Medico-Social Commission on Disability. Medical and social expertise is torture for the disabled. How to appeal an ITU decision

Many patients who first undergo such a procedure as a medical and social disability commission ultimately remain dissatisfied with the decisions made, as well as with the very principle of conducting all examinations. After all, they have to constantly deal with additional processing of various documentation, go through a large number of surveys and perform a number of other actions. However, if you know how the medical and social commission on disability is carried out correctly, you can solve the overwhelming majority of problems.

Documents are the most important

First of all, you should check how well the various documents that you will provide during the examination process are drawn up and drawn up. A referral for you to pass the medical and social disability commission is issued at a specialized medical and preventive institution located at the place of your treatment and observation. However, this document must without fail be certified by the appropriate seal of this institution, as well as the signatures of three doctors, including the signature of the head physician or the chairman of the commission.

Check everything carefully

Make sure in advance that the passport data specified in the documents you provided is correct, since even if there is an error literally in one letter, the document can be considered invalid, and you will not achieve anything with it. Before the medical and social commission on disability is held, you should make photocopies of each extract from the hospital you receive, after which they can be applied to the referral to the ITU. The most optimal is to attach them in chronological order, so that, if necessary, representatives of the relevant services can quickly and better check all the documentation. For examination, it is mandatory to take the original of each extract from the hospital, as well as the originals of any other medical documents so that experts can verify them against the copies you provided. After the verification is carried out, all originals will be returned to you immediately.

What influences the result?

The results of the observation of the patient, as well as the results of treatment in the outpatient setting, are of great importance in the ongoing commission, as a result of which you always need to have an outpatient card with you. In the event that there are ambulance call coupons, also try to collect them and attach them to (ideally, you should also make a copy of each such certificate).

What else to take with you?

If you have any pathologies of the musculoskeletal system, then in this case you should provide the commission with the appropriate x-rays, while it is immediately worth noting the fact that, in order for the medical and social commission on disability to be successfully passed, take only fresh documents with you (made a maximum of a month before the date of submission). It is also worth noting that the referral for such an examination should include a description of these documents.

If you have accumulated a large enough number of pictures, you should still take them all with you in order to qualified specialists could give you a picture of the dynamics of your disease in as much detail as possible. Again, it's best if all the shots are packed in chronological order. In the presence of any hypertension, as well as the presence of crises in accordance with the outpatient card, you can simply make a few neat colored bookmarks on the pages where these crises were recorded, but it is immediately worth noting the fact that such records should be collected only after Last year prior to the inspection.

References from doctors

If you took sick leave, as a result of which you received the relevant sheets from the doctor, then in this case it is advisable to write on one separate sheet from what and by what date you had a disease, what diagnosis you were given and how many days it took to get rid of this ailment . Unfortunately, the medical commission on disability does not always make a footnote to the fact that the doctors of health facilities can fill out referrals to the ITU far from being of the highest quality.

If there are opinions from highly specialized specialists that you received in any other medical institutions, you can also provide such documents, but do not forget that each such conclusion must be approved by the seal of this institution without fail. In addition, be sure to check the dates on which the conclusions were issued, as well as the passport data indicated in them, because otherwise the disability medical commission may simply refuse to accept your documents.

Additional documents

In some situations, it may be necessary to provide information about your education, while students must provide a certificate that they are studying in a particular educational institution. For everyone else, you will need to provide a copy along with the original diploma of education. In some situations, the disability commission also requires the provision of a work book or a copy of it, but in the latter case, you need to ensure that the copy is confirmed by the seal of your personnel department. Here it is also recommended to make a photocopy of the passport and attach it with the rest of the documents.

If a person is on this moment works, then in this case a full-fledged production characteristic, which will indicate the working conditions, as well as how a sick person copes with the tasks assigned to him. This document must contain the date of compilation, and must also be certified by the individual seal of the enterprise.

What do you need to be prepared for?

You should mentally prepare for the fact that in the end, the disability commission for children or adults will not make the decision that you would like. You should not rely too much on the opinions of some medical doctors, who often allow themselves to simply share their opinion with clients about the fact that they are entitled to a certain disease. Few people know that this is actually one of the most common causes of conflict situations appearing in the process of announcing the decision made by medical commission by disability.

Why do doctors have different opinions?

Do not forget that the attending physicians do not have the appropriate expert training, as a result of which they are professionally forbidden to set their patient up for the fact that the examination will ultimately make a certain decision. Such specialists do not bear any responsibility for the words they said orally, while the expert doctors who conduct the commission for the appointment of disability draw up a specialized expert medical file for each patient, in which the decision provided is substantiated in writing in detail, referring to to various regulations. Ultimately, such a document is certified by the appropriate seals and signatures of the institution, after which these experts bear full legal responsibility for it. It is very important to understand this point in order to avoid useless proceedings and disputes.

Getting ready for inspection

Before the ITU commission is held for you, you should prepare and take all the necessary things. In particular, take a clean sheet with you, as it may be useful to you during the examination on the couch in the supine position. If you wish, you can also take interesting book, which will allow you to brighten up the call waiting time. It is not recommended to take a radio or a player with you, since in the process of their work you can simply interfere with others. Of course, you can use headphones, but in such a situation you risk simply not hearing how you will be invited. The Disability Assignment Commission is a relatively lengthy procedure, however, veterans and invalids of the Second World War, as well as liquidators of the Chernobyl accident, are given the opportunity to call first. Thus, if you fall into any of the above categories, always try to inform the commission about it.

Medications must be taken with you

You should not hope that this is a matter of a few minutes, and therefore you will not need to take any drugs there. In fact, the duration of the examination can be several hours, depending on how busy the premises are and how many people need a commission to determine disability. This is especially important for those people who suffer from coronary artery disease, hypertension, or diabetes. Always be prepared for the fact that you may have a rather long wait for your turn.

What to do if there is no opportunity to come to the commission?

For the most critically ill patients who do not have the opportunity to independently arrive for an examination at the ITU institution, the possibility of examination at home is provided. At the same time, it is worth noting the fact that in extremely rare, one might say, even exceptional cases a decision on disability is also made in absentia, based on the documentation provided. AT this case you will need to additionally attach a certificate stating that, due to the state of health, the patient is not able to come for examination.

If a we are talking about seriously ill or elderly people, they are advised to come only accompanied by their relatives, who, if necessary, will help them undress and dress during the examination, and can also supplement complaints or control them on their own.

Medical and social expertise(ITU) came into being in November 1995 based on the federal law No. 181-FZ, which in Art. 7 gives its direct definition within the framework of general trends in activities to protect the disabled in the Russian Federation.

Until that moment, the functions of examination of the disabled were carried out by the Medical Labor Commission (VTEK). The principles of its activity practically did not differ. Respectively, ITU expediently replaced it in the system of social relations.

Such a replacement was logical, since in this case the question is not only about persons who have lost their ability to work, but also minors with disabilities who have not entered the working age. This also applies to those disabled due to congenital or acquired early age disorders belonging to the category "disabled since childhood".

Significant differences between these institutions are expressed only in the development of the technical and social capabilities of the state. This is natural, since progressive development medical science and the Institute of Social Relations expands the range of state and legal support for disabled people and provides more advanced ways of their rehabilitation.

Now let's talk more specifically about how to pass the examination.

Algorithm of preparation and passage

The initial stage of preparation depends on the state of the citizen. In any case, the procedure begins with the collection of available medical:

• references;
• acts;
• extracts from the medical history.

It ends with their submission to the bureau at the place of residence, they are fixed by area of ​​residence. The process goes on:

• Records, with the appointment of the date of examination.
• Direct examination by the commission.
• Obtaining a disability assignment or denial of a request.
• AT for three days receives an extract and transfers it to the pension fund, with a positive decision.
• Receives rehabilitation appointments and fulfills them, also uses possible benefits to receive free treatment, surgery, etc.
• In case of refusal: we take all additional documents (you need to do it in a month) and submit it. Or we write a statement to the head of the district bureau on the transfer of papers to the main bureau (you need to have time to transfer them in three days).

How to pass VTEK: overcoming difficulties

Problems may arise already at the stage of collecting certificates, this is the longest process in the entire certification procedure. Each situation requires a specific approach. Options may be as follows:

• A seriously ill patient is in the intensive care unit of the hospital or is in a position unsuitable for transport. In this case, all the documentation is prepared by the hospital doctors. If necessary, relatives bring the required documents, or a request is made to the production where the person worked. These papers are transferred without the participation of the patient, accompanied by a special certificate about the impossibility of his personal presence.
• A similar process occurs when it comes to a patient in a psychiatric clinic.

In these situations, close relatives or other interested persons act as representatives, acting under a power of attorney certified by a notary.

The notary is called to the department and he certifies the admissibility of the representation. In critical situations, the certificate of the head physician is acceptable.

In other cases:

• A patient receiving treatment in a hospital may receive a referral from the hospital if his case qualifies as eligible for social support.
• A citizen receives inpatient, outpatient, private clinics, etc. treatment for a certain period of time. Having collected extracts from the medical history and certificates with an established diagnosis, he turns to the therapist district polyclinic. The doctor gives a referral for the passage of specialists and prepares an extract. It is certified by the head of the polyclinic and gives the right to apply to the ITU.
• After an injury, a person collects all the papers at work, from the hospital where he was treated and sends them for examination.
• In the polyclinic, the citizen was denied a referral. He requires form No. 6, independently passes through specialists, collects the necessary certificates and applies to the ITU with an application.

The referral for examination must be signed by the head of the institution and at least three specialists, with a mandatory seal.

When registering for an examination, you may be required to bring additional certificates from specialists. It is legal, this requirement should be fulfilled. Often it is required to bring additional information or characteristics about working conditions.

Experts should provide originals, as well as copies of the main papers.

If an ambulance was called, it is advisable to take call coupons and file them with the documentation.

The main stage of the entire certification procedure is the passage of the commission. All specialists who are authorized to resolve the issue of your disability will gather here.

For a positive decision, they will need to conclude that the treatment, and if re-survey- rehabilitation program, did not bring sustainable positive changes in health status.

When you find yourself in front of specialists who examine the patient independently of each other. Everyone draws conclusions regarding his state of health.

After examination by all doctors, answers to their questions, the examined citizen is asked to leave the door. The decision is made by voting, which does not allow the personal presence of outsiders. Everything in your power should be done at the time of inspection.

Do you think that an examination by a specialist who is not related to your disease does not play a significant role? It's a delusion.

Each vote in your favor will guarantee a successful examination. This suggests that each of the members of the commission should be aware of your problems not only with health, but also with the possibility of self-service.

For example, in diseases of the musculoskeletal system, it is suggested to remove socks. Make no mistake that this is done to examine your feet.

The doctor observes how difficult your movements are, how much they cause pain. Therefore, it is worth showing everything as it is.

In case of hypertension, a diary of pressure drops should be kept, indicating the name and dose of the drugs with which they were knocked down. This will allow doctors to be additionally convinced not only of the development of the disease, but also of your responsible attitude to maintaining health.

How to behave at ITU to get a group?

First of all, doctors pay attention to the reasons for examining citizens.

If the basis of the appeal is the desire to receive pensions, the procedure will be more difficult. Psychologically, the patient will not concentrate on demonstrating the true state of things, which will reduce his presentation abilities.

When passing, you need to focus solely on the disorder of health, be able to show yourself as a person who really needs government subsidies. The purpose of receiving pension benefits should be relegated to the background.

Keep in mind that your documents do not play a significant role in establishing the group, although without them the examination is in principle unacceptable. The main decision will remain with the members of the commission. Be kind to them and do not be offended by incorrect questions and requests.

For example, patients with hyperthyroidism, with the preservation of intelligence, often feel resentful when they are asked to show their tongue.

Doctors check for characteristic bite marks if the tongue falls out involuntarily.

There is nothing offensive in this, it is a common diagnosis. But the patient's resistance speaks volumes. In particular, that he is extremely adaptable and tries to lead. Keep this in mind. Such characteristics will lead to a denial of disability.

The main thing you need is to show low level survival without assistance. These are the characteristics of a person claiming the status of a limited person in the processes of life. Feel free to share the most embarrassing details that back this up.

If you have a pronounced lameness, come to the commission with a badik, even if ordinary life you can do without it. Well-groomed women who are accustomed to taking care of themselves, despite the pain, should not:

• apply makeup;
• to dress up beautifully or brightly;
• come in high heels.

You need to show the doctors your weakness and helplessness (but not go too far). ITU is the only place where such behavior is appropriate and even useful.

In addition to the above, try to prepare for answers to the most unexpected questions of medical and social expertise.

Set yourself a challenge: if you can't answer a question, it's better to react with embarrassment than aggression. At the same time, try to give a precise answer, not vague reasoning. Questions to be asked may include:

In addition to the above, ask questions related to direct characteristic manifestations underlying disease.

Conclusion

Often people assume that doctors should receive answers to all questions from medical papers and certificates. In this case, physicians are interested not only in the opinion of colleagues, but also in the subjective idea of ​​the situation of the person being examined.

Disability can be issued if:

• health disorder with a persistent disorder of body functions due to diseases, consequences of injuries or defects;
• limitation of life activity (complete or partial loss by a citizen of the ability or ability to carry out self-service, move independently, navigate, communicate, control their behavior, study or engage in work activities);
• need for action social protection including rehabilitation and habilitation.

The decision on recognition as a disabled person is made based on the results of a medical and social examination (MSE).

Depending on the state of health, adults are assigned I, II or III group disability, children under 18 years old - the category "disabled child".

2. How to get a referral to the Bureau of Medical and Social Expertise?

Referrals for medical and social expertise are issued by medical organizations (legal form medical organization and where you live doesn't matter).

When determining whether you have signs of a disability, the doctor should rely on diagnostic studies, results of treatment, rehabilitation and habilitation. Therefore, for a referral to ITU, it is best to contact your doctor. But you can also go, for example, to the chief physician of the medical organization in which you are undergoing treatment.

By Decree of the Government of the Russian Federation of February 20, 2006 No. 95 “On the procedure and conditions for recognizing a person as a disabled person”.

If you are denied a referral, ask for a written denial. With this certificate, you have the right to contact ITU bureau on one's own. In this case, the examination will be assigned to you by the employees of the ITU Bureau, and based on its results, they will determine whether there is a need for a medical and social examination.

After you receive a referral, you will need to sign up for a medical and social examination at the ITU bureau.

3. What documents are needed to enroll a child in ITU?

To register a child for a medical and social examination, you will need:

• application (children over 14 years of age fill out and sign the application on their own, for children under 14 years of age, this must be done by legal representatives);
• an identity document (for children under 14 years old - a birth certificate, for children over 14 years old - a passport);
• medical documents evidencing the state of health of a citizen ( outpatient card, extracts from hospitals, consultants' conclusions, examination results - usually issued by the doctor who issued the referral to the ITU);
• SNILS;
• passport of the parent or guardian;
• guardian (representative of the body of guardianship and guardianship) - a document on the establishment of guardianship.

4. What documents do adults need to register for ITU?

To sign up for a medical and social examination, you will need:

• application (can be filled in by the citizen himself or by his representative);
• identity document (original and copy);
• referral to ITU issued by the attending physician;
• work book (original and copy);
• professional and production characteristics from the place of work - for working citizens;
• medical or military medical documents evidencing the state of health of a citizen (outpatient card, extracts from hospitals, consultants' conclusions, examination results, Red Army or military book, certificate of injury, etc.);
• SNILS;
• if the documents will be submitted by a representative - a power of attorney for the representative and his passport.

In some cases, you may need Additional documents(depending on the specific case):

• act on an accident at work in the form of H-1 (certified copy);
• who occupational disease(certified copy);
• conclusion of the interdepartmental expert council on causation diseases, disabilities with exposure to radioactive factors (a certified copy, the original is presented in person);
• certificate of a participant in the liquidation of the consequences of an accident at Chernobyl nuclear power plant or living in the exclusion or resettlement zone (a copy, the original is presented in person);
• for foreign citizens and stateless persons permanently residing on the territory of the Russian Federation - a residence permit;
• for refugees - a refugee certificate (presented in person);
• for non-resident citizens - a certificate of registration at the place of residence;
• for those laid off from military service- a certificate of illness, drawn up by the VVK (a certified copy, the original is presented in person).

An application for a medical and social examination may be considered up to one month from the date of submission of the application.

5. Which ITU office should I contact?

Medical and social examination is carried out in the ITU office at the place of residence. In some cases, ITU may be conducted:

• at the ITU Main Bureau - in case of an appeal against the decision of the Bureau, as well as in the direction of the Bureau in cases requiring special types surveys;
• in the Federal Bureau of ITU - in case of appeal against the decision of the Main Bureau of the ITU, as well as in the direction of the Main Bureau of the ITU in cases requiring particularly complex special types of survey;
• at home - if a citizen cannot appear at the bureau (ITU Main Bureau, Federal Bureau ITU) for health reasons, which is confirmed by the conclusion of a medical organization, or in a hospital where a citizen is being treated, or in absentia by decision of the relevant bureau.

6. How is the examination carried out?

During the examination, the specialists of the bureau will study the documents submitted by you, analyze social, professional, labor, psychological and other data.

In some cases, ITU bureau specialists may assign you additional examination. You can refuse it. In this case, the decision to recognize you as a disabled person or to refuse to recognize you as a disabled person will be made based only on the data you provide. Your refusal will be reflected in the ITU protocol, which is kept during the examination.

At the invitation of the head of the bureau, representatives of state non-budgetary funds, Federal Service on labor and employment, as well as specialists of the relevant profile (consultants). You also have the right to invite any specialist with his consent, he will have an advisory vote.

The decision on recognition as a disabled person or on refusal to recognize him as a disabled person is made by a simple majority of votes of the specialists who conducted the medical and social examination, based on a discussion of the results of the medical and social examination.

Based on the results, an act of medical and social examination is drawn up. You have the right to request copies of both the act and the minutes.

In addition, after the medical and social examination, the specialists of the bureau will prepare for you an individual rehabilitation and habilitation program (IPRA).

7. What documents are issued after the examination?

A citizen recognized as disabled is issued:

• a certificate confirming the fact of the establishment of disability, indicating the group of disability;
• individual program of rehabilitation or habilitation (IPRA).

A citizen who is not recognized as a disabled person, at his request, is issued a certificate of the results of a medical and social examination.

If it is necessary to make changes (new personal data, technical errors) to the IPRA or, if necessary, clarify the characteristics of previously recommended types of rehabilitation and (or) habilitation measures, it is not necessary to undergo a new medical and social examination. It is enough to write an application to the ITU bureau that issued the document. You will be given a new IPRA.

The date of establishment of disability is the day of receipt by the Bureau of the application for the ITU. Disability is established before the 1st day of the month following the month for which the next MSE (re-examination) is scheduled.