we need a trace. :
An examination can also be taken at home - if there is a doctor's opinion that a person cannot visit the institution on his own.
Is it possible to go through VTEK not at the place of registration?
The medical and labor expert commission determines the degree of a person's ability to work and his further suitability after the disease for his previous work. It is created on the basis of the district medical institution and adopts in the order of a collegiate meeting.
You can pass it not only at the place of permanent registration, but in any city where a person lives (Government Decree No. 95 of February 20, 2006).
How is MSEC going?
The first thing to do is to submit an application for examination to the ITU office, which is located at the place of your stay. It is written by the citizen himself or his authorized person on the basis of a notarized power of attorney.
What will be included in the application:
- name of the bureau, surname and initials of the head;
- passport information of the candidate, his address of residence;
- request for an examination; its purpose;
- your consent to receive and process your personal information;
- passport details of your authorized representative (if you act through him);
- through which channel they preferred to keep in touch with you (telephone, e-mail, mail);
- date, signature.
The next step in the vtek, how the commission goes, is the preparation of your package of documents. All analyzes and medical papers must bear the seal of the institution, not only the personal seal of the attending physician. If you have x-rays and sick leave, attach them, they will be needed. Please remember that the "shelf life" of certificates is a maximum of one month.
If, for some reason, there is a lack of documents, do not be discouraged, submit only an application - there are still ten days to bring the missing "papers".
The application is submitted to the office of the bureau where you apply and is registered in the register. Now wait. Within five days will be invited for examination. Receive an invitation with the exact address, time and number of the office where you should come. And with the expectation that you had to wait at the office for no more than half an hour.
It can be carried out in absentia or in a hospital - if the citizen confirms that he is unable to reach the institution.
You should take a clean sheet with you to the examination, as well as a book or a tablet computer - so that you don’t get bored waiting in the corridor.
You may be assigned an additional examination (Order of the Ministry of Health and Social Development No. 295n. But you can refuse it, this is your right.
Then the decision to assign a disability (or lack thereof) is made on the basis of the data that doctors have in their hands.
The results of the meeting are communicated to the candidate immediately, without delay. If the examination was carried out without your presence, then the results will be sent to the link indicated in the application.
If there are good reasons to disagree with the conclusions of the luminaries - do not agree. It depends on how you live. But don’t immediately rush into objections simply because you read what you were most afraid to see.
If you are going to challenge, you should not immediately rush to court, this is the last resort. You can appeal either to the same bureau where you were examined, or to the Main or Federal. The main thing for this is to indicate what the essence of the claims is, on what they are based.
If, however, the federal authorities remain deaf to the arguments, then an independent examination is appointed and an application is submitted to the court. One month is allotted for appealing the decision.
The result of the commission's decision will be reflected in a special act. Certificate will be handed out, and an extract from the inspection report will be sent to the social security institution (or pension).
Upon assignment of a disability, an individual rehabilitation program is also assigned.
Making an expert decision
Specialists conduct a survey of a citizen, they also study his social and living conditions, what kind of work he worked, how harmful it was. All medical documents will be carefully studied and, on the basis of this, a conclusion will be made whether the person will recover from the disease or not, as well as how much he will need social support.
Not a pleasant moment.- may be recognized as disabled if they find at least one item from the following list:
- the subject needs to apply to the social protection authorities;
- there are serious violations of body functions, health is significantly undermined;
- permanent disability.
ITU Help - what is it and where can I get it?
It is issued to a citizen on the fact of passing the examination. It indicates which institution he went there and on what basis. Next is the verdict of the doctors. It doesn't matter if you are recognized as a person with a disability or not.
In the first case, it is indicated which group was assigned, in the second - the decision with which you were released home. It also indicates the degree of ability to work and the need for transfer to an easier job (and if transferred, then by how much).
Sick leave and act
Based on the results of the examination, a certificate with an application in the form of an extract from the act will be issued.
The act of examination in the bureau of medical and social expertise itself is a document that will contain:
- passport data;
- information about education, qualifications;
- information about living conditions;
- psychological characteristics;
- degree of loss of health;
- forecast;
- data on work - the degree of harmfulness, compliance with sanitary criteria, the frequency of business trips, etc.
- sources of income of the subject;
- the patient will recover from the disease completely or he needs support in this;
- the level of endurance, including emotional;
- Is it easy for a person to get along with people?
- what hobbies he has, how he behaves in society.
The ITU certificate of disability is handed over to the subject, and the extract is sent to the social protection authority or a division of the PFR.
As for sick leave, it plays a role here whether you need a new sick leave or want to extend the existing one.
The fact is that the Bureau of Medical and Social Expertise itself does not extend them. It can issue a document stating that you are not disabled, or that rehabilitation has not been completed. The sick leave will be extended by the clinic from where they came to the ITU.
The ITU Bureau, where the examination took place, can issue a certificate of incapacity for work to those who were not recognized as disabled and who were considered unsuitable for “write-off”, that is, the person will still return to work. In this case, the institution issues a sick leave, the extension period of which will be at least thirty days. Or - until the date of the next re-examination.
If you have the prospect of an expert examination - do not be nervous and do not curse fate. The state will do everything to help you live, not exist. The main thing for this is not to interfere with those who are engaged in healing. But do not be indifferent to determining your fate, refer to other specialists in case of questions or doubts.
Last year, the administration of the President of the Russian Federation received more than 130,000 complaints about the work of the medical and social expertise: about the incompetence and bias of specialists, about corruption and increasing errors. Every week, the Public Chambers of the regions register dozens of appeals from citizens.
The situation in the ITU system is out of control, according to the chairman of the Commission on Social Policy, Labor Relations and the Quality of Life of the OPRF, Vladimir Slepak. 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 Grigoryevna sent a letter to the editorial office from a young woman with a disability, telling about her trip to the next commission. Showed that journalists understand what people with disabilities face. There are no generalizations and analysis of problems, but there is resentment, frankness, and just real life ... We immediately contacted the author: is it possible to publish it? "Why not? I don’t mind,” said Ludmila Simonova, a wheelchair user from Bashkiria.
“Grandma is disabled, she has diabetes, and she has been in line for 7 hours ...”
“I have a disability group I since 2008. Injury to the cervical spine, dysfunction of the pelvic organs, explains Lyudmila Simonova. - I live in the village. I recently went to my doctor and got tested. He wrote a letter and sent it to the city to see a urologist, a neurologist, and so on.
I'm going to the city of Beloretsk for a hundred kilometers. Doctors receive at different times and on different days - whoever is lucky to make an appointment. I had to live in the city for a week to get around everyone. I did not find a proctologist, so I went to the next city - Magnitogorsk. Another hundred kilometers… The building is not suitable for wheelchair users, the premises are old, the plaster is falling off, it is damp and cold inside. People wait in line for hours. From one 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 after eight hours. She said: "How to plow the shift." The other was crying, begging to be accepted. The old woman is disabled, she has diabetes, she wanted to eat, and she stood in line for 7 hours. ITU workers walked past with stone faces and pretended not to notice anything.
There has been no ITU in Beloretsk recently, experts from Ufa come to us on certain days. I had to live in Beloretsk, wait for the specialists to arrive. Well, 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 much it would take to dangle from the village to the city on impassable roads (we don’t have asphalt), to rent a car, because our buses are not equipped for wheelchair users.
This time, employees of the ITU Bureau No. 6 of 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 means of rehabilitation that would make life easier and help to adapt and adapt. It is not for nothing that the word “habilitation” was added to the individual rehabilitation program. I thought that the ITU should work for the disabled, but I was wrong. I sat in line, they called me, looked at me and said: “If we redo the IPR, then we remove half of what you have entered, you are not allowed to under the new rules. Better leave the old program and go home.”
How are they removed? By what law? It turned out that I was not supposed to have an electric wheelchair, but I am a "neck", my hands do not work well. Yes, I use an active wheelchair around the house, it is easy to put it in the trunk, lift it up the stairs with me to the third floor when I visit my sister in the city, but for walking around my village without asphalt with pits and bumps, an electric wheelchair is needed. And in 2012, she entered the program for me. Now they said: "We don't care where you live."
The experts did not agree with many decisions of the attending physicians and ignored their recommendations. They treated me and other disabled people as if we had come to them to ask for alms, they were rude. The commission gave a friend a disability group, and then called her to Ufa for a second 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 drive not a hundred, but three hundred kilometers, spend your money 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 the II disability group 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, everything that Lyudmila Simonova writes about is true?
- Of course. Russian disabled people overcome so many obstacles in order to pass a commission, get a status or receive subsidized drugs, that mom does not cry. Now it is impossible to get an appointment with a narrow specialist, bypassing the therapist - he gives directions. 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 100 to another. And, in theory, should be examined and receive assistance at the place of residence. The task of the ITU is not to challenge the diagnoses established by clinicians, but to determine the limitations of life. In our country, experts change diagnoses, cancel the recommendations of doctors, they say: "The patient has no pronounced disorders."
In the Federal Law of November 24, 1995 No. 181-FZ "On the Social Protection of Disabled Persons in the Russian Federation", disability is interpreted as "social insufficiency due to a health disorder with a persistent disorder of body functions, leading to a limitation of life and the need for social protection." In accordance with this, in addition to expert examination, ITU institutions are responsible for developing individual programs for the rehabilitation of disabled people 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 expertise is the duration and complexity of obtaining a disability group and rehabilitation services for citizens with disabilities through the examination procedure in ITU institutions. Currently, people with disabilities often refuse to go through bureaucratic procedures and solve problems at their own expense. The legal rights of the disabled are being violated. The ITU forces people to undergo unnecessary examinations, collect unnecessary tests, arguing that they allegedly discipline a disabled person: “At least once a year he will pass a medical commission, otherwise you won’t force him.” But, in fact, the ITU bureau today is a complex bureaucracy 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 composition of the bureau is the presence of at least one doctor in the ITU. However, the specialty of the doctor 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 VTEKs, there were three doctors in the commission. Then they tried to include 5 specialists. Three experts are currently working, one of them is on medical and social issues. Moreover, clarifications about the specialization of the doctor were removed from the documentation. Specialists do not go to ITU, since it is impossible to get a category, it is not taken into account.
ITU General Bureaus examine citizens with a variety of diseases, and no matter how competent a doctor in ITU is, it is almost impossible to navigate well in all nosological forms. And the psychologist and rehabilitation specialist included in the bureau are not competent at all in the issue of establishing disability.
In addition, according to the rules approved by the 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 experts who conducted the ITU. If there is only one doctor for medical and social expertise, the objectivity of such a vote is doubtful - the main condition for recognizing a person as a disabled person to this day remains the type and severity of impaired body functions, which can only be determined by an ITU doctor (with the exception of mental functions).
In other words, the ITU bureau turns into a bureau for issuing disability certificates, which significantly increases the corruption component and significantly reduces the objectivity of the decision.
— Disabled people complain about the low professional level of ITU specialists in the regions. They say that they even confuse 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 advanced training institute for doctors. And in the ITU federal bureau. The level is really low. There are few professionals: the leaders are weak, sometimes it is embarrassing to listen to them - they do not know the regulatory documents, they are poorly versed in the legislation, and the experts in the regions do not have enough knowledge and competencies to understand and execute the orders of the Ministry of Labor of the Russian Federation. This is sad, because the ITU system is an absolute monopoly. Her decisions cannot be challenged. In the pre-trial procedure, an appeal is carried out in the service itself: with one composition, with another, and then you need to contact the federal bureau, where often the documents sent are not opened at all. I defended my candidate and doctoral thesis there and repeatedly saw how the meetings are held, how the experts do not see the patient, do not study the documentation, but immediately take the decisions of the main bureau of the region as a basis. Decisions rarely change. Sometimes the courts, considering the claims of the disabled, decide: undergo an examination in any region of your choice. And which region will change its mind after the federal bureau?
No independent expert can approach the service, since there is no independent ITU by law - the license is given only to federal agencies. Therefore, no matter how objective and fair the opinion of an independent expert is, it will not affect the change in the decision of the federal institution ITU.
- The Public Chamber of the Russian Federation proposes to consider “ITU errors 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 rates. I'll probably put up tariffs for the card soon - there are a lot of complaints from people with disabilities. I remember when I was first told that in Vorkuta the II disability group costs 450 thousand rubles, I did not believe it. And then people confirmed. In the same Vorkuta, a surgeon was caught red-handed. It is especially scary when they extort money from real people with disabilities. Alas, this is also part of the system. It needs to be changed, but I no longer believe the talk about the reorganization of 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 did not offer anything specific.
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, Rostov-on-Don. The leaders were removed a few years ago, and on the ground the specialists of the primary bureaus both worked 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 the medical commission of a medical organization on the proposal of the attending physician on the basis of the data of the primary medical documentation, without filling out a referral to the ITU. Currently, the attending physician presents to the medical commission a patient with temporary disability, a disabled person with a deterioration in 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 the specialists of the ITU bureau determine the disability group without knowing anything about the patient (if we are not talking about re-examination) and rely only on the submitted medical documents and a single examination of the patient within a few minutes.
I consider it expedient to abolish the ITU service, and entrust the conduct of the ITU to the medical commissions of healthcare organizations, especially since the medical commission currently performs most of the functions to one degree or another. The reform will require a change in the procedure for medical institutions to conduct an examination of disability, a revision of the functional duties of medical commissions of primary care medical organizations. On the other hand, it will make it possible to shorten the route of movement of citizens with disabilities, simplify the examination procedure, improve the quality and expand the volume of medical and social rehabilitation services provided to the disabled.
The liquidation of the ITU service by transferring its functions to medical commissions of medical organizations will allow:
reduce social tension among the disabled and citizens who are initially sent to the ITU (the long procedure for filling out referrals to the ITU and subsequent examination at the bureau will be excluded);
reduce federal budget expenditures on the maintenance of the ITU service;
reduce the burden on specialists of the medical commission and doctors of a medical organization by eliminating the need to fill out a referral to the ITU;
increase the availability of expertise for the population, because medical commissions exist in all medical organizations, while the ITU bureau is created at the rate of 1 bureau for 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 the ITU bureau specialists;
to legislate an independent ITU.