Diabetes qualifies for disability. I. clinical forms. Follow-up of patients with diabetes

People who have diabetes know that this disease is not curable, but thanks to complex treatment can only alleviate the symptoms of the disease. This disease has several degrees, but after its acquisition, a person is not assigned a disability. In order to receive it, complications must occur against the background of this disease. Type 1 diabetes mellitus, which disability group should be assigned to the patient - about this will be discussed in this article.

In the event that a doctor limits the performance of his patient, this does not mean that he has been assigned a disability group. Type 1 diabetes can be of two types: autoimmune and idiopathic.

Disability group and type 1 diabetes

Any person, even who does not have a disability, knows that there are several degrees. The medical commission can assign the first degree to patients with the following complaints:

• heart failure of the third degree;
• blindness in both eyes;
• hypoglycemic coma;
• kidney failure;
• neuropathy;
• paralysis.

Important! Disability of the first degree is assigned to patients who cannot do without outside help, this is the most serious degree that relies on people with complex complications. Although patients are allowed to perform household chores, communicate with others and move independently.

The second group is assigned to patients with the following complaints:

• chronic renal failure;
• change in the psyche;
• ritinopathy, which manifests itself less severe symptoms than with the first degree of disability;
• neuropathy of the second degree.

This group of disabilities can be called moderate. Patients should be supervised, but not always. Some patients can easily move around, do light work and take care of themselves.

As a rule, the most common disability groups are the first and second. The third group is assigned to people with the development of a labile course of the disease, with simple disorders.

Fact! Often, such a disability group is assigned to young people during internship or mastering a new profession in order to reduce mental and physical activity.

How to get a group?

Many people want to apply for a disability group just to get free medicines and social payments. Indeed, for most patients, it is not affordable to be treated for diabetes, since the cost of drugs is very high. And as it shows medical practice, most often, diabetes mellitus of the first type makes out disability. The decision on whether or not to assign a disability group to a patient is decided by the medical social expertise, which accepts it based on the available data.

To qualify for a disability group, a patient must meet the following conditions:

• the ability to take care of oneself, navigate in space and move around has been completely or partially lost;
• the patient needs rehabilitation and social assistance;
• the patient has not only complaints, but also failures in the operation of many systems;
• the patient cannot communicate with others;
• the person cannot work.

In order to get a disability, you will have to collect a lot of documents and wait for the decision of the medical commission. First of all, you need to contact a therapist so that he writes out a referral for tests. In some cases, the doctor will also give directions to narrow specialists.

Important! If the medical commission does not assign you a disability, and your disease has acquired the character of complications, you need to go to court to appeal the decision. In medical practice, such and unreasonable refusals are often encountered.

To get a group for type 1 diabetes, you need to collect and provide the following documents:

• statement;
• outpatient card;
• referral or certificate for the assignment of disability;
• the passport;
• open sick leave;
• characteristics from the place of work or study;
• education data;
• a copy of the work book - for working citizens;
• certificate of disability and certificate of rehabilitation - upon re-applying.

But it is worth noting that, once having received a group, you will have to regularly confirm your position. So, for example, for the first degree of disability, it is necessary to collect certificates and undergo an examination every two years, for the second group every year.

As the statistics show, recent times this disease develops in children, and it is precisely the first degree.

Important! Children under 18 years of age, when type 1 diabetes mellitus is diagnosed, are immediately assigned a disability that does not have a group. But if complications appear, then the child can be assigned a group number and then the range of benefits and benefits will be larger.

Privileges

The benefits that a person with a diagnosis of diabetes mellitus can count on when assigning a disability group to him are as follows:

• free medicine;
• issuance of syringes;
• free test strips, counting 3 strips for one day;
• delivery of insulin;
• issuance of a glucometer.

Many of the benefits on this list should be available to patients, whether or not they have a disability. But, unfortunately, many people do not know this, and therefore spend money on treatment out of their own pocket.

For children with disabilities with diabetes, the number of benefits is wider, they can claim free rest in a sanatorium once a year, receive a pension and take advantage of preferential places when entering universities. If the child is sent to Spa treatment, then in addition to the cost of the voucher, the state pays for the two-way trip and the payment for the accommodation of the parent or accompanying child.

If the disease develops in pregnant women, then another 16 days must be added to the parental leave. If diabetes is hereditary disease, a newborn child is also entitled to free meals. In addition, you can receive the following benefits:

• discount on travel in suburban transport;
• discount on payment of tax for real estate;
• exemption from payment of state duty for the services of a notary and a lawyer;
• service out of turn in different institutions;
• 50% subsidy for utility bills;
• exemption from paying land tax;
• receiving a social apartment in the order of the general queue.

If a disabled child is brought up in the family, then the state must pay a monthly allowance for his maintenance, in addition to the benefits described above.

Important! Diabetics of the first insulin type are completely disabled.

To answer the question: what group of disability is assigned for type 1 diabetes, it will definitely not work. Since in the first place it depends on how the disease proceeds. As medical practice shows, when diabetes of the first type, often all applicants are assigned a degree of disability due to the serious condition of a sick person. Also, people have the right to receive disability in this disease due to the fact that it is chronic.

Do they give disability in type 2 diabetes mellitus, what disability group is assigned in this case - such questions concern people who are diagnosed this disease. Not always with diabetes, a disability group is assigned. Let's see in what situations a person can apply for disability if he has an elevated blood sugar level.

It should be noted that this is not the basis for a decision by the relevant commission and the appointment of disability. It is provided only if various physiological and mental abnormalities develop, which lead to disability and the impossibility of self-service. The type of illness is not taken into account when assigning disability, only the fact how severely the disease proceeds is taken into account. related complications and the consequences of the pathology and how much they prevent a person from maintaining working capacity at the proper level.

If we turn to statistics, we can see that in any developed country, from 4% to 8% of people who suffer from this disease are recorded. More than 60% of patients were assigned group 2 disability.

Often, a person who has been diagnosed with diabetes (type 2), who adheres to all the prescriptions of the medical staff, proper nutrition and controlling glucose levels may not acquire the group.

What deviations should be present

The first group is prescribed if there is a severe form of the disease, which is characterized by retinopathy, neuropathy, ataxia, cardiomyopathy, encephalopathy, nephropathy. If repeated hypoglycemic coma was present, a person cannot move on his own, serve himself, then in this case a disability group is not assigned. Patients with such deviations need constant help.

The grounds for the second group are obvious mental and physiological deviations. These include loss of vision (first and second stages), neuropathy (second degree), encephalopathy, resulting in persistent mental changes. In the presence of such pathologies and complications, some people can move independently and serve themselves. In this case, disability is not assigned, but only when it is possible to stabilize the glucose level.

Grounds for the third group. Experts prescribe disability for mild or moderate pathology, if the violations of the functioning of body systems are moderate.

Diabetes mellitus of the 1st degree of a compensated type, in which insulin injections are not needed, which is not accompanied by pronounced consequences, is the basis for a negative decision of the expert commission.

Important! Adolescents under the age of majority are assigned disability without a group, regardless of the type of disease. To arrange a group for small children, teenagers, an extract and referral from a local hospital, further medical and social examination are necessary. In the course of it, the cause and group of disability will be established, taking into account how much disability has been lost. At the same time, specialists will determine the type, volume, term rehabilitation period, social security criteria.

When can you expect to receive

How to get disability with diabetes? Experts will make a positive decision if they diagnose severe manifestations consequences of high sugar levels, characterized by severe violations, physiological and mental disorders. That is, if the disease is accompanied by:

• less pronounced loss of vision than with;
• chronic renal failure;
• neuropathy II degree (if paresis is present);
• encephalopathy.

If high blood sugar and lack of insulin are the cause limited ability II degree to movement, a person cannot independently serve himself, is disabled, then disability of the 2nd group with elevated level sugar will be given.

For people with any type of diabetes, disability group 2 is assigned only in cases where insulin treatment is necessary and this is evidenced by the relevant documentation. The question of people whether they give disability in diabetes mellitus cannot be answered unambiguously. It all depends on the general condition of the person, and on how strong the consequences of the pathology are. Disability is for those who need help from loved ones.

What documents need to be collected

You will need the following:

• a statement from a person who has a pathology of any type (for children - a statement from parents, guardians);
• proof of identity (passport, birth certificate);
• discharge and referral from a local medical hospital, court order;
• to obtain a type 2 disability, you must have an outpatient card and all medical records, which confirms the history of the disease;
• if a person is officially employed - a photocopy employment contract, books (necessarily certified by an employee of the personnel department);
• diploma of education;
• for employed persons - an extract issued by the personnel department, indicating the nature and working conditions;
• for students - documents from the place of study, characterizing educational activities;
• if the examination is repeated, you should provide a certificate of disability, an individual rehabilitation course program (marks on the procedures performed must be present).

Expert opinion

It is possible to assign a disability group, if sugar is detected, only after carrying out the relevant laboratory research and studying the medical history. This process is carried out by experts. medical and social expertise.

It should be noted that it is carried out not only to establish a disability group, but also in order to determine in the course how much a person has professional working capacity and the duration of the rehabilitation period if type 1 diabetes is diagnosed. Conclusions and results will be issued on the basis of diagnostics and research:

• blood and urine, sugar, acetone;
• renal and hepatic biochemical tests;
• electrocardiograms.

For the appointment of disability in without fail held ophthalmological examination for blindness. It is mandatory to examine a neurologist with all necessary research for condition assessment nervous system and the extent of her injury.

Patients are examined by a surgeon, a specialist does dopplerography, rheovasography (to detect gangrene, trophic ulcers).

Therapeutic conclusions are taken into account - echocardiography, pressure indicators and cardiograms, if symptoms of diabetic cardiomyopathy are present.

To reveal diabetic nephropathy, tests of Zimnitsky and Rehberg are carried out.

If any violations are identified or total absence disability experts can give a disability group.

Disability is not only a way social protection people who suffer from diabetes. patients after careful diagnostic examination they are sent for rehabilitation, in which all the recommendations and prescriptions of doctors should be followed. In some cases, patients require treatment in sanatoriums, resorts. Expert opinion makes it possible to pass free course rehabilitation.

To date, pharmacology has not developed a cure for diabetes. All methods of treatment are aimed at prolonging the life of patients and improving its quality. But sometimes disability with such a pathology is an inevitable consequence.

Diabetes - severe incurable disease, at which excess amount blood sugar damages many systems and organs.

The treatment developed to date can only temporarily restrain the development of diabetes mellitus, but cannot get rid of it.

In itself, the presence of this disease is not an indication for, which is assigned in the presence of complications that disrupt the function of the organ, reduce the quality of life, and disable it. It does not matter what type of diabetes (1 or 2) the patient has.

The group is assigned to patients with type 1 or 2 diabetes, accompanied by significant decline functions certain bodies, as well as in the presence of decompensation.

Diabetes is considered compensated, in which blood sugar does not rise during the day above the norm set for diabetics, even after eating.

• passport or (up to 14 years old);
• statement of the legal representative;
• pediatrician's referral, outpatient card, examination results;
• characteristics from the place of study.

Working conditions for diabetics

Diabetes is incurable endocrine disease in which the natural mechanism of insulin production is disrupted. Complications of the disease affect the patient's ability to lead full life. First of all, it concerns the labor aspect. Patients with both types of diabetes require constant control from the side medical professionals and receiving special medications.

In order to realize additional rights to social and medical care, suffering from this pathology are often interested in whether they give disability in diabetes mellitus.

Factors affecting the receipt of disability

The disability group that will be assigned to a diabetic depends on the nature of the complications that appear during the course of the disease. The following points are taken into account: congenital or acquired diabetes in humans, type 1 or 2 disease. When preparing the conclusion, doctors must determine the form of severity of the pathology localized in the body. Gradation of forms of diabetes:

1. Light: maintenance of glucose levels is achieved without the use of pharmacological agents- due to diet. Indicators of morning measurement of sugar before meals should not exceed 7.5 mm / liter .;
2. Medium: twice the normal concentration of sugar. The manifestation of concomitant diabetic complications- retinopathy and nephropathy in the early stages.
3. Heavy: blood sugar level of 15 mmol/liter or more. The patient may fall into diabetic coma or long time stay on the edge. Severe kidney damage occurs of cardio-vascular system; possible severe degenerative changes in the upper and lower extremities.
4. Particularly heavy: paralysis and encephalopathy caused by the complications described above. In the presence of a particularly severe form, a person loses the ability to move, is not able to perform the simplest self-care procedures.

Disability in type 2 diabetes mellitus is guaranteed in the presence of the complications described above in the event that the patient has decompensation. Decompensation is a condition in which the sugar level does not normalize when dieting.

Factors affecting the assignment of a disability group

The disability group in diabetes mellitus depends on the nature of the complications of the disease.

The first group is assigned in the presence of:

• acute kidney failure;
• encephalopathy of the brain and mental abnormalities caused by it;
• gangrene of the lower extremities, diabetic foot;
• regular states of diabetic coma;
• factors that do not allow you to work, serve your own needs (including hygiene), move around;
• disturbances of attention and orientation in space.

The second group is assigned in the presence of:

• diabetic retinopathy of the 2nd or 3rd stage;
• nephropathy, the treatment of which is impossible with pharmacological drugs;
• renal failure in the initial or terminal stage;
• neuropathy, accompanied by a general decrease vitality, minor lesions of the nervous system and musculoskeletal system;
• restrictions on movement, self-service and labor activity.

Diabetics can count on the third group of disability with:

• moderate impairment functional state some internal organs and systems (provided that these violations have not yet led to irreversible degenerative changes);
• minor restrictions on work and self-service.

Disability in type 2 diabetes usually involves the assignment of the third group.

Before applying for disability, the patient must be aware that he will be expected to be limited in the performance of work duties. This is relevant for those employed in production and work associated with physical activity. Holders of the 3rd group will be able to continue working with minor restrictions. Disabled persons of the second category will be forced to withdraw from activities related to physical activity. The first category is considered incompetent - such patients need constant care.

Diabetes Disability Form

Before you get a disability with diabetes, you need to go through several medical appointments, take tests and provide medical institution at the place of residence a package of documents. The process of obtaining the status of "disabled" should begin with a visit to the local therapist, and based on the history and results primary examination require a referral to the hospital.

In the hospital, the patient will be required get tested and tested. The list below:

• urine and blood tests for sugar concentration;
• results of measurements of glucose levels;
• urine test for the presence of acetone;
• results of a glucose load test;
• tomography of the brain;
• results of an examination by an ophthalmologist;
• Rehberg's urine test;
• data with measurements of the average daily volume of urine;
• conclusion after examination by the surgeon (the presence of trophic ulcers, other degenerative changes in limbs);
• results of hardware dopplerography.

In the presence of concomitant diseases, conclusions are attached on the current dynamics of their course and prognosis. After passing the examinations, the patient must begin to form a package of documents necessary for submission to the medical and social examination - the body at the place of residence, which assigns the status of "disabled".

If a negative decision is made regarding the patient, then he has the right to challenge the verdict in the regional office by attaching a corresponding statement to the package of documents. If the regional ITU bureau similarly denied, the diabetic has 30 days to appeal to Federal Bureau ITU. In all cases, the response from the authorities must be given within a month.

The list of documents to be submitted to the competent authority:

• copy of the passport;
• the results of all analyzes and examinations described above;
• doctors' opinions;
• application of the established form No. 088 / y-0 with the requirement to assign a disability group;
• sick leave;
• an extract from the hospital on passing examinations;
• medical card from the institution at the place of residence.

Employed citizens are additionally required to attach a copy of the work book. If a person quit earlier due to poor health or has never worked, he needs to include certificates in the package confirming the presence of diseases incompatible with professional activity, and the conclusion about the need for rehabilitation.

If disability is issued for a diabetic child, then parents provide a birth certificate (up to 14 years old) and a reference from a general education institution.

The process of collecting and submitting documents is simplified if the examination of patients and the ITU are administered by the same medical institution at the place of residence. The decision to assign a disability to the corresponding group is made no later than one month from the date of submission of the application and documents. The package of documents and the list of analyzes are the same regardless of whether the applicant intends to issue a disability for type 1 or type 2 diabetes.

Disability in type 1 diabetes, like disability in type 2 diabetes, requires periodic confirmation.

Upon re-passing, the patient provides a certificate confirming the previously assigned degree of incapacity and a rehabilitation program with marks of current progress. Groups 2 and 3 are confirmed annually. Group 1 is confirmed once every two years. The procedure takes place at the ITU office at the place of residence.

Benefits and other types of social assistance

A legally assigned category of incapacity allows people to receive additional funding. Diabetics with disabilities of the first group receive allowances as part of the disability pension fund, disabled people of the second and third groups - when they reach retirement age.

Regulations oblige diabetics with disabilities to be supplied free of charge (in accordance with quotas):

• insulin;
• syringes;
• glucometers and test strips to determine the concentration of sugar;
• drugs to lower glucose levels.

Patients with type 2 diabetes have the right to sanatorium treatment, the right to training for a new labor specialty. Also, patients of all categories should be provided with drugs for the prevention and treatment of complications of diabetes. Also, for these categories, utility bills are reduced by half.

A child who has received the status of "disabled" due to diabetes is exempted from passing military service. During study, the child is exempted from final and entrance examinations, certification takes place on the basis of average annual grades. More

Diabetic women can count on a two-week increase in maternity leave.

Pension payments for this category of citizens are in the range of 2300-13700 rubles and depend on the assigned disability group and the number of dependents living with the patient. Disabled people with diabetes can generally use the services social workers on a universal basis. If a person's income is 1.5 living wages or less, then the services of a social service specialist are provided free of charge.

With the progression of the disease, the quality of life of a person worsens: the patient often loses the ability to move independently, work, and serve himself. Diabetes is incurable chronic illness Therefore, if there are indications, a diabetic is recognized as permanently disabled.

Do diabetes give disability?

A pathology in which the regulation of blood glucose levels is disturbed is called diabetes mellitus (DM). The disease has several types, differing in causes and mechanisms of development. Pathology may be associated with a violation of the secretion of the hormone insulin, which reduces glucose levels (insulin-dependent or type 1 disease) or with a violation of the hormone (type 2). Increased amount blood sugar leads to damage to blood vessels and the nervous system, as a result of which, over time, each of the forms of the disease leads to complications.

What does disability depend on?

A group for diabetes mellitus is assigned after examining the patient's condition according to certain criteria. The patient is assessed by a special medical and social examination. The evaluation criteria include:

• Employability. At the same time, the patient's ability to engage in not only habitual activities, but also light work is determined.
• The ability to self-care and the ability to move independently. Due to complications, some patients lose their limbs and vision.
• The presence of dementia. severe forms pathologies are accompanied by serious mental disorders up to dementia.
• The degree of compensation general state organism. Assessed using the results of a laboratory examination.

Groups of disability in diabetes mellitus

In total there are three groups of disability. Medico-Social Commission distributes patients into categories according to certain criteria: the severity of the condition general health, the presence and degree of compensation of the disease. The size of state payments, various benefits, and the opportunity to get a job depend on which group is assigned to a diabetic. Among the conditions for registration of disability, there are restrictions on self-service, movement, and communication. Disability in type 2 diabetes is assigned several times more often.

First

When determining the degree of disability, the commission takes into account the peculiarities of the course different forms diseases. To establish the first group, the patient must have serious violations in the functioning of organs, systems, the impossibility of independent movement, self-service. In addition, the first group is assigned in the presence of the following complications:

• complete blindness in both eyes;
• neuropathy;
• heart failure in the stage of decompensation;
• severe angiopathy and gangrene;
• frequent diabetic coma.

Second

The conditions for assigning the first and second categories of disability for complications of diabetes are different. Patients with the second group suffer from the same pathologies, but in a more mild form. In addition, the patient must have a first-degree limitation on working capacity, movement and self-care, so patients need partial care. Medical and social examination assigns the second group of disability in the presence of the following pathologies:

• third degree retinopathy;
• chronic renal failure;
• second or third degree neuropathy (general strength muscle tissue less than 2 points);
• encephalopathy;
• mental disorders;
• mild angiopathy without trophic disorders.

Third

In the presence of complications that occur in a mild or moderate form, but affect the ability to work and worsen the patient's quality of life, a third disability group is assigned. In this case, the patient has no pronounced pathological changes organ systems. For self-service, operability should be determined by the first degree of limitation. The third group is assigned to those patients who need a change in working conditions and the elimination of contraindicated factors. In diabetes mellitus, third-degree disability is often prescribed temporarily.

About children

For a child under the age of 18, members of the medical and social examination (MSEK) establish a state of disability without specifying the status. After reaching the age of majority, you should undergo a re-examination and re-examination to establish a certain disability group. The following documents are required for registration:

• passport (if available) or birth certificate;
• parent's statement
• medical card with survey results;
• referral from the local pediatrician to MSEC (the design must comply with the form No. 088 / y-06).

How to get a disability

The issue of disability is decided by a special medical commission after evaluating the results of tests, examining the patient different specialists. During the examination, the degree, timing of the loss of working capacity, the volume necessary rehabilitation. The procedure for establishing disability is often lengthy and laborious. The disability group for type 1 diabetes mellitus is indicated in the following cases:

• serious condition the patient;
• frequent hypoglycemic coma, states of ketoacidosis;
• violations normal operation internal organs.

AT Russian Federation exists normative act(Order of the Ministry of Labor), which regulates disability in diabetes and the procedure for referring patients with permanent disability for examination. In accordance with the document, the severity of the disease and its complications is assessed as follows:

• insignificant;
• moderate;
• pronounced persistent violations;
• significant violations.

Surveys

To pass an examination for the assignment of a disability, you should contact a local therapist who will issue the necessary referrals to narrow specialists (endocrinologist, neurologist, ophthalmologist, surgeon, etc.). During examinations, doctors assess the presence of indications and the possibility of obtaining the status of a disabled person. In addition, during the examination, a number of instrumental research and clinical analyzes:

• blood tests (biochemistry, sugar analysis, glycated hemoglobin, sugar load test);
• urinalysis according to Zimnitsky;
• electrocardiogram;
• echocardiogram;
• arteriography;
• rheovasography;