Nurse as a participant in the medical and social examination. Vtek: transcript

Hello! The doctor of the ITU bureau in Moscow is writing to you. Everyone, of course, knows what kind of atmosphere of evil rumors, and sometimes outright lies, has developed around the doctors working in this department. Like, you sell disability groups, and take bribes, and the like. It's a shame to hear this for expert doctors who have devoted their years to the cause of medical and social rehabilitation and helping sick people. There is no need to talk about a meager salary: Everyone knows how ridiculous it is. I would like to talk about something else, namely, our leaders. Why should honest workers be constantly humiliated by their superiors? For example, why can Oleg Aleksandrovich Vasiliev, a lawyer at the FKU GB ITU for Moscow, afford to accuse almost everyone working in this system of corruption? Why does Oleg Alexandrovich allow himself to speak inadequately, if not rudely, with people who are much older than him? Has Oleg Aleksandrovich, a lawyer, forgotten that there is such a thing as the presumption of innocence, and in this case he himself can be accused of slander? It is simply pointless and useless to talk with our higher authorities: he has one answer for everything: "I don't like it, no one is holding you!". And they leave. People who have devoted decades to helping the sick are leaving! It even got to the point that at the expense of their own funds from a meager salary, ITU employees are forced to purchase office equipment necessary for work! " No money!" - all one answer from our management. In addition, in 2017, the management loaded the ITU bureau with overwork! Not only do branches receive much more daily more people than planned! Doctors were given the task to enter into a computer database all disabled people who have been examined since 2005 in a new database, the so-called FRI. And now the elderly are forced to sit literally until night, doing what is essentially unusual for doctors! Needless to say, there is no compensation for overtime? And they gave the task to manually enter several hundred thousand people! When working around the clock at a computer, people lose their sight and health, and all because the management, having decided to save on paying IT workers, assigned an unusual task to doctors! With such an attitude, there are fears that from the system medical and social expertise almost all the doctors will leave! But then socially unprotected people will suffer first of all! But the leadership, perhaps, needs to destroy the system, it seems that everything is going to this.
There is more than enough evidence for that. So, since 2016, a certain Sergey Petrovich Zapariy from Omsk has headed the FKU GB ITU. It is not known in what ways Sergei Petrovich was appointed to this position, but there are suspicions that it was not entirely honest. It is known that for some of his actions Sergei Petrovich was taken in Omsk under the increased control of journalists,

Which has not yet been removed.
With his arrival, unfounded accusations of corruption, systematic humiliation of expert doctors, both working in the FKU MAIN BUREAU of ITU and in regional divisions, unjustified dismissals of employees without explanation, and other illegal actions began with renewed vigor.

It is also known that the daughter of Sergei Petrovich, Zapariy Natalya Sergeevna, works at the Federal State Budgetary Institution FB ITU of the Ministry of Labor of Russia. From a legal point of view, I think this is doubtful.
And the last thing: this is how Sergey Petrovich parks near the FKU GB ITU building. How can a wheelchair user get through? It seems that this is also a manifestation of disrespect for sick people?

With sincere respect, Vitaly Sedov. Honored Doctor of the Russian Federation

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1. General Provisions

1. GENERAL PROVISIONS

1.1. A doctor for medical and social expertise (hereinafter referred to as the "Employee") refers to specialists.

1.2. This job description defines the functional duties, rights, obligations, responsibilities, working conditions, relationships (positional connections) of the Employee, criteria for assessing his business qualities and work results when performing work in his specialty and directly at the workplace in "____________________" (hereinafter - " Employer").

1.3. The employee is appointed to the position and dismissed from the position by the order of the Employer in accordance with the procedure established by the current labor legislation.

1.4. The employee reports directly to ____________________.

1.5. The employee must know:

the Constitution of the Russian Federation; laws and other regulatory legal acts of the Russian Federation in the field of healthcare, consumer protection and sanitary and epidemiological welfare of the population; theoretical foundations in the chosen specialty; modern methods treatment, diagnosis and drug supply sick; basics of medical and social expertise; rules of action in case of detection of a patient with signs of especially dangerous infections, HIV infection; the procedure for interaction with other medical specialists, services, organizations, including insurance companies, associations of doctors, etc.; the fundamentals of the functioning of budget-insurance medicine and voluntary medical insurance, the provision of sanitary and preventive and medicinal assistance to the population; medical ethics; psychology of professional communication; fundamentals of labor legislation; internal labor regulations; rules on labor protection and fire safety;

____________________.

1.6. The employee must meet the qualification requirements for the specialty "Medical and social expertise", established by order of the Ministry of Health of Russia dated 08.10.2015 N 707n "On approval of the Qualification requirements for medical and pharmaceutical workers with higher education in the direction of training" Health and medical sciences ":

- Higher education - a specialist in one of the specialties: "Medicine", "Pediatrics";

- Residency training in the specialty "Medical and social expertise" or professional retraining in the specialty "Medical and social expertise" in the presence of training in internship / residency in one of the specialties: "Pediatric surgery", "Neurology", "General medical practice (family Medicine)", "Oncology", "Otorhinolaryngology", "Ophthalmology", "Pediatrics", "Psychiatry", "Therapy", "Traumatology and Orthopedics", "Phthisiology", "Surgery", "Endocrinology";

- Advanced training at least once every 5 years during the entire career.

2. Job responsibilities

Employee:

conducts a medical and social examination of citizens on the basis of an assessment of life restrictions caused by a persistent disorder of body functions;

develops individual programs for the rehabilitation of disabled people, including determining the types, forms, terms and volumes of measures for medical, social and vocational rehabilitation;

establishes the fact of the presence of disability, the group, causes, date and time of the onset of disability;

determines the degree of loss of professional ability to work (in percent);

determines permanent disability;

determines the need for medical, social and professional rehabilitation of victims of industrial accidents and occupational diseases and develops programs for the rehabilitation of victims of industrial accidents and occupational diseases;

determines the causes of death of a disabled person, as well as a person injured as a result of an accident at work, an occupational disease, a disaster at the Chernobyl nuclear power plant and other radiation or man-made disasters, or as a result of injury, concussion, injury or illness received during military service, in cases when the legislation of the Russian Federation provides for the provision of social support measures to the family of the deceased;

determines the need for health reasons in constant outside care (assistance, supervision) of the father, mother, wife, brother, sister, grandfather, grandmother or adoptive parent of citizens called up for military service (contractual military servicemen);

gives citizens undergoing medical and social examination explanations on the issues of medical and social examination;

participates in the development of programs for the rehabilitation of disabled people, prevention of disability and social protection disabled people;

forms a data bank on citizens living in the served territory who have passed the medical and social examination; carries out state statistical monitoring of the demographic composition of disabled people living in the served territory;

submits to the military commissariats information on all cases of recognition of persons liable for military service and citizens of military age as disabled.

3. Rights of the Employee

The employee has the right to:

providing him with a job stipulated by an employment contract;

a workplace that meets the state regulatory requirements for labor protection and the conditions provided for by the collective agreement;

To increase your chances of getting a disability, it is important to know how the VTEC commission works. To do this, the patient collects the relevant documents and applies for examination. A detailed description of the sequence of actions, as well as how to behave correctly when communicating with the commission, is presented in the article.

It should be said right away that a person needs to know how the medical and social examination of the ITU, and not the VTEK for disability, is carried out. The fact is that despite the use of both terms, from a formal point of view, the patient applies specifically for the examination of the ITU, which includes the passage of:

• doctors' commissions;
• social worker;
• psychologist;
• other specialists (as needed).

Therefore, despite the fact that the term "VTEC" is still used very widely, in fact, it is about the ITU. To pass the commission, you must contact the local ITU Bureau on your own initiative or (usually just like that) in the direction of:

• the attending physician;
• or pension fund.

Step 1. Collecting the necessary documents

Along with the application for the commission, the patient also submits his passport and medical documents:

• outpatient card;
• conclusion of the medical commission;
• test results;
• results diagnostic procedures that are associated with the disease.

Other documents to be submitted:

• diploma or certificate of education;
• employment history.

In some cases, you may also need an act of the form H-1, which registers an accident at work (if the disability is supposed to be assigned precisely in connection with this incident).

Documents can be submitted by both the patient himself and his legal representative (parents of children, guardians) or a person acting under a power of attorney, which must be notarized.

From work, they may also request a production characteristic, which describes in detail:

• What exactly are job responsibilities?
• what is the duration and mode of the working day, the number of shifts per month;
• whether there were breaks in work in connection with the issuance of a sick leave;
• whether the person enjoys facilitated conditions.

Thus, the patient needs to worry in advance about which documents will be needed, and prepare a complete set of required papers by the date of the appointment of the commission.

Step 2. Passing the commission

On the appointed day, the patient arrives at the medical facility and undergoes a commission. Basically, the procedure takes place in the form of answers to questions from doctors, a psychologist and a social worker. In order to understand how the VTEK commission for disability goes, it is better to prepare for it in advance - dress neatly and modestly, and also tune in to communication (this is described in detail below).

DEADLINE FOR DECISION. After the end of the questions and examination, the patient leaves the office, and the commission begins to discuss opinions. The decision is made by a simple majority vote, and the patient is notified by mail or telephone. The deadline for making a decision is 6 working days. In any case, the patient is issued an examination certificate, and if the decision is positive, then the standard form.

front side

Step 3. What to do in case of refusal

In case of refusal, you need to contact a higher authority (regional Bureau, and then to the federal one). In exceptional cases, they draw up a statement of claim in an attempt to protect their rights in court.

Features of registration of disability for certain groups

If we talk about how the VTEC is carried out, how the commission that registers a patient for disability works, in general terms, the procedure is almost always the same. However, there are also features that depend on the specifics of the groups of some patients.

7 rules for how to behave in ITU

The patient must immediately understand: a specific decision is made by specific people, so the presence of certain documents does not always guarantee the assignment of a degree of disability (with the exception of obvious cases severe violations health, which require registration of the 1st degree).

Therefore, even before visiting the disability commission of the VTEK, one should have a good idea of ​​how it goes, how to better tune in the psychological sense, what questions can be asked. Here are 7 useful tips which will surely help to understand the features of this procedure:

1. The basic principle is that a person needs show your real helplessness more-less. You can take a cane with you if you usually use it, a standard set of medicines that you take several times a day, and others. medical devices. That is, the members of the commission should get a clear idea that you really need some care and support from the state.
2. Another important rule– to the patient should not clearly demonstrate their material interest in the decision of the commission. It is clear that assistance from the state is the main purpose of visiting VTEK. However, the members of the commission should not get the impression that they have enough healthy man with minor violations, who simply wants to receive benefits and other types of support without sufficient grounds.
3. The tone of communication with members of the commission should be neutral, correct, polite enough but not too warm. Familiarity, "kinship", familiarity are not allowed, as this can be negatively regarded as an attempt to influence the decision.
4. It is better for the patient to look quite modest- for example, girls do not need to wear bright makeup or dress too attractively, as they are used to in everyday life. The external image of a person should not attract attention, let alone make a dubious impression.
5. However, appearance must be impeccable- neat, tidy, clothes without specks of dirt, protruding threads, seams, clean. In addition, it should be borne in mind that a person may be asked to partially undress - for example, in case of diseases of the spine, bones, the back or feet are examined, etc.
6. Do not be too active, ask questions, the answers to which you can find out on your own (in medical institution, in open Internet sources, brochures, etc.). An aggressive tone, threats, phrases like “I will complain”, etc. are excluded. It is important to understand that there will not be a second chance to make a first impression. This is a very important rule of how the commission of the VTEK for disability passes.
7. On the other hand, it is important to be prepared for uncomfortable questions from any member of the committee. Some phrases may seem incorrect because they will be too personal, but it is better to immediately tune in and pass the test with restraint, and communicate correctly. The patient must show their interest in recovery, as well as the fact that he carefully monitors his health - for example, he keeps a diary of pressure readings, takes medication regularly and follows all other doctor's orders.

Doctors in most cases are negative about the fact that a person is trying to self-medicate. Therefore, even if you use folk remedies, you should not talk about it - the information will not be perceived as a fact that the patient cares about his health.

The duties of specialists arise from the tasks of the Bureau of Medical and Social Expertise.

Head of branch (primary bureau) primarily performs the functions of an organizer of the activities of experts and represents the bureau in relations with other institutions and with citizens undergoing examination (or their legal representatives) when discussing problems that arise during the examination.

The head discusses the results, makes a decision, makes a decision in the medical documents. The head of the bureau may concurrently perform the functions of an expert doctor in one of the specialties included in the bureau.

Traditionally in composition of medical experts are included therapist, neuropathologist and surgeon . Among them, the duties of examining citizens with various pathologies are distributed. As a rule, this corresponds to the classification of diseases adopted in practical medicine: nervous diseases and neurological conditions are within the competence of a neuropathologist; disorders of the musculoskeletal system and the musculoskeletal system - within the competence of the surgeon; internal diseases - in the competence of the therapist.

Expert doctors have equal rights and obligations, and their activities differ only in the type of client's illness.

This separation is associated with the so-called "disabled disease", i.e. the disease, the consequences of injuries, developmental defects, which are recognized (or chosen by the client together with his doctor) as the main ones in the occurrence of restrictions on body functions.

The responsibilities of the medical examiner include:

examine the medical documents submitted by the examined citizen,

collect anamnesis of the patient (own characteristic of the client's condition),

Conduct a personal inspection

report the results to the discussion of the members of the expert commission,

make the necessary entries in the medical documents of the commission.

If necessary, the expert doctor may request additional information or refer the client (examined) for additional examination to other institutions.

AT The duties of an expert also include collection and registration of statistical information about citizens who have passed examination in the bureau.

An expert doctor is obliged to maintain a high level of his qualifications, to engage in professional self-training and self-education. From point of view professional activity Doctors-experts should fundamentally take a different position in working with clients than treating doctors, i.e. doctors of the healthcare system. Their efforts are aimed not so much at identifying the presence of a disease, a defect, but at determining the residual capabilities of the person being examined, the persistence of his pathological abnormalities that limit life.

An expert doctor does not establish methods of treatment, he considers the pathological condition of a citizen and, based on his observations, determines the severity and persistence of dysfunction.

In the expert composition, in addition to specialist doctors who make an expert decision, includes a social worker, a psychologist and a rehabilitation specialist.

These are new specialists for expert commissions, therefore their functions and duties have not yet been settled. Moreover, there were objective contradictions between the old and new specialties within the same expert commission. They follow from the fact that in the former medical and labor expert commissions, the role of the researcher social problems the examined citizen was performed by expert doctors, therefore, with the introduction of new positions, the specialists replacing them, as it were, invaded the old field of activity of experts. Apparently, over time, the distribution of functions will become more defined, and each specialist within the bureau will take only the place allotted to him.

Some scientists see the duties and technologies of the bureau's specialists as follows.

Tasks of the rehabilitation specialist:

Conduct social diagnostics - assessment occupational status(broken, not broken, labor activity impossible, possible with reduced intensity, possible in another profession, possible in specially created conditions); educational (disturbed, not violated, education is possible under normal or specially created conditions), social and domestic(self-service not lost, partially lost, completely lost; social skills not lost, partially lost, completely lost, personal safety not lost, partially lost, completely lost) and social and environmental status(violated, not violated, social independence is not lost, partially lost, completely lost, social communication is not lost, partially lost, completely lost, the possibility of solving a range of personal problems is not lost, partially lost, completely lost, the opportunity to play sports is lost, partially lost, not lost), the opportunity to engage in cultural and leisure activities (not lost, partially lost, completely lost, the opportunity to engage in social activities not lost, partially lost, completely lost);

· assess the rehabilitation potential and rehabilitation prognosis;

to assess the structure and degree of disability;

determine the person's need for rehabilitation.

Tasks of a social worker:

Conduct social diagnostics

assess the structure and degree of disability,

· take part in determining the rehabilitation potential and rehabilitation prognosis;

determine the person's need for social protection measures, including rehabilitation;

determine the possibility of carrying out rehabilitation activities of the IPR;

establish conditions for the provision of rehabilitation services;

· determine the range of institutions for the implementation of IPR;

determine the place and conditions for the acquisition of technical means of rehabilitation.

His technologies are determination of a number of social characteristics of the person being examined: analysis of income, marital status, the role of the family in helping a disabled person, the availability of technical means and devices and the need for them, the equipment of housing for a disabled person.

social work specialist must assess the possibility of a disabled person to perform social and social and environmental activities , including:

assessment of the possibility of providing personal care;

assessment of the possibility of personal safety (use of gas, electricity, water supply, transport, medicines, etc.);

assessment of social skills (possibility of cooking, cleaning, washing clothes, shopping, etc.);

assessment of the possibility of ensuring social independence (the possibility of independent living, enjoyment of civil rights, compliance with responsibility, participation in social activities), - assessment of the possibility of social communication;

Evaluation of the possibility of solving personal problems (control of births, control of gender relations).

Tasks of a psychologist:

Psychodiagnostics of mental development;

Determination of the structure and severity of violations of higher mental functions;

assessment of professionally significant mental functions, learning ability, emotional-volitional sphere, personal and socio-psychological characteristics and possibilities for correcting personality deformities;

assessment of social adaptation;

· evaluation of socio-psychological, social and other statuses;

· assessment of rehabilitation potential and rehabilitation prognosis;

assessment of the structure and degree of disability of a disabled person;

· the implementation of psychological support for the examination procedure, the development of IPR and its implementation, the definition of measures for psychological rehabilitation.

The following commentary may be added to this division of responsibilities. The psychologist is the leader in determining the rehabilitation prognosis for this disabled person, since the rehabilitation effect depends on the desire of the citizen and his willingness to make efforts to attract his potential.

It must be said that the work of a psychologist in the bureau of medical and social expertise is most of all aimed at establishing those qualities of the client's personality that will contribute to his rehabilitation. At the same time, other aspects of the person being examined have to be ignored. It may be that the conclusions of the psychologist to a small extent can affect the fact of recognizing him as a disabled person and the group assigned to him, but this should not remove his responsibility for the collegial decision being made.

A social work specialist should eventually become a key figure in the process of medical and social expertise, since even the legislation emphasizes that the ultimate goal of the expertise is to provide social assistance to a citizen who has applied to the bureau.

In the very general view the decision of the bureau is divided into two blocks :

1. recognition of a citizen as a disabled person and the establishment of a disability group for him;

2. determination of rehabilitation potential and development of rehabilitation measures (individual program).

FROM first block solution do better medical experts, which determine the degree of disability, with the assistance of a social work specialist, who determines the degree of social insufficiency.

But second block solutions more qualified can be executed by efforts rehabilitation therapist, psychologist and social worker. At the same time, the main and very important role of the psychologist is to establish, and perhaps even form in the disabled person, psychological readiness for rehabilitation.

The role of the rest of the employees of the Bureau of Medical and Social Expertise is to create necessary conditions expert activities:

nurse- provides the material and technical basis of the expert procedure;

medical registrar- draws up all the necessary documentation, keeps minutes of the commission meetings, writes out the relevant certificates.

Important update!

How to pass the commission: algorithm

Step 1

First you need to get from the therapist on the basis of the data entered in the outpatient card.

Step 3

Passing a citizen examination. It can take place both in the office and, if necessary, at the patient's home. As a rule, employees of the institution (at least three) and other doctors of all necessary profiles are present.

During the examination itself, specialists first of all get acquainted with all the documentation, then they already conduct an examination and a conversation with the patient, analyze his condition. All actions and conversations during the work of the commission are recorded.

Step 4

Step 5

Important! The decision made by the commission is communicated to the patient on the same day on which the examination took place. In the case of a positive conclusion, the person is given the original certificate, as well as a scheme for future rehabilitation and treatment developed specifically for him.

Step 6

The appeal of a citizen with this very certificate to a pension fund or other social organization to receive a pension and other assistance. This must be done within three days after receiving the papers..

In total, in about two months it is really possible to successfully apply for a disability.

However, this does not mean that a visit to the ITU bureau can be forgotten. Depending on the assigned group, people with disabilities in Russia must confirm their status with a certain frequency:

• the first group - every two years;
• the second and third - annually;
• children with disabilities - once during the validity of this status.

Before the deadline is also possible. If this is due to a noticeable deterioration in the state of a citizen, then at any time, if not, then the disability should be valid for no more than two months.

Decree of the Government of the Russian Federation of 20.02.2006 N95 gives citizens the right to challenge the decision of the commission. A period of one month has been allotted for the local ITU center in the main office. The same period applies for a complaint against the decision of the main bureau in the federal center.

At the same time, documents for appeal must be brought to the office where you have already been examined. It is it itself that is forced to transfer the applications of dissatisfied citizens to higher authorities within no more than three days. The last body to which you can turn in such proceedings, and the decision of which is no longer subject to appeal, is the court.

Possible difficulties

• The patient himself is in a non-transportable state or in intensive care. The doctors of the medical institution, his relatives and the company in which the patient is employed are then required to collect papers. His collected documents are transferred to the ITU bureau on the basis of a special certificate confirming the citizen's inability to deal with everything personally.
• The clinic in which the patient is located is a psychiatric one, and the situation is similar to the previous one, that is, the person’s condition is very difficult. At such moments, a notarized power of attorney is usually issued, and his relatives have the right to speak on behalf of the patient.
• A citizen is able to independently deal with the registration of disability, but in a medical institution he was denied a referral. The solution to this problem is to require a form in the form