Classifications and criteria used in the implementation of medical and social examination of citizens

Recently, more and more people are turning to a doctor with serious health problems, but few people know that most chronic pathologies require registration of disability. Disability is a certain condition of a person who has some limitations in physical capabilities, mental or psychological deviations. But who can confirm this, what degrees of disability exist and what can a person who has received the status of a disabled person count on? Let's understand in our article.

Passing the examination

A medical and social examination is a commission of several people that meets to determine the degree of disability, taking into account the general condition of the person and the presence of any abnormalities that prevent the body from functioning normally. After passing the commission, everyone who applies to the commission receives a document that confirms that the patient has manifestations of limitations for leading a normal lifestyle.

Only with this document in hand does a person have the opportunity to be assigned one of the disability groups. It is given only on the basis of an examination, and all deviations that imply restrictions on the normal functioning of the human body are mainly associated with serious diseases or injuries received at birth or throughout life. But what degrees of disability can a person expect? Who is eligible for disability?

What are limitations in ability to work?

The ability to work, according to Order of the Ministry of Labor and Social Protection of the Russian Federation dated December 17, 2015 No. 1024n “On classifications and criteria used in the implementation of medical and social examination of citizens by Federal state institutions of medical and social examination”, is determined by the employee’s ability to meet the criteria in terms of volume and the content of the work.

People who cannot fully perform their job duties in full, after undergoing appropriate research, receive the right to create special working conditions. The degree of disability is the level of deviation of a person’s physical capabilities from existing norms determined by age.

The imperfections of a citizen as a full-fledged worker include:

Mental. Disorders of perception of the world, memory and attention, control of emotions, etc.
Speech. Loss of the ability to verbally and nonverbally communicate, including the inability to fully use oral and written language (dysgraphia, stuttering, etc.).
Physical. Imperfections of the body structure, including external and internal deformities (deformation of the face or limbs, disproportions of body parts, etc.).
Functional. Disturbed functioning of the body's systems and organs (circulatory, immune, etc.).
Sensory. Deviations of the organs of vision, hearing or smell (including exacerbation and dulling of sensitivity under the influence of external factors)

Note! If there is a disease included in the list, each person can apply to a medical institution to obtain disabled status. However, if the medical commission has doubts about the authenticity of the diagnosis, the patient may be required to undergo additional examinations and re-examination.

The law identifies three degrees of restriction on work activity, each involving specific deviations from the norms of a healthy person:

Persistent disorders of the body caused by chronic diseases, congenital or acquired defects during life that interfere with normal work activity. They entail a loss of the ability to work according to qualifications, but leave the opportunity for general working conditions with a reduction in the volume of production and the severity of labor by at least 2 times. A more rational option, provided for by law, is transfer to lower-skilled activities, which entails primitivization of work and a discrepancy between the level of professionalism and job responsibilities.
Disturbances in the functioning of systems and organs caused by congenital or acquired illnesses or injuries. Labor activity is possible only with the availability of specialized technical means or with the help of third parties.
Significant persistent disorders of various etiologies, as a result of which the ability to work is completely lost, including work with the use of aids and the involvement of third parties.

Assigning a degree of restriction on work activity also presupposes the assignment of one of three disability groups, however, an inverse relationship is not provided - disability is not necessarily accompanied by restrictions on work.

Classification and features of disability groups

Thanks to the classifier of disability groups, it is possible to accurately determine the factor limiting the life activity of a disabled person. As mentioned earlier, only the commission has the right to declare a person incompetent and gives him a certain degree of disability. All disorders in human health can be divided into the following groups:

Statodynamic - impaired motor abilities, for example, limited movements of the head, body, limbs and problems with coordination.
Mental disorders, which are characterized by the inability to remember, perceive the surrounding reality, and lack of sound thinking.
Speech – stuttering, difficulty learning writing techniques, presence of verbal or non-verbal speech.
Problems in the functioning of the hematopoietic system, metabolic processes, malfunctions in the digestive system or respiratory system.
Physical deformity is severe changes in the configuration of the body or its individual parts. This also includes pathologies such as the presence of holes in the respiratory, digestive, and urinary systems, as well as unacceptable body size, which can have a detrimental effect on health.
Sensory – This category includes people with poor hearing, vision, smell and abnormal sensitivity to temperature and pain.

Anyone who has one or more of these changes in the body must immediately be sent to a commission that will determine disability. The degree of limitation of the ability to work for each individual patient is determined individually depending on his diseases and disorders. You can't lump everyone with the same brush.

Causes of disability

Very often, many patients have heard this formulation, which asserts the fact of assigning a degree of disability according to one of the forms of a general disease. But for most patients, such a conclusion does not raise questions, but there are a number of reasons that few people know about that fit this formulation - establishing disability status based on the form of a general disease. These include:

Injuries acquired in the workplace that resulted in serious defects.
Occupational illnesses.
Birth defects.
Pathologies, wounds and injuries received during service in the armed forces.
Diseases caused by the Chernobyl accident.

All people who have been injured or belong to one of the categories have the full right to receive the status of a disabled person of a certain group. But what degrees and groups of disabilities exist?

Let's sum it up

If, upon passing a medical commission, a patient is assigned one or another disability group with or without a degree of disability, this does not mean a complete loss of ability to work. At the same time, the individual rehabilitation plan (IRP) clearly states the requirements for the workplace and position held, which the employer must comply with.

For people with disabilitiesThe procedure for establishing disability in Russia by order of the Ministry of Health of the Russian Federation

For people with disabilitiesList of benefits for employers when hiring people with disabilities

First disability group

The first group is considered one of the most difficult degrees of disability. People with significant impairments in the functionality of the body can count on it - the highest degree of difficulty in movement, communication, learning and the inability to control their actions. A person faces serious limitations in his life activities; he does not have the opportunity to take care of himself, which leads to the fact that he must constantly be looked after. Disability group (1st degree) provides for the provision of everyday functions that are vital. Such people are only to a small extent capable of self-care.

Disabled people of the first group are mostly unable to work, but there are also those who can work - these are blind or deaf-mute. In most cities, special societies have been opened that create special working conditions for people with first-degree disabilities. People who cannot use their lower limbs are able to perform certain types of work while sitting, and most often they work at home.

Can a group 2 disabled person work?

The labor legislation that operates in our state was created to ensure equal rights and opportunities for all people. This allows such a group of citizens as disabled people to realize themselves in work. Currently, there are government programs that allow such people to adapt to real working conditions. Usually, when it comes to employment, this relates to groups such as persons with the third or second group of disabilities.

Disabled people of the second group

The second group is for people with minor impairments in the functioning of the body. They can take care of themselves and do not require constant supervision. This category may include people with a height of less than 150 cm or those who do not have first fingers.

The second group, the second degree of disability, is reserved for people who have the following pathologies: skull defect, paralysis, serious consequences after injuries, congenital pathologies. The second group is assigned to disabled children for the duration of their training, after which a certificate is issued stating that the person is fit for work.

People belonging to the second disability group are able to work, but only if their working day is shortened, additional breaks are provided, and the production rate is significantly reduced.

If we comprehensively evaluate all indicators, then the main categories of life activity can be divided into three degrees:

1st, 2nd degree (serious disability) - this is when a person has the opportunity to serve himself independently, while spending a lot of time, and to reduce the volume he cannot do without the help of technical means.
3rd degree - a person practically cannot take care of himself, he needs outside help.

Pathologies

A medical and social examination recognizes a disabled person of the second group if the following pathologies of moderate severity were identified during the examination:

A disorder of body functions, the cause of which lies in physical inferiority.
Speech impairment caused by voice dysfunction or stuttering.
Mental disorder.
Damage to the body's circulatory or respiratory system.
Sensory disorder, that is, dysfunction of the senses.

Through the ITU, a certificate confirming disability is issued indicating information about the category, and at the same time a conclusion about whether a person with the second group can work at all. People who have a disability and permission to perform labor functions without contraindications are, in addition to the certificate, given an individual rehabilitation program with recommendations for the necessary organization of work.

It is important to find out in advance whether a group 2 disabled person can work.

Disabled people of the third group

People who have been given the third disability group have moderate impairments in the functioning of one or another organ - this could be deafness, inability to navigate, or paralysis of the hands. As a disability of the third group, restriction of the 1st degree provides for disturbances in the functioning of the body as a result of diseases, birth defects or injuries received during life. The result of such ailments can be a moderately severe limitation in ability to work.

People with the third degree of disability can take care of themselves and they do not have such dependence on others, but the help of social workers is still necessary.

It is also worth saying that in a comprehensive assessment of certain indicators that characterize disorders in the functioning of the human body, four main degrees of disability are distinguished:

1st degree – these are minor disruptions in the functioning of the body.
2nd degree – disturbances manifest themselves moderately.
3rd degree – all violations are of a pronounced nature.
4th degree of disability is serious disruptions in the functioning of the whole organism, which are very pronounced and cannot be ignored.

Causes of the disease

Doctors distinguish deforming osteoarthritis of the knee as a separate type of disease and call it gonarthrosis. It is customary to divide the disease into primary and secondary forms. For the primary form, there is no exact definition of the causes, but most experts tend to blame excessive stress and age for the disease. The secondary form occurs against the background of injuries to the knee joint and as a result of various diseases. Combining all the negative factors, we get the following list of reasons:

inactivity;
heavy weight;
changes associated with old age;
excessive load (sports, work);
injuries of the knee, its ligaments and muscles;
certain diseases (rheumatoid arthritis, diabetes).

If at least one of the listed reasons is present in your life, you are at risk and may develop deforming osteoarthritis of the knee. Some of the negative factors can be eliminated from your life. For example, remove extra pounds, change profession, reduce sports activities.

For how long is the disabled status granted, re-examination

After the ITU commission has recognized a person as disabled, it issues him a corresponding document with a seal. The patient receives a rehabilitation program and a certificate of assignment of one or another degree of disability. Three days after the disability is assigned, an extract from the minutes of the commission meeting is sent to the local Pension Fund. The 1st disability group is assigned to a person for a period of 24 months, and the second and third – for a year.

As for disability for a child, in this case the period for assigning status can be from one year until he turns 18 years old. Lifelong disability can be established in some cases if it is not possible to reduce the degree or eliminate restrictions on a person’s life activity that were caused by serious morphological changes or disturbances in the functioning of body systems.

That is why, in order to monitor the health of the patient and the working capacity of the disabled person, regular re-examination is carried out. Those patients who were given an indefinite group may also be sent back to the commission at their own request or on the recommendation of their attending physician. Every disabled person has the right to receive financial assistance from the state; for each individual degree of disability, it is determined individually.

Financial support for people with disabilities

The main way to ensure the life of disabled people is a pension. To get it, you need to pass the ITU and receive one of three disability groups. A labor disability pension is a payment made once a month that is awarded to those who have limitations in their work activities to compensate them for lost earnings.

If the disability was received due to a general disease acquired during life, then in this case, to assign a pension, the total length of work experience with a certain duration is taken into account. Those who were injured in childhood, even before the person turned 20 years old, are assigned a financial benefit, which in no way depends on work experience. If the second group, the second degree of disability was given due to an illness acquired while performing professional duties, then in this case a pension is assigned regardless of work experience.

For military personnel, a monthly payment is assigned if the grounds for receiving a disability group appeared during service or no later than three months after its end. Also, a military pension can be established if a person’s disability was assigned quite a long time after dismissal. In this case, the main thing is that the injury or illness that caused the disability was acquired during the period of service.

Let us consider, using the example of patients with coxarthrosis of the hip joint, what disability group is assigned and how to register it correctly.

Disability due to coxarthrosis

Coxarthrosis of the hip joint is a serious pathology that to some extent limits a person’s mobility, in this case the patient has every right to apply to the commission and receive group 3 disability, 1st degree limitation or any other, depending on the severity of the disease and its accompanying pathologies . The main criterion for registering disability is the inability of a disabled person to independently perform certain household operations and go to work. As a result, a person loses the ability to provide for himself independently and for this reason he is assigned a monthly disability benefit. But what degree of disability can a person be given for coxarthrosis and what will he need for this?

In order to obtain disability, first of all you need to visit your doctor, who will present all the necessary documents and a referral to the ITU. If the commission makes a positive decision, then in this case the person is assigned one or another degree of disability. But what disability group can a person be given in this case?

Most often, with such a disease, the patient is given a disability of the 3rd group, a restriction of the 1st degree, because the patient is able to take care of himself, although he spends a lot of time on it. It is possible to get a second group, but it will be much more difficult. At the same time, it will be necessary to regularly confirm the presence of the disease according to the established schedule, but if a person does not appear at the commission at least once, then the disability group will be removed and it will be even more difficult to return it.

Such measures are explained by the emergence of new unique technologies that allow a person with coxarthrosis to undergo a surgical procedure and replace the diseased joint with an artificial one.

If the patient was given a degree of disability of 3, a degree of limitation of 1, then after the operation it can be taken away, and if the surgical intervention does not help, the second group can also be given.

But the presence of one degree or another of the disease does not give a person the right to automatically receive disability; only a commission, having examined all the documents that confirm the presence of pathology and deformation in the joint, will be able to assign the status of a disabled person or not. Thanks to modern diagnostic techniques, today this has become much easier and faster. It will be enough to provide the commission with an x-ray that confirms the presence of joint pathology and the results of arthroscopy. After studying the documents, which also confirm the fact that the patient cannot independently care for himself and has limitations in his ability to work, the commission makes a decision and assigns a disability of the second or third degree.

In cases where the complexity of the disease is not too high and the patient does not feel any special problems, he does not have major restrictions in movement, and he can go to work or do it at home, then he may be denied disability status. In the same cases, if the inflammatory process in the joint proceeds at a moderate pace and the patient has a history of a diagnosis of stage 3 coxarthrosis, then the patient has the right to receive group 3 disability. This usually applies to those people whose pathology was recently identified.

In cases where the disease has led to the patient experiencing shortening of the lower limb, the patient may qualify not for the third group, but for the second. But, as practice has shown, this only happens if the leg is shortened by 7 centimeters or more. But the first group can only be received by people who suffer from deforming arthrosis and are unable to move without a wheelchair. Most often, with such a diagnosis, they give a degree of disability of 3, a degree of restriction of 1, and then only for a period of one year, and then it is removed, since surgical intervention is prescribed, allowing the patient to forget about the disease and begin to live a full life.

But not only adults with certain diseases can receive disabled status; there is also a category - disabled children.

Working conditions for disabled people of group 3 within the level of labor regulations

Based on the assigned quota category of ability to perform duties, disabled people can work in regular or specially created production conditions at the following levels:

1st degree

Having such reductions in abilities, employment of a disabled person is possible in normal production indicators. The employer and the subordinate himself must understand that in the presence of such limits, a special employee can work in ordinary production and perform his task in a regular production place together with other healthy employees. The functional process is carried out when the requested volumes of production activity are reduced compared to healthy employees or the level of qualifications is reduced. An employee who has such regulations must be transferred by the employer to light work.

2nd degree

This subcategory foretells employment in specially created criteria. In this case, the employer can hire a candidate who has the second level of regulation for the performance of duties, provided that he has:

there are no contraindications to performing harmful or difficult types of work of the 1st or 2nd class of hazard in the regulations for their performance in a reduced working time mode;
professionally significant functions are preserved, even partially;
it is possible to compensate for lost professional functions with the help of auxiliary technical means, ergonomic mechanisms of the workplace, adaptation of the technological process to the pathological characteristics of a disabled person, or with the help of other persons.

It is possible to attract disabled people of groups I and II with the 2nd subcategory to professional implementation

If necessary, the employer will be able to:

Assign them to work with optimal and acceptable production criteria.
Significantly reduce working hours.
Fix production standards on a preferential basis.
Allow additional breaks from work.
Equip a special production place.
Allow the functionality in production to be partially or completely replaced by home-based work.

However, not all patients with the 2nd degree of this localization need the listed measures - it all depends on the severity of the disease and the severity of the dysfunction of the body. The necessary recommendations on acceptable working conditions are specified in the section “Professional rehabilitation measures”. When employing a special person, according to Article 224 of the Labor Code of the Russian Federation, the company is obliged to provide the production conditions that are indicated in the section “Recommendations on contraindicated and accessible conditions and types of work.”

Disabled children

Even children can be given a disability, and the category of disabled child is assigned to those who have not reached the age of majority and have limitations as a result of congenital injury or acquired pathology. Receiving serious injuries that resulted in difficulties with independent movement and self-care, the inability to fully study, control one’s behavior, and concentrate is also the basis for receiving a degree of disability.

To obtain the status of a disabled person for a child, you must also contact the ITU commission, which not only determines the degree of disability, but also gives certain recommendations on training, place of detention, the need for technical means to ensure optimal conditions for normal life activities, and prescribes a rehabilitation program.

Special education teachers must constantly work with disabled children and teach them all the necessary skills that allow them to better adapt among their peers. They prepare the child for further education, relying on preserved body functions. But we can say for sure that in our modern times, disability is not a death sentence. Today everyone is calling for everyone to treat people with disabilities with loyalty. Many new programs are being developed that allow people with problems to improve the quality of their life; they have the opportunity to start a new life and not pay attention to their status.

Healthy people must take into account the fact that a person did not become disabled of his own free will and, if possible, help him in any way they can. Today, the state has developed a number of social support measures that allow a disabled person not only to live a full life, but also not to deny himself anything. Today such a person has the right:

Receive financial monthly support from the state.
He has a benefit for utility bills.
For free accommodation and treatment in specialized sanatoriums.
To pay for travel to the place of rehabilitation and treatment.
To receive a quota in monetary terms for treatment and diagnosis.
Have shorter hours if the group allows the person to work.

It is worth remembering that disability is not a death sentence, and every person with disabilities can live a full life and not deny themselves the joys. You should not isolate yourself and consider yourself flawed and inferior; it is still unknown who has lost and who has gained in this life, because, as practice proves, most disabled people achieve a lot in life and the presence of such a status is not at all an obstacle to achieving great results .

What kind of help is this?

Such assistance, as a rule, includes the provision of an appropriate pension along with a package of benefits for travel in transport, the purchase of medicines necessary for a sick person. Among other things, there is an additional opportunity to visit a sanatorium-resort treatment in combination with monthly cash payments from the Pension Fund of the Russian Federation. In addition to these measures, in some regions of our country regional subsidies are also provided, and in case of low income levels, funds are also provided for the payment of housing and communal services.

But we also have to admit that even the support provided to such citizens from the state is often not enough for a decent standard of living. And at the same time, many of them are forced to agree to working conditions that are not provided for and are not suitable for their health condition.

We examined the degree of limitation of the ability to work.