Preliminary and periodic preventive medical examinations of employees of certain professions, industries, and organizations whose activities are related to public services and may lead to the spread of infectious diseases, and issuance of personal medical books (Form No. 1-OMK).
The medical examination of candidates for drivers and drivers of vehicles is conducted to determine the suitability of a person for safe driving, taking into account the list of diseases and disabilities in which a person may not be allowed to drive the relevant vehicles.
A medical certificate for drivers in the form 083/о is required in the following cases:
Passing a maintenance check (technical inspection);
Passing a driving test for all categories of vehicles;
Renewal of a driver's license and other similar documents;
Restoration of lost driving license and other similar documents.
The medical examination includes a general examination by specialists of the medical commission, laboratory and functional examination (general blood and urine test, blood sugar test, ECG, examination of visual acuity and fields, examination of the vestibular apparatus, determination of blood type and Rh factor). In some cases, to clarify the diagnosis, the specialists of the medical commission prescribe individual additional examinations. When conducting a medical examination, the results of a mandatory preventive drug testing of a person and data on his/her psychiatric registration at the place of residence are taken into account.
Based on the results of the preliminary (periodic) medical examination, the medical commission issues a Medical Certificate in form 083/о. The Commission for Medical Examination of Vehicle Drivers operates based on the hospital (with a polyclinic) of the Ministry of Transport.
The list of documents required for admission of candidates for drivers and drivers of vehicles to the medical examination:
Passport of the person wishing to undergo a medical examination.
Certificate of preventive psychiatric examination - form 122-2/о
Certificate of passing a preventive drug test - form 140/о.
Two photos of 3 cm x 4 cm in size.
Medical certificate for obtaining a permit (license) for the object of the permitting system (f. N 127/о (a record), is the only document issued to a citizen by the medical advisory commission after a medical examination to decide on the presence or absence of medical contraindications for obtaining a permit (license) for an object of the permitting system following the resolutions of the Cabinet of Ministers of Ukraine of October 12, 1992. No. 576 'On Approval of the Regulation on the Permitting System' and No. 706 'On the Procedure for Sale, Purchase and Use of Permits' of September 7, 1993. No. 706 'On the Procedure for the Sale, Purchase, Registration, Accounting and Use of Special Self-Defense Means Charged with Substances of Tear and Irritant Effect'.
The issue of issuing a medical certificate is decided by a medical advisory committee consisting of the chairman of the commission, a general practitioner, a neurologist, an otolaryngologist, and an ophthalmologist. The list of laboratory and functional examinations includes the mandatory scope (general blood and urine tests, blood sugar test, ECG, visual acuity, and visual fields), as well as individual additional examinations prescribed by doctors who are members of the medical advisory committee. When deciding whether to issue a medical certificate, the results of mandatory preventive drug testing of a citizen and data on the citizen's psychiatric registration must be taken into account.
List of documents required for medical examination:
1. Passport of the person wishing to undergo a medical examination.
2. Certificate of preventive psychiatric examination - form 122-2/о.
3. Certificate of passing a preventive drug test - form 140/о.
4. Two photos of 3 cm x 4 cm.
Preliminary and periodic medical examinations of persons working in heavy work, work in harmful or hazardous working conditions, or where there is a need for professional selection and medical examination of persons under the age of 21.
The purpose of mandatory preventive medical examinations is to prevent the spread of infectious and dangerous diseases and to monitor the health of the working population on a dynamic basis.
A mandatory preventive medical examination includes a general examination by specialized doctors (general practitioner, dermatovenerologist, otolaryngologist, dentist, and other specialists (if necessary), laboratory and functional examination according to the List of necessary examinations of specialized doctors, types of clinical laboratory and other tests required for mandatory medical examinations and the frequency of their conduct, approved by Order of the Ministry of Health of Ukraine No. 280 dated July 23, 2002, registered with the Ministry of Justice of Ukraine on September 8, 2002, under No. 639/6927.
In some cases, individual additional examinations are prescribed to clarify the diagnosis.
List of documents required for medical examination:
Passport of the person wishing to undergo a medical examination.
A 3 cm x 4 cm photo.
Preliminary medical examination. A mandatory preliminary medical examination is conducted during the hiring process.
Its purpose is to:
To determine the employee's health status and record health indicators. Based on this examination, the employee's ability to perform professional duties in a particular production environment without deterioration of health is determined.
Identification of occupational diseases (poisonings) that occurred earlier when working in previous production facilities and prevention of occupational and industrial diseases (poisonings).
The list of general medical contraindications to working with harmful and dangerous factors of the production environment and labor process is given in Annex 6 to List No. 246.
To undergo a medical examination, an employee must present a referral to the Commission:
A referral issued by the employer in the prescribed form (Annex 3 of the Procedure for conducting medical examinations of employees of certain categories, approved by Order of the Ministry of Health of Ukraine No. 246 of 21.05.2007)
Passport or other document proving his/her identity.
Medical record of an outpatient from the place of regular service.
Employees who are required to undergo initial and periodic preventive drug testing shall provide the Commission with a certificate of passing a preventive drug testing.
Employees who are required to undergo preliminary and periodic psychiatric examinations shall provide the Commission conducting the medical examination with a certificate of passing the preliminary (periodic) psychiatric examination.
Employees engaged in work requiring professional selection shall provide the Commission conducting the medical examination with the conclusion of a psychophysiological examination.
According to the Order of the Ministry of Internal Affairs of 14.12.2015 No. 1568 "On Approval of the Procedure for Preferential Rehabilitation, Sanatorium and Resort Treatment, Recreation and Rest in Medical Rehabilitation Centers, Sanatoriums, Rest Homes, Boarding Houses and Recreational Facilities of the Ministry of Internal Affairs of Ukraine for Police Officers, Some Other Categories of Persons and Members of Their Families", the following are entitled to free medical and medical-psychological rehabilitation
police officers and employees of the Ministry of Internal Affairs and the National Police of Ukraine (hereinafter - the National Police) who defended the independence, sovereignty, and territorial integrity of Ukraine and directly participated in the anti-terrorist operation, ensuring its implementation and were directly in the areas of the anti-terrorist operation;
police officers and employees of the Ministry of Internal Affairs who were injured in the performance of their duties and/or need to continue treatment after inpatient treatment;
For preferential sanatorium treatment, rehabilitation, and recreation:
police officers and their family members (spouse, children under 18 years of age, and if they are studying in higher education institutions - under 23 years of age);
citizens of Ukraine from among former police officers who were dismissed from service for health reasons, age reasons, due to staff reduction, who were granted a pension based on the Law of Ukraine "On Pension Provision for Persons Dismissed from Military Service and Some Other Persons", and their family members (spouse, children under 18 years of age, and if they are studying in higher education institutions - under 23 years of age) - once a year;
Citizens of Ukraine from among former rank-and-file and senior staff of internal affairs bodies who were dismissed from service for health reasons, age reasons, due to staff reduction, who were granted a pension based on the Law of Ukraine "On Pension Provision for Persons Dismissed from Military Service and Some Other Persons", and members of their families (spouse, children under 18 years of age, and if they are studying in higher education institutions - under 23 years of age) - once a year;
family members of police officers who died while serving in the police - once every two years free of charge (wife (husband), if she (he) has not remarried, children under 18 years of age, and if they are studying in higher education institutions - up to 23 years of age), children who have been disabled since childhood (regardless of age) and who are granted a survivor's pension based on the Law of Ukraine "On Pension Provision for Persons Discharged from Military Service and Certain Other Persons");
family members of former rank-and-file and senior officers of the internal affairs bodies who died in the line of duty - once every two years on a free-of-charge basis (wife (husband), if she (he) has not remarried, children under 18 years of age), and, if they are studying in higher education institutions, up to 23 years of age, as well as children who have been disabled since childhood (regardless of age) and who are granted a survivor's pension based on the Law of Ukraine "On Pension Provision for Persons Discharged from Military Service and Certain Other Persons");
civil servants and employees of educational institutions, medical, scientific, and support institutions of the Ministry of Internal Affairs or the National Police from among former police officers who, as of the date of publication of the Law of Ukraine "On the National Police", served in the internal affairs bodies and had at least five years of calendar service and continued to work in the Ministry of Internal Affairs or the National Police (their territorial bodies, institutions, and establishments) in positions filled by civil servants following the Law of Ukraine "On Civil Service", and in educational institutions
Citizens of Ukraine from among former police officers referred to in paragraph six of this clause, who is granted a pension based on the Law of Ukraine "On Pension Provision for Persons Discharged from Military Service and Some Other Persons", and members of their families (spouse, children under 18 years of age, and in case of their studying in higher education institutions - under 23 years of age);
civil servants following the Law of Ukraine "On Civil Service" and other employees of bodies, institutions, and establishments of the National Police and the Ministry of Internal Affairs who do not belong to the categories of citizens referred to in paragraphs one through eight of this clause.
The following documents MUST be submitted for registration for a health resort voucher
You must have them with you when you receive the voucher:
The organization and conduct of the ETE are carried out following the requirements of the current legislation, in particular the Regulations on ETE, the Instruction on the procedure for issuing documents certifying temporary disability of citizens, approved by the Order of the Ministry of Health of Ukraine No. 455 dated 13.11.2001 (hereinafter - Instruction No. 455), as well as the Instruction on the procedure for filling out a sick leave certificate, approved by the order of the Ministry of Health of Ukraine, the Ministry of Labor and Social Policy of Ukraine, the Social Insurance Fund for Temporary Disability, the Social Insurance Fund for Veterans, etc.
I. Tasks of the ETN
1. Establishing the fact of temporary disability (hereinafter referred to as TD) in employees, determining its duration, and providing recommendations on appropriate working conditions for patients who do not have a disability group but need special working conditions, temporarily or permanently, for health reasons.
2. Conducting full and timely examination, and treatment of patients and providing appropriate recommendations.
3. Deciding whether to refer patients to a medical and social expert commission if they have persistent or irreversible disease, unfavorable labor prognosis regardless of the duration of temporary disability, or long-term temporary disability within the time limits specified in Instruction No. 455.
4. Deciding on the referral of insured persons from among former IAA employees to the MSEC if there is evidence of persistent impairment of body functions caused by diseases, or consequences of injuries (related to service in the IAA or related to the performance of official duties) that cause disability.
II. Levels of E&E
the first is the attending physician;
second - head of the specialized department, deputy head of the hospital (with a polyclinic) in charge of the polyclinic section of work and ETH;
third - the medical advisory commission (hereinafter - MAC);
fourth - the chairman of the MCC.
III. Procedure for conducting an ETN by levels
First level.
The attending physician:
Decides on the issuance of documents certifying the citizens' temporary disability in case of illness or injury, to care for a sick family member, a sick child, or a disabled child under 18 in case of illness of the mother or other person caring for the child, during quarantine based on the data of a comprehensive medical examination of the patient, taking into account the degree of functional disorders of organs and systems, the nature and course of the pathological process, and working conditions.
Issues a document certifying the PT to individuals who are recognized as unable to work during a home visit.
Issues, together with the head of the specialized department, documents certifying the citizens' TN for the period of inpatient treatment.
Reflects in the medical records of an outpatient (inpatient) patient complaints, anamnesis, including insurance (for the last 12 months), data of objective examination, additional examination methods, and other information that is the basis for determining the diagnosis and issuing documents certifying the citizens' TN, a list of necessary medical and health measures, consultations by the standards of medical technologies of the treatment and diagnostic process and protocols for the provision of medical care by specialty, the recommended regimen; the number of the document certifying the TN.
During regular examinations of the patient, the medical record of an outpatient (inpatient) patient reflects the dynamics of the disease, justifies the correction of treatment and the appointment of additional examinations, taking into account the standards of medical technologies of the treatment and diagnostic process and protocols for the provision of medical care by specialties; determines the duration of the LT and its extension, indicating the number of the document certifying the LT, the date from which it is extended, and the date of the next examination. Upon restoration of the patient's ability to work, he or she enters the data of the patient's clinical examination, which is the basis for closing the document certifying the LT, indicating its number and the date from which the patient is to return to work. In case of discharge from the hospital upon recovery of working capacity, the extract from the inpatient's medical record (form 027/o) must indicate the date of the conclusion of the medical examination committee (if any), medical and labor recommendations, the date of closure of the sick leave certificate, the date from which the patient must return to work, and the numbers of the documents certifying the citizens' RT. If the patient continues to be ill, the discharge statement indicates the date of the visit to the outpatient clinic doctor and justifies the extension of the sick leave certificate and the referral for outpatient treatment after the patient is discharged from the hospital.
In the case of a patient's treatment for accidents, indicate in the outpatient's medical record the date and time of the patient's treatment; date, time, place and circumstances of the injury; type of injury (industrial or domestic) according to the patient, which cannot be corrected or changed in the future; describe in detail the nature of the injury and draw up the relevant documentation (in accordance with the Procedure for Investigation and Recording of Accidents, Occupational Diseases and Accidents Occurred in the Bodies and Units of the Ministry of Internal Affairs of Ukraine, approved by the Order of the Ministry of Internal Affairs of Ukraine dated 27. 12.2002 No. 1346 (as amended), the Procedure for Investigation and Record Keeping of Accidents, Occupational Diseases and Accidents at Work, approved by the Resolution of the Cabinet of Ministers of Ukraine No. 1232 of 30.11.2011, and the Procedure for Investigation and Record Keeping of Non-Production Accidents, approved by the Resolution of the Cabinet of Ministers of Ukraine No. 270 of 22.03.2001).
Formulates the diagnosis that causes a TS following the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), reflecting the degree of functional disorders of organs and systems, complications, and their severity.
Ensures registration of documents certifying the patient's TN on the day the patient's TN is established from the day of admission; and when issuing documents certifying the patient's TN during home visits, no later than 10:00 a.m. the next day.
Provides medical recommendations for further treatment, employment, diet, sanatorium treatment, etc.
Ensures timely referral of patients to inpatient facilities for treatment, and provides an extract from the outpatient's medical record on the preliminary examination, treatment, and duration of the hospitalization for the last 12 months.
Represents patients to the deputy head of the hospital (with a polyclinic) for the polyclinic section of work or the head of the department in complex cases on issues of diagnosis and treatment, issuance, extension, and registration of sick leave certificates, referral to the MCC; for commission examination of patients and resolving the issue of the state of incapacity for work of patients with a duration of illness of more than 10 days before their referral to the MCC, as well as in case a patient visits a doctor the next day or on weekends after the closure of the previous document certifying the patient's disability.
Forms dispensary groups, including from among patients with frequent and long-term illnesses (persons who have been incapacitated for work due to one disease for at least four cases in the last 12 months with a total number of days of incapacity for work of 40 or more or due to different diseases for at least six cases in the last 12 months with a total number of days of incapacity for work of more than 60).
Together with the deputy head of the hospital (with a polyclinic) in charge of the polyclinic section or the head of the department, he/she represents the hospital at the MCC:
Outpatients or inpatients, if their disability lasts 30 days or more, to decide on the continuation of treatment, its correction, issuance of certificates for sanatorium treatment or rehabilitation;
Patients with signs of permanent disability, regardless of the duration of the illness, to decide whether to refer them to the VLC (for certified employees) to determine their fitness for further service, or to decide whether to refer them to the MSEC (for civilians);
Analyzes the causes of TDs among IAA employees, especially the dispensary group of patients, as well as persons who are frequently and long-term ill, working disabled; disability rates; implement measures to reduce and prevent them.
Involves specialists of other specialties in the examination of patients to clarify the diagnosis, and treatment plan and determine the cause of disability.
Refers to patients with diseases that are difficult to diagnose, treat, or recommend for work-related recommendations to the deputy head of the hospital (with a polyclinic) or the head of the department and the Medical and Occupational Therapy Committee.
Makes proposals to the management on the improvement of the organization of ETN in the institution.
2. Second level.
Head of a specialized department, deputy head of a hospital (with a polyclinic) in charge of the polyclinic section of work, and VTE:
Provides organizational and methodological guidance on ETH issues.
Counsels patients with diseases that are difficult to determine, with long treatment periods and signs of permanent disability, and, together with the MCC, initiates their referral to the MCC (for certified officers) to determine their fitness for further service and to the MSEC (for civilians).
Analyzes the quality of ETNs at the level of polyclinic (department) doctors based on the expert evaluation of patient's medical records and the analysis of errors and shortcomings in the quality of medical care, causes of VT, the procedure for issuing and extending sick leave, treatment time, with the discussion at medical conferences, meetings, etc.
Analyzes the reasons for the increase in the number of cases of RTs, their duration by nosology, by doctors of the subordinate unit, and days of the week, every month. Investigates the causes of negative indicators, and develop and implement measures to reduce the level of LT.
Analyzes the state of primary disability and develop measures to prevent it.
Together with the attending physicians, he/she draws up sanatorium cards (form No. 072/о).
Carries out a commission examination of patients with the attending physician and resolves the issue of the state of disability of patients with a duration of illness of more than 10 days before the time of referral to the Medical Examiner's Committee.
Controls:
timeliness and completeness of examination, diagnosis, and treatment of patients at the pre-hospital and hospital stages, their compliance with the standards of medical technologies of the treatment and diagnostic process and protocols for the provision of medical care by specialty
timeliness of referral and quality of medical records submitted to the MCC;
compliance by doctors with the procedure for issuing documents certifying the citizens' TN per the current regulations on ETN;
indicative terms and quality of treatment of patients during TN in outpatient (inpatient) settings;
quality of records in the outpatient (inpatient) patient's medical record, namely, completeness of complaints and their compliance with the diagnosis; quality of the patient's insurance history and medical history; compliance of records with the patient's objective condition; sufficient justification of the diagnosis made to the patient; availability of a plan for examination and treatment of the patient; availability and correctness of medical and labor recommendations; availability of records of the issuance of a sick leave certificate, the period of extension (from what date and until what date) and the date of the next visit to the doctor, and when closing the sick leave certificate, a record of its closure indicating the date from which it is necessary to return to work;
justification of the extension of the sick leave certificate in case of need to continue treatment on an outpatient basis after inpatient treatment in the medical record of the inpatient and an extract from it;
timely referral of a patient to a hospital if there are medical indications, taking into account the disease profile;
correctness of medical records;
correctness of selection when referring patients to sanatoriums, rehabilitation facilities, and specialized healthcare facilities;
quality of medical care with entries in the medical record of an outpatient (inpatient) patient regarding the correction of the diagnosis, examination plan, treatment, and state of working capacity;
effectiveness of dispensary observation, rehabilitation of patients who are often and long-term ill;
the quality of periodic medical examinations and detection of diseases, registration of patients for dispensary observation, and their rehabilitation, including for disabled persons for whom an individual rehabilitation program has been developed by the MSEC;
making notes in the sick leave certificate (certificate) and the medical record of an outpatient (inpatient) patient about violations of the prescribed treatment regimen;
the date of closing the sick leave certificate when determining the disability group and conducting rehabilitation measures;
the work of attending physicians in the study and prevention of morbidity and disability.
9. Refer patients in cases that are difficult to diagnose and/or treat for consultations at other specialized and highly specialized healthcare facilities.
10. Submits proposals to the management of the institution to bring to justice medical workers who have committed violations in establishing a diagnosis, prescribing appropriate examination and treatment, issuing, extending, and filling out documents certifying the VTC, and filling out medical records.
11. Provides proposals to the management of the institution to improve the organization of the ETN.
3. Third level.
The Medical Advisory Commission carries out its activities following the Regulations on the MAC of the SI "TMA", approved by the order of the SI "TMA".
Work schedule of the MCC: From Monday to Friday from 13-30 to 15 00.
Office #304.
4. The fourth level.
Head of the SCC:
1) Heads the MCC and ensures its work is under the order of the Head of the SI "TMA".
2) Carries out the work on advanced training of doctors on ETN issues.
3) Ensures timely study of current regulations on ETN by physicians.
4) Organizes activities aimed at improving the quality of ECT.
5) Conducts instruction on ETN with physicians employed by the SI "TMO" and authorized to issue documents certifying temporary disability of citizens.
6) Counsel patients with cases that are difficult to determine their ability to work and, after a personal examination of the patient upon the recommendation of the deputy head of the hospital (with a polyclinic) for the polyclinic section of work and VTE or the head of the department and the attending physician, with the involvement of the necessary specialists, determines the further tactics of treatment of the patient and the state of his/her ability to work.
7) Ensures constant control and verification of compliance by the doctors of the SI "TMA" with the current legislation and other regulatory documents on ETH:
correctness and timeliness of diagnosis, examination, prescribed treatment, the validity of issuance and extension of documents certifying temporary disability
the duration of temporary disability, taking into account the severity of the disease, the estimated duration of treatment of patients (by the hospital (with a polyclinic), departments, offices; by days of the week, doctors, nosological forms of diseases, etc;)
validity of selection and referral to sanatorium and rehabilitation facilities, specialized healthcare institutions;
implementation of medical and social rehabilitation measures;
compliance with the standards of medical technologies for the treatment and diagnostic process and protocols for the provision of medical care by specialty;
conducting quality expertise of primary medical records at different levels of expertise and in different periods of temporary disability and based on the results of treatment, with an assessment of the effectiveness of the treatment and diagnostic process;
compliance with the procedure for recording, storage, distribution, and use of documents certifying temporary disability.
8) Ensures interaction with:
social insurance funds - regarding compliance by doctors with regulations on the examination of temporary disability;
Medical and Social Expert Commission - on the quality of examination and treatment of patients, their rehabilitation, and study of the causes of disability.
9) Analyzes the identified shortcomings that affect the quality of the ETN and make decisions based on the results of the analysis within its competence. Resolves the issue of the need for an additional examination of patients with difficult-to-diagnose pathology.
10) Organizes the work of doctors to study the causes of morbidity with temporary disability, and participates in the implementation of a system of measures to prevent and reduce morbidity. Summarizes materials and prepares analytical reports on this issue for consideration at operational meetings and the Medical Council.
11) Considers citizens' appeals to determine their ability to work, complex and conflict cases, claims of citizens and interested organizations, insurance companies, and social insurance funds.
12) Following the plan, holds operational meetings on VTE with the medical staff of the institution, and meetings with representatives of social insurance funds.
13) Decides on the repeated ETN with the examination of the patient in cases of unreasonable issuance of documents certifying temporary disability.
14) Submits proposals to the management of the SI "TMA" on bringing to responsibility medical workers who violated the procedure for issuing, and extending documents certifying temporary disability of citizens and registration of medical records.
15) Submits issues related to ETNs for consideration by the Medical Council of the SI "TMA".
16) Submits proposals to the Head of the SI "TMA" on the improvement of the ETN.
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