The procedure for the examination of msek. ITU: when and how is a medical examination carried out? What documents do adults need to register for ITU

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 quality of life OPRF Vladimir Slepak. The head of the Interregional Center for Independent Medical and Social Expertise, Dr. medical sciences Svetlana Danilova. 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 cervical spine, dysfunction 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 take in different time and in different days- who is lucky enough to sign up. 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.

There has been no ITU in Beloretsk recently, experts from Ufa come to us in 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 I would have to travel from the village to the city off-road (we don’t have asphalt), rent a car, because our buses are not equipped for wheelchair users.

This time the workers came to us ITU bureau No. 6 Ufa. 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 about the entire list technical means rehabilitation that would make life easier and help to adapt, 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 move around the house in an active wheelchair, 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 Grigoryevna, everything that Lyudmila Simonova writes about is true?

- Of course. Russian invalids overcome so many obstacles to pass the commission, get a status or get subsidized drugs that mom does not cry. Now, after all, 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."

AT federal law dated November 24, 1995 No. 181-FZ “On social protection disabled people 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.

Entry into force of the order of the Ministry of Labor of Russia dated 11.10.2012 No. 310n "On approval of the Procedure for the organization and activities of federal public institutions 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 necessary condition The formation of the composition of the bureau is the presence of at least one doctor according to 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 will examine citizens with the most various diseases, and no matter how competent the ITU doctor 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. mother of a child with serious illness recently showed a copy of a document in which adrenogenital syndrome experts say... diabetes. 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 a pre-trial procedure, an appeal is carried out in the service itself: with one composition, with another, and then you need to contact federal bureau, where often sent documents do not open at all. I defended my candidate and doctoral thesis there and repeatedly saw how meetings are held, how 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, to change the decision federal agency ITU will not be affected.

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

- And there is corruption, and, unfortunately, the regions have their own 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 ITU to this stage cannot 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 medical commission of a medical organization can be engaged in the determination of disability groups on the proposal of the attending physician on the basis of data from the primary medical records, without filling in the direction 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, knowing nothing about the patient (if we are not talking about re-examination) and rely only on the presented 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 most functions in varying degrees, the medical commission performs at the present time. Reform will require a change of order medical institutions to conduct an examination of incapacity for work, review functional duties medical commissions medical organizations primary link. 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 primarily sent to the ITU (it will be excluded long procedure filling out referrals to the ITU and subsequent examination in the bureau);

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 per 90,000 people, and citizens of small settlements are forced to travel considerable distances at their own expense to get to the ITU bureau;

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

to legislate an independent ITU.

MOSCOW AND MOSCOW REGION:

SAINT PETERSBURG AND LENIGRAD REGION:

REGIONS, FEDERAL NUMBER:

ITU Medical and Social Commission on Disability (VTEC) - what documents are needed?

Competence of ITU

Preparation and passage of the commission

Terms of re-examination

The state for the social protection of those persons who have persistent health disorders, injuries, cannot work, have limited opportunities socialization, has created a whole system of assistance. 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, and created a medical and social expertise (ITU). 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 main functions of the body of a particular person, to identify possible ways rehabilitation, legal recognition of his disability.

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. At 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 the actual overall rating the state of health of the person applying to the Bureau.

For the 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". The Bureau ITU disability can be set 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 restriction of the main categories of life, there are grounds for the appointment Group III disability.

If there are persistently expressed disorders of body functions that require labor activity special devices or creating specific working conditions, any special tech. 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, there is a 3rd degree. These are signs of the I group of disability.

The purpose of the group depends on general condition 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 occupational disease or 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:

1. Contact a medical institution of healthcare of the Russian Federation , where the person requiring examination is observed or treated.
2. Apply to the branch of the Pension Fund. Here you will need to submit the necessary medical documents certifying the disease, injury or disability.
3. 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 legal representatives. They can be parents, children, other relatives, spouses or strangers 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. Yes, they collect necessary information, 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.

In order for a person to receive a disability, it is necessary to undergo a special examination, which will confirm the fact of disability. Such an examination is called a medical and social examination - ITU.

Passing this test is not easy. You should start with the fact that to start the passage you need full package documents.

Legislative regulation

Legislation clearly regulates the procedure and conditions for granting disability. Those who apply for disability for the first time have to face a lot of incomprehensible nuances, moments that make a person fall into apathy or panic.

In particular, grounds for disability is evidence of three facts:

Moreover, it is important to note that obtaining a disability possible only if available two of the above signs, since one of them may not be enough.

Only the right to establish a disability medical and social expertise, which represents the main or federal bureau.

Direction issued for examination by medical institutions, regardless of property rights, as well as by pension or social protection authorities. It is important to understand that a person can independently apply to the ITU bureau if one of the organizations has previously refused to issue a referral.

At the same time, the examination provides for the establishment one of three degrees of disability, namely:

Obtaining the status of "disability" implies strict adherence to all norms of the law. Regulation in this matter is carried out at the expense of the Federal Law on the social protection of disabled people in Russia, as well as the PP on the procedure and conditions for recognizing a person as disabled.

List of required documentation

To apply for a disability, you must submit the following documents:

Step by step procedure

Registration of disability is a painstaking process that requires a huge amount of patience, and, of course, time.

In addition to the fact that it is necessary to collect the necessary documents, it is important to defend your rights. In some cases, an applicant for disability is faced with a reluctance on the part of health workers to provide assistance and assistance in a difficult matter, despite the fact that this is their direct responsibility. However, in view of the fact that the state of health requires it, it is important to overcome all obstacles.

Medical checkup

Before applying for disability, the applicant undergoes a medical examination, according to which the diagnosis is confirmed, and the presence of a disease that prevents a full life and work is justified.

The first action that must be taken by an applicant for obtaining the status is to visit his attending physician, who is obliged to record all complaints in outpatient card and issue a referral to narrow-profile specialists in order for the person to undergo a full examination.

The doctor gives the patient an appropriate form, in which there are marks which specialists need to be visited, as well as which examinations to undergo. It is important to note that the results of some examinations are valid for only two weeks. In some cases, it may be necessary to undergo an examination in a hospital setting.

Also, the attending physician draws up a package of documents for further passage of the ITU commission. If the doctor refuses to issue an appropriate referral, a written refusal must be issued with a reference to the reasons for the refusal. Only in this case, a person is allowed to apply independently to the ITU Commission. If the doctor refuses to write a documented refusal, the person has the right to apply to the judicial authorities.

Documents that are drawn up by the attending physician are called messengers. They should record the state of health at the time of application, the results of tests, as well as necessary funds for rehabilitation. In particular, to rehabilitation facilities refer wheelchair, special orthopedic shoes, diapers or walkers, hearing aid or Spa treatment And so on. In addition, a referral form for the passage of the ITU commission is issued, which is certified by the seal of the hospital or medical institution, and also has the signature of three doctors.

Collection of necessary documentation

After the date for the passage of the commission is set, you must have all the necessary documents, in particular:

Passing commission

After collecting the necessary documentation, it is very important to come to the ITU regional office at the appointed time. As a rule, the waiting period for admission to the bureau is one month from the date of submission of documents.

The ITU commission is attended by a patient who needs to obtain a disability status, as well as specialists, in the amount of three people. They can examine the patient, if necessary, ask questions related to the health and material condition of the patient. The commission may also be interested in living conditions, social skills, education, characteristics from the place of work, etc.

All questions and answers during the meeting are recorded in the minutes, after which a vote is taken. If there is disagreement, an additional examination may be ordered.

Terms and results of registration

The process of registration of disability is carried out in stages. It takes at least 7-10 days to collect documents and pass the examination. The decision to assign a disability is made on the day of the examination.

If the commission is satisfied with everything, a disability group is assigned, which is framed by an appropriate certificate and the development of an individual rehabilitation system.

In fact, the registration of disability should not take more than two and a half months, taking into account all the nuances and problems.

Form of disability for a child

Assignment takes up to four months. At the same time, it also ITU expertise directed by the attending physician.

At the ITU bureau the following documents must be provided:

1. A doctor's note.
2. Outpatient card.
3. Registration.
4. Documents proving the identity of the parent or.
5. Documents proving the identity of the child.

Children are not assigned any degree of disability, that is, there are no degrees of severity.

What to do in case of refusal

When passing the commission, a situation may arise when the patient is refused. In such a case, the patient has the right to file an appeal against the decision. It is important to observe time limits for appeals- not later than one month from the date of such decision.

AT statement indicates:

1. Full name of the bureau to which the application is sent.
2. Applicant details.
3. Statement of the essence, indicating the composition of the commission.
4. Requirement for a re-examination.

Consideration of the application takes place over three days. If the answer is positive, a new examination is appointed within 30 days after consideration of the application.

Recertification

Re-examination takes place annually, since the ITU commission annually examines persons who have been assigned the status of a disabled person.

Pass order There are three types of recertification:

1. For the first group of disabled people - once every two years.
2. For the second and third groups of disabled people, re-examination is carried out once a year.
3. For children, once during the prescribed period.

It is absolutely impossible to skip the re-examination procedure, since a person may lose the right to be considered a disabled person. When passing a re-examination, there is every chance of getting a category change if the doctors consider that man goes on the mend or his health deteriorated. With a satisfactory state of health, a person may lose his disability status.

For re-examination must be provided:

Registration of disability is a painstaking task that requires a lot of patience and strength, but if you are not afraid of difficulties and know your rights and all the rules for registration, the procedure will go almost smoothly, allowing you to receive additional benefits and payments.

About the rules passing ITU described in the following video:

If the baby is so sick that he has developed stable signs that distinguish him from his peers and do not allow him to fully exist, parents or guardians have to think about the admissibility of registering a disability.

Indeed, not every situation can be assessed by the Federal Bureau of ITU VTEK as meeting the requirements for obtaining a disability. Here are the established criteria:

1. The disease has an obvious form that can be diagnosed, while it is difficult to treat, or - the treatment only relieves the symptoms without causing an improvement in the general condition.
2. Against the background of the disease, an irreversible deterioration in well-being occurred, a complete or partial loss of the functioning of certain organs and systems of the body is possible.
3. A person has partially or completely lost the ability to self-service.

As related characteristics, important will be:

Individual signs or their combination allow applying to the bureau for examination. However external indicators won't be enough.

The main reason is documentary evidence an emerging or continuing condition, without which the examination procedure would be useless. In addition, it will be required. Step-by-step preparation of a package of required documentation takes leading place during the examination.

The legislative framework

The work of the institution is regulated by numerous legislative acts and regulations, which does not allow the use of local arbitrariness on the part of survey participants. Particularly significant are the guarantees of protection for minors, which approved by the Orders of the Ministry of Health and Social Development of the Russian Federation:

• under No. 1013n, dated December 23, 2009;
• under No. 906n, dated 11/17/09;
• under No. 1031n, dated 11/24/10

In addition to the listed unified forms, direct work with juvenile patients is based on the Order of the Ministry of Social Development, announcing the forms and methods of rehabilitation of disabled children, which entered into force on March 16, 2009, under No. 116n.

An important place is occupied Decrees of the Government of the Russian Federation under No. 247, dated April 7, 2008, under No. 95 dated February 20, 06

Step-by-step instruction

It is worth starting with an understanding of the fact of what happened, with an awareness of the complexity of the situation and responsibility for the minor, whose representative is the parent.

Appeal is permissible in three instances, provided that the previous one refused to recognize the rights to registration. They are dealt with in stages:

• ITU city and regional offices;
• regional and regional bureaus;
• federal bureau.

If you need to examine a child, go to the district or city branch at the place of residence. If you are not satisfied with the result, move on - to the regional one. The last instance is the federal bureau, which has the right to cancel the decision of lower structures and whose decisions are not contested.

But the appeal to the ITU does not occur at the will of the parents. Only an authorized organization from among:

• medical, medical-prophylactic, medical-pedagogical institution;
• establishment of a pension fund;
• social institution.

For the most part, citizens receive a referral from a local pediatrician or in a hospital where the baby is undergoing treatment or rehabilitation. Please contact the person who provides medical care for a minor with a request.

First, they will prescribe an examination according to a standard form in a polyclinic with specialists. In this case, they issue a list of doctors who need to be bypassed. If the referral is being prepared at the hospital- Specialists conduct examinations directly in the hospital.

Doctors' testimony will be entered into a card, from which an authorized person of a medical or social institution will make an extract of information in Form No. 088 / y-06.

Based on the diagnosis of specialists, it is revealed overall picture diseases, the multiplicity or singularity of indications requiring examination is considered. medical examination is carried out in depth, taking into account the criteria established by the ITU.

In case of refusal to issue a referral, the medical (social) institution issues a certificate with a reasoned statement about the reasons for the refusal. Based on this extract, an independent appeal to the commission is allowed.

The address of the office in your locality can be found:

• in the institution that issued (did not issue) the referral;
• on the official website of the bureau.

The first visit is limited to the submission of documentation and registration for examination. Upon receipt, the authorized person:

1. Will accept the documents and appoint the day of passage. The term should not exceed 5 days from the date of submission of documents.
2. He will check the documents, point out the missing certificates, acts, conclusions and require them to supplement the documentation package. It should take no more than 10 days to collect them.
3. If there is a queue, they will sign up for more late deadline, but it should not exceed 30 days. In this case, it is required to notify representatives of the need to put on the queue. The date of admission is appointed immediately, at the time of registration.

After a month, the referral becomes invalid, the procedure must begin anew. If the deadline is missed due to the fault of the parents, this may negatively affect the attitude towards the issue of interest to them on the part of the members of the commission and the head of the clinic that issued the referral.

All events held at the ITU Bureau are free of charge. You have no right to demand payment for any services.

For examination, you will need to collect certificates of individual rehabilitation (IPR). They gather in hospitals rehabilitation centers, places of sanatorium treatment.

Based on them, it is concluded that all possible forms treatments that did not lead to the desired result in terms of improved health. Without their presence, they can send the child to pass medical procedures and refuse to recognize him as disabled.

At re-survey it is required, issued according to a standard form, in which a list of measures established for a disabled person is presented. It is framed a special column where marks are made on the implementation of the program.

If the child is studying at a school, technical school, college, etc., his characteristics from educational institution. For schoolchildren, it is compiled class teacher and certified by the director's signature and seal. Similarly, it is made up in secondary specialized educational institutions.

The characteristic should be based on such characteristics of the minor, which indicate his academic performance, behavior and social adaptability in the context of prevailing norms or pathologies.

The information given in the characteristic is considered as an application to the holistic picture of the disease, revealing its ability to function independently in society.

For university students under the age of 18, examination often ends with a negative decision. The reason becomes high level adaptability required for studying at a university.

Documents for ITU for children

Documents of minors are collected by their legal representatives, underage teenagers have the right to do certain things. The required documents include:

1. The passport the applicant, who is the representative, passport or birth certificate of the subject.
2. Statement, filled in by the representative at the initial appointment, directly at the office, according to the submitted sample.
3. Form No. 088/u-06 issued by a children's clinic or other authorized institution, which plays the role of a referral for examination.
4. Medical card from the clinic, case histories from medical institutions.
5. IPR certificates from institutions where the child underwent rehabilitation. Upon re-examination, it is issued in the form of a map, in which marks of completion must be affixed.
6. Characteristic from school(educational institution), for students.
7. Psychologist's conclusion. Examination in the medical-psychological commission - conclusion.
8. SNILS.

If a minor works, they additionally provide:

1. Documents about education.
2. Production characteristics, certificate of working conditions.
3. Copy of work book.

In case of receipt work injury, he presents:

1. An act that registered an accident at work with the participation of the subject.
2. Extract from the medical history.

When re-examination, citizens present a certificate of disability issued during the previous examination.

If you do not have enough evidence of a child’s illness provided by doctors, you have the right to additionally collect expert opinions, according to own initiative and by self-financing their services.

The procedure for passing the ITU

The survey is carried out at the local - city or district bureau. A sick child comes with his parents personally. If it is not possible to transport it, the possibility of examination at home is allowed. In this case, the representative stipulates this opportunity even at . This nuance should be included in the direction.

Juveniles are always examined with their parents. Representatives, acting in the interests of the child, have the right to ask any questions and insist on the protection of legal rights.

The decision to grant the status of a disabled person is made by voting. All materials of the meeting on the condition of the patient are drawn up in a protocol. On its basis, an extract is made, which becomes the basis:

• recognition of a minor as disabled;
• denial of recognition.

In case of refusal, parents or guardians have the right to:

• in the regional office;
• go to court.

The certificate is issued within three days after the positive ITU decisions. It has the legal force of a document that provides its owner with certain statutory guarantees.

The certificate is issued in person, against signature.. Minors are not allowed to receive the document. This procedure is completed by their parents or guardians.

After receiving it, it is transferred to the pension fund for the calculation of pension benefits. Together with the document, a certificate of appointment of an IPR is issued for further rehabilitation.

There are practically no deadlines for determining disability. A certificate issued within 3 days confirms the status of a disabled person, additional actions this is not required. P The pension fund of the Russian Federation assigns a pension benefit to a minor since the day when the commission recognized him as disabled.

The remaining benefits and social guarantees due to a person by law begin to operate at the request of a representative. He has the right to submit it immediately upon receipt of a certificate of disability.

Disability of children's medical and social expertise is established in accordance with the group, which implies a difference in the duration of the status of a disabled person. In particular:

• the first group - for 2 years;
• second, third - for 1 year;
• special diseases included in the List - indefinitely.

Category indefinite illnesses includes irreversible disorders, as a rule - in relation to unpaired organs, with loss of vision, hearing, with severe morphological and organic disorders.

AT this case disability is established before reaching the age of majority, which will subsequently require re-examination.

Based on the requirements that came into force on 20.20.06, in case of oncological diseases or acute forms leukemia, the status of a disabled child is assigned for 5 years.

Conclusion

Many parents are concerned about the fact that to some extent they cancel out the future prospects of children by formalizing disability. Others, having made the false conclusion that it is impossible to get a disability, retreat. And the third - act, finding Right way and opening access to child-supporting social programs.