A person is faced with a medical and social examination when his life activity is limited due to deviations in a physical or mental state. Moreover, these deviations are so serious that a citizen needs to apply social support measures to him.
ITU bureau specialists conduct a survey of a person who has received a special referral, and by a majority vote decide on his disability. The decision made as a result of the examination can be perceived by the patient as incorrect, violating his rights.
In this case, as indicated in paragraph 42 of Chapter VI of the Decree of the Government of the Russian Federation N 95 of February 20, 2006, he was given the right to appeal the result.
Criteria for awarding disability
Based on the results of the examination at the ITU bureau, a person receives a certificate, which contains confirmation of his recognition as a disabled person of any degree.
If a citizen is not recognized as a disabled person, the certificate contains information about the results of the work carried out with him. In both cases, the content of the received document may not satisfy the patient. Then the question naturally arises about the appeal of the medical report.
Registration of disability
When deciding to challenge the results of the ITU, the patient needs to imagine what conditions, established by the legislator, are guided by today when awarding a disability of a particular group.
In 2015, the Ministry of Labor and Social Protection approved an order, according to it, bureau employees during the ITU are obliged to make decisions based on the results of the examination of citizens, taking into account special classifications and criteria. The document lists:
- types of health disorders of a long-term nature;
- categories of human life.
The possible degrees of such disorders and the degree of disability in the indicated categories are indicated here.
Disability is assigned depending on the degree to which the functional limitations of the body caused by a long-term illness are expressed.
The disability group is determined in accordance with the degree of restriction of any categories of life activity.
The result of this approach was that the recognition of a person in need of measures of social support due to disability does not depend on the presence of a disease or defect in the body. The main condition is to what extent they prevent a person from leading a normal life:
- serve yourself on your own;
- get education;
- perform labor activities;
- control your behavior;
- communicate with others;
- move freely without providing him with outside help;
- navigate in space and surrounding reality.
Obviously, this is why the examination was called medical and social. Its task is to establish not only the presence of a defect, but also its social significance for a person.
In addition, a condition for classifying a citizen as a group of disabled people is also the need for social support, mainly the need for rehabilitation.
When assessing a patient's condition, ITU specialists should take into account possible improvements in his condition as a result of rehabilitation. For example, how much the intended prosthetics can reduce the severity of the restriction of one or more categories of life activity.
When is the appeal necessary?
The existing system for assessing the state of human health does not always allow a patient to undergo MSU with the desired result. Then he has to undergo a re-examination, proving not the presence of a defect in his body, but the impossibility, with a particular disease, to lead a lifestyle that is recognized as normal in society.
In a citizen's statement with a requirement to revise the results of a survey conducted by ITU members or to re-survey, it is necessary to indicate as accurately and correctly as possible the grounds that determine the need to satisfy such a statement.
Taking into account the criteria for recognition as a disabled person established by the Russian legislator, such grounds are:
- The presence of a health disorder, which is long-term and persistent to a moderate degree, pronounced or pronounced, in the patient, unaccounted for by the commission of specialists.
- The presence in the patient of such consequences from the previous illness, which limit his suitability for performing work or serving his own needs.
- The presence of a group of consequences that led to the disruption of the normal existence of a person in society.
- The inability, due to a mental disorder, to fully communicate with people around and perform social functions.
- The absence of limbs and the impossibility for any reason to replace them with prostheses.
Application to host ITU The listed grounds for appealing against the conclusion on recognition / non-recognition of disability follow from the classification of health disorders and impairment of life opportunities and the severity of these categories.
The presence of any of the listed factors, ignored by the ITU Bureau specialists, gives the patient the opportunity to challenge:
- refusal to recognize that a citizen has sufficient grounds for assigning a disability;
- the appointment of a disability group that does not correspond to the situation;
- inadequate registration by the bureau staff of the documentation necessary for the patient.
Such violations are subject to mandatory elimination, since their result is an infringement of the constitutional rights of citizens.
The patient's requirements include:
- invalidation of the decision of the commission;
- conducting a new survey;
- assignment of disability to the group corresponding to the current situation.
It is not so difficult to achieve revision of the results in accordance with the current legislation. It is much more difficult to prove that the conclusions of the commission are incorrect and violate the rights of a citizen guaranteed by the state.
Complaint
Having determined the actual existence of grounds for appeal against the opinion of the ITU, recognized by law as sufficient, you can proceed to the procedure itself. It can run in two directions:
- administrative (we apply to higher authorities);
- judicial (we go to court).
Many lawyers advise their clients to take the first route first. This is due to the fact that otherwise the court will still appoint a re-examination.
Having received an unsatisfactory result of the examination, you can apply for the restoration of justice to the body that conducted the examination.
The Bureau for Medical and Social Examination has three stages:
- ITU Bureau of Cities and Regions.
- The main ITU bureau, operating in a single constituent entity of the Russian Federation.
- Federal Bureau, the decision of which is relevant for all corners of the country.
The initial stage of appeal can be filing a claim with the head of the city / district bureau or directly with the main bureau. If the desired result cannot be achieved there, it is necessary to file a complaint with the ITU Federal Bureau.
Sample application for an appeal against an ITU decision At each stage, the deadline for filing a complaint is one month from the date of the decision by the commission.
The statement sent to the ITU bureau must necessarily indicate:
- to whom the application was sent;
- who is its author (full name, passport data with registration and indication of residence, phone number and email address (if any);
- topic (statement of appeal against ITU actions);
- when the survey was carried out;
- what is considered by the author to be untrue;
- grounds for appeal;
- patient requirements;
- number and signature.
A sample of such a statement looks like this:
Example of an appeal against an ITU decision The Appendix lists the documents that are attached to the application:
- Copies of passports, birth certificates.
- Certificate issued by ITU based on the survey results.
- Documents confirming the reasons and grounds listed in the application.
Consideration of such a complaint takes place within one month. As a result, an extract is issued, which indicates a reasoned decision regarding the application. This can be a refusal to fulfill the requirements or their satisfaction. Depending on the result, you can proceed further.
Going to court
When all possible options have been exhausted, and the result remains unsatisfactory, it makes sense to apply to the courts. It is important to provide the court with evidence that the plaintiff took steps to resolve the issue out of court.
The submission of an application is preceded by the payment of a state fee in the amount of three hundred rubles. The persons listed in Article 333.36 of the Tax Code were exempted from it.
Appealing the ITU decision in court The jurisdiction of such cases belongs to the district court. Like most claims, this document is submitted to the court at the location of the defendant, that is, the bureau that conducted the medical and social examination. An application to the court is drawn up in the form traditional for claims. It states:
- Name of the court.
- Plaintiff's data.
- Respondent data.
- The name of the application.
- Description of the current situation, indicating the dates and imprint of the documents referred to.
- Requirements.
- Number and signature.
- Appendix listing all documents provided with the application.
When drafting a claim, it is important to mention those examples that can be proven by documents. The participation of witnesses who will be able to confirm the stated facts is quite possible.
The package of documents corresponds to the one provided upon appeal to the bureau. Additionally, a copy of the application is provided. All documents must be submitted to the court in the amount that corresponds to the number of persons involved in the case.
Consideration of such cases takes place within a period of one to two months.
To draw up a statement of claim, you can use the following sample.
Sample statement of claim The judge's decision on this statement of claim shall take legal effect one month after it was issued by the court. It can also be appealed to a higher authority.
Nuances of ITU action
The decisions to change the status of a disabled person made by the ITU experts are not always inappropriate, although they may seem so at first glance.
There are a number of cases where the ITU Bureau is obliged to make a different decision in relation to a person. Then it happens depending on the emergence of new criteria.
This happens in the following situations:
- The transfer of a disabled person from a group of children to a group of adults.
- The original disease ceases to dominate, but a new one comes to the fore.
- During the initial examination, the reason for the severe health condition was not fully clarified, but during the re-examination the picture became clear.
The presence of these criteria makes the issuance of a new opinion necessary from a legal point of view.
Such actions can also be appealed by patients or their representatives if there is a suspicion that they were performed in violation of the law.
Appealing an ITU decision As practice shows, citizens' complaints to the ITU Federal Bureau often have a positive tendency for patients. This is especially important when the question arises if at the local level doctors constantly refuse.
On the website of the Federal Bureau of Medical Expertise, you can find many positive reviews about the activities of this organization.
The employees of the institution are grateful to:
- for a humane and sensitive attitude towards patients;
- for the provision of highly qualified assistance;
- for an attentive attitude;
- for hard work.
Problems and difficulties for citizens arising from the appeal of the decision of the ITU You can learn more about the opinion of patients. People who are faced with a difficult situation, judging by the reviews, find help.
Getting a disability in Russia today is not an easy task. It is obvious that the development of a program for helping such people needs to be improved, but for now, patients independently appeal against the illegal actions of medical commissions and achieve the necessary results.
Elderly people rarely have excellent health. In what cases a pensioner can receive the status of a disabled person, what gives a disability, where to start, what is the procedure for registration, experts say.
Most pensioners have acquired health problems by their age, which significantly worsens the quality of life: there are additional costs for medicines, medical care, treatment in sanatoriums. Meanwhile, some diseases allow a citizen to receive a disability status of one group or another, which can be a good help to retirement: people are entitled to a variety of benefits and benefits. Among them:
monthly cash payments (MAP), free medicines, free travel on public transport, free treatment in a sanatorium and payment of travel to it, tax incentives, subsidies for utility bills and a number of other benefits.
Does a pensioner need a disability?
For pensioners, getting a disability gives the following benefits:
the possibility of receiving an increase to pension; receiving preferential drugs and rehabilitation means; receiving a number of benefits, which include free travel or travel at a discount, a discount on utility bills.
How to start registering a disability?
Experts warn that in Russia this is a rather tedious procedure: you need to know a lot of subtleties so that the process does not turn into torment. Disability status is assigned by the ITU (medical and social expertise) on the basis of the presentation of the attending physician.
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Procedure:
get a referral for a full medical examination from a local doctor; have time to go through all the appointed specialists no later than 14 days; bring a "bypass sheet" to the therapist, who makes a conclusion on the need to assign a disability group and draws up a document for the ITU - a "messenger sheet"; certified by the signatures of at least three doctors, the personal seal of the therapist and the stamp of the clinic, after which the day of the passage of the ITU will be appointed.
In case of a positive decision, a disabled person's certificate is issued.
Documents for submission to ITU
a letter of delivery to the ITU (original and copy); medical card with a "bypass sheet" and earlier studies; pension certificate; work book - original and a copy certified by a notary; in case of an occupational disease - an act in the form of H1.
The package of collected papers must be submitted to the local ITU office, where the date of the medical examination will be set and the decision on the disability group (first, second or third) will be made. It depends on the group when it will be necessary to come to confirm the disability: for the first group - after 2 years, for the second and third - after a year. For some diseases, disability is established indefinitely.
The certificate of disability will need to be brought to the PFR branch, where the person is already receiving benefits and pension payments.
If a pensioner is a bedridden patient
What if a pensioner cannot move independently? In this case, he will not be able to bypass all the necessary doctors and take tests. Such a patient can also be granted disability at home. To do this, you need to call a local doctor who will examine the patient, give a referral and call other specialists for examination.
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When applying for the ITU, it is important to indicate that the patient cannot appear for examination at the bureau. In this case, the commission visits the patient's home and holds a meeting there.
Usually, the patient's confidant is engaged in the registration of disability in such a situation - the wife or son, daughter, any other close relative.
Disability pension for the military
A slightly different procedure for issuing a disability pension for military personnel and employees of the Ministry of Internal Affairs. Persons who have suffered significant damage to their health during the service and performance of their duties, or within three months after the end of the service, can count on it. It is also issued if the disability was obtained by a citizen as a result of injury or contusion, injury during service, but was issued after the end of military service.
To apply for a pension, you must go through the standard procedure for registering a disability, then contact the pension authority of the Ministry of Defense. The main documents are provided:
application for the appointment of a disability pension; passport and its copy; military ID and a copy; ITU certificate; results of the military medical commission.
Refusal to obtain disability
The Commission can also refuse to grant a disability. In such a situation, it is necessary to submit an application for passing the commission within a month. You have the right:
Submit an application to the same bureau, indicating that you want to undergo an examination with a different staff of specialists. Submit an application to the higher authority of the bureau. For example, you applied to the district office. You are already filing the second time with the regional office. If you disagree with the decision of the commission for the second time, you have the right to file a claim in court to establish disability. But please note that in the event of a negative decision, it will no longer be possible to appeal against it.
Unfortunately, it happens that people are not fully functional. This leads to a decrease in the workforce and physical capabilities. Naturally, in this situation, it is much more difficult to fulfill your social function - to find a decent job and feed yourself. We have to use state benefits. However, in order to access them, as a rule, you have to work hard. If for some unknown reason you were denied a disability, be sure to read this article.
Certificate of refusal to obtain disability
The first step on the way to becoming disabled is to obtain an appropriate referral for a medical examination. You need to get it at the clinic at your place of residence. Surprisingly, even here you can be warned of serious difficulties. District doctors can refuse you under a variety of pretexts. In fact, it is difficult to explain where they get this kaleidoscope of reasons from, however, nothing can be done with them. If doctors refuse, contact the higher authority in the clinic, this may be the chief doctor, director of the hospital, and so on.
If it was not possible to get the coveted direction in this way, you can try to contact the bodies of social protection of the population. It is worth bringing all the medical certificates that confirm the decline in disability there. However, this does not guarantee that you will receive the required document. By the way, at this stage you can also contact the pension fund.
If a refusal was received here, then demand to issue it in writing with an indication of the reason for the refusal. The point is that without an official refusal, you will not be able to go to the ITU on your own. In the ITU itself, they will conduct an examination, which will confirm that you have signs of disability. Now the circle begins to rotate in the opposite direction. After the ITU, you need to go to the district clinic, and from there, with the already received referral, for a medical and social examination. It is on it that we can get the required category of disability.
How to appeal ITU decisions
It is possible that the last instance from the previous heading cannot help either. In such cases, as a rule, a corresponding statement of appeal is written and sent to the ITU head office. Then the system works in a very simple way. Within a month from the date of application, the ITU head office will be obliged to conduct its own medical and social expertise. If you are not satisfied with its results again, you can write applications to all higher-level ITU up to the federal one. And if the refusal was received at the federal level, and you are still confident in your own rightness, you need to go to court.
Challenge the denial of disability in court
The next step will be the most time consuming procedure - litigation. You will definitely need professional legal assistance. Why is it worth contacting lawyers and attorneys? The fact is that even when you are quite right, you can still get into an unpleasant situation. When carrying out any legal action, you must be specific, clear and know your goals. The lawyer knows the procedures, for example, of the same court sessions, prepares you for them, sets the pace of the conversation, shows you how to behave correctly, etc. The law always contains many holes, and it is impossible to regulate every aspect of every issue. Therefore, there are so many amendments to the legislation that lawyers know about by virtue of their profession. A year ago, you could have done this, but today you have not, or, on the contrary, until recently you had no reason to carry out current legal action, but now you do.
Legal aid on the issue of disability
Yes, the courts should be objective and impartial, but there are a great many cases when a not entirely logical verdict was passed. Only a lawyer will be able to create a competent complaint, refer the case to higher authorities and turn the case in their favor. Moreover, it also happens that lawyers decide the case even before the court order, when your rights are clearly violated. An ordinary person may know about his rights, but does not know how to protect them even in an ordinary situation, which is why it is so important to use the help of lawyers, including lawyers.
In addition to a good lawyer, you will need an independent and professional medical examination. Based on her findings, you will give your arguments at the trial. Article 196 of the Civil Code of the Russian Federation states that a citizen has three years to challenge the initial ITU decision in court.
When applying to the court, it is worth simultaneously filling up with complaints all the instances responsible for the work of the federal ITU. Perhaps, in this case, you will already be awarded the necessary degree of disability in order to end this conflict as soon as possible. It should be understood that the services of a professional lawyer and an independent medical examination will be quite expensive. Therefore, to go to such a matter as a trial, you just need to weigh everything carefully and be sure of your own righteousness.
Hello Alexey.
What is the procedure for granting a disability?
The procedure is clearly regulated by the Rules for recognizing persons with disabilities (Decree of the Government of the Russian Federation of 20.2.2006, No. 95). In accordance with the current legislation, a person applying for disability must undergo a medical and social examination (MSE), to which he is sent by the medical and preventive institution where the corresponding diagnosis was made and which carries out the necessary medical and preventive measures in relation of a given citizen. In addition to such treatment-and-prophylactic organizations, the social protection body and the body that provides pensions have the right to refer to the ITU.
ITU is necessary to accurately establish the degree of disability, its structure and the possibility of full or partial rehabilitation. In your case, most likely, the referral should have been issued by the district pediatrician in the clinic visited by the child at the place of residence.
After passing the ITU, a person recognized as a disabled person is issued a certificate confirming the fact of establishing a disability. If disability is denied, at the request and desire of a person, a document may be issued to him in his hands, which indicates the grounds for refusal - the results of the examination.
Has your child passed this examination? If yes, then were all degrees of restrictions and violations specified in the Rules for recognizing persons as disabled taken into account during the certification? On what grounds was it refused? Unfortunately, you provide too little information regarding your situation.
I would like to clarify right away, because the assignment of the category "disabled child" can be carried out with any of the degrees of violations, which are differentiated in detail in the Rules. The degrees are assessed based on the age category of the child, the need for his social protection and rehabilitation, as well as taking into account the International Classification of Diseases. A comprehensive assessment of the child's condition based on a huge amount of data and collected information is the main task of specialists conducting medical and social expertise.
Grounds for recognizing a child as disabled
If the developmental pathology associated with cleft lip and palate is congenital, the disability should be assessed. However, at the same time, as mentioned above, there must be pronounced pathologies and restrictions associated with impaired health, life, the need to implement social protection measures for the child.
At the same time, children with maxillofacial pathologies are most often given recommendations regarding the assignment of disability already during the initial examination. If the pathology is congenital, this recommendation should be issued directly at the hospital, when it immediately becomes clear that the functions of sucking and swallowing are impaired or impossible.
What if I was denied a disability?
If you are denied a disability grant at the local level, i.e. the employee of the institution does not issue a referral to the ITU, you need to contact this bureau yourself. It is necessary to have on hand all the documents confirming the violations and restrictions associated with this pathology.
If you have passed ITU, but do not agree with the decision of the authority, you can submit a written application requesting an appeal and reconsideration of the decision:
- to the institution that carried out the survey;
- to the main bureau of medical and social expertise;
- to the appropriate body for social protection of the population.
If you choose the first option, keep in mind that within 3 days your application will still be sent to the ITU head office. At the same time, all the necessary documents and decisions on this issue at the appropriate level will be attached to it. The ITU Bureau, no later than one month from the date of registration of the application, must re-survey and, based on its results, make a second decision.
If a refusal is received from the main ITU bureau, an appeal will need to be sent to the Federal Bureau of Medical and Social Expertise. The decision must be made no later than one month from the date of registration of the citizen's application. The last instance of appeal against the decision of the ITU Federal Bureau is the court.
Sincerely, Natalia.
Procedure for appealing ITU decisions
Appealing the decision of the bureau of medical and social expertise
A citizen (his legal representative) can appeal against the decision of the bureau to the main bureau within a month on the basis of a written application submitted to the bureau that conducted the medical and social examination, or to the main bureau.
The bureau that carried out the medical and social examination of the citizen, within 3 days from the date of receipt of the application, sends it with all the available documents to the main bureau.
The main bureau, no later than 1 month from the date of receipt of the citizen's application, conducts his medical and social examination and, based on the results obtained, makes an appropriate decision.
In the event that a citizen appeals against the decision of the main bureau, the chief expert on medical and social expertise for the relevant constituent entity of the Russian Federation, with the consent of the citizen, may instruct another staff of specialists from the main bureau to conduct his medical and social expertise.
The decision of the main bureau can be appealed within a month to the Federal Bureau on the basis of an application submitted by the citizen (his legal representative) to the main bureau that conducted the medical and social examination, or to the Federal Bureau.
The Federal Bureau, no later than 1 month from the date of receipt of the citizen's application, conducts his medical and social examination and, based on the results obtained, makes an appropriate decision.
The decisions of the bureau, the main bureau, the Federal Bureau can be appealed in court by a citizen (his legal representative) in the manner prescribed by the legislation of the Russian Federation.
Practical advice:
It is irrational to appeal the decision of the primary bureau immediately to the court, since there are no specialists in medical and social expertise in the court and a competent judge as an arbitrator will have to resort to the advice of experts from the main bureau - just spend money on a lawyer. Therefore, it is more rational to appeal against the decision of the primary office to the higher main office. The addresses and work schedule of the main bureaus in all regions of Russia can be found here. In addition, litigation can last for years (you have to pay for the services of a lawyer), and examination in the higher Main Appeals Bureau is carried out within a maximum of 1 month ...
Additionally:
Currently, the Russian Federation has created a 3-level ITU system: the ITU bureau, the main ITU bureau and the Federal Bureau. In case of disagreement with the decision of the bureau, the citizen has the right to appeal this decision within a month to the main bureau on the basis of a written application. The application must be submitted to the bureau where he passed the examination, or to the main bureau. The decision of the main bureau within a month from the date of its issuance can be appealed to the Federal Bureau (127486, Moscow, Susanina st., 3). The application is submitted to the main bureau that carried out the survey, or to the Federal Bureau. In addition, decisions of the Bureau, the Main Bureau and the Federal Bureau can be appealed in court in the manner prescribed by the legislation of the Russian Federation.
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