Medical Social Commission on Disability MSE (VTEK) - what documents are needed? Vtek: transcript. medical labor expert commission

Many people with disabilities do not understand the need for a re-examination procedure, especially in the case of a disability assigned in childhood or associated with severe irreversible changes in the body. Repeated examination is necessary not only to confirm a previously established disability, but also to adjust the rehabilitation program and monitor the dynamics of changes in health status. Re-examination of a child’s disability is especially important for organizing optimal living conditions and rehabilitation. The developed rehabilitation system allows for maximum integration into the life of society.

In addition, a group 3 disabled person receives monthly benefits, benefits and other payments, which greatly facilitates the solution of many problems that a sick person faces. For other disability groups, the value state support even more significant. Therefore, the re-examination procedure is important point in the life of a person with disabilities.

Procedure and terms for re-examination of disability

Re-examination takes place in accordance with the established federal law order with frequency determined depending on disability groups. Currently in effect following rules going through this procedure:

A disabled person of group 3 is required to undergo re-examination once during the year.

A disabled person of group 2 must come for re-examination 1 time during the year.

Disabled people of group 1 must undergo re-examination 2 times during the year.

Disabled children undergo the procedure once before the end of the period for which the disability is determined.

At permanent disability You can undergo a re-examination by writing an application in person or on behalf of a legal representative. In addition, the institution providing medical and preventive care may also refer for a disability re-certification procedure if there is a change in the patient’s health status.

You can go through the procedure in advance, but to conduct a re-examination earlier than two months before the end of the disability period, you must have a personal statement or a referral from a medical organization that monitors the progress of the citizen’s illness.

The re-examination procedure is also carried out at home. To do this, it is necessary for the attending physician to make special marks in the direction.

Main and Federal Bureau of Medical and Social Expertise

Re-examination of the disability group is carried out on the basis medical and social examination, which is carried out free of charge in the bureau of medical and social examination at the place of residence, the main bureau and the Federal Bureau.

The federal government institution “Main Bureau of Medical and Social Expertise” (FKU GB MSE) is a regional service for conducting examinations, as well as providing a range of services for rehabilitation and health restoration.

FKU GB MTU performs the following functions:

Organizes a re-examination in case of filing an application to appeal the conclusion of the expert commission to the bureau at the place of residence.

Conducts MSE in situations where a special medical examination is necessary.

Performs statistical analysis of data on the number and demographic composition of citizens with disabilities who contact the bureau.

Develops measures to prevent disability.

Controls the activities of each bureau.

Federal Bureau of Medical and Social Expertise (FB ITU) is federal Service conducting an examination, as well as providing a range of services for rehabilitation and health restoration. In addition, the tasks of the FB ITU include ensuring high-quality prosthetics.

The Federal Bureau organizes control over the activities of other bureaus, can appoint and carry out repeated examinations, change or cancel decisions, accepted by employees other bureaus.

Citizens who do not agree with the conclusions of the commissions of the main bureaus can file a complaint with the Federal Bureau, where a new examination will be ordered. Here ITU and consultations are carried out on the direction of the main bureaus in situations where it is necessary to obtain it expert opinion or it is necessary to carry out complex look medical examination.

Medical and social examination procedure

The examination procedure is organized by employees of the bureau's expert group. An examination of the person who applied for an examination is carried out, his social, everyday, psychological and work characteristics. Medical documentation of the disease is studied. Based on an assessment of all the data received, a decision is made to establish disability, extend it, or change the disability group.

If, as a result of the commission, an improvement in the health, ability to work and social adaptability of a citizen was revealed, then the disability group can be changed. A disabled person of group 2, in case of improvement in health indicators and living conditions, may receive, during re-examination,

The commission’s conclusion is announced to the citizen in the presence of all members of the expert panel and is included in the report on the examination performed. The document also contains a number of information and certificates on the basis of which the conclusion was made.

If necessary, additional examinations are prescribed, carried out at a medical organization or the Federal Bureau. In a situation where a citizen refuses the program additional examinations this information is noted in the act, and a decision is made based on the available information.

The examination procedure can be carried out at home if, due to health conditions, a person cannot come to the office. This requires a decision from the relevant bureau or a referral from the medical institution where the citizen is being observed, or from the hospital where treatment is provided.

Conclusion of ITU specialists

The ITU conclusion is the result of the work of the expert commission. The composition of the commission’s specialists depends on the bureau and its profile. The examination of the main bureau is carried out by four doctors of different profiles, an expert in rehabilitation work, and a psychologist. The staffing of the bureau at the place of residence includes the same specialists as the main bureau, but the number of doctors various profiles less (three medical workers). The commission staff makes decisions based on a majority vote.

The composition of the expert commission depends on the head of the bureau, who decides on the participation of a particular specialist in the ITU procedure. Also, a citizen sent for examination to the bureau has the right to attract additional experts, but subject to payment for their work. The decision of these panel members will influence the final conclusion of the ITU.

ITU specialists draw up a conclusion based on the provided medical documentation, after examining the citizen, and discussing all the information received collectively. After announcing the decision, the commission’s experts provide explanations on the conclusion made to the citizen who contacted the bureau.

Appealing ITU findings

In a situation where the decision of the bureau's expert commission during the re-examination of disability seems unfounded, you can file an appeal with the bureau at the place of residence where the examination took place. During three days the application will be sent to the main bureau, where a conclusion will be issued based on the results of the new examination. In a situation of disagreement with the conclusion of the main bureau, an appeal is sent to the Federal Bureau. In connection with the appeal, a re-examination will be carried out and a final decision will be made.

The conclusion of the federal bureau can only be appealed in court.

To appeal the bureau's conclusion, you must write a statement indicating:

Names of the specific bureau for consideration of which the application is sent.

Personal data (last name, first name, patronymic, residential address, contact information) of the applicant.

Personal data of the representative.

The subject of the complaint about the examination performed.

Requests for a re-examination procedure.

Application submission dates.

How to pass the ITU?

Based on the results of the re-examination, the disability is extended or removed, the disability group is changed, which entails a change in the IPR, the amount of benefits and allowances.

For successful completion During the examination, it is important not only to collect all the necessary documents and test results, but also to prepare psychologically for the procedure. The decision is made by members of the expert panel based on an assessment of disability, and the impression that the citizen makes on the commission members plays an important role. Therefore, you should not behave aggressively or be offended by incorrect questions. You should answer calmly and accurately. In this case, the reaction of embarrassment to the question will be much better than impatience and anger. Some of the most frequently asked questions that you need to be prepared for include:

Questions about the course of the disease.

Questions about ability to work (availability of work, comfortable working conditions, etc.).

Questions about the treatment being carried out (passing IPR procedures, reasons for refusing recommended types of diagnostics, etc.).

Questions related to the functioning of the body.

Questions about the financial condition of family members, in order to identify the possibility of the patient’s participation in expensive rehabilitation programs that are not subject to government subsidies.

Re-examination of disability, documents required for ITU

To undergo re-examination of disability, you must have with you a passport of a citizen of the Russian Federation, a work book, a referral from for the examination procedure, an outpatient card, an IPR with instructions for implementation. You must also write and take with you an application to the head of the bureau for re-examination. If during the year before the re-examination procedure consultations with specialists were carried out or treatment was carried out in a hospital, then the relevant documentation must be provided by an expert specialist. It is better to make copies of some documents to provide if necessary.

Disabled children undergo the re-examination procedure in almost the same order as the initial examination. List necessary documents the same, but a certificate of disability and IPR is added. When re-certifying a child’s disability, the following must be present:

Child's birth certificate or passport (if the child reaches 14 years of age).

Outpatient card.

Certificates of education received or certificates from where the training took place.

Conclusions of specialized specialists, extracts from hospitals.

A document confirming disability;

Extension of disability

Before extending your disability, you must contact a medical institution at your place of residence. It is necessary to have a passport, medical insurance policy, ITU certificates on the establishment of disability, outpatient card, discharge from the hospital (if treatment took place there), IPR. Medical worker will issue a referral for examination, as well as for necessary procedures and taking tests. You need to visit the office and make an appointment for the closest date to the end of your disability period for re-examination. After this, you need to contact your doctor for the underlying disease, who will give an opinion for the expert commission. It is also required to undergo examination by two narrow specialists, to whom the local therapist will refer. After receiving the test results and undergoing consultation with all doctors, you should again come to see the therapist, who will enter the data into the certificate and issue a referral. Then, with all the certificates and copies of the main documents, you can go to the ITU procedure.

In case of refusal to extend disability, a certificate is issued indicating the result of the examination and the grounds for refusal. The bureau's decision can be appealed to the Federal Bureau or in court.

Re-examination of childhood disability

Re-examination of a child’s disability takes place in a slightly different manner than for adults. One parent must be present. The list of required documents differs. In addition, a disability group cannot be established, since childhood assigned the general category “disabled child”.

A referral is required for the procedure. medical institutions. The re-examination takes place no earlier than two months before the expiration of the disability, but no later than the specified date of the medical and social examination. Inpatient observation is not necessary to prolong a child’s disability. The individual rehabilitation program is of a recommendatory nature; the implementation of all the measures specified in it is not prerequisite for re-examination of disability.

Very often, upon reaching the age of 18, upon re-examination, the person’s ability to work is recognized. This is due to the fact that when installing adult disability the main focus is not on violations of body functions, but on assessing the ability to move independently, self-care, labor activity etc.

Disability without re-examination

There is a list of diseases for which disability is established without specifying the period for re-examination.

Such diseases include:

Diseases of internal organs.

Neuropsychiatric disorders.

Anatomical defects.

Eye diseases.

In this case, disability without re-examination is established no later than two years after the initial recognition of disability for diseases on this list.

Disability can also be established without re-examination if the expert commission has identified the impossibility of improving the health status, rehabilitating a person and reducing the limitations of his life activities. In this case, no more than four years must pass after the initial disability examination.

To establish disability without a period for re-examination, there must also be no positive dynamics in rehabilitation carried out before the appointment of ITU. The relevant data is indicated in the referral for examination.

In addition, the re-examination procedure is not prescribed for women after 55 years of age and men after 60, and permanent disability is established.

According to social protection specialists, it is better to undergo re-examination even in the case of permanent disability, in order to promptly identify deteriorating health conditions or the need to replace a prosthesis.

If the federal bureau checks the decisions of the main bureau, then in case of disability without a period for re-examination, an ITU may still be assigned.

Failure to appear for re-examination of disability

In case of failure to appear for the medical and social examination procedure, the payment of the pension will be suspended for three months. If, within the specified period, the medical and social examination services confirm disability, pension payments will resume from the date of re-recognition of disability.

In a situation where re-examination was missed due to good reason, payment of pensions will be assigned from the date of re-certification of disability, including payments for missed deadlines. The length of the period during which pension payments were not made does not matter. Moreover, if the expert commission establishes a different degree of disability, then payments for the missed period will be made according to the previous calculation system.

Resumption of payments is made automatically after the Pension Fund receives the relevant documentation, which is sent by a specialized medical and social examination service and confirms the re-examination procedure.

A medical and social examination (MSE) of a citizen is carried out in the bureau at the place of residence (at the place of stay, the location of the pension file of a disabled person who has moved for permanent residence outside the Russian Federation) (clause 10, Administrative Regulations, approved by Order of the Ministry of Labor of Russia dated January 29 .2014 N 59n; clause 20 of the Rules, approved by Decree of the Government of the Russian Federation of February 20, 2006 N 95).

Place of residence is a residential house, apartment, room, residential premises of a specialized housing stock or other residential premises in which a citizen permanently or primarily resides as the owner, under a lease (sublease) agreement, a lease agreement for specialized residential premises or on other grounds provided for by law of the Russian Federation, and in which he is registered at the place of residence (paragraph 8 of article 2 of the Law of June 25, 1993 N 5242-1; clause 3 of the Rules, approved by Decree of the Government of the Russian Federation of July 17, 1995 N 713 (hereinafter referred to as Rules N 713) ; clause 1 of article 20 of the Civil Code of the Russian Federation).

A citizen must be registered at the place of residence (Article 6 of Law No. 5242-1). The fact of registration of citizens at the place of residence is confirmed by a mark in the passport or a certificate of registration at the place of residence for persons under 14 years of age (clause 18 of Rules No. 713).

Note. Registration at the place of residence is often called the place of registration.

The place of residence is the place where a citizen temporarily resides - a hotel, sanatorium, holiday home, boarding house, camping, tourist base, medical organization or other similar institution, an institution of the penal system that carries out punishments in the form of imprisonment or forced labor, or residential premises that are not the place of residence of a citizen (paragraph 7, article 2 of Law No. 5242-1; clause 3 of Rules No. 713).

Citizens are registered at their place of stay without being deregistered at their place of residence (Article 5 of Law No. 5242-1). The fact of registration of citizens at the place of stay in residential premises that are not their place of residence is confirmed by a certificate of registration at the place of residence (Article 3 of Law No. 5242-1; Clause 12 of Rules No. 713).

However, if a citizen moves between populated areas (arrives in a populated area) of the constituent entity of the Russian Federation in whose territory he is registered at his place of residence, then he has the right not to register at his place of residence (Part 2 of Article 5 of Law No. 5242-1).

The same rule applies to Moscow and the Moscow region, St. Petersburg and the Leningrad region, as well as to Sevastopol and the Republic of Crimea. In particular, this means that a citizen of the Russian Federation has the right not to register at the place of residence in a residential building located in Moscow or in one of the settlements of the Moscow region, if he is already registered at the place of residence in Moscow or the Moscow region. A similar rule applies to other specified entities (Parts 3, 5, Article 5 of Law No. 5242-1).

Thus, a citizen has the right to undergo medical examination at the registration address at the place of residence or place of stay. Registration at the place of residence is mandatory only if you pass the ITU in locality located outside the constituent entity of the Russian Federation in whose territory the citizen is registered at his place of residence. Residents of Moscow and the Moscow region, as well as residents of St. Petersburg and the Leningrad region, as well as Sevastopol and the Republic of Crimea, have the right to undergo the ITU at their place of residence, both in the city and in any locality of the subject of the Federation without registration.

How to successfully pass an examination in medical and social examination institutions?

Many patients who apply for the first time to medical and social examination institutions remain dissatisfied with the decisions made and the examination procedure itself, since they are forced to complete additional documentation and undergo additional clinical and laboratory examinations.
Some simple tips will help in solving such problems.

First of all, it is necessary to check the correctness of the documentation that will be submitted for examination.

A referral for a medical and social examination (your main document), drawn up in a medical and preventive institution (MPI) at the place of observation and treatment, must be certified by the seal of this institution and at least 3 signatures of doctors (including the signature of the chairman of the medical commission or the chief doctor).

Extracts from hospitals must be certified by their seals (having only a corner stamp and the doctor’s personal seal is not enough).

Check the correctness of the passport data in the above documents, since an error in even one letter will invalidate them.

Make photocopies of all hospital extracts and attach them to the referral for medical examination, preferably in chronological order. For examination, be sure to take the originals of all hospital extracts and other medical records. documents ( ITU experts They will check them with photocopies and the originals will be returned to you).

The results of your observation and treatment in an outpatient setting are important in the examination, so the outpatient card should be with you. If there are ambulance call tickets, they must be attached to outpatient card(it is advisable to photocopy them as well).

If you have pathologies of the musculoskeletal system (fractures, arthrosis-arthritis, spinal pathology), you should take with you x-rays- preferably fresh (no more than 1 month before the date of examination). In this case, the direction to the ITU should contain a description of them. If there are a lot of pictures (take everything you have - it is important to assess the dynamics of the disease) - it is advisable to put them in chronological order. If you are suffering hypertension and there are crises on the outpatient card - you can carefully make bookmarks with colored stripes (stickers) on the pages where they are recorded - this should be done in the last 12 months before the examination.

If for Last year were sick leave- it is advisable to write it down on a separate sheet - from what date and to what date, indicating the diagnosis and duration in days. Unfortunately, doctors at health care facilities do not always fill out this item in detail and accurately when sending it to the medical examination.

If there are conclusions of narrow specialists (consultations: cardiologist, pulmonologist, nephrologist, gastroenterologist, orthopedic traumatologist, neurosurgeon, etc.) - obtained in other medical institutions- they must also be certified by the seal of these health care facilities (and not just the personal seal of the consulting doctor). Check the dates of issue of the conclusions and passport data in them.

Information about your education may be required - for students - a certificate of study from an educational institution, for others (especially young people of working age) - a copy and original (bring it with you) of an education diploma.

The work record book (or its copy certified by the HR department) is also provided to the ITU. It is also advisable to make a photocopy of your passport (the original, of course, must be with you). For workers - a production description, indicating working conditions and how the patient copes with his duties (the date of its preparation must be indicated and must be certified by the seal of the enterprise).

You must be mentally prepared for the fact that the decision made may not coincide with the one you expect. You should not rely excessively on the opinions of medical doctors, who sometimes allow themselves to express an opinion about the specific disability group you are entitled to. This is the most common reason conflict situations arising in the process of announcing an expert decision.

The attending physicians do not have the appropriate expert training and should not “tune” the patient to a certain specific solution. They bear absolutely no responsibility for their verbally expressed opinion about which group a particular patient belongs to. In contrast, expert doctors draw up an expert medical file for each patient, where they justify their decision in writing with reference to the relevant regulations, certify it with their signatures and the seal of the ITU institution and bear full responsibility for it. legal liability. This important point should be very well understood.

It is advisable to take a clean sheet with you to the examination, since during the examination while lying on the couch, you will need it.

You can take an interesting book so that waiting to be called into the meeting room is not tiresome. It is not advisable to take a player or radio - you may disturb others, and if you use headphones, you will not hear how they invite you.

The right of priority call is enjoyed by: WWII veterans, WWII disabled people and liquidators of the Chernobyl accident. Therefore, if you belong to one of the above categories, you should inform the commission about this.

Take it with you medicinal preparations, which may be useful to you when waiting for a call for a long time, first of all this applies to patients diabetes mellitus, hypertension and ischemic heart disease. The duration of the examination can vary from several tens of minutes to several hours, depending on the workload of the ITU institution.

Therefore, you should be prepared for a possible long wait.

The most severely ill patients, who are unable to come to an ITU institution for examination, are examined at home (very rarely and in cases of exceptional remoteness of the patient, a decision can be made in absentia - based on documents). In this case, the referral for medical examination is accompanied by a certificate from the Medical Commission (medical commission) stating that for health reasons the patient cannot appear for examination. It is advisable for elderly and seriously ill patients to come accompanied by relatives - who, if necessary, will help them get dressed and undressed during the examination, complement their complaints, and supervise their return home.

Given the high workload of most ITU institutions, you should prepare in advance to answer the questions that will be asked during the certification process.

Experts, as a rule, first get acquainted with your honey. documentation - therefore, during the communication process, only the necessary clarifying questions are asked.

You should answer the question posed precisely, avoiding, if possible, unnecessary details. As a rule, questions are asked about the onset of the disease, how it progressed, whether (when, where and how many) inpatient treatment, operations (their dates), the effect of the treatment and your personal plans regarding employment (do you consider yourself completely disabled, intend to find an easier job, or plan to continue treatment on sick leave). Questions are asked about outpatient treatment- what medications, in what dosage, the patient takes daily.

After questioning the complaints, the patient is examined by experts, if necessary, in a lying position on the couch. The details of the examination depend on the specific diagnoses of the patient. In most cases, the patient is asked to undress down to his underpants. After the examination, the patient is asked to wait in the corridor, at which time the specialists collectively, during a joint discussion, make an expert decision. Then decision announced to the patient.

It is possible that you will be offered further examination - if the experts consider that in order to make a final decision it is important to obtain additional information characterizing the state of your health.

In this situation, it is advisable, if possible, to agree, since it is in your best interests to obtain additional information about the state of your health and thereby increase the accuracy of the decision made. However, you have the right to refuse further examination - in this case you will be asked to write written refusal from him, the decision will be made on the basis of available documents and objective examination data.

Do not forget that if you are recognized as disabled, your pension and other benefits will be accrued from the moment the examination begins (if you have a second examination, i.e. if you have previously been recognized as disabled). The beginning of the examination is considered to be the day of registration at the ITU institution of your documents (application with a request for examination with a referral to the ITU attached to it).

If you are recognized as disabled for the first time, then your pension will begin to accrue not from the date the examination begins, but from the date of writing the application for accrual of the pension (this application is written in Pension Fund, where you will need to appear with a certificate of disability).
Therefore, you should not delay your visit to the Pension Fund after you have been initially recognized as disabled (the sooner you write an application to the Pension Fund, the sooner they will start accruing your pension).

Briefly about how to act correctly in a situation when you do not agree with the decision made. In this case, firstly, you should remain calm and not insult the employees of the ITU institution who are in the performance of their duties. official duties. You should state that you do not agree with the decision and ask for clarification of the procedure for appealing it. You are required to provide appropriate explanations.

The decision of the ITU establishment can be appealed to a higher headquarters ITU Bureau or to court, in the manner prescribed by current legislation. There is no particular point in appealing the decision directly to the court, since there are no specialists in ITU there and a competent judge will be forced to look for the same specialists from the higher Main Bureau as an arbitrator, just spend money on a lawyer. It is more rational to write a statement of disagreement with the decision made and with a request to have your examination carried out at the higher ITU Main Bureau. This statement can be written either directly at the institution where you were examined, or in person to the higher ITU Main Bureau (at your discretion). Within three days from the date of writing your application, your expert medical file is transferred to the ITU Main Bureau, whose specialists will check the validity of the decision (within a maximum of 1 month). You will be invited to them for an examination (or they will come to your home - if there is a certificate from the VK about the patient’s inability to come for the examination). If there are grounds, they have the right to change the decision made.

By following these simple recommendations, you will be able to feel more confident during the examination and go through the medical and social examination procedure faster and more successfully. Believe in yourself and you will definitely feel better. Good luck to you in achieving your goals.

First of all, you need to contact your doctor to arrange a referral for a medical and social examination. Referral to ITU is official document, the form of which is approved by the Ministry of Health and social development Russian Federation.

The referral for a medical and social examination - your main document - must be certified by the seal of the medical organization at the place of observation and treatment and at least 3 signatures of doctors (including the signature of the chairman of the medical commission).

Upon receipt of a formalized referral for medical examination, the attending physician explains to you where you will undergo a medical and social examination. Actual information information about the work schedule of the ITU office, telephone numbers is always available in medical organizations.

There are cases when the attending physician refuses to refer you to medical examination. Then he is obliged to issue a certificate of refusal to the ITU.

In some cases, a referral to ITU may be issued by the body carrying out pension provision, organ social protection population at the place of residence.

ATTENTION! Currently, it has become possible to submit an application for a medical and social examination and to appeal the expert decision of the ITU Bureau to the Unified Portal of State and municipal services.

On Portal public services (www.gosuslugi.ru) you can submit an application for a medical and social examination for any purpose:

definition of disability,
determining the degree of loss of professional ability to work,
change in the cause of disability,
development individual program rehabilitation or habilitation of a disabled person (disabled child),
development of a rehabilitation program for the victim,
establishing the cause of death of a disabled person.

Through the Portal, you can also submit an application to appeal the expert decision of the Main Bureau to the Federal Bureau.

To undergo the ITU, you need to take with you additional medical and other documents that can help medical experts better understand the course of your disease:

extracts from the hospital (preferably in chronological order);
medical card outpatient;
Ambulance call tickets (if available) must be attached to the outpatient card.
X-rays - preferably fresh (no more than 1 month before the date of examination). In this case, the direction to the ITU should contain a description of them. If there are a lot of pictures (take everything you have - it is important to assess the dynamics of the disease) - it is advisable to put them in chronological order;
conclusions of narrow specialists (consultations: cardiologist, pulmonologist, nephrologist, gastroenterologist, orthopedist-traumatologist, neurosurgeon, etc.) received in other medical institutions must be certified by the seal of these medical institutions (and not just the personal seal of the consulting physician). Check the dates of issue of conclusions and passport data in them;
information about your education - for students - a certificate of study from an educational institution, for others (especially for people of working age) - a diploma of education;
the work book (or a copy thereof certified by the HR department) is also provided to the ITU.
for working citizens - a production characteristic, indicating working conditions and how the employee copes with his duties (the date of its preparation must be indicated and must be certified by the seal of the organization).

It is advisable to take a clean sheet with you to the examination, since during the examination while lying on the couch, you will need it.

You can take an interesting book so that waiting for a call is not tiresome. It is not advisable to take a player or radio - you may disturb others, and if you use headphones, you will not hear how they will invite you.

Take it with you medications which may be useful to you, this primarily applies to patients with diabetes, hypertension and angina pectoris.

The most severely ill patients who are unable to come to the ITU office for examination are examined at home (very rarely, and in some cases, a decision can be made in absentia - based on documents). In these cases, the referral to the ITU indicates that for health reasons the patient cannot appear for examination. It is advisable for elderly and seriously ill patients to come accompanied by relatives who, if necessary, will help them dress and undress during the examination, complement their complaints, and supervise their return home.

You should prepare in advance to answer questions that will be asked during the examination process.

Expert doctors, as a rule, first get acquainted with your medical documentation Therefore, during the communication process, only necessary clarifying questions are asked.

You should answer the question posed precisely, avoiding, if possible, unnecessary details. As a rule, questions are asked about the onset of the disease, how it progressed, whether (when, where and how many) there were inpatient treatments, operations (their dates), the effect of the treatment and your personal plans regarding employment (do you consider yourself completely disabled, do you intend to find an easier job or plan to continue treatment on sick leave). Questions are asked about outpatient treatment - what medications do you take daily and in what dosage.

After questioning the complaints, the patient is examined by expert doctors, if necessary, in a lying position on the couch. The details of the examination depend on the specific diagnoses of the patient. In most cases, the patient is asked to undress down to his underpants. After the examination, the patient is asked to wait in the corridor, at which time the specialists collectively, during a joint discussion, make an expert decision. Then the decision made is announced to the patient.

It is possible that you will be offered additional examination - if in order to make a final decision it is important to obtain additional information characterizing the state of your health.

In this situation, it is advisable, if possible, to agree, since it is in your best interests to obtain additional information about the state of your health and thereby increase the accuracy of the decision made. However, you have the right to refuse further examination - in this case you will be asked to write a written refusal and the decision will be made on the basis of available documents and objective examination data.

You must be mentally prepared for the fact that the decision made may not coincide with the one you expect.

How to act correctly in a situation where you do not agree with the decision made: in this case, you should remain calm and not offend ITU bureau employees who are in the performance of their official duties. You should state that you do not agree with the decision made and ask for clarification of the procedure for appealing it. You are required to provide appropriate explanations.

The decision of the ITU Bureau can be appealed to the higher ITU Main Bureau or to the court, in the manner prescribed by current legislation. It is more rational to write a statement of disagreement with the decision made and with a request to have your examination carried out at the higher ITU Main Bureau. This statement can be written either directly at the bureau where you were examined, or at the higher ITU Main Bureau (at your discretion). Within three days from the date of writing your application, your medical expert documents are transferred to the ITU Main Bureau, whose specialists will check the validity of the decision. You will be invited to them for examination within 1 month (or they will come to your home - if there is a conclusion in the direction of ITU). If there are grounds, they have the right to change the decision made.

However, this article was written at a time when ITU bureaus were still working the old fashioned way - without the use of specialized software.
Currently, most ITU bureaus in the Russian Federation work using a specialized program - EAVIAS (Unified Automated Vertically Integrated Information Analytical System).
In this regard, during the examination at the ITU bureau, patients are asked questions, the answers to which are necessary to fill out the relevant points of this program.

Currently, most ITU bureaus in the Russian Federation work using a specialized program - EAVIAS (Unified Automated Vertically Integrated Information Analytical System).
In this regard, during the examination at the ITU bureau, patients are asked questions, the answers to which are necessary to fill out the relevant points of this program.

Passport data - filled out using an identification document (most often a passport) and there are no special questions for the patient when filling out this section of the program.

Family status;
number of family members living with a disabled person;
presence (and number) of disabled people in the family;
presence (and number) of children under 18 years of age in the family;
social status of the patient (the program offers a choice of only 2 options: “breadwinner” and “dependent” - this item is usually filled out without asking the corresponding question to the patient and is not always easy to answer unambiguously);

living conditions (the program offers several options to choose from: “separate apartment”, your own house (part of the house)”, “dorm room”, “lack of housing”, etc.);
availability of standard amenities in the home (electricity, sewerage, heating, bathroom, gas, telephone, balcony, Internet...);
the patient has his own separate room;
floor of residence.

education (what educational institution and when did you graduate, profession according to your diploma);
the beginning and end of his working life, what professions he worked in (usually this data is taken from a photocopy work book, which must be provided to the ITU);
what profession does the patient currently work in (if he works);
name of the organization (institution) in which the patient works;
address of the patient's place of work;
telephone number of the place of work (filling out this item often causes difficulties, since patients usually do not remember it from memory, but in production characteristics- it is not indicated);
characteristics of the work performed (according to the patient and according to the presented production characteristics);
way of moving from place of residence to place of work ( public transport, personal car, company transport, on foot);
duration of stay on sick leave (for the last 12 months - theoretically - this data should be in the Referral to ITU in form 088/u-06, but the attending physicians do not always fill it out properly - therefore - it is advisable - or check the completion of this item in form 088/u-06, or - write out on a separate sheet all sick leave certificates for the last 12 months, indicating diagnoses and dates of issue).

You also need to be able to complain.

Next comes the complaints section.
You also need to be able to complain.
Many patients, unfortunately, cannot even clearly state their complaints.
Phrases like: “I have a head, I have a back, I have legs, etc.”
- will cause nothing but irritation among experts (especially in conditions of time shortage).
Everyone has a head, back and legs.
And what needs to be presented is COMPLAINTS.
That is - WHAT, WHERE and HOW it hurts or otherwise bothers you (headaches - constant or periodic, pain in the heart (behind the sternum) - constant or periodic - how often (once a day, once a week, once a year, etc.) etc.) and when they occur (at rest, while walking, after eating, with excitement, etc.), what their nature is (stabbing, aching, pressing, bursting, dull, etc.), they themselves pass or are relieved with tablets (inhalers) - if they are relieved with medications - then what kind and (approximately) - after what period of time, the same applies to other attacks (choking, dizziness, pain in the abdomen, lower back, joint, spine, etc. .).

Next, the program contains a section on the medical history.
For primary patients (who are examined by the ITU bureau for the first time), the following points are usually clarified:
1. since when do they consider themselves sick;
2. how the disease progressed (very briefly);
when there were inpatient treatments for the main pathology (photocopies of all extracts from the hospital must be attached to the Referral to ITU in form 088/u-06 - in chronological order (at the top - the most “recent”, below - the “older”), and their originals - be sure to take them with you to the ITU (they may be required to verify them with photocopies, but after such verification they must be returned to you);
3. what treatment the patient is currently receiving (what drugs and in what dosage he is taking, what effect he notes from the treatment).

For repeat patients, information on the course of the disease (and its treatment) is clarified for the period that has elapsed since the last examination at the ITU bureau (that is, usually for 1 year - if we're talking about about the 2nd and 3rd disability groups or for 2 years - if we are talking about disabled people of the 1st group).

Next, the program contains sections that are filled out based on the results of an objective examination of the patient and on the basis of documents submitted to the ITU (without any questions to the patient).
The final section of the program is the development of IPR (PRP).
When filling out this section, the patient may have questions.
Repeated patients (previously recognized as disabled) - must submit to the ITU the old (developed during the previous examination) IPR - with the appropriate marks of completion (on receipt (or non-receipt) of TSR in the FSS, marks from the Central Employment Center (if recommendations were given for employment in the center employment), etc.
For primary patients, they can clarify the need for TSR ( technical means rehabilitation).
For example, there are crutches: axillary and with armrest support, walkers - walking or on wheels, etc. - the patient can be asked which ones he prefers.

After completing the survey of complaints and examining the patient (it is advisable to take a sheet with you), he is asked to wait outside the office while the experts process the data received, enter them into the program, consult and make a specific expert decision on his case.

The waiting period may vary - depending on many factors (the complexity of a particular expert case, the number of experts working in the bureau remaining after the reductions in the ITU Service taking place throughout the country, their experience in the EAVIIA program (mainly on how quickly they know how to type) and even about the stability of computer equipment (the phrase: “the computer is frozen” is probably known to many and has been heard in a variety of institutions and organizations - the ITU bureau is no exception in this regard), from the stability of the power supply in the ITU bureau (if there is a power outage, there may be big problems and time delays).
The number of patients (load per meeting) also plays a big role.
It is clear that the larger the volume of work and the fewer workers, the more time it will take to complete this work.

When the workload for 1 meeting is up to 18 people and when working with 4 medical experts (one of whom is the head of the ITU bureau), when working in the EAVIIAS program - the estimated time for completing documents after the patient leaves the office (after questioning his complaints and examination) - is approximately 1.5 hours (but this is ONLY provided that ALL ITU experts have EXCELLENT skills in working in the program, disability certificates are not written by hand, but printed on a printer and computer technology works stably).
In other cases, this time can increase significantly.
In general - in BEST CASE- 1,5 hour.
If certificates of disability are written by hand, then (subject to the above conditions) - 2 hours.

The decision is announced to the patient orally, and the following are issued: a certificate of disability, IPR (PRP).
If a patient is not recognized as a disabled person, he - at his request (only if the patient expressed such a desire orally) - is issued a free-form certificate stating that he is not recognized as a disabled person and the procedure for appealing the decision of the ITU bureau is explained (as a rule, most primary ITU bureaus already have standard forms statements of disagreement, which the patient can fill out to appeal the decision to the ITU Main Bureau).