Terms of referral to ITU. What is a referral to ITU? Which medical and preventive organizations issue it and how to get it

The state has created a whole system of assistance for the social protection of those people who have persistent health disorders, injuries, cannot work, have limited opportunities for socialization. Its goal is to reduce the distance between a sick person and society. It consists of several components:

ITU - what is it

To resolve some of these issues in relation to each specific person requiring state support, they created a medical and social expertise (MSE). Strictly speaking, ITU is a state examination designed to resolve the issue of establishing disability for a particular person.

Among the main tasks of the MSE is to determine the degree of damage to the basic functions of the body of a particular person, identify possible ways of rehabilitation, and legally recognize him as a disabled person.

ITU structure

For each specific person who needs to establish a disability, an examination is carried out at the ITU office at the place of residence. They are branches of the Main Bureaus located in the regions.

There are city and district branches of the Main Bureaus, where you should come with a referral and documents. A disabled person can apply to the ITU at the place of residence (this may be the place of his stay) or at the location (if he left the Russian Federation). For example, to conduct ITU Moscow, one should contact one of the 95 branches of the ITU GB in Moscow (their addresses are posted on the official website of the Head Office).

In case of disagreement with the decision of the local branch, a person (or his guardian) can appeal it to the Head Office, as a rule, these are regional structures. Then the examination will be carried out here (in our example, it will be the ITU Headquarters for Moscow).

The main structure is the Federal Bureau of ITU. In difficult situations, in case of disagreement with the decision of the Head Body, the examination is carried out here, its decision can be appealed in court.

The Federal Bureau of Medical and Social Expertise is subordinate to the Ministry of Labor of the Russian Federation.

Tasks and powers

One of the main functions of the ITU is the establishment of a disability group. This procedure is an actual general assessment of the state of health of the person who applied to the bureau.

To conduct an examination of persons with various diseases, special expert groups have been created:

mixed profile groups will examine patients with common diseases;
special groups are created to consider issues on persons aged 18-1 years.

And also specialized groups have been created for examination:

tuberculosis patients;
persons with mental disorders;
suffering from visual impairment.

The examination will be carried out by an expert group, depending on the disease that the patient has.

When passing the ITU, the issue of rehabilitation is also resolved and an individual rehabilitation program (IPR) is issued (or adjusted).

Place of examination

At the same time, in accordance with the Rules for Recognizing a Person as a Disabled Person (Decree of the Government of the Russian Federation of February 20, 2006 No. 95), an examination is possible:

On disability groups and criteria for their establishment

The ITU survey implies the definition of a disability group (its extension) or the refusal to establish it. All and also there is a category "disabled child". Bureau ITU disability can be established for 1 or 2 years, for 5 years and for life (this is determined by the relevant criteria of the Rules).

The specification of groups has a detailed list of health disorders of the examined person. These criteria underlie the establishment of a disability group by an examination.

For example, when persistent moderate violations lead to a decrease in the ability to perform previously habitual professional duties or to a decrease in the volume or intensity of work, and also cause an inability to continue activities in the main profession, but at the same time it remains possible for a person to perform duties of a lower qualification under standard conditions. This indicates the presence of 1 degree of limitation of the main categories of life, there are grounds for assigning a III group of disability.

If there are persistently expressed disorders of body functions that require special adaptations or the creation of specific working conditions for the performance of labor activity, any special technical equipment. funds or assistance from outsiders, they qualify as the second degree of restriction. In this case, the second group of disability is assigned.

When fixing persistently expressed health disorders, leading to the impossibility (even contraindications) of labor activity or unconditional inability to it, a 3rd degree occurs. These are signs of the I group of disability.

The appointment of the group depends on the general health of the person undergoing the examination. It takes into account very many factors that limit the basic categories of life. Among them will be his ability to self-care, orientation, communication, movement, self-control and learning (which is very important for children and young people).

When all these factors are taken into account, a group will be established. The criteria themselves are approved specifically for each group and have uniform, very clear recommendations for all ITU branches in Russia.

About the possible purposes of the examination

In addition to the main goal - the maximum adaptation of a disabled person to society - the ITU also pursues more specific goals. These should include:

identification of a person with a disability group (category "disabled child");
determination of the degree of loss of professional skills and ability to work;
development (or its correction);
development (or its correction) of the program of rehabilitation of the victim.

And also the commission can be held in order to establish:

stages of loss of professional skills from an occupational disease or an accident at work;
the need for extraneous care of a close relative, a citizen undergoing military service;
signs of a persistent health disorder for police officers and other structures.

How to get a referral

To pass the examination, you need to get a referral (to the patient himself or his guardian). This can be done in the following ways:

Contact a medical institution of healthcare of the Russian Federation , where the person requiring examination is observed or treated.
Apply to the branch of the Pension Fund. Here you will need to submit the necessary medical documents certifying the disease, injury or disability.
Come with an appeal to the social protection authorities, and there must be signs of a person's life restriction and his need for social protection.

The medical institution issues a referral in the form No. 088 / y-06. In which there will be information about the state of health of the person being sent and the restorative possibilities of his health, about the rehabilitation measures taken, their results and, necessarily, the purpose for which the person is sent to the ITU (disability and group are not indicated in it).

The social protection authorities and the Pension Fund of the Russian Federation issue a referral in the form approved by the order of the Ministry of Health and Social Development of the Russian Federation of December 25, 2006 No. 874, which contains information about the signs of limited life activity (as a rule, on the basis of a fact established by them) and the need for social protection, the purpose of the referral.

If a person was denied a referral by all of the listed institutions, he has the right to appeal directly to the ITU branches .

What other documents are required for examination

Documents are attached to the received direction. Their list will depend on the purpose for which the referral is issued. And it can be obtained along with the referral.

Common to all types of expertise will be:

a written application for an examination from a person who needs it;
a document proving the identity of the disabled person and his guardian (if any). For children under 14, documents of one of the parents are required;
medical certificate confirming health disorders.

You will most likely need the following documents:

Who are legal representatives

In a number of cases, a person who requires the establishment of a disability, due to his illness, cannot be fully responsible for his actions or is physically unable to collect certificates and go to the authorities. This will be the basis for their interests to be represented by legal representatives. They can be parents, children, other relatives, spouses or strangers who are guardians of a disabled person (in this case, a guardianship decision will be required).

When examining children under 14 years of age and adolescents under 18, their parents will be their legal representatives. The law provides for their mandatory participation in the process (the examination is not carried out without them). If the child does not have parents, they are replaced by guardians.

In all these cases, legal representatives for ITU are an important part of the process. They must submit documents that certify kinship or marriage, and can carry out a number of actions for the patient. So, they collect the necessary certificates, bring the patient for examination, organize the departure of the commission home, if it is impossible to deliver it. In fact, they represent the interests of their ward at the ITU.

About results

A protocol is kept during the examination. Then an inspection report is drawn up, which consists of 2 parts. It is kept for 10 years. On the hands of the person in respect of whom the examination was carried out, they issue:

Help. It indicates the group of disability, the reason and the period for which the disability was established, there must be a link to the examination certificate and its details.
Individual rehabilitation program.

An extract from the act, which must be drawn up, is sent to the regional branch of the Pension Fund no later than 3 days.

If a person does not agree with the results of the examination, it is necessary to write an application to the same regional or head office no later than 1 month from the date of receipt of the certificate. The period during which the re-examination must take place is 1 month.

In case of disagreement with the conclusions of the commission, you can also apply to the court.

Important update!

What does this paper look like?

If a person received a referral at a polyclinic or other medical organization, then the appearance and shape of this paper are subject to the rules. They are formulated in order No. 77 of the Ministry of Health and Social Development of the Russian Federation:

Already in the direction itself, the results of previous examinations and studies, the estimated severity of the established disease and the disability that it may entail, as a percentage, are necessarily entered.
The results of rehabilitation measures and the actual purpose pursued by the issuance of the referral are also indicated in such a paper.

Directions issued by authorized pension and social security institutions are somewhat different in appearance due to the fact that they are subject to another regulatory act - order of the Ministry of Health and Social Development of the Russian Federation No. 874.

The differences are as follows:

The restrictions that the patient is forced to comply with, in this case, are considered not as a fact, and not from the point of view of working capacity, but from the standpoint of whether a person needs social assistance and protection.
The purpose of receiving the direction, as in the previous case, is written necessarily.

The procedure for registration for medical and social examination

The registration procedure for ITU consists of several stages:

Clarifications

Who directs?

Direction is issued:

Medical institutions providing medical and preventive care (polyclinics, hospitals, including psychiatric ones).
Organizations for the social support of citizens.
pension funds.

Who issues the document?

The attending physician, the therapist of the local polyclinic - this is who most often directs citizens to undergo ITU, based on studies of their health status or a sick leave that has been going on for about 10-12 months. But, if there is a corresponding desire, the patient can start this process on his own.

Paper of any other sample cannot be considered as a valid beginning of the procedure. An officially issued form in accordance with all regulatory standards is sent to the ITU center when an application is submitted by a citizen or his authorized representative.

Advice! For those situations when a citizen, due to his serious condition, does not have the physical ability to arrive at the institution and undergo an examination, the legislation provides for the possibility of undergoing a medical and social examination in a hospital or at home.

Disability procedure

There are situations when an employee took a sick leave - and everything prolongs and prolongs it, and there are no positive changes in the condition of such a patient. In case of repeated repetition of a leaflet with an unchanged diagnosis, an employee of a medical organization is authorized to issue a referral to the ITU for the patient.

As you know, the standard validity of the sick leave is ten days. By decision of a council of doctors, it can be extended for up to thirty days, and sometimes up to 10 months, but not more than a year.

If within a year the patient's ability to work has not recovered, then the attending physician is obliged to send him for examination. Already the ITU commission will decide whether a further extension of the sick leave is possible, or final rehabilitation is impossible, as a result of which the citizen acquires the status of a disabled person.

If a person was not satisfied with the results of the commission, then he has the opportunity by submitting an application to the appropriate higher authority. The statistics of this practice shows that at the highest level, the commission rarely refuses to recognize a citizen as a disabled person.

When this is issued, the infinitely extended sick leave is finally closed on the date preceding the day of the examination, and the verdict of the commission is also entered. All the days on which the patient passed the ITU are not considered absenteeism at work, however, they are not paid.

What to do if the clinic refuses to pass the examination?

For various reasons, health care institutions may refuse to issue a referral to the ITU. However, this does not mean at all that it will not be possible to pass the examination. In this case, it is not so difficult to protect your rights.

The fact is that for a long time, since 2005, the order of the Ministry of Health of the Russian Federation No. 535, deprived doctors of the opportunity to decide whether to give a referral or not. According to him, an employee of a medical institution must accept an application for ITU from a citizen, and then issue a referral. This document is already considered invalid, but this requirement is still relevant.

And if the therapist refuses to accept the application, it is quite possible to apply with a similar requirement, say, to the head physician of the clinic. In extreme cases, the local government has such a body as the Department of Health.

Important! If a citizen applied for a referral to the ITU, and he was refused, then you need to insist and make sure that the doctor of the appropriate authority writes about his refusal in the outpatient card of the patient (which contains summarized data from all studies and observations for many years).

The reason for this is that without a documented fixation of the refusal of a medical worker, it is impossible to appeal his current decision and further attempts to achieve his own at a higher level.

Conclusion

Health is a great value for every person. Recognizing the presence of serious illnesses is a difficult step for any person and a test for his environment.

And that is why citizens of the Russian Federation have the right to apply for specialized medical expertise as many times as they need. Defending your rights and needs for social protection is not only possible, but moreover, it is necessary.

1. Application of a citizen (or his legal representative);

2. Passport or other identity document; passport for citizens from 14 years old (for persons under 14 years old: birth certificate and passport of one of the parents or guardian).

3. Referral to a medical and social examination of a medical institution (Form 088 \ y-06); or Certificate of the medical commission in cases of refusal to send a citizen to the ITU; or the ruling of the court.

4. Medical documents (outpatient card, extracts from hospitals, R-images, etc.).

5. A copy of the work book, certified by the personnel department for working (original work book for non-working) citizens.

6. Documents on education.

7. Information about the nature and working conditions (for employees) - production characteristics.

8. Pedagogical characteristics of a child attending a preschool institution.

9. Pedagogical characteristics for the student.

10. Certificate of disability upon re-examination.

11. An individual program for the rehabilitation of a disabled person (IPR) with notes on its implementation upon re-examination.

To determine the degree of loss of professional ability to work

1. Application of a citizen (or his legal representative), employer (insured), insurer (FSS), court ruling.

3. Referral to a medical and social examination of a medical institution (Form 088 \ y-06); or the ruling of the court.

5. An act on an accident at work in the form of H-1, or an act on an occupational disease upon initial contact with the ITU.

6. A copy of the work book, certified by the personnel department for working (original work book for non-working) citizens.

7. Conclusion of the State Expertise of Working Conditions on the nature and working conditions of the victim during the initial application to the ITU.

8. Conclusion of the medical commission of the medical institution on the need for medical rehabilitation.

9. Rehabilitation program of the victim (PRP) with marks on its implementation during the re-examination.

10. Certificate of the results of determining the degree of loss of professional ability to work in percent during the re-examination.

For the development (correction) of the Individual Program for the Rehabilitation of the Disabled (IPR)

2. Passport or other identity document; passport for citizens from 14 years old (for persons under 14 years old: birth certificate and passport of one of the parents or guardian).

3. Certificate of disability.

4. Referral for a medical and social examination of a medical institution (Form 088 \ y-06); or Referral of a citizen to the ITU, issued by the social protection authority.

5. Medical documents (outpatient card, extracts from hospitals, R-images, etc.).

6. Information about the nature and working conditions (for employees) - production characteristics.

7. Pedagogical characteristics of a child attending a preschool institution.

8. Pedagogical characteristics for the student.

9. An individual program for the rehabilitation of a disabled person (IPR) with notes on its implementation upon re-examination.

For the development (correction) of the Victim Rehabilitation Program (PRP)

1. Application of a citizen (or his legal representative).

2. Passport or other identity document.

4. Medical documents (outpatient card, extracts from hospitals, R-images, etc.).

5. Information about the nature and working conditions (for employees) - production characteristics.

6. The conclusion of the medical commission of the medical institution on the need for medical rehabilitation.

7. Rehabilitation program of the victim (PRP) with marks on its implementation during the re-examination.

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1 MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION ORDER of January 31, 2007 N 77 On approval of the form for referral for medical and social examination by an organization providing medical and preventive care (as amended on October 28, 2009) Document with amendments made by: order of the Ministry of Health and Social Development of Russia dated October 28, 2009 N 853n (Rossiyskaya gazeta, N 232,) (entered into force on January 1, 2010). In accordance with the Decree of the Government of the Russian Federation of February 20, 2006 N 95 "On the procedure and conditions for recognizing a person as disabled" (Collected Legislation of the Russian Federation, 2006, N 9, Art. 1018) I order: for a medical and social examination by an organization providing medical and preventive care" according to the appendix. Minister M. Zurabov Registered with the Ministry of Justice of the Russian Federation on March 12, 2007, registration N 9089 Appendix. Form N 088 / y-06. Referral for medical and social examination by an organization providing medical and

2 preventive care Supplement to the order of the Ministry of Health and Social Development of the Russian Federation of January 31, 2007 N 77 (as amended, entered into force on January 1, 2010 by order of the Ministry of Health and Social Development of Russia of October 28, 2009 N 853n, - see the previous edition) Medical documentation Form N 088 / y-06 Ministry of Health and Social Development of the Russian Federation (name and address of the organization providing medical and preventive care) REFERRAL FOR MEDICAL AND SOCIAL EXAMINATION BY THE ORGANIZATION PROVIDING THERAPEUTIC AND PREVENTIVE CARE Date of issue " " 20*

3 1. Surname, name, patronymic of the citizen sent for medical and social examination (hereinafter referred to as the citizen): 2. Date of birth: 3. Gender: 4. Surname, and my name, patronymic of the legal representative of the citizen (to be filled in if there is a representative) : legal 5. Address of the place of residence of the Citizen (in the absence of a place of residence, the address of stay, actual residence on the territory of the Russian Federation is indicated): 7. Excluded 8. The degree of loss of professional ability to work in percent:

4 (to be filled in upon re-sending) 9. Sent initially, re-sent (underline as appropriate). 10. Who works at the time of sending for a medical and social examination (indicate the position, profession, specialty, qualifications and length of service in the specified position, profession, specialty, qualifications; for non-working citizens, make an entry: "does not work") 11. Name and address of the organization in which the citizen works: 12. Conditions and nature of the work performed: 13. Main profession (specialty): 14. Qualification in the main profession (class, rank, category, rank):

5 15. Name and address of the educational institution: 16. Group, class, course (underline to be indicated): 17. Profession (specialty) for which training is provided: 18. Observed in organizations providing medical and preventive care since a year. 19. History of the disease (beginning, development, course, frequency and duration of exacerbations, medical and recreational and rehabilitation measures taken and their effectiveness):

6 (it is described in detail during the primary referral; during the second referral, the dynamics for the period between examinations is reflected, new cases of diseases detected during this period that led to persistent violations of body functions are described in detail) operations, diseases for which heredity is aggravated, in addition, in relation to the child, it is indicated how the mother's pregnancy and childbirth proceeded, the timing of the formation of psychomotor skills, self-service, cognitive-playing activities, skills of neatness and self-care, how early development proceeded (by age, lagging, ahead of schedule): (filled in during the primary referral) 21. Frequency and duration of temporary disability (information for the last 12 months): N Date (day, month, year) of the beginning of temporary disability disability Number of days (months and days) of temporary disability Diagnosis

7 22. The results of the measures taken for medical rehabilitation in accordance with the individual rehabilitation program for a disabled person (to be filled in upon re-referral, specific types of restorative therapy, reconstructive surgery, sanatorium treatment, technical means of medical rehabilitation, including prosthetics and orthotics, as well as the terms, to which they were provided; lists the functions of the body that could be compensated or restored in whole or in part, or a note is made that there are no positive results): other specialties):

8 24. Results of additional research methods (the results of laboratory, X-ray, endoscopic, ultrasound, psychological, functional and other types of research are indicated): 25. Body weight (kg), height (m), body mass index. 26. Assessment of physical development: normal, deviation (underweight, overweight, short stature, high stature) (underline as appropriate).

9 27. Evaluation of psychophysiological endurance: norm, deviation (underline as necessary). 28. Evaluation of emotional stability: norm, deviation (underline as necessary). 29. Diagnosis when referring to a medical and social examination: a) underlying disease code according to the ICD: b) underlying disease: c) concomitant diseases: d) complications: 30. Clinical prognosis: favorable, relatively favorable, doubtful (uncertain), unfavorable ( Underline whatever applicable).

10 31. Rehabilitation potential: high, satisfactory, low (underline as appropriate). 32. Rehabilitation prognosis: favorable, relatively favorable, doubtful (uncertain), unfavorable (underline as appropriate). 33. The purpose of the referral for a medical and social examination (underline as appropriate): to establish disability, the degree of loss of professional ability to work as a percentage, to develop (correct) an individual rehabilitation program for a disabled person (disabled child), a rehabilitation program for a victim of an accident at work and an occupational disease , for another (specify): 34. Recommended measures for medical rehabilitation for the formation or correction of an individual rehabilitation program for a disabled person (disabled child), a rehabilitation program for a victim of an accident at work and an occupational disease:

11 (specific types of rehabilitation therapy are indicated (including drug provision in the treatment of a disease that caused disability), reconstructive surgery (including drug provision in the treatment of a disease that caused disability), technical means of medical rehabilitation, including prosthetics and orthotics, a conclusion on the sanatorium - spa treatment with a prescription for the profile, frequency, duration and season of recommended treatment, the need for special medical care for persons injured as a result of accidents at work and occupational diseases, the need for medicines for the treatment of the consequences of accidents at work and occupational diseases, other types of medical rehabilitation) Chairman of the medical commission: (signature) (signature transcript) Members of the medical commission: (signature) (signature transcript) (signature) (signature transcript) (signature) (signature transcript) M.P. Cutting line

12 To be returned to the organization providing medical and preventive care that issued the referral for medical and social examination Return coupon (name of the federal state institution of medical and social examination and its address) social examination 4. Diagnosis of the federal state institution of medical and social examination: a) code of the underlying disease according to the ICD:

13 c) concomitant diseases: c**) complications: 5. Types of violations of body functions and their severity (according to the classifications approved by the order of the Ministry of Health and Social Development of Russia of August 22, 2005 N 535 (registered in the Ministry of Justice of Russia on September 13, 2005 N 6998): 6. Limitations of the main categories of life activity and the degree of their severity (according to the classifications and criteria approved by the order of the Ministry of Health and Social Development of Russia dated August 22, 2005 N 535):

14 7. Decision of the federal state institution of medical and social expertise: disability of the first, second, third groups was established, in the category "disabled child" (underline as necessary); cause of disability: degree of loss of professional ability to work in percent: date of re-examination: recommendations for medical rehabilitation: recommendations for professional, social, psychological and pedagogical rehabilitation:

15 8. Reasons for refusal to establish disability: 9. Date of sending the return coupon: " " 20. Head of the federal state institution of medical and social expertise (signature) (signature decoding) M.P. * Not later than one month from the date of issue, this referral can be submitted by a citizen (his legal representative) to the branch of the main bureau of medical and social expertise - the bureau of medical and social expertise. ** The numbering corresponds to the original. - Database manufacturer's note.

16 The version of the document, taking into account changes and additions, was prepared by Kodeks JSC

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Registered with the Ministry of Justice of Russia on December 21, 2012 N 26297 MINISTRY OF LABOR AND SOCIAL PROTECTION OF THE RUSSIAN FEDERATION ORDER dated October 11, 2012 N 310n ON APPROVAL OF THE ORDER OF ORGANIZATION AND ACTIVITIES

Registered with the Ministry of Justice of the Russian Federation on April 9, 2009 N 13729 MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION ORDER dated March 27, 2009 N 138n ON THE PROCEDURE FOR ORGANIZING DISTRIBUTION WORK

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A.S. Bovina Peoples’ Friendship University of Russia

Annex Approved by order of the order of the Ministry of Health and Social Development of the Russian Federation dated TO BE FILLED BY A DOCTOR OF A MEDICAL ORGANIZATION DISABILITY SHEET 001 234 567 891

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(approved by order of the Ministry of Health of Russia dated May 14, 1997 No. 141)

Form No. 088 / y-97 is filled out for persons sent for the first time to the ITU (including face-to-face consultations) and for disabled people sent for re-examination.

The procedure for filling out the “Referral to ITU” is determined by the Instruction introduced by order of the Ministry of Health of the Russian Federation of December 15, 1999 No. 06-23 / 6-2.

In the line "Date of issue" - indicates the date of issue of the referral to the person sent to the ITU or his legal representative.

In line 1 - the “full name” of the person being sent is indicated in full.

In line 2 - "Date of birth" - day, month and year of birth; "sex" - "m" or "f".

In line 3 - "Address of the patient" - the place of residence according to the passport.

Line 4 - "Disabled ___ group" - indicates the group of disability based on the available ITU certificate, or a dash if the patient is sent for the first time.

Line 5 - "Place of work" - indicates the name of the organization in which the sent person works at the time of filling out the referral. If a citizen does not work, an appropriate entry is made about this.

Line 6 - “Address of the place of work” - indicates the address of the organization in which the person sent on the day of opening the sick leave is working.

Line 7 - "Profession" - indicates the profession that was obtained through special education (engineer, teacher, construction technician) or the one in which there is the longest work experience and (or) the highest qualification.

Line 8 - "Position" - indicates the position in which the patient was occupied on the day the l / n was opened for him

Line 9 - “Under the supervision of a medical institution with ...” indicates the date of the initial filling out of the outpatient card of the patient in the health facility.

In line 10 - "History of the present disease" - during the initial registration of the referral to the ITU, details are given about the onset of the disease (the nature of the injury, injury), the course, the date of exacerbations (indicate the frequency and duration of exacerbations for the 12 months preceding the referral of the patient to the ITU, information about the nature of the treatment performed (outpatient or inpatient, indicating the profile of the department), types of treatment (therapeutic, surgical, physiotherapy, etc.) When making a referral for re-examination, line 10 indicates information about the course of the disease for the period elapsed from the date of establishment disability groups.

Line 11 - “Results of the rehabilitation measures taken” - indicates information about the measures to restore the patient's ability to work and their effectiveness, or measures to implement an individual program for the medical rehabilitation of a disabled person when he is sent for re-examination.

Line 12 - “Frequency and duration of temporary disability over the past 12 months” in the column “Numbers from ____ to ____” indicates the dates of opening and closing l / n, the total number of days of VN is indicated in the last line or under the line. If the patient does not work, then this section indicates the frequency of requests for medical care in health facilities and the name of the diseases for which the patient applied. In the column "Name of the disease" - on the line corresponding to the date of issue of the l / n, the name of the disease is indicated, for which the patient was recognized as temporarily disabled in the corresponding period.

In line 13 - “Name of the profession and working conditions for the last year” - indicates the profession (position) that the patient was performing at the time of issuing a l / n to him, as well as the predominant production factor, the severity of physical and neuro-emotional stress, etc. . Information is recorded from the words of the patient, if necessary, requested from the place of work.

In line 14 - "The condition of the patient when referring to the ITU" - when describing the objective status, each specialist describes in detail and consistently the patient's complaints, primarily related to the underlying disease (determining permanent disability), then others; the data of an objective examination of the patient by specialists are reflected with exhaustive completeness (conclusions of a therapist, neurologist, surgeon, oculist, and for women - a gynecologist are required).

In lines 15 - "X-ray studies", 16 - "Laboratory studies", 17 - "Additional research methods" - the results of studies confirming the established diagnosis of the underlying disease, and others that, to one degree or another, may influence the course of the underlying disease, are entered .

In line 18 "Diagnosis when referring to the ITU":

In paragraph 1 - "the main disease" - a detailed diagnosis is indicated in accordance with ICD-10, etiology, course features, stage, degree of functional impairment. When several diseases are combined, the disease that determines disability is indicated as the main one.

Clause 2 - “comorbidities” - indicates those diseases that are not decisive in the assessment of disability;

Clause 3 - "complications" - indicates the complications of the underlying disease.

In line 18.1 - "Violations of the basic functions of the body" (according to the adopted Classification of 01.29.97 No. 1/30), the patient's violations are indicated in accordance with section 1.2 "Classification of violations of the main functions of the human body."

In line 18.2 - "Signs of disability" (according to the adopted Classification dated 01/29/97 No. 1/30) the patient's OB is indicated in accordance with section 1.5 "Classification of vital functions disorders".

In line 19 - “The basis for referral to the ITU: the presence of signs of disability; the end of the period of disability; early re-examination; the need to extend the l / n (underline) ”- the necessary is underlined. If it is necessary to extend the l / n, it is extended within the period established by clause 2.3. instructions "On the procedure for issuing documents certifying temporary disability".

Responsibility for the correct execution of the "Referral to ITU" lies with the chairman of the KEK. The direction to the ITU is signed by the members of the KEK, the date is indicated, the seal of the medical facility is affixed. The decision of the CEC to send the patient to the ITU is recorded in the card of the outpatient (inpatient) patient and in the account. No. 035 / y - 02 "Journal of accounting for clinical and expert work of health care facilities."