LPU stampApproved by Order of the Ministry of Health
and social development Russian Federation
dated January 31, 2007 N 77
Medical documentation
Form N 088/u-06DIRECTION
on the medical and social expertise organization providing
therapeutic preventive care
Date of issue "______" ___________________________ 20_____
1. Surname, name, patronymic of a citizen sent for a medical and social examination (hereinafter referred to as a citizen): Ivanov Viktor Alexandrovich
2. Date of birth: 07/11/1948.
3. Gender: male
4. Surname, name, patronymic of the legal representative of the citizen (to be filled in if there is a legal representative): __________________________________________________________________________
5. Address of the place of residence of a citizen (in the absence of a place of residence, the address of stay, actual residence on the territory of the Russian Federation is indicated): Russian Federation, 000000, N-sky region, N-sky district, N-sky, st. Gulagskaya, d. 1, GBUSONO "N-sky PNI"
6. Not a disabled person, disabled person first, second, third groups, category "disabled child" (underline as appropriate).
7. The degree of loss of professional ability to work in percent: __________________________
(to be completed upon resubmission)
8. Sent first, re(Underline whatever applicable).
9. What job at the time of referral for medical and social examination: does not work
(indicate the position, profession, specialty, qualifications and length of service in the specified position, profession, specialty, qualifications; in relation to non-working citizens record: "does not work")
10. Name and address of the organization in which the citizen works: does not work
11. Conditions and nature of the work performed: does not work
12. Main profession (specialty): driver, tractor driver
13. Qualification in the main profession (class, category, category, rank): No
14. Name and address educational institution: No
15. Group, class, course (underline to indicate): No
16. Profession (specialty) for which training is provided: No
17. Observed in organizations providing medical and preventive care, with 2005 of the year.
18. History of the disease (beginning, development, course, frequency and duration of exacerbations, carried out medical, recreational and rehabilitation measures and their effectiveness):
In 2005, he suffered a traumatic brain injury, was treated in a hospital with a diagnosis of brain contusion. For 20 years, he abused alcohol, long-term binges with severe withdrawal symptoms, for which he was repeatedly treated in a hospital. changed mental condition- began to leave the house for long time, wandering, lost. He became whiny, sentimental, lost his hygiene skills, spent a lot of time in bed, became indifferent to relatives. At the same time, he expressed unrealistic plans for the future, which he immediately forgot about. In connection with the growth of the emotional-volitional defect and behavioral disorders, he was repeatedly hospitalized in the PND of the city of N-ska. The first medical and social examination was carried out on November 18, 2013. For the period between ITU mental state with negative dynamics. The last hospitalization in PND No. 1 of N-ska from 03.04.2014 On June 20, 2014, he was discharged with a diagnosis: “ organic disorder personality in connection with mixed diseases(TBI, intoxication) with cognitive impairment. Astheno-neurotic syndrome". In PND No. 1, N-ska received treatment: phenibut, vinpocetine, pentoxifylline, omarone, during the treatment the emotional background somewhat leveled off. After being discharged on social grounds, he was transferred to the N-sky PNI. In the boarding school he is passive, spends time in bed, does not take care of himself, does not go to the dining room himself, washes with a reminder. He takes medication under the supervision of staff: piracetam, cinnarizine, betahistine, thioryl, combilipen, cavinton, phenazepam, azafen. Relatives of the patient do not visit. Needs to outside help and leaving.
________________________________________________________________________________________
(described in detail at primary direction; when re-directed, the dynamics for the period between examinations is reflected, new cases of diseases detected during this period that led to persistent violations of body functions are described in detail)19. History of life (diseases, injuries, poisonings, operations, diseases suffered in the past, for which heredity is aggravated are listed, in addition, in relation to the child, it is indicated how the mother's pregnancy and childbirth proceeded, the timing of the formation of psychomotor skills, self-service, cognitive and gaming activities, neatness and self-care skills, how early development(by age, behind, ahead of)):
Born in the city of N-sk. Younger of two brothers. Heredity is not psychopathologically burdened. Grew up, developed according to age, attended children's preschool institutions. I went to school from the age of 7, graduated from 10 classes. Served in the army. He graduated from driving courses, worked as a bulldozer, tractor driver, driver. He was married twice and has an adult son. Lived with an elderly mother. Family ties are lost. Pensioner. Socially maladjusted. On June 20, 2014, he entered the N-sky PNI for residence by transfer from PND No. 1 of the city of N-ska.
_______________________________________________________________________________________
(to be filled in at the primary referral)20. Frequency and duration of temporary disability (information for the last 12 months):
№
Date (day, month, year) of the start of temporary disability
Date (day, month, year) of the end of temporary disability
Number of days (months and days) of temporary disability
Diagnosis21. The results of the activities carried out to medical rehabilitation in accordance with the individual rehabilitation program for the disabled (to be filled in upon re-sending, specific types are indicated rehabilitation therapy, reconstructive surgery, spa treatment, technical means medical rehabilitation, including prosthetics and orthotics, as well as the terms in which they were provided; lists the functions of the body that could be compensated or restored in whole or in part, or a note is made that positive results missing):
Medical rehabilitation measures without positive effect. He received treatment with nootropic and vasoactive drugs, vitamins, tranquilizers, antidepressants according to indications in various doses.22. The state of a citizen when sent for a medical and social examination (complaints, examination data by the attending physician and doctors of other specialties are indicated):
Seen by a psychiatrist: the posture is hunched, moves independently, uncertainly, uses glasses. He dresses and eats on his own. Outwardly, somewhat unkempt. Consciousness is not clouded. Disoriented in place, in time, believes that now is 1948. In his own personality is oriented correctly. Contact is available. He misunderstands many questions and asks again. He interrupts the doctor, tries to tell how difficult life is for him, refers to his helplessness, complains that no one is treating him. Complains about general weakness, dizziness. Requires bed rest, then rudely refuses this opportunity. Emotionally unrestrained, easily affected. Irritated, when asked about his state of health, he answers with anger: “How can a sick person feel?!”. Intelligence, memory with a significant decrease. Thinking is slow in pace, viscous, unproductive. He finds words with difficulty, quickly exhausts himself in conversation. Volitional abilities are significantly weakened. In the department, he spends time in bed, refuses to go to the dining room, because he is afraid of getting lost, rudely refuses outside help: “bring food to the ward.” The mood background is reduced. She denies having suicidal thoughts. To his condition and the current situation is not critical. Active psychoproduction is not detected. Sleep, appetite are not disturbed. Physiological functions are controlled.
________________________________________________________________________________________
________________________________________________________________________________________23. Results additional methods research (the results of the conducted laboratory, radiological, endoscopic, ultrasound, psychological, functional and other types of studies are indicated):
UAC dated 10/23/14.:Hb=131g/l, WBC=5.7x109/l, ESR=5mm/h
OAM dated 06.11.14.:Ket=none, Glu=none, Lev=none
FG dated 11/18/14.: Lungs and heart are normal
ECG dated 10/31/14.: Sinus rhythm, normal ECG
Circle chest 85 cm,waist circumference 80cm,hip circumference 87 cm.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________24. Body weight: 59 kg., height: 1,68 m., body mass index: 20,9 .
25. Grade physical development: normal, deviation (underweight, overweight, short stature, high growth) (Underline whatever applicable).
26. Evaluation of psychophysiological endurance: norm, deviation(Underline whatever applicable).
27. Grade emotional stability: norm, deviation(Underline whatever applicable).
28. Diagnosis when referring to a medical and social examination:
A) code of the underlying disease according to the ICD: F07.08
B) underlying disease: Severe organic personality disorder due to mixed diseases (TBI, intoxication) with cognitive impairment. Persistent social and labor maladaptation.
Therapist: Chronic toxic (alcoholic) hepatitis in remission.
Neurologist: Dyscirculatory encephalopathy III stage.combined genesis.Astheno-neurotic syndrome.
Optometrist: Retinal angiopathy in both eyes.
D) complications: ________________________________________________________________________
________________________________________________________________________________________29. Clinical prognosis: favorable, relatively favorable, doubtful
30. Rehabilitation potential: high, satisfactory, short(Underline whatever applicable).
31. Rehabilitation prognosis: favorable, relatively favorable, doubtful(indefinite), unfavorable (underline as appropriate).
32. Purpose of referral for medical and social examination (Underline whatever applicable): to establish disability , the degree of loss of professional ability to work in percent, for the development (correction) of an individual rehabilitation program for a disabled person (disabled child), rehabilitation programs for victims of industrial accidents and occupational disease, for other (specify) : _______________________________________
________________________________________________________________________________________33. Recommended measures for medical rehabilitation for the formation or correction of an individual rehabilitation program for a disabled person (disabled child), a rehabilitation program for a victim of an accident at work and an occupational disease:
1. Monitoring by a psychiatrist is constant.
2. Medical treatment: nootropics, vasoactive drugs, tranquilizers, antidepressants according to indications.
3. Rational occupational therapy for the development and maintenance of household skills for self-care.
(specify specific types of rehabilitation therapy (including drug supply in the treatment of a disease that caused disability), reconstructive surgery (including drug provision in the treatment of a disease that caused disability), technical means of medical rehabilitation, including prosthetics and orthotics, a conclusion on spa treatment with a prescription for the profile, frequency, duration and season of the recommended treatment, about the need for a special medical care persons injured as a result of accidents at work and occupational diseases, about the need for medicines for the treatment of the consequences of accidents at work and occupational diseases, other types of medical rehabilitation)
Chairman medical commission:
Commission members:
- Form N 088 / y-06.
- Referral for medical and social examination by an organization providing medical and preventive care.
Recommendations for the procedure for filling out the registration form No. 088 / y-06 “Referral for medical and social examination by an organization providing medical and preventive care”
The line "Date of issue" indicates the date of issue of the "Referral for medical and social examination by an organization providing medical and preventive care" to a citizen sent for a medical and social examination or his legal representative.
Form n 088 / y-06 referral for medical and social examination by an organization providing medical and preventive care Order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2007 77 (as amended on October 28, 2009) on approval of the form for referral for medical and social examination by an organization providing medical and preventive care medical and preventive care (2017). Relevant in 2017 | The law is simple!
APPROVED
- APPROVED Order of the Ministry of Health. Donetsk People's Republic.
- page 2 of form No. 088 / y. 13. Change of profession or working conditions for Last year: 14. The patient's condition when referred to the MSEC (data from an objective examination by a specialist.
On approval of the Rules for conducting medical and social expertise
- Preamble as amended by the order of the Minister of Health and Social Development of the Republic of Kazakhstan dated
- the following documents: 1) referral for medical and social examination (hereinafter - form 088 / y)
- Republic of Kazakhstan dated November 23, 2010 No. 907 "On approval of the form...
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Appendix
- Appendix to the Order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2007 No. 77.
- Medical documentation. Form No. 088/u-06.
- Referral for medical and social examination by the organization ...
www.invalidnost.com
Form No. 088/u-06
Appendix to the Order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2007 No. 77. Download Form No. 88/u-06 (.doc). Medical documentation. Form No. 088/u-06.
On approval of the Rules for conducting medical and social expertise - "Adilet" ILS
- 1) referral for medical and social examination (hereinafter - form 088 / y), approved by order of the Acting Minister of Health of the Republic of Kazakhstan dated November 23, 2010 No. 907 "On approval of forms of primary medical documentation ...
“Referral for medical and social examination by an organization providing medical and preventive care”
The line "Date of issue" indicates the date of issue of the "Referral for medical and social examination by an organization providing medical and preventive care" to a citizen sent for a medical and social examination or his legal representative.
On line 1 the surname, name, patronymic of the citizen sent for medical and social examination are indicated in full.
On line 2“Date of birth” indicates the day, month and year of birth.
On line 3 the gender of the citizen is indicated in abbreviated form: “m” or “g”.
Line 4“Last name, first name, patronymic of the legal representative of a citizen” is filled in in full if there is a legal representative.
On line 5“Address of the place of residence of a citizen” in the absence of a place of residence, the address of stay, actual residence on the territory of the Russian Federation is indicated.
On line 6“He is not a disabled person, a disabled person of the first, second group, the category “disabled child” of the group” the disability group is indicated on the basis of the certificate of the medical institution that the disabled person has. social expertise about the established disability group or underlined “not a disabled person” if the patient is sent for the first time.
Line 7"The degree of limitation of the ability to work" is excluded by the Decree of the Government of the Russian Federation of December 30, 2009 No. N 1121
Line 8“The degree of loss of professional ability to work as a percentage” is filled in during a re-examination on the basis of a certificate of a medical and social examination institution that a citizen has on determining the degree of loss of professional ability to work.
On line 9 it is emphasized whether a citizen is first or re-sent to the ITU.
On line 10“Who works at the time of sending for a medical and social examination” should indicate the position, profession, specialty, qualifications and length of service in the specified position, profession, specialty, qualifications; in relation to non-working citizens, make an entry: “does not work”.
On line 11“Name and address of the organization in which the citizen works” indicates the name of the organization with the address in which the person being sent works on the day the sick leave is opened. If a citizen does not work, an appropriate entry is made about this.
On line 12“Conditions and nature of the work performed” information is recorded from the words of the patient, in necessary cases requested from the place of work in the form production characteristics(duration of the working day, shifts; manual, machine-manual, mental labor, conveyor: position at work (as a percentage: sitting, standing, variable, walking); degree of physical stress: permanent (mild, moderate, severe) and temporarily (mild , moderate, severe); degree of neuropsychic stress: permanent (mild, moderate, severe) and temporarily (mild, moderate, severe); administrative work (large, medium, small volume), indicate the number of subordinates; the presence of unfavorable working conditions (work in a hot shop, in the cold, increased dust and gas pollution, exposure to chemical substances, at height, with vibration).
On line 13“Main profession (specialty)” indicates the profession acquired through special education(for example, an engineer, teacher, construction technician), or a profession in which there is the longest work experience and (or) the highest qualification (for example, a repairman of the 5th category, etc.).
On line 14“Qualification in the main profession (class, category, category, rank)” should indicate the qualification that the patient had on the day the sick leave was opened.
Lines 15, 16. 17 filled out for citizens who are studying at an educational institution at the time of being sent for a medical and social examination (full-time or part-time department). Line 15 indicates the name and address of the educational institution, line 16 underlines the indicated group, class, course, line 17 indicates the profession (specialty) that a citizen sent for a medical and social examination will receive upon graduation from an educational institution.
On line 18“Observed in organizations providing medical and preventive care since _____ year” indicates the date of initial filling outpatient card patient in a medical facility.
On line 19 during the initial registration of a referral for a medical and social examination, information is provided in detail about the onset of the disease (the nature of the injury, injury), the characteristics of the course, exacerbations (indicate the frequency and duration of exacerbations for the 12 months preceding the referral of the patient for a medical and social examination), information about the nature of the treatment (outpatient or inpatient with an indication of the profile of the department), types of treatment: therapeutic, surgical, physiotherapy, etc. When making a referral for re-examination, information is indicated on the course of the disease for the period that has elapsed since the date the disability group was established, new cases identified during this period are described in detail diseases that lead to permanent impairment of body functions.
Line 20“Anamnesis of life” is filled in at the primary referral. The diseases transferred in the past, injuries, poisonings, operations, diseases for which heredity is burdened are listed. In relation to the child, it is additionally indicated how the mother's pregnancy and childbirth proceeded, the timing of the formation of psychomotor skills, self-service, cognitive-playing activities, skills of neatness and self-care, how the development proceeded (by age, lagging behind, ahead of schedule).
On line 21“Frequency and duration of temporary disability for the last 12 months” in the columns “Date (day, month, year) of the beginning of temporary disability” and “Date (day, month, year) of the end of temporary disability” indicate the dates of opening and closing of sick leave sheets, in the column “number of days (months and days) of temporary incapacity for work” indicates the total number of days of temporary incapacity for work. If the patient does not work, then this section indicates the frequency of his calls for medical care to a medical institution and the diagnosis of diseases, about which the patient applied to a medical facility. The column "Diagnosis" indicates the diagnosis of the disease, for which the patient in the relevant period was recognized as temporarily disabled or sought medical help.
On line 22“The results of the measures taken for medical rehabilitation in accordance with the individual rehabilitation program for a disabled person” indicates information on measures to restore the patient’s ability to work, specific types of restorative therapy, reconstructive surgery, spa treatment, technical means of rehabilitation, including prosthetics and orthotics, as well as the period in which they were provided; lists the functions of the body that could be compensated or restored in whole or in part, or a note is made that there are no positive results.
On line 23“The state of a citizen when referring to a medical and social examination (complaints, examination data by the attending physician and doctors of other specialties are indicated) when describing the objective status, each specialist describes in detail and consistently the patient’s complaints, primarily related to the underlying disease, then others, with exhaustive completeness the data of an objective examination of the patient by specialists are reflected, while the specialty of the doctor (therapist, surgeon, neurologist, etc.) is indicated.
In necessary cases, for records of the patient's condition, the results of the examination, specialists can use an insert for the referral of an arbitrary form, which must be sealed and signed by the chairman of the medical commission and members of the commission.
On line 24 the results of laboratory, radiological, endoscopic, ultrasound, psychological, functional and other types of studies are indicated.
On line 25 the body weight of a citizen in kg, height in meters, body mass index are indicated. The latter is calculated by the formula:
BMI = Weight (kg) / Height (in meters) squared
Preobesity 25–29.9
Obesity I degree 30–34.9
Obesity II degree 35–39.9
Obesity III degree 40 or more
A person's height is measured using a stadiometer. Normally, the height of men ranges from 160-180 cm, women 155-170 cm. Body weight is determined using medical scales.
On line 26 an assessment of physical development is given - normal, deviation (lack of body weight, excess body weight, short stature, high stature) - the necessary is underlined. Physical development is a set of morphological functional characteristics of an organism that determine its reserve physical strength, endurance and performance.
On line 27“Assessment of psychophysiological endurance: norm, deviation” is underlined. Psychophysiological endurance is the ability of a person to maintain any activity for a long time without reducing the effectiveness of its implementation, i.e. in a broad sense - performance. Psychophysiological endurance is determined by the degree of physical development, condition functional systems organism, personality traits, temperament, level of motivation to perform activities, and other factors. Psychophysiological stability is assessed by a psychologist based on an analysis of the dynamics of psychophysiological and physiological indicators in the process of implementation psychological tests, sensory, sensorimotor and physical activity, as well as knowledge that imitates different kinds household, professional and other activities. At the same time, it is not just the level of development or the state of certain functions that is assessed, but, first of all, their characteristics such as stability and the ability to maintain activity at a certain level for a long time.
On line 28“Assessment of emotional stability: norm, deviation” is underlined. Emotional stability is a trait that expresses the preservation of organized behavior in ordinary and stressful situations and is characterized by maturity, excellent adaptation, lack of great tension, anxiety, tendency to leadership, sociability; emotional instability- extreme nervousness, instability, maladjustment, tendency to quickly change mood, feelings of guilt and anxiety, preoccupation, depressive reactions, absent-mindedness, instability in stressful situations, impulsiveness, unevenness in relationships with people, variability of interests, self-doubt, pronounced sensitivity, impressionability, a tendency to irritants. Emotional stability is assessed by a psychologist using various projective techniques, questionnaires and scales.
On line 29"Diagnosis when referring to a medical and social examination" in paragraph "a" the code of the underlying disease according to ICD-10 is indicated; paragraph “b” indicates a detailed diagnosis, reflecting the nosological form of the disease in accordance with ICD-10, etiology, course features, stage, degree functional disorders. When several diseases are combined, the main disease is indicated, which determines the presence of signs of disability; in paragraph “c” “comorbidities” indicate those diseases that are not decisive in the assessment of disability; in paragraph “c” the complications caused by the underlying disease are indicated.
On line 30“Clinical prognosis: favorable, relatively favorable, doubtful (uncertain), unfavorable” is underlined. Clinical prognosis - a medical assessment of the outcome of the disease, taking into account the nature of the disease and its course, stage, severity of symptoms, the degree of dysfunction of the affected organs and systems and the state of their compensation, as well as effectiveness adequate treatment. The prognosis can be: favorable - full recovery or compensation for impaired functions resulting from illness, injury or disability, leading to disability; relatively favorable - incomplete recovery with residual manifestations, reduction, stabilization or partial compensation of impaired functions leading to disability, with chronic disease- slowing down the progression of the disease, lengthening the periods of remission, etc., doubtful - unclear course of the disease, unfavorable - impossibility of stabilizing the state of health, stopping the progression pathological process and reducing the degree of violation of body functions, leading to limitation of life. In order to predict the degree of recovery of impaired functions, it is possible to use various tests and scales.
On line 31“Rehabilitation potential: high, fair, low” is underlined. Rehabilitation potential is a set of preserved physical, psychophysiological, mental abilities and inclinations that allow a person to compensate or eliminate, to one degree or another, the limitations of life activity that have formed as a result of an illness or defect. High rehabilitation potential - full restoration of health, all types of life that are usual for a person, working capacity and social status. Satisfactory potential - incomplete recovery with the preservation of a moderately pronounced dysfunction, the performance of the main activities with labor in a limited volume or with the help of technical aids. Low rehabilitation potential - progressive course of the disease, pronounced violation functions; a significant limitation in the performance of most types of activities, expressed by a decrease in working capacity and ability to social integration; need in social support and ongoing financial support. The rehabilitation potential is assessed by the attending physician, who directs the citizen to a medical and social examination.
On line 32“Rehabilitation prognosis: favorable, relatively favorable, doubtful (uncertain), unfavorable” is underlined. Rehabilitation prognosis - the estimated probability of realizing the rehabilitation potential and the estimated level of integration of the disabled person into society. The rehabilitation forecast is determined not only by the level and content of the rehabilitation potential, but also by the real possibilities of using modern rehabilitation technologies, means and methods for its implementation. The rehabilitation prognosis is assessed as: favorable - if possible full recovery impaired body functions and categories of disability, full social, including professional integration of a disabled person; relatively favorable - the possibility of partial restoration of impaired body functions and categories of disability, with a decrease in the degree of their limitations or stabilization, with an expansion of the ability to integrate and move from full to partial social support; doubtful (uncertain) - unclear forecast; unfavorable - the impossibility of restoring or compensating for impaired body functions and categories of life restrictions. The rehabilitation prognosis is assessed by the attending physician, who directs the citizen to a medical and social examination.
On line 33 the purpose of the referral for a medical and social examination is indicated (the necessary is underlined): to establish disability, the degree of limitation of the ability to work, the degree of loss of professional ability as a percentage, to develop (correct) an individual rehabilitation program for a disabled person (a program for the rehabilitation of a victim of an accident at work and occupational disease), for another (specify).
On line 34“Recommended medical rehabilitation measures for the formation or correction of an individual rehabilitation program for a disabled person, a rehabilitation program for a victim of an accident at work and an occupational disease” indicates specific types of rehabilitation therapy (including drug provision in the treatment of a disease that caused disability), reconstructive surgery, technical means of medical rehabilitation, including prosthetics and orthotics, a conclusion on sanatorium treatment with a prescription for the profile, frequency, duration and season of recommended treatment, on the need for special medical care for persons injured as a result of accidents at work and occupational diseases, about the need for medicines for the treatment of the consequences of accidents at work and occupational diseases, other types of medical rehabilitation.
The direction is signed by the chairman of the medical commission, members of the commission with a transcript of the signatures and sealed with the seal of the medical institution.
Responsibility for the correctness of filling out Form No. 088 / y-06 “Referral for medical and social examination by an organization providing medical and preventive care” rests with the chairman of the medical commission of the medical institution, or with the head physician.
The form must be submitted to the Bureau of Medical and Social Expertise no later than 1 month from the date of its issuance.
Similar information.
In line 12 “Conditions and nature of the work performed”, information is recorded from the words of the patient, if necessary, requested from the place of work in the form of production characteristics (duration of the working day, shift; manual labor, machine-manual, mental, conveyor: position at work (in percent: sitting, standing, variable, walking); degree of physical stress: permanent (mild, moderate, severe) and temporarily (mild, moderate, severe); degree of neuropsychic stress: permanent (mild, moderate, severe) and temporary ( light, moderate, heavy); administrative work (large, medium, small volume), indicate the number of subordinates; the presence of unfavorable working conditions (work in a hot shop, in the cold, increased dust and gas pollution, exposure to chemicals, at height, with vibration).
The procedure for filling f. No. 088 / y-97 "referral for medical and social examination"
Low rehabilitation potential - progressive course of the disease, severe dysfunction; a significant limitation in the performance of most activities, expressed by a decrease in working capacity and the ability to social integration; the need for social support and constant material assistance. The rehabilitation potential is assessed by the attending physician, who directs the citizen to a medical and social examination. In line 32 “Rehabilitation prognosis: favorable, relatively favorable, doubtful (uncertain), unfavorable” the necessary is underlined.
Rehabilitation prognosis - the estimated probability of realizing the rehabilitation potential and the estimated level of integration of the disabled person into society.
The list of documents required for msek when applying for disability
Referral to the ITU in case of temporary disability In the case when the referral for an examination arises upon the fact of stable preservation bad condition health, ready to become the basis for recognition of disability, a medical institution can send to the ITU when repeating the issuance of a “sick leave” sheet for the same diagnosis. In most cases, a temporary disability certificate is issued for up to 10 days; by decision of the medical commission, the certificate is extended up to 30 days. In some situations, the medical commission has the right to extend this document for up to 10 months.
In an exceptional situation for a period of up to 12 months, but no more. After 12 months, the patient must be sent for an examination, which determines the degree of his ability to work. The commission determines whether it is possible to further extend sick leave or there will be no final recovery.
Direction to ITU
Clinical prognosis: favorable, relatively favorable, doubtful (uncertain), unfavorable (underline). 31. Rehabilitation potential: high, satisfactory, low (underline as appropriate). 32. Rehabilitation prognosis: favorable, relatively favorable, doubtful (uncertain), unfavorable (underline as appropriate).
33. The purpose of the referral for a medical and social examination (underline as appropriate): to establish disability, the degree of limitation of the ability to work, the degree of loss of professional ability to work as a percentage, to develop (correct) an individual rehabilitation program for a disabled person (a rehabilitation program for a victim of an accident on production and occupational disease), for another (specify): 34.
Medical and social expertise
Line 22 “The results of the measures taken for medical rehabilitation in accordance with the individual rehabilitation program for a disabled person” indicates information about measures to restore the patient’s ability to work, specific types of restorative therapy, reconstructive surgery, spa treatment, technical means of rehabilitation, including prosthetics and orthotics, as well as the terms in which they were provided; lists the functions of the body that could be compensated or restored in whole or in part, or a note is made that there are no positive results.
How to get a disability and what documents are needed for its registration
V " family doctor» the procedure for obtaining certificate 088 / y 06 is clearly planned and requires a minimum of time. You make an appointment at a convenient time for you, come, and the doctor explains in detail the procedure for you. If necessary, you can go through the necessary examinations at the Family Doctor on the same day, but if you have the results in your hands, the doctor will enter the data in the certificate form 088 / y 06.
Info
After filling out the mailing list, you can go to the ITU (medical and social examination). V medical center"Family doctor" all doctors have vast experience in diagnosing diseases, besides, they know exactly the algorithm for passing the medical and social examination. If you have questions regarding the next steps, the "Family Doctor" will not only quickly issue a mailing list to the ITU, but will also explain what to do next and where to go.
The results of the measures taken for medical rehabilitation in accordance with the individual program for the rehabilitation of a disabled person (to be filled in upon re-referral, specific types of restorative therapy, reconstructive surgery, sanatorium-resort treatment, technical means of medical rehabilitation, including prosthetics and orthotics, as well as the terms in which they were provided; lists the functions of the body that could be compensated or restored in whole or in part, or a note is made that there are no positive results): specialties): 24.
In line 23 “State of a citizen when referring to a medical and social examination (complaints, data of examination by the attending physician and doctors of other specialties are indicated), when describing the objective status, each specialist describes in detail and consistently the patient’s complaints, first of all related to the underlying disease, then others, with exhaustive completeness, the data of an objective examination of the patient by specialists are reflected, while the specialty of the doctor (therapist, surgeon, neurologist, etc.) is indicated. In necessary cases, for records of the patient's condition, the results of the examination, specialists can use an insert for the referral of an arbitrary form, which must be sealed and signed by the chairman of the medical commission and members of the commission.
Disability certificate 088
Attention
Service name Price Issuance of a mailing list to ITU. Form No. 088/u-06 RUB 1,500 Making an entry on the mailing list to the ITU. Form No. 088 / y-06 900 rubles. Help 088 / y 06 is a referral for a medical and social examination.
It, in turn, is an official procedure in which a person is recognized as disabled and awarded social assistance. Accordingly, without a certificate in form 088, it is impossible to obtain the status of a disabled person for both an adult and a child. Where can I get a referral for a medical and social examination? It can be given in one of three instances: firstly, in medical institution where the patient is observed, received treatment or rehabilitation. Secondly, in the department of the pension fund. Thirdly, in the social security authorities. All these options are associated with queues, a waste of time and effort.
Important
Appendix to the Order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2007 No. 77 Medical documentation Form No. 088 / y-06 Ministry of Health and Social Development of the Russian Federation (name and address of the organization providing medical and preventive care) EXAMINATION BY THE ORGANIZATION PROVIDING MEDICAL AND PREVENTIVE CARE Date of issue " " 20 * 1. Surname, name, patronymic of the citizen sent for medical and social examination (hereinafter - the citizen): name, patronymic of the legal representative of the citizen (to be filled in if there is a legal representative): 5.
Address of the place of residence of a citizen (in the absence of a place of residence, the address of stay, actual residence on the territory of the Russian Federation is indicated): 6.
Physical development is a set of morphological functional features of the body that determine the reserve of its physical strength, endurance and performance. In line 27 “Assessment of psychophysiological endurance: norm, deviation”, the necessary one is underlined. Psychophysiological endurance is the ability of a person to maintain any activity for a long time without reducing the effectiveness of its implementation, i.e. in a broad sense - performance. Psychophysiological endurance is determined by the degree of physical development, the state of the functional systems of the body, personality traits, temperament, the level of motivation to perform activities, and other factors.
The Bureau considers complaints about the work of lower bodies and conducts re-examination. Who has the right to send to ITU? For examination sends: 1) body social protection population; 2) a pension provision body; 3) medical institutions. If these organizations refused to give a referral to the ITU, then they issue a certificate of this refusal. With the last document, you can independently contact the bureau.
Documentation that is required for the ITU I. Copy and original of the passport or other document that certifies the identity. II. An application for holding the ITU, which must be written on the day the documentation is submitted.
III. A form that is a direction. IV. For those who work - information on working conditions. V. Still for those who work - a copy work book. And for those who do not work - the original work book and its copy. VI.
In order to legally recognize a person as a disabled person and determine the degree of damage to his health, a medical and social examination is carried out.
Medical and social expertise (hereinafter referred to as ITU) is the determination in the established manner of the needs of the person being examined for social protection measures, including rehabilitation, based on an assessment of disability caused by a persistent disorder of body functions.
ITU involves a comprehensive assessment of the state of the body of a disabled person.
The procedure and conditions for recognizing a person as a disabled person are determined by the Rules for Recognizing a Person as a Disabled Person.
The conditions for recognizing a citizen as disabled are:
a) a health disorder with a persistent disorder of body functions due to diseases, consequences of injuries or defects;
b) limitation of life activity (complete or partial loss by a citizen of the ability or ability to carry out self-service, move independently, navigate, communicate, control their behavior, learn or engage in labor activity);
c) the need for social protection measures, including rehabilitation.
Depending on the degree of disability caused by a persistent disorder of body functions resulting from diseases, the consequences of injuries or defects, a citizen recognized as disabled is assigned I, II or III disability group, and a citizen under the age of 18 is assigned the category "disabled child". ".
You can get a referral for a medical and social examination:
- in a healthcare facility (polyclinic or other organization where a person receives treatment and prophylactic help);
- in the body of social protection of the population;
- in the body or department of the Pension Fund of the Russian Federation at the place of residence.
To receive a referral to the ITU, a person must undergo the necessary diagnostic, therapeutic and rehabilitation measures in a healthcare institution. The specialists of the medical institution themselves determine a specific list of such examinations and activities if the patient has persistent impairment of body functions due to diseases, consequences of injuries or defects. Only after complete examination, who confirmed the fears of doctors, the medical institution issues a referral to the ITU.
The body of social protection of the population or a branch of the Pension Fund of the Russian Federation can also send for a medical and social examination of a person who has signs of disability and who needs social protection. But such a person must have medical documents, confirming the violation of the functions of the body due to diseases, the consequences of injuries and defects, for example, certificates or extracts from the medical history.
The form of referral to the ITU by an organization providing medical and preventive care is approved by the Ministry of Health of the Russian Federation. V this form data on the state of health of a citizen are indicated, reflecting the degree of violation of the functions of organs and systems, the state of the compensatory capabilities of the body, as well as the results of rehabilitation activities. To date, the form is valid (M ° 088 / y 06, approved by order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2007 No. 77.
The form of referral to the ITU, issued by the body providing pensions, or the body of social protection of the population, is approved by the Ministry of Labor and Social Protection of the Russian Federation. To date, there is a form approved by the order of the Ministry of Health and Social Development of the Russian Federation dated December 25, 2006 No. 874.
The referral to the ITU is filled in by the organization sending the person for examination. Organizations providing medical and preventive care, bodies providing pensions, as well as bodies of social protection of the population are responsible for the accuracy and completeness of the information indicated in the direction to the ITU.
In the event that a medical institution, a body providing pensions, or a body of social protection of the population refused to send a citizen to the ITU, he is issued a certificate on the basis of which the citizen or his legal representative have the right to apply to the bureau on their own.
ITU is conducted free of charge, at the expense of funds allocated under the basic program of compulsory medical insurance for citizens of the Russian Federation.
The direction indicates the name of the ITU bureau (at the place of residence (at the place of stay, at the location of the pension file of a disabled person who has left for permanent residence outside the Russian Federation)), where the person should apply.
A citizen sent to the ITU must personally apply to the ITU bureau. If the child has not yet reached the age of 14, then his interests are represented by a legal representative (parent, guardian, trustee or adoptive parent).
ITU can be held at home if a citizen cannot come to the bureau (main bureau, Federal Bureau) for health reasons, which is confirmed by the conclusion of the organization providing medical and preventive care, or in a hospital. where the citizen is being treated, or in absentia by decision of the relevant bureau.
Applicant to the institution for the ITU Must have on hand a referral to the ITU and medical documents confirming the violation of health. A citizen (his legal representative) draws up a written application for hosted by ITU(a sample application is usually available from the ITU agency). The application is submitted to the head of the decisions. A referral and medical documents are attached to the application.
If a person has only a certificate of refusal to send him to the ITU, then the specialists of the bureau conduct an examination of the citizen and, based on its results, draw up a program for an additional examination of the citizen and rehabilitation measures, after which they consider whether he has a disability.
The day the institution receives an application from a citizen to recognize him as a disabled person with the documents attached to it after the necessary examinations is considered the date of establishment of disability.
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