Asthma disability in adults how to get. Medical and social expertise in bronchial asthma

Bronchial asthma is one of the most common diseases, covering about 10% of the total population. Its signs are asthma attacks and coughing, in connection with this, performance in dusty rooms is sharply reduced. But do they give disability in bronchial asthma based on the diagnosis and physical condition of the patient?

The severity of the development of the disease

When assigning a disability, the stage at which the symptoms can be stopped with the help of medications prescribed by the attending physician is not taken into account. Bronchial asthma is divided into only 4 degrees of flow. Each of them is classified according to certain manifestations.

First degree

It is the easiest, so disability is not assigned. There is intermittent asthma with the following symptoms:

Attacks of suffocation can occur during the day up to once a week and twice at night per month.
Relief of shortness of breath occurs spontaneously or with the use of a high-speed inhaler.
The manifestation of exacerbations is observed no more than once a year, while the use of glucocorticosteroid drugs is not required.

A persistent form is also possible, in which short-term suffocation overtakes 2 times during the day and at night per month. Removal is carried out by inhalation aerosol in a metered amount. The level of PSV (peak expiratory flow rate) is more than 80%, and with the use of Salbutamol it rises to 95-100%. At this stage, asthma in adults and children is curable, and obstructions that prevent breathing are not detected on x-rays.

Second degree

Persistent moderate asthma has the following symptoms:

suffocation overtakes: during the day - 2 or more times, at night - 1-2 times a week;
exacerbation is possible up to 4 times a year;
the use of corticosteroids (glucocorticosteroids) per day - 1000 mgc;
the need to use 2-agonists every day;
PSV varies from 80 to 60% and can decrease by 20% during physical exertion;
respiratory failure (DN) 1 degree is characterized by shortness of breath with 25 breaths per minute;
Hypoxemia occurs due to lack of oxygen in the blood.

Asthma is controlled, but there may be difficulties in breathing, movement and labor activity of 1-2 degrees.

Third degree

It is severe, therefore, it often provides for obtaining a disability group. It is characterized by daily attacks of suffocation, while exacerbations overtake more than 5 times a year. Treatment is possible only in stationary conditions. The PSV level is less than 60% with a possible decrease to 30%.

As drugs, corticosteroids are used at a dose of more than 1000 mcg per day, and there is a dependence on their use. Dyspnea is classified as DN grade 2 or 3 with an increase in respiratory rate up to 30 times per minute. Fluoroscopic examination reveals lung or diaphragmatic obstruction. The disease is practically uncontrollable and limits the patient in movement and work of 2-3 degrees.

fourth degree

Particularly severe and occurs with chronic obstructive pulmonary disease (COPD) or asthma. Signs:

Attacks of suffocation - 2 or more times a day with a lack of control of the disease.
The need to use large doses of glucocorticosteroid drugs.
The indicator of shortness of breath is 3-4 degree, while even light physical and psychological stress is unacceptable.
Complications of the respiratory tract, 3-4 degree disability and self-service.

Obtaining disability for asthma of this degree is possible in 95-100% of cases. At the same time, deterioration in health should be constantly documented. The relief of suffocation is carried out by an ambulance team or directly in the clinic.

Varieties of disability groups

Patients with asthma may experience a variety of symptoms. The course of the disease is imperceptible or with serious complications, so disability is classified into several groups. With a minor form of the disease, in rare cases, it is possible to obtain the status of a disabled person of the third group, when the patient complains of such symptoms:

Partial disability.
Shortness of breath during exercise.
Problems with self-service and movement.

The second group is assigned if there is an average severity of the disease. Then some heart diseases, shortness of breath with light exertion, disruption of the circulatory system and adrenal glands, and diabetes mellitus appear. There are also difficulties in self-service.

In order for the ITU to establish the first group of disability, the patient must complain of such signs as: severe or chronic asthma of 3-4 degrees, severe shortness of breath at rest, diseases of the lungs and bronchi, pathologies of some internal organs, partial or complete disability, frequent bouts of suffocation. It is also possible the manifestation of mixed symptoms, then the determination of the group is carried out on the basis of the latest indications of the attending physician.

List of documents for registration of a group

The main document submitted for medical and social examination (MSE) is a certificate from the attending physician of the form o88\y-o6. You should also prepare the following documents for submission:

Application from your own or authorized person.
Original and copy of birth certificate or passport.
Medical certificates, extracts and x-rays from the patient's outpatient card (original and copy).
A copy of the work book or certificate of education.
Extracts with periods of incapacity for work on sick leave.

All patient extracts, diagnoses from treating specialists, as well as the referral must have the seal of the doctor, the signature of the head physician and the seal of the medical institution. If the document has not been certified by the LPU seal, it will not be accepted until the necessary requirement is met. After the documents have been accepted, the time for the commission is set, where it is necessary to fully describe the problem based on the diagnosis and the patient's current state of health.

You will also need a description of the course of bronchial asthma, an extract on the conduct of therapeutic measures and what drugs were used. The procedure for assigning a disability group can be carried out at home or in absentia, if the patient is seriously ill and unable to independently appear at the commission. To do this, you need a certificate from a medical institution with medical protocols.

If a person believes that the refusal to receive benefits is unreasonable, he has the right to ask the experts for an explanation of the reason for such a conclusion. Submission of documents for re-examination and appeal of the verdict is carried out in the Main Bureau of Medico-Social Examination. However, such a procedure must be carried out no later than one month from the date of refusal. Acceptance and invitation for examination is also determined within a month.

An example of re-acquiring a disability based on a primary examination

If you managed to get disability due to asthma, then the registration date is considered from the moment of submission of the referral and related documents. However, pension accruals under the benefit are issued only from the date of submission of the relevant application to the Pension Fund. In order for them to be carried out as early as possible, you should immediately contact the FIU.

Privileges

After receiving the group, you can count on benefits:

For therapeutic and preventive measures in boarding houses and sanatoriums.
When taking out a mortgage, as well as waiting lists for housing and other real estate issues.
To provide better working conditions (if health permits).
To receive a free annual voucher to medical institutions.
To receive medicines free of charge or at a discount of up to 50%.

In case of bronchial asthma in children, the state may issue special benefits. These include rights to free public transport, free dairy products and medicines. Permission is also issued to parents for an additional day off per week, exemption from business trips, night shifts or overtime work. The mother of a sick child retires early.

Obtaining a disability is not possible in all cases, however, if there is an opportunity and a chance, it is recommended to apply to the ITU. If the state of health indicates that, then it will be possible to get a group, however, the problems and complications caused by the disease should be characterized as fully as possible.

Do asthma patients get disabled? This is a fairly common question, to which not all patients know the exact answer. Bronchial asthma is a long-term, practically incurable disease, sometimes leading to quite serious complications.

As a rule, the process starts with a mild degree, attacks in which are very rare, and outside the exacerbation, the disease does not make itself felt. Over time, the course of the disease worsens, the frequency of attacks increases. Even outside the exacerbation, patients complain of a significant decrease in working capacity, a constant feeling of lack of air, and poor health.

Sometimes the disease progresses and with the right treatment, even hormonal drugs can be included in the therapeutic complex. If the course of the disease worsens every year, the patient is not able to perform his usual work, you should think about making a disability.

Third group of disability

This group can be established in patients with mild and moderate bronchial asthma. In this case, the patient can receive hormonal therapy. The criteria for establishing the third group of disability are the following signs:

development of respiratory failure. Its symptoms appear already during the usual physical labor.
The exclusion of the opportunity to engage in the usual work activities.
Limitation of self-service and independent movement.
The need to change activities, downgrade skills or reduce the usual scope of work.

Disability of the second group

The second group is given to patients with the second and third severity of bronchial asthma, with a pronounced deterioration in general well-being. Criteria:

Severe respiratory failure, the manifestation of its symptoms with little physical activity.
Attachment of heart failure.
Severe impairment of peripheral circulation.
Concomitant diseases - diabetes mellitus, disruption of the endocrine organs (adrenal glands) as a result of hormone therapy.
Severe limitation of physical activity and self-care.
Inability to perform professional tasks.
For work, patients require special conditions, it is possible to continue their professional activities at home.

The first group of disability

The design of the first group is indicated for patients with a severe form of bronchial asthma, stubbornly progressing despite the implementation of therapeutic measures. The following states are the criteria for creating a group:

Bronchial asthma is not amenable to ongoing therapy, its course is constantly aggravated.
Respiratory failure is pronounced, patients are tormented by shortness of breath at rest, emphysema is noted.
Severe heart failure.
The development of severe complications from the internal organs.
Complete restriction of self-service and independent movement, the need for outside care.
Complete loss of the opportunity to carry out any work activity.

Bronchial asthma does not necessarily lead to severe complications, in which the patient's vital activity is significantly limited. The disability group is drawn up individually in each clinical case. In this case, the basis is the severity of the underlying disease and comorbidities, the severity of complications (including those caused by taking hormonal drugs). An important role is played by the violation of the respiratory system, and the ability to perform the usual work. The qualifications of the patient, the nature and working conditions are also taken into account.

Third group of disability
Disability of the second group
The first group of disability

Third group of disability

development of respiratory failure. Its symptoms appear already during the usual physical labor.
The exclusion of the opportunity to engage in the usual work activities.
Limitation of self-service and independent movement.
The need to change activities, downgrade skills or reduce the usual scope of work.

Disability of the second group

The second group is given to patients with the second and third severity of bronchial asthma, with a pronounced deterioration in general well-being. Criteria:

Severe respiratory failure, the manifestation of its symptoms with little physical activity.
Attachment of heart failure.
Severe impairment of peripheral circulation.
Concomitant diseases - diabetes mellitus, disruption of the endocrine organs (adrenal glands) as a result of hormone therapy.
Severe limitation of physical activity and self-care.
Inability to perform professional tasks.
For work, patients require special conditions, it is possible to continue their professional activities at home.

The first group of disability

Bronchial asthma is not amenable to ongoing therapy, its course is constantly aggravated.
Respiratory failure is pronounced, patients are tormented by shortness of breath at rest, emphysema is noted.
Severe heart failure.
The development of severe complications from the internal organs.
Complete restriction of self-service and independent movement, the need for outside care.
Complete loss of the opportunity to carry out any work activity.

allergolife.ru

Disability groups for patients with bronchial asthma

In patients with bronchial asthma, the disease process proceeds in different ways. Some suffer from a mild form, while others have a progressive severe form of the disease. Accordingly, the disability groups are different.

Third disabled group given for mild to moderate disease. The features of these forms are as follows:

with a decrease in the ability to work;
impossibility of independent movement, self-care;
manifestation of the disease during daily physical exercises (respiratory failure).

To the second group disability can be attributed to patients with such symptoms;

In addition to bronchial asthma, heart failure is manifested.
A clear disorder of the peripheral circulation.
Inability to perform their professional activities.
In parallel with this disease, the patient has a violation of the adrenal glands (after undergoing hormone therapy), diabetes mellitus.
Limited physical activity in self-service.

first group assigned to patients with progressive severe bronchial asthma.
The criteria for group formation are as follows:

aggravation of the disease, despite ongoing therapy;
at rest, the patient suffers from shortness of breath;
emphysema develops;
there are complications in the work of internal organs;
stably manifested heart failure;
constant care is required, a person is limited in self-service;
unable to work.

Important! With any degree of severity of the course of the disease, even with favorable dynamics of treatment, military service is unacceptable. If there is a dynamics of changes in bronchial reactivity over 5 years, then the conscript is recognized as limited fit.

Your actions for obtaining a disability - how to apply for it in case of bronchial asthma

No one except you yourself will worry about your health, so you should take care of receiving disability benefits. To do this, take the following steps:

♦ First. Discuss this issue with your doctor. He is obliged to write out a certificate so that you can pass a medical and social examination.

♦ Second. Pass a medical examination at the place of registration by filling out a special form (this paper is issued by the district doctor).

♦ Third. After receiving the results of the tests, and going through all the doctors, take a referral to the ITU from the attending physician.

♦ Fourth. At the place of residence, sign up for an examination of the results of the medical examination in the Office of Medical and Social Expertise. They will appoint a day for the appearance and conduct an examination. In addition to the referral issued by your doctor, please bring with you:

Your passport.
Medical insurance policy.
Certificates issued by doctors.

♦ Fifth. Come on the appointed day, undergo an examination and receive a group or a refusal.

bronhial.ru

Members of the ITU (Medical and Social Expertise), when assigning disability in bronchial asthma, take into account many criteria. Disability, quality of life and features of the organization of medical and social expertise of patients with bronchial asthma and medical and social aspects of disability and rehabilitation of people with disabilities due to bronchial asthma Bronchial asthma(BA) is a chronic inflammatory disease of the respiratory tract, which involves mast cells, eosinophils and T-lymphocytes.

In susceptible individuals, this inflammation leads to repeated episodes of wheezing, shortness of breath, chest tightness, and coughing, especially at night and/or early morning. These symptoms are accompanied by widespread but variable obstruction of the bronchial tree, which is at least partially reversible, spontaneously or under the influence of treatment. Inflammation also causes a friendly increase in airway response to various stimuli.
Epidemiology. According to studies, from 4 to 10% of the adult and 10-15% of the child population of the world suffer from asthma. Etiology and pathogenesis. In the etiology of the disease, 5 groups of factors are distinguished, which, under certain conditions, lead to the progression of congenital and / or acquired biological defects of the bronchi, lungs, immune, endocrine and nervous systems. These factors include infectious allergens (pollen, dust, industrial, medicinal, allergens of mites, insects, animals, etc.); infectious agents (viruses, bacteria, fungi, etc.); mechanical and chemical irritants (metal, wood, silicate, cotton dust, acid and alkali vapors, fumes, etc.); physical and meteorological factors (changes in temperature and air humidity, fluctuations in barometric pressure, etc.); neuropsychic stress effects.
The main role in the pathogenesis of asthma is played by chronic inflammatory processes. There is a clear relationship between inflammatory changes in the mucous membrane of the respiratory tract with bronchial hyperreactivity and the degree of bronchial obstruction.
hypersensitivity of the tracheobronchial tree is manifested by a characteristic triad - bronchospasm, mucosal edema and hypersecretion, and can be caused by both immunological and non-immunological mechanisms.

Risk factors for the onset and progression of the disease:

1. Heredity (if one of the parents is sick - the probability of the disease in children is 20-30%, if the parent is sick with asthma - 75%).
2. Prolonged contact with household and professional allergens
(house dust, allergens of indoor plants, animals, mushrooms, food products); Occupational asthma is characterized by the dependence of the onset of the disease on the duration and intensity of exposure to the causative factor (the absence of a previous respiratory symptom, the development of symptoms no later than 24 hours after contact with the causative factor at work, the elimination effect; the prevalence of cough, wheezing and shortness of breath in the clinical picture).
3. Chronic infection of the lungs.
4. The presence of prolonged or intense psycho-emotional stress.
5. Increased tone of the parasympathetic division of the autonomic nervous system.
6. Endocrine disorders (hyperthyroidism, fibromyoma, adrenal insufficiency).
7. Features of the development of children: high levels of immunoglobulins E, early artificial feeding, dysfunction of the gastrointestinal tract, food and drug allergies, frequent acute respiratory infections, passive smoking.

Classification.

According to the international nomenclature, the following forms of BA are distinguished:

1. Immunological (exogenous, atopic).

2. Non-immunological (endogenous).

3. Mixed.

In clinical practice, the classification of BA according to severity is used:
light, medium and heavy.

Clinical picture and diagnosis.

The main clinical manifestations of asthma are paroxysmal cough,
feeling of choking or difficulty breathing; hard breathing; wheezing and buzzing rales, the attack is completed by the separation of viscous sputum, after which breathing becomes freer and dry rales gradually disappear.

Laboratory data: eosinophilia in the blood, sputum changes (Curshman spirals, eosinophils, Charcot-Leiden crystals); positive results of allergological tests and an increased content of immunoglobulin E (with an immunological form); determination of indicators of the activity of the inflammatory process (with non-immunological asthma).

Examination of the function of external respiration: 1) spirography with an assessment of FEV1, FVC,
and peak expiratory flow (PEV). An important diagnostic criterion is an increase in FEV1 (more than 12%) and PSV (more than 15%) after inhalation (short-acting 3r-agonists. 2) peak flow - daily variability depending on the severity of the disease is more than 15%.

Current and forecast. With a mild intermittent (episodic) course of BA
exacerbations of the disease occur 1-2 times a year; asthma attacks are mild, short-term, less than 1 time per week, nighttime - less than 2 times a month, they are stopped on their own or using inhalers. In the interictal period, there are no signs of bronchospasm, the function of external respiration is within the normal range: FEV1, PSV> 80%, daily variability (daily fluctuations in PSV) -15-20%. In most cases, it is atopic asthma.
With BA of a mild persistent course, asthma attacks occur 1 time per week or more often, but less than 1 time per day, night attacks - more than 2 times a month; exacerbations of the disease can disrupt activity and sleep; PSV more than 80%, daily variability 20-30%.
With moderate asthma, asthma attacks can be daily, night attacks - more than 1 time per week; symptoms disrupt activity and sleep; daily intake of short-acting b2-agonists is required; FEV1 and PSV within 80-60%, daily fluctuations in PSV over 30%.
Severe asthma is characterized by persistent symptoms during the day, frequent exacerbations with severe asthma attacks, frequent nocturnal attacks; physical activity and quality of life are significantly reduced; FEV1 and PSV less than 60%, daily fluctuations in PSV more than 30%.

The prognosis of the disease, in addition to the severity of the course, is determined by the severity
complications: 1) pulmonary complications: status asthmaticus, pulmonary emphysema, respiratory failure, atelectasis, pneumothorax, thromboembolism of the pulmonary artery and its branches; 2) extrapulmonary complications: chronic cor pulmonale, heart failure, hypoxic ulcers, etc.; 3) complications of AD treatment: steroid diabetes, steroid ulcers, osteoporosis, steroid obesity, secondary adrenal insufficiency, etc.

Principles of treatment. In the treatment of AD currently used "stepped"
an approach in which the intensity of therapy increases (step up) if asthma worsens and decreases (step down) if asthma is well treated. The least severity of asthma is presented in stage 1, the greatest - in stage 4.
Prophylactic drugs for long-term use - basic therapy: inhaled corticosteroids (beclomethasone dipropionag, budesonide, fluticasone propionate, aldecine, beclocort, etc.); non-steroidal anti-inflammatory drugs (sodium cromoglycate and nedocromil are effective in preventing bronchospasm provoked by allergens, exercise and cold air); long-acting b2-adrenergic agonists (salmeterol, formoterol); theophyllines of prolonged action; leukotriene receptor antagonists (zafirlukast, montelukast - improve respiratory function, reduce the need for (short-acting b2-agonists, effective in preventing allergen-induced bronchospasm, exercise); systemic corticosteroids. actions (salbutamol, fenoterol, terbutaline, etc.); anticholinergics (ipratropium bromide, berodual); systemic corticosteroids (prednisolone, etc.); short-acting theophyllines (eufillin, aminophylline).

WUT criteria. During the exacerbation of BA, patients are temporarily unable to work. At
non-immunological, mixed forms of BA, the terms of treatment are determined by the nature and severity of the infectious exacerbation, the effectiveness of treatment, the severity of complications (DN, decompensation of chronic pulmonary heart): mild course - up to 3 weeks; moderate severity - 4-6 weeks; severe course - more than 6 weeks.
With immunological asthma of a mild course, the period of temporary disability is 5-7 days, of moderate severity - 10-18 days, of severe course - over 35 days. (depending on complications, effectiveness of therapy).

Criteria for mild asthma:
attacks no more than 1 time per month, mild, quickly stopped (with bronchodilators or on their own); there are no night attacks or they are rare, do not affect the child's sleep and his physical activity; outside the attack, there are no signs of bronchial obstruction, remission lasts up to 3 months or more, the physical development of the child does not suffer; forced expiratory volume and average daily bronchial patency - 80% and above, average daily bronchial lability - below 20%; basic treatment is either not carried out, or is carried out with drugs of the intala group.

Criteria for moderate asthma:
asthma attacks of moderate severity, with impaired function of external respiration, 3-4 times a month; night attacks up to 2-3 times a week; the child's physical activity is reduced, sleep is disturbed, physical development does not suffer; out of an attack, clinical and functional remission is incomplete, its duration is less than 3 months, relief of an attack is possible with the use of inhaled bronchodilators or parenteral corticosteroids, the average daily bronchial patency is 60-80%, the average daily bronchial lability is 20-30%; basic treatment is carried out with drugs of the intal group, and if they are ineffective
medium dose inhaled corticosteroids.

Criteria for severe bronchial asthma: asthma attacks almost daily and almost every night, which disrupts the physical activity, sleep and physical development of the child; in the interictal period, the phenomena of bronchial obstruction with signs of ARF persist, the duration of incomplete remission is no more than 1-2 months; for the relief of seizures, hospitalization is required (in a pulmonological hospital and an intensive care unit); average daily bronchial patency - less than 60%, average daily bronchial lability - more than 30%; basic treatment - high doses of inhaled corticosteroids.

Contraindicated types and working conditions: hard physical labor, work,
associated with severe mental stress, exposure to allergens that cause bronchospasm, adverse microclimatic factors (temperature changes, pressure, high humidity, etc.), in conditions of dustiness, gas contamination; types of labor activity, the sudden termination of which due to an asthma attack can harm the patient and others (air traffic controllers, drivers of vehicles, work related to staying at height, servicing moving mechanisms, on a conveyor, etc.); long business trips. With the development of DN II Art. work associated with physical stress of moderate severity, significant speech load during the working day is contraindicated.

Indications for referral to the ITU Bureau: the presence of contraindications in the conditions and nature of work and the impossibility of employment in an accessible profession without reducing qualifications or a significant decrease in the volume of production activities; unfavorable clinical and labor prognosis (severe, complicated course, treatment failure, etc.).

Required minimum surveys when sending to the ITU Bureau: clinical blood and urine tests; biochemical analysis of blood - the content of sialic acids, C-reactive protein, total protein and fractions, sugar, electrolytes; general sputum analysis (with non-immunological BA - culture for flora and sensitivity to antibiotics, for VC); KOS and blood gases; ECG; chest x-ray; spirography (if necessary, testing with anticholinergics, b2-adrenergic agonists); peak flowmetry; pulmonary artery rheography or Doppler echocardiography (to detect pulmonary hypertension).

Additional laboratory and instrumental research methods are carried out depending on the indications. For example, with constant intake of corticosteroids per os (more than 1 year), it is necessary to study the function of the adrenal cortex, exclude steroid ulcers and diabetes, osteoporosis (if there are relevant complaints and objective data), etc.

disability criteria. When evaluating life limitations, take into account
the form and severity of the course of asthma, the severity of complications, including those caused by the therapy, the effectiveness of treatment, the severity of concomitant diseases; education, profession, qualifications, nature and working conditions, labor orientation.

Disability III group installed in patients with mild to moderate asthma
currents, including hormone-dependent, DN I and II Art. with limited ability to work, self-service, movement - I st., working in contraindicated types and working conditions and in need of rational employment (decrease in qualifications or a decrease in the volume of production activities).

Disability II group installed in patients with moderate to severe BA
course with persistent severe disorders of respiratory and circulatory function (DN II-III stage and HF stage IIA), as well as endocrine system dysfunctions (diabetes mellitus, adrenal insufficiency) caused by steroid therapy, with limited ability to self-care, movement, learning II Art. In some cases, patients can work in specially created conditions, in particular, at home, taking into account professional skills.
Disability I groups are established in case of severe progressive course of BA,
refractoriness to treatment, the development of DN stage III, heart failure stage IIB-III, other irreversible complications, with limited ability to self-service, movement, work activity stage III.

Prevention and rehabilitation. Primary rehabilitation should be carried out in practically healthy people in the presence of biological defects that pose a threat to the development of asthma: exclusion of all trigger mechanisms (allergens; upper respiratory tract infections, including viral ones, especially in children; provoking drugs; psychotraumatic factors; physical overload; gastroesophageal reflux), as well as early and long-term anti-inflammatory therapy.

Secondary prevention of asthma should include elimination from the environment
adverse factors (allergens, irritants, etc.), the organization of the regime of life, physical education, rational employment arrangements, timely training and retraining, organization of the work of asthma schools and asthma clubs; preparation of printed, video, audio educational products, creation of an association of patients. It is necessary to conduct individual work with patients, including communication with psychologists.
The basis of secondary prevention is timely and adequate treatment at all stages (outpatient, inpatient, sanatorium-resort); drawing up and monitoring the completeness and quality, timeliness of the implementation of an individual rehabilitation program for a disabled person.

krasgmu.net

Disability groups

The disability group is assigned on the basis of the severity of the disease, the patient's ability to perform professional activities and self-care. Equally important is the possibility of psychological interaction with people.

Based on the severity of the manifestations of bronchial asthma, there are 3 groups of disability:

Third group

Disability in mild asthma 3 groups are given in the presence of an average stage of the disease. Only then the patient is limited to work. In some cases, a reduced working day and restrictions on employment with harmful substances (smoke, dust, paintwork, etc.) may be recommended. As a rule, glucocorticosteroids are recommended for such patients.

Such disability is established for patients with bronchial symptoms of moderate severity.

Group 3 is established on the basis of the following symptoms:

insufficient respiratory functionality, the symptoms of which can appear during physical exertion;
inability to work;
difficulties of movement and self-care.

In this case, it is necessary to reduce the workload, and in some cases, labor activity.

Second group

Disability due to asthmatic disease of the 2nd group is given as a result of a violation of the pulmonary function of the middle stage. In addition, it is established in case of violations in the hormonal background, malfunctions in the endocrine system, which leads to impaired functional abilities of the kidneys and pancreas. Such complications, as a rule, contribute to the onset of diabetic diseases.

The criteria for registration of group 2 asthma are:

obvious manifestations of respiratory failure, the symptoms of which are noted even with minimal physical exertion;
symptoms may be complicated by heart failure;
obvious violations in the peripheral circulation;
the presence of concomitant diseases, such as diabetes and malfunctioning of the adrenal glands, which occur after hormone therapy;
the impossibility of self-service and the performance of professional activities.

When assigning group 2, the patient is prescribed the easiest working conditions with the possibility of home work.

First group

Disability, when asthma is most severe, provides for the establishment of 1 disability group. It is prescribed when the effects in the body are irreversible and is indicated for patients with increasing asthma symptoms that develop after specific therapy.

The criteria for registration of 1 group are:

cases when asthma is constantly complicated, despite ongoing treatment;
respiratory manifestations are pronounced, and shortness of breath may be present constantly, even at rest. Often there are emphysema in the lungs;

insufficient work of the cardiovascular system;

severe complications in the internal organs;
absolute inability to serve themselves and move independently. These complications require outside help;
complete loss of the ability to work of any kind.

It must be remembered that bronchial disease may not lead to disability. This issue is discussed on an individual basis, even if there are no obvious manifestations of the severity of the disease. The basis for the appointment of a medical commission can be comorbidities and analysis of the state of the body after taking hormonal drugs.

Rules for registration of disability

First of all, it is necessary to analyze the violations in the body that have occurred since the detection of asthmatic disease. As a rule, a disability is assigned to a patient on the basis of disorders in the body that occurred during the illness. If these changes are minimal or not at all, the patient may be denied the establishment of a disability group.

In case of bronchial disease, the medical commission may pay attention to the following complications:

repetitive and long-lasting suffocation;
insufficient work of the cardiac and pulmonary systems
chronic inflammation in the pulmonary system;
hormonal dependence of the patient.

Most often bronchial asthma develops in a delayed manner, especially in a child. In this case, drug treatment is prescribed, which effectively relieves an asthma attack, allowing the patient to lead a normal life for a long time.

At the initial stage, the patient must be registered in connection with a bronchial disease in local medical institutions, and then he is sent for treatment in a hospital.

Before applying for a disability, you should consult with a doctor who can offer alternative methods of the treatment regimen, if there are no contraindications to this.

The medical commission is held in the clinic, and then the therapist or pulmonologist makes their conclusion based on the results of the examination by all doctors, and issues a special form for the ITU. In any case, a doctor, even if he has doubts for registering a disability, is obliged to give a certificate for the ITU (medical and social examination).

Necessary examinations for obtaining a disability

blood sampling for general analysis;
blood for biochemistry;

it is necessary to collect a general urine test;
sputum culture;
conducting spirography;
radiography of the pulmonary region;
expert advice.

The severity of the condition depends on the appointment of additional examinations. For example, long-term use of hormone therapy requires an examination of the work of the adrenal glands.

List of documents for the medical commission

A patient with asthma should have:

passport (if it is missing - any identity document);
card with passed commission;
policy;
referral to the commission.

Based on the attached documents and a personal conversation, the expert commission makes a decision on the assignment or refusal of disability. If the patient does not agree with the decision of the commission, he can challenge the decision in the regional office.

It is important to know that in the absence of asthma exacerbations, this disease can interfere with the full life of the patient and especially the child. Therefore, the right to receive a disability to any person is legally enshrined.

allergiyanet.ru

In what cases is disability due to asthma.

Despite the fact that asthma is a serious disease, specialists in medical and social expertise believe that it is quite possible to lead a full life with it. Therefore, not in every case, if there is an appropriate diagnosis, it is impossible to obtain a disability. This is due to the following factors:

The development of the disease is slow. At the time of diagnosis, the patient's condition may be quite satisfactory. Attacks of suffocation occur infrequently and are quickly stopped.
Respiratory and cardiovascular insufficiency is absent. Inflammation of the bronchi occurs rarely and the patient can continue to lead an active lifestyle, fully study and work.
The disease can be controlled by a medical course of treatment, sanatorium-resort rehabilitation and properly selected nutrition.

Accordingly, in order for an asthmatic to be given a disability, it will be necessary not only to confirm the diagnosis, but also to establish the severity of the disease. For example, children are sent to ITU only six months after they are diagnosed with asthma.

Disability groups in asthma.

The degree of severity of the disease depends on which disability group for bronchial asthma will be assigned.

The third group of disability assumes the presence of a diagnosis of "asthma" and the course of the disease in moderate severity. Attacks are long, but quickly stopped. In order to prevent a new exacerbation, hospitalization is possible. The third group with asthma in childhood indicates limited working capacity and ability to learn. Physical activity for children of this disability group is contraindicated.

Adults can be transferred to light work or reduced working hours. Working conditions must correspond to the characteristics of the disease: a well-ventilated area, the absence of dust and chemical fumes.

Second group. In this case, asthma is complicated by problems with the lungs, endocrine and cardiovascular systems, and digestive organs. Against the background of a deterioration in well-being, physical activity and the level of self-service decrease. Such patients need special working conditions and regular spa treatment. Children with the second group of disability due to asthma rarely attend kindergarten, and at school age they are transferred to home schooling.

The first group is given to patients in whom asthma has provoked irreversible processes in the body. Often, asthma of the first group is accompanied by coronary heart disease and pulmonary emphysema. The patient practically cannot serve and move independently, shortness of breath is present even at rest. Such patients are not capable of work and education.

Disability procedure.

The decision to assign a disability is made by the Medical and Social Commission. It is passed in the direction of a therapist, pulmonologist or pediatrician (if we are talking about children).

The attending physician also fills out an extract from the medical history, which indicates the severity of the disease and the frequency of attacks, dependence on hormonal drugs and the presence of complications. In addition, the patient undergoes the necessary diagnostic procedures (fluorography, ECG, spirogram), as well as tests (general blood and urine tests, blood for hormones).

Experts evaluate not only the severity of the disease, but also the quality of life of the patient (specialty, job functions, working conditions). Considering all the factors in the aggregate, disability is assigned.

Commission is by appointment. You must have with you: a passport or a birth certificate for a child, a medical policy, a referral and medical documents.

prava-invalidov.com

Members of the ITU (Medical and Social Expertise), when assigning disability in bronchial asthma, take into account many criteria. Disability, quality of life and features of the organization of medical and social examination of patients with bronchial asthma and medical and social aspects of disability and rehabilitation of people with disabilities due to bronchial asthma

Bronchial asthma(BA) is a chronic inflammatory disease of the respiratory tract, which involves mast cells, eosinophils and T-lymphocytes. In susceptible individuals, this inflammation leads to repeated episodes of wheezing, shortness of breath, chest tightness, and coughing, especially at night and/or early morning. These symptoms are accompanied by widespread but variable obstruction of the bronchial tree, which is at least partially reversible, spontaneously or under the influence of treatment. Inflammation also causes a friendly increase in airway response to various stimuli.
Epidemiology. According to studies, from 4 to 10% of the adult and 10-15% of the child population of the world suffer from asthma. Etiology and pathogenesis. In the etiology of the disease, 5 groups of factors are distinguished, which, under certain conditions, lead to the progression of congenital and / or acquired biological defects of the bronchi, lungs, immune, endocrine and nervous systems. These factors include infectious allergens (pollen, dust, industrial, medicinal, allergens of mites, insects, animals, etc.); infectious agents (viruses, bacteria, fungi, etc.); mechanical and chemical irritants (metal, wood, silicate, cotton dust, acid and alkali vapors, fumes, etc.); physical and meteorological factors (changes in temperature and air humidity, fluctuations in barometric pressure, etc.); neuropsychic stress effects.
The main role in the pathogenesis of asthma is played by chronic inflammatory processes. There is a clear relationship between inflammatory changes in the mucous membrane of the respiratory tract with bronchial hyperreactivity and the degree of bronchial obstruction. The implementation of hypersensitivity of the tracheobronchial tree is manifested by a characteristic triad - bronchospasm, mucosal edema and hypersecretion, and can be caused by both immunological and non-immunological mechanisms.