Re-examination of disability. Medical and social expertise
Many people with disabilities do not understand the need for a re-examination procedure, especially in the case of a disability acquired in childhood or associated with severe irreversible changes in the body. Re-examination is necessary not only to confirm the previously established disability, but also to adjust the rehabilitation program, to monitor the dynamics of changes in the state of health. A reassessment of the disability of the child is especially important for the organization of the optimal conditions for his life and rehabilitation. The developed system of rehabilitation allows to fully integrate fully into the life of society.
In addition, the disabled group 3 receives monthly benefits, benefits and other payments, which greatly facilitates the solution of many problems that the sick person is facing. With other groups of disabilities, the importance of state support is still weighty. Therefore, the re-examination procedure is an important moment in the life of a person with disabilities.
The procedure and terms for the reassessment of disability
Surveillance is conducted in accordance with the procedure established by federal law with the frequency determined according to the groups of disability. At the moment, the following rules apply to the passage of this procedure:
• The disabled person of the 3rd group is required to undergo a one-time re-examination within a year.
• Invalid 2 groups during the year must come for a re-examination 1 time.
• Disabled persons of the 1st group must undergo a second examination 2 times during the year.
• Disabled children undergo the procedure once before the end of the period for which disability is determined.
With an indefinite disability, a second survey can be completed by writing the application in person or on behalf of the legal representative. In addition, the institution that carries out preventive care can also send a procedure for re-examining the disability with a change in the patient's state of health.
You can go through the procedure in advance, but for a re-examination earlier than two months before the end of the period of disability, you must have a personal application or referral of a medical organization that monitors the course of a citizen's illness.
The re-examination procedure is also carried out at home. For this, it is necessary that the attending physician make special notes in the direction.
General and Federal Bureau of Medical and Social Expertise
The reassessment of the disability group is carried out on the basis of medical and social expertise, which is carried out free of charge at the medical and social expertise office at the place of residence, the main office and the Federal Bureau.
The Federal State Institution "Main Bureau of Medical and Social Expertise"( PKU GBE ITU) is a regional examination service, as well as providing a complex of services for the rehabilitation and restoration of health.
PKU GBE The ITU performs the following functions:
• Organizes a re-examination in case of submitting an application to appeal an expert commission's conclusion to a local office.
• Conducts ITU in situations where a special medical examination is necessary.
• Carries out a statistical analysis of data on the number and demographic composition of citizens with disabilities and applied to the office.
• Develops prevention and prevention measures for disability.
• Controls the activities of each bureau.
The Federal Bureau of Medical and Social Expertise( FB of the ITU) is a federal service for conducting an examination, as well as providing a complex of services for the rehabilitation and restoration of health. In addition, the task of the ITU FB includes the provision of quality prosthetics.
The Federal Bureau organizes control over the activities of the rest of the bureau, can appoint and conduct a second examination, change or cancel decisions taken by employees of other bureaus.
Citizens who do not agree with the conclusions of the main bureau commissions may drop a complaint to the Federal Bureau where a new examination will be appointed. Here ITU is held and consultations are held on the direction of the main offices in situations where it is necessary to obtain his expert opinion or a complex type of medical examination.
Procedure for medical and social expertise
The examination procedure is organized by the employees of the expert group of the bureau. A survey of the person applying for examination is conducted, his social, everyday, psychological and labor characteristics are examined. Medical documentation of the disease is being studied. Based on the evaluation of all the data received, a decision is made to determine the disability, its extension or change of the disability group.
If, as a result of the commission, the health, disability and social adaptation of a citizen has been improved, the disability group can be changed. Invalid group 2, in case of improvement of health indicators and living conditions, may receive a third group of disability in the course of a reassessment.
The conclusion of the commission is disclosed to the citizen in the presence of all members of the expert staff and is included in the act on the examination carried out. The document also includes a number of information and references, on the basis of which a conclusion was made.
If necessary, additional examinations are conducted in the medical organization or the Federal Bureau. In the situation when a citizen refuses from the program of additional surveys, this information is noted in the act, and the decision is made on the basis of available information.
The examination procedure can be carried out at home, if in connection with the state of health a person can not come to the office. This requires the decision of the appropriate bureau or the direction of the medical institution in which the citizen is being monitored, or the hospital where the treatment is being performed.
ITU experts report
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. Examination of the main office is carried out by four different doctors, an expert on rehabilitation work, a social worker and a psychologist. The staff of the local office includes the same specialists as the main office, but the number of doctors of different profiles is smaller( three medical workers).Commission staff make a decision on the basis of a majority of votes.
The composition of the expert commission depends on the head of the bureau who decides on the participation of one or another specialist in the ITU procedure. Also, a citizen sent for examination in the bureau has the right to recruit additional experts, but on condition that they pay for their work. The decision of these members of the expert commission will influence the final conclusion of the ITU.
ITU specialists draw up a conclusion on the basis of the provided medical documentation, after examining the citizen, having discussed all the received information collegially. After the announcement of the decision, the commission's experts give explanations on the conclusion made to the citizen who applied to the bureau.
Appealing to ITU decisions
In a situation where the decision of the expert commission of the bureau during the re-examination of a disability seems unreasonable, you can file an appeal application with the office where the examination took place. Within three days, the application will be sent to the main office, where a conclusion is drawn based on the results of the new examination. In the situation of disagreement with the conclusion of the main bureau, the appeal about appeal is forwarded to the Federal Bureau. In connection with the appeal, a second examination will be carried out and a final decision will be made.
The Federal Bureau can be appealed only in court.
To appeal against the conclusion of a bureau, you must write a statement indicating:
• The name of the particular bureau for which the application is being sent.
• Personal data( surname, name, patronymic, address of residence, contact information) of the applicant.
• Personal data representative.
• Subject of complaint about the expertise.
• Requests for a re-examination procedure.
• Application submission dates.
How to get through ITU?
Based on the results of the reassessment, the disability is prolonged or withdrawn, the disability group is changed, which entails a change in the IRP, the amount of benefits and allowances.
To successfully pass the examination it is important not only to collect all the necessary documents and test results, but also psychologically prepare for the procedure. The decision is made by the members of the expert staff on the basis of the assessment of the limitation of vital activity, while the impression produced by the citizen on the members of the commission plays an important role. Therefore, one should not behave aggressively or take offense at incorrect questions. Answer should be calm and accurate. At the same time, the reaction of embarrassment to the question will be much better than impatience and anger. Among the most frequently asked questions, which need to be prepared, include:
• Questions about the course of the disease.
• Questions about working capacity( availability of work, comfort of working conditions, etc.).
• Questions about the ongoing treatment( the passage of IPR procedures, the reasons for refusal of the recommended types of diagnostics, etc.).
• Issues related to the characteristics of the functioning of the body.
• Questions about the financial status of family members, in order to identify the possibility of the patient's participation in expensive rehabilitation programs that are not subject to state subsidies.
Revision of disability, documents required for ITU
To undergo a reassessment of a disability, it is necessary to have a passport of a Russian citizen, a work record card, a referral from an outpatient clinic to the examination procedure, an outpatient card, an IPR with instructions for compliance. It is also necessary to write and bring along a statement to the head of the bureau about carrying out a re-examination. If within a year before the procedure of reassessment consultations were held with specialists or hospital treatment was conducted, the relevant documentation should be provided by an expert expert. With some documents, it is better to make copies for provision if necessary.
Children with disabilities undergo a procedure for re-examination in almost the same way as a primary survey. The list of necessary documents is the same, but a certificate of disability and IPR is added. When re-examining a child's disability, it is necessary to have:
• Birth certificate of a child or passport( when the child reaches the age of 14).
• Outpatient card.
• Information about the education received or a certificate from the educational institution where the training takes place.
• Conclusions of specialists with a narrow focus, extracts from hospitals.
• A document confirming disability;
Prolongation of disability
Before extending the disability, it is necessary to apply to a medical institution at the place of residence. It is necessary to have a passport, medical insurance policy, ITU certificate on disability, outpatient card, discharge from the hospital( if there was treatment), IPR.The medical worker will issue a referral for examination, as well as for the necessary procedures and the delivery of tests. You need to visit the office and make an appointment for the nearest date by the end of the disability period for re-examination. After this, it is necessary to contact the treating physician for the underlying disease, which will give an opinion to the expert commission. Also it is required to pass examination at two narrow experts to which the local therapist will direct. After receiving the results of the tests and passing the consultation of all doctors, you should again come to the reception to the therapist, who will enter the information into the certificate and write out the direction for the passage of the VVC( military medical commission).Next, with all the references and copies of the main documents, you can send it to the ITU procedure.
In case of refusal to prolong the disability, a certificate is issued, indicating the result of the examination and the grounds for refusal. The decision of the bureau can be appealed in the Federal Bureau or in court.
Re-examination of a child's disability
A child's disability is re-examined in a different order from that of adults. The presence of one of the parents is compulsory. The list of necessary documents differs. In addition, a disability group can not be established, since in the children's age the general category "disabled child" is assigned.
For the procedure, referral of medical institutions is necessary. Re-examination takes place not earlier than two months before the end of the period of disability, but not later than the indicated date of medical and social expertise. Fixed monitoring for the extension of disability in the child is not necessary. The individual rehabilitation program has a recommendatory character, the implementation of all the measures specified therein is not a prerequisite for a reassessment of a disability.
Very often, when you reach the age of 18 years with a second survey, recognition of work capacity takes place. This is due to the fact that when establishing an adult disability, the focus is not on impairing the functions of the body, but on assessing the ability to move independently, self-service, work, etc.
Disability without reassessment
There is a list of diseases in which a disability is established without a periodre-examination.
To such diseases carry:
• Diseases of internal organs.
• Neuropsychiatric disorders.
• Anatomical defects.
• Diseases of the eye.
In this case, a disability without re-examination is established no later than two years after the initial recognition of the disability for the diseases of this list.
Disability without re-examination can also be established if the expert commission has revealed the impossibility of improving the health status, rehabilitation of a person and reducing the limitations of his life activity. In this case, no more than four years should pass after the initial examination of disability.
In order to establish a disability without a re-examination period, there should also be no positive dynamics in the rehabilitation conducted before the appointment of the ITU.The relevant data are indicated in the direction for examination.
In addition, the procedure of reassessment is not assigned to women after 55 years and men after 60, and permanent perpetual disability is established.
According to the specialists of social protection, reassessment is better to take place even in case of permanent disability, in time to reveal the deterioration of health status or the need to replace the prosthesis.
If the Federal Bureau verifies the decisions made by the main office, then, with a disability without a re-examination period, ITU can still be appointed.
Failure to re-examine the disability
In case of failure to attend the medical and social examination procedure, the pension payment will be suspended for three months. If during the specified period the medical and social expertise services confirm disability, pension payments will be resumed from the day of re-recognition of disability.
In a situation when the re-examination was missed for good reason, the payment of pensions will be fixed from the day of reassessment of the disability, including payments for the missed period. The length of the period during which no pension payments were made does not matter. At the same time, if the expert commission establishes another degree of disability, then payments for the missed period will be made according to the previous system of calculation.
Renewal of payments is made automatically after receipt by the Pension Fund of the relevant documentation sent by the specialized service of medical and social expertise and confirms the conducted re-examination procedure.