FREQUENCY OF MEDICAL EXAMINATIONS FOR DIFFERENT CATEGORIES OF EMPLOYEES

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Svetlysheva Olga Yurievna , teacher of the Center in the direction of Personnel Management and Personnel Management

From this article you will learn:

• How to properly organize medical examinations
• Which employees need to undergo a medical examination?
• What types of medical examinations are there?
• What is the algorithm for conducting periodic medical examinations of employees?
• What is the list of harmful factors and professions for which periodic medical examinations should be carried out?
• How are the results of medical examinations of the organization’s employees recorded?

This article will help you competently organize and conduct medical examinations of employees at your enterprise.

We will find out what types of medical examinations there are, what is the procedure for conducting periodic medical examinations of employees and get acquainted with the registration of periodic medical examinations.

How to properly organize periodic medical examinations

An important obligation of the employer is the mandatory conduct of medical examinations of its employees, and it also pays the costs associated with their conduct.

To perform certain types of work, employees are required to undergo a medical examination.

This is required in order to find out what the state of health is at the time of entry to work and the ability to perform the proposed types of work, as well as to prevent the occurrence and spread of various dangerous infectious diseases among clients and employees of the organization. Medical examinations are carried out to solve several problems:

• the ability of workers to perform labor functions is confirmed;
• their health status is checked;
• professional/general diseases are detected in a timely manner;
• prevention is carried out to prevent accidents.

Preliminary medical examination

According to clause 1.4 of the Procedure for conducting medical examinations of workers of certain categories, approved by Order of the Ministry of Health dated May 21, 2007 No. 246 (hereinafter referred to as Procedure No. 246), a preliminary medical examination is carried out upon hiring an employee.

It is prohibited to conclude an employment contract with a citizen for whom, according to a medical report, the proposed work is contraindicated for health reasons (Article 24 of the Labor Code).

Before concluding an employment contract, the employer must notify the employee about dangerous and harmful production factors that may negatively affect his health. A collective agreement may contain rules governing the mutual obligations of the parties regarding medical care for employees (clause 8, part 2, article 13 of the Labor Code).

Which employees need to undergo a medical examination?

The following are the categories of workers who require a preliminary medical examination:

1.Physiological characteristics of the body:

• Employees who are under 18 years of age (Article 69, 266 of the Labor Code of the Russian Federation)
• Citizens for whom military conscription service has been replaced by alternative civilian service (Part 1, Article 13 of Law No. 113-FZ of July 25, 2002; Article 5.1 of Federal Law No. 53-FZ of March 28, 1998)
• Athletes, among them those who are under 14 years of age (Articles 213 and 328 of the Labor Code of the Russian Federation; order of the Ministry of Health and Social Development of the Russian Federation dated 08/09/2010 No. 613n)

2. Special working conditions:

• Those who are registered for work in the Far North and in equivalent regions (Article 324 of the Labor Code of the Russian Federation)
• Workers who perform their labor function on a rotation basis (Article 298 of the Labor Code of the Russian Federation)
• Persons who work in heavy work (Article 213 of the Labor Code of the Russian Federation)
• Those whose work is associated with harmful and/or dangerous working conditions, including underground work (Article 348.3, part five of Article 348.8 of the Labor Code of the Russian Federation; order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n)
• Persons who are allowed to work on a ship (Article 55 of the Code of Labor and Trade of the Russian Federation)
• Personnel associated with ionizing radiation (clause 7, part 1, article 14 of the Federal Law of 01/09/1996 No. 3-FZ)
• Workers performing labor functions in railway warehouses, marshalling yards, etc. (clause 2.3.1 of Sanitary Rules 2.5.1250-03 dated 04.04.2003 No. 32)
• Work in conditions related to serving other people:
• Personnel of the food industry, public catering, trade, water supply facilities, medical and preventive care, as well as children's institutions (Article 213 of the Labor Code of the Russian Federation)
• Employees working in the kitchen, teachers and educators of primary vocational education organizations (clause 2.8.7 SanPiN 2.4.3.1186-03 dated January 28, 2003 No. 2)
• Personnel working in preschool organizations (clause 20.1 SanPiN 2.4.1.2660-10 dated July 22, 2010 No. 91)
• Persons whose work is related to traffic (Articles 213 and 328 of the Labor Code of the Russian Federation; Part 1 of Article 23 of the Federal Law of December 10, 1995 No. 196-FZ)
• Workers engaged in construction work (clauses 13.1, 13.2 SanPiN 2.2.3.1384-03 dated 06/11/2003 No. 141)
• Employees involved in the production of building materials and structures (clauses 13.1, 13.2 SanPiN 2.2.3.1385-03 dated 06/11/2003 No. 142)
• Workers providing hairdressing and cosmetic services (clause 9.29 of SanPiN 2.1.2.2631-10 dated May 18, 2010 No. 59)
• Metro employees (clause 4.4.2 of Sanitary Rules 2.5.1337-03 dated May 29, 2003 No. 110)
• Personnel working in the water area of ​​the water park: medical workers, rescuers, etc. (clause 5.4. SanPiN 2.1.2.1331-03. 2.1.2 dated May 28, 2003 No. 104)
• Workers of additional education for children (clause 10.1 SanPiN 2.4.4.1251-03 dated 04/03/2003 No. 27)
• Employees working in health institutions (clause 10.1 SanPiN 2.4.4.1204-03 dated March 17, 2003 No. 20)
• Personnel working in the pool: medical workers, coaches, swimming instructors (clause 3.12.1 SanPiN 2.1.2.1188-03 dated January 30, 2003 No. 4)
• Employees of operating organizations (clause 7, part 1, article 2 of Federal Law dated 03/08/2011 No. 35-FZ; Decree of the Government of the Russian Federation dated 07/20/2011 No. 597)
• Persons who are engaged in disinfection activities (clause 2.21 of Sanitary Rules 3.5.1378-03 dated 06/09/2003 No. 131)

Guarantees for employees when undergoing medical examinations

In accordance with Art. 191 of the Labor Code, it is prohibited to employ persons under 18 years of age without undergoing a preliminary medical examination. Workers aged 18–21 years are required to undergo medical examinations once a year (Article 11 of Law No. 2694, Article 191 of the Labor Code).

For employees sent for examination to a medical institution, the average salary and place of work are preserved

(Article 123 of the Labor Code). This provision does not apply to workers who undergo a preliminary medical examination.

In accordance with Part 5 of Art. 6 of Law No. 2694 of an employee who, for health reasons, taking into account a medical report, requires lighter work, the employer:

• must transfer to such work, but with the consent of the employee. The transfer occurs only for the period specified in the medical report;
• may establish, if necessary, a shortened working day and organize training for an employee to acquire another profession in accordance with the law.

What types of medical examinations are there?

All medical examinations that employees in organizations must undergo are divided into three types:

• preliminary medical examinations for certain work
• periodic medical examinations for certain categories of employees
• extraordinary/unscheduled medical examinations - based on the results of a medical report or at the request of the employee

Art. 214 of the Labor Code of the Russian Federation contains a requirement for the frequency of medical examinations, which applies only to the categories of workers specified in the law.

For example, employees under the age of 21 must undergo annual periodic examinations.

In some cases, the legislator requires the employer to monitor the health status of its employees before and after each admission to work (at the employer’s expense).

Therefore, immediately before the shift, a medical examination is carried out; pre-trip, pre-flight and other types of medical examinations can also be carried out (Order of the Ministry of Health of Russia dated December 15, 2014 N 835n).

Such examinations are carried out to identify conditions and diseases that prevent the employee from performing his duties (for example, for drivers).

Post-shift/post-trip medical examinations are carried out at the end of a work shift/trip in order to identify the impact of harmful/hazardous production factors on the health of workers.

Such medical examinations should be carried out by medical professionals with higher/secondary vocational education or a medical organization (if it has the appropriate license).

All results are entered into the registration log of pre-trip/pre-shift or post-trip/post-shift medical examinations, respectively.

The procedure for conducting a medical examination will depend on the types of work performed, the level of hazards/hazards of factors (based on the results of a special assessment of working conditions in the workplace).

Extraordinary medical examination

The employer is obliged to provide, at his own expense, an extraordinary medical examination:

• at the request of the employee, if he believes that the deterioration of his health is associated with working conditions;
• on his own initiative, if the employee’s health condition does not allow him to perform his job duties;
• in case of detection of infectious diseases and/or bacterial carriage;
• if the epidemic situation worsens.

The procedure for undergoing extraordinary medical examinations is regulated by Art. 17 of Law No. 2694 and clause 4 of the Rules for conducting mandatory preventive medical examinations of workers in certain professions, industries and organizations whose activities are related to serving the population and can lead to the spread of infectious diseases, approved by order of the Ministry of Health dated July 23, 2002.

What is the algorithm for conducting medical examinations of employees?

There are different procedures for conducting different types of medical examinations.

Thus, for conducting a preliminary medical examination, the following algorithm is proposed:

1. A list of all persons applying for work who must undergo a medical examination is drawn up.

2. Information that the employee has been sent for a medical examination is entered in a special Register of referrals for medical examinations.

3. A referral is issued to the candidate against his signature.

4. The conclusion of medical workers is registered.

In the case of organizing a periodic medical examination, a different algorithm is used:

1. A list of the contingent of employees of the organization for whom periodic examination is mandatory is developed and approved (for this purpose, the list of professions with periodic medical examination is taken into account)

2. Within 10 days this list is sent to Rospotrebnadzor

3. The start date of the periodic medical examination must be agreed with the medical institution (you should pay attention to the fact that such agreements need to be concluded with those medical institutions whose license will be valid for the next three years; it is also necessary to clarify whether doctors of all required specialties work in a medical institution - practice shows that not every clinic has all the necessary specialists).

4. An approved list of employees indicating their full names is sent to the medical institution.

5. The calendar plan for medical examinations is approved.

6. Employees, no later than 10 days before the start, familiarize themselves with the calendar plan of medical examinations against their signature.

7. Employees are given a referral for a medical examination against their signature.

8. The referral is recorded in the Register of Referrals for Medical Examinations

If an employee refuses to undergo a medical examination, the employer is obliged to remove him from work (Article 76 of the Labor Code of the Russian Federation)

Each enterprise must develop a list of employees subject to medical examination.

On its basis, a list of employees is compiled to be sent for a medical examination. The list is impersonal; it indicates the positions and professions of workers who must undergo a preliminary medical examination.

To create a list of employees who require medical examinations, you must provide the following information:

• Details: name of the organization, its address; approval stamp; name of the type of document, indicating the period for which it was drawn up; Name of works
• Contents: the structural unit is indicated; profession; name of the harmful production factor (reference is made to the appendix clause of the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n)

Step-by-step instructions for preparing for a periodic medical examination

Since all preparation for a medical examination at an enterprise is the responsibility of the employer, you will need to understand the nuances.

There is an algorithm that allows you to quickly and correctly prepare for a medical examination:

Step 1. Selecting the company that will conduct the medical examination and concluding an agreement with it. Most clinics are licensed to examine employees. After concluding the contract, it is necessary to select and agree on the terms of medical examination.

Step 2. Compiling a list of employees who require a medical examination. This document is sent to the Rospotrebnadzor department of your district. Indicate in the list all workers by profession who are affected by the negative factors discussed above.

Step 3. When the list of contingents has been agreed upon with Rospotrebnadzor, you will need to draw up a second list, listing by name the company specialists sent for a medical examination. Indicate their full name and the influencing negative factor. This list also needs to be agreed upon.

Step 4. After certification, send this list to the company with which you entered into an agreement for the medical examination. This must be done no later than two months in advance.

Step 5. The party providing medical examination services will draw up an action plan by dates. This usually takes about ten days. You, as the employer, only need to approve the plan.

Step 6. Once the implementation plan has been drawn up and agreed upon, you will need to familiarize your company’s staff with it. This step must be implemented no later than two working weeks before the medical examination.

Step 7. All specialists who must undergo a medical examination are given a referral. Its receipt is confirmed by signature. The direction contains information about the enterprise, medical organization, complete data of the employee, including occupation, according to the staffing table, and the presence of harmful factors. The document is certified by an authorized person of the employer.

Step 8. After passing the medical examination, supporting documents are issued: a conclusion based on the examination results and a report. The conclusion is drawn up in two copies. One is given to the employee, the second remains in the personal card. Four copies of the acts are drawn up by the commission together with Rospotrebnadzor. One of them is sent to the employer.

Employees are only responsible for reporting to the medical organization at the appointed time with a passport and referral.

How are the results of medical examinations of the organization’s employees recorded?

Depending on the type of medical examination, the following documents are drawn up:

• a corresponding conclusion based on the results of a preliminary/periodic medical examination, which reflects the result of the medical examination (medical contraindications identified/not identified); the document is drawn up in 2 copies, one of which is immediately given to the employee, and the second is stored in the medical record
• final act (drawn up in 4 copies no later than 30 days after the medical examination), one copy is sent to the employer within 5 working days from the date of approval of the act.

Thus, we found out which employees should undergo medical examinations, what types of medical examinations there are, what is the procedure for conducting periodic medical examinations of employees, and became familiar with the list of hazardous production factors and professions in which periodic medical examinations should be carried out; and also learned how the results of medical examinations of enterprise employees are compiled.

30.11.2017

Who should pay for employee medical examinations?

The company fully bears the cost of the entire range of measures to inspect employees . In addition, the employee of the organization retains the average salary for the period of passing the medical commission. The personal medical record is given to you, as the employer, for the entire time the employee works for the company.

The cost of a medical examination by one specialist can vary from 1,500 to 5,000 rubles, depending on the region and the necessary tests. Most clinics offer a discount proportional to the number of employees.

The costs of the initial medical examination for the applicant also fall on the employer. Payment for a medical examination for employment is made in the same way as for a periodic examination. If the candidate’s health does not allow concluding an agreement with him, the medical book remains for his personal use.

If a potential or current employee has paid for specialists, the law provides for compensation for the costs of a medical examination by the employer. To do this, the employee just needs to write a free-form application and attach documents confirming payment.

If employees fail to undergo a medical examination due to the fault of the employer and are subsequently removed from duties, the company is obliged to pay them an amount equal to 2/3 of the salary.

Through the compulsory insurance fund, part of the amount for undergoing a medical examination is compensated.

What changes are officials preparing?

In 2020, the procedure for undergoing a medical examination may change: amendments are planned to be made to the order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n. A notice has been published on the unified portal for posting draft regulations that the Ministry of Labor is preparing to reduce the list of workers who must be regularly sent for medical examinations. As officials note, work on computers (PC) (work on reading and entering information, work in dialogue mode in the amount of at least 50% of working time) “is not work with harmful and (or) dangerous working conditions and is not associated with high risk receipt of industrial injuries and occupational diseases." Therefore, it is permissible to exempt the persons who carry them out from mandatory preliminary and periodic medical examinations. This means that the current subclause 3.2.2.4 of the list of harmful and (or) dangerous production factors can be excluded from Order No. 302n.

It is unknown when the amendments will come into force. And for now, employers are required to send for periodic monitoring all employees whose activities are carried out under the influence of the electromagnetic field of the broadband frequency spectrum.

How to submit lists of employees for medical examination

It is important to promptly submit lists of all employees for a medical examination. It is recommended to do this in the following sequence:

1. Prepare a list of all employees in the department so as not to miss anyone. This can be requested from the HR department.
2. When compiling lists, be guided by special assessment cards for working conditions, namely, these documents contain a clause on passing a medical examination. If there are none, then you can use the applications from the Order of the Ministry of Health No. 302-N. It details the list of harmful factors and hazardous work for which a medical examination is required. At the same time, everyone should take into account what harmful factors are present in the workplace, and their excess indicates that the employee must be included in the list for passing the commission.
3. It is also recommended to include information from the employee’s passport, pension and medical certificate numbers, and the employee’s place of residence according to registration in the list for a medical examination.
4. The lists must be approved by the responsible engineer for labor protection and transferred to the organization conducting medical examinations.
5. Before the actual organization of the medical examination, the lists are clarified, since rotation of employees is possible.

Procedure for medical examinations

When conducting a medical examination, the main thing is to correctly formulate the lists, issue directions to employees against signature in the appropriate journal, and approve the doctors’ schedule.

List of doctors for periodic medical examinations

It cannot be stated unequivocally that everyone is required to undergo certain specialists. The list of doctors will differ for men and women, and for certain positions.

Note! When undergoing a medical examination, a special commission is created, approved by order of the chief physician. The group should include an occupational pathologist and specialists who have undergone appropriate retraining and have a confirming certificate.

The list of doctors by profession is indicated in Appendix No. 1 of Order No. 302n of the Ministry of Health and Social Development, it may include:

• therapist;
• neurologist;
• psychiatrist;
• ENT
• dermatovenerologist;
• gynecologist;
• dentist;
• surgeon;
• ophthalmologist;
• orthopedist;
• allergist;
• oncologist;
• urologist;
• endocrinologist;
• infectious disease specialist;
• mammologist (for women over 40 years old).

All specialists that need to be examined are indicated in the direction.

List of procedures for MO

What is needed for a medical examination

To undergo a medical examination you must have:

• passport or other identification document;
• referrals for medical appointments;
• health certificate (for professions specified by law);
• conclusions of a narcologist and psychiatrist;
• outpatient card.

You also need to have a compulsory health insurance policy and SNILS with you.

The most necessary regulations

Remember the main thing

1

Based on the results of the mandatory medical examination, the employer can only obtain a conclusion on the presence (absence) of the employee of contraindications to work. It does not provide specific information about the patient’s health.

2

In the event of an accident, the employer receives information about the employee’s diagnosis, indicating the injuries sustained and their severity. Obtaining such information, which constitutes medical confidentiality, is permissible without the consent of the victim.

3

In the case of an occupational disease, a violation of medical confidentiality is also permissible. In particular, the employer can obtain information about the employee’s preliminary and final diagnosis.

4

If an employee has been tested for alcohol intoxication, the employer cannot obtain information about the results of the procedure without the employee’s consent.
2015-12-28T11:31:48+00:00 admin Publications Is it possible to obtain information about an employee’s health after a medical examination? According to the law, information about a citizen’s application for medical care, his state of health and diagnosis constitutes a medical secret1. Medical confidentiality cannot be disclosed without the patient’s consent. Therefore, the employer does not have free access to information about the employee’s health status. However, in some cases there are ways to reveal medical confidentiality. Let's consider... admin website Administrator Expert