Medical labor expertise

Examination of long-term or permanent loss of ability to work and study of the health status of patients are VTEC, which are organised on a territorial basis in the basis of medical institutions, which are in charge of social security and they are subordinated. VTEC accept for examination of patients who were unable to work continuously for 4 months. or a total of 5 months. in the last year.
Main objectives of VTEC: establishing the degree of disability reasons and duration of disability and its group (see Disability); the definition for the disabled the conditions and types of work (employment guidelines), as well as measures to restore their ability to work (training, retraining, rehabilitation, prosthetics, provision of vehicles and so on).
Workers, employees and collective farmers, whom according to the conclusion of VTEC established group of disability, permanently or for a long time are exempt from professional work (students from learning), they are assigned a pension, provided facilitated conditions of work and define other types of benefits. This conclusion is made in the form of the certificate of VTEC, which is granted to the disabled. Without the employment recommendations of doctors-experts, heads of enterprises and institutions have no right to give disabled persons.
VTEC operates on the basis of special regulations and acts in a role of the state body, enshrining in the manner prescribed by law of the right of workers to social assistance (see Social security, Social insurance). The organization and functions of medical labor expertise are part of the system of activities that form the basis of social and labour rehabilitation of disabled persons (see Rehabilitation).
There are city, district and Interdistrict VTEC, each of which consists of three doctors (therapist, neurologist, surgeon), representative of the Department of social welfare and the representative trade Union organizations. One of the doctors-experts appointed by the Chairperson. For carrying out of medical labor examination of patients with tuberculosis, mental, oncological, cardiovascular, ophthalmic diseases and consequences of traumas are specialized VTEC; they consist of two doctors relevant specialty (one of them is the Chairman) and a General practitioner or a specialist. In the state of all VTEC there is a medical Registrar, and in the committees, working full working week, in addition approved the position of senior nurses.
VTEC decides on the basis of collective discussion of data of the medical examination of the patient, taking into account his profession and production characteristics of employment. No member of VTEC not have the right to unilaterally to carry out examination of ability to work and to make an expert decision.
A comprehensive analysis of the factors of biological and social nature is one of the most important principles that determine the content of the medical and expert solutions. This takes into account the causes and mechanism of disease development, features of its course, anatomical and functional disorders, forecast, and so on, as well as the attitude of the patient to work, his professional activities before (in process) diseases and dynamics disabilities after the disease has become chronic or left permanent pathological consequences. The uniform and unified character of expert decisions due to the fact that the methodological basis of medical labor expertise is normative, generally accepted definition of the criteria of disability and the degree of reduction or loss of working capacity.
Nurse together with representatives of trade Union organizations, doctors, medical institutions, VTEC exercise control over ensuring of the conditions of labour of persons with disabilities, in particular for the transfer on the work corresponding to their state of health.

Medical labor examination - determination in a disability, permanent or temporary, for people with abnormalities of organism functions due to illness, injury or congenital underdevelopment. A thorough and comprehensive examination of the patient, study the depth and extent of the pathological process, verification of the functional state of different systems, accounting in the dynamics of compensatory adaptations, to determine the impact of social factors and the external environment provide an opportunity to make an objective conclusion about disability and the degree of the violation.
Basic principles of medical labor expertise in the determination of the status of disability: 1) state the nature of (the state regulates and finances the activities of the expert and authorizes the expert Commission with appropriate evidence to adjudicate on disability, which determines the legal status of persons with a disability); 2) the accounting of biological and social factors when making decisions and determining the appropriateness and nature of further work; special attention is given to the specific situation (institution) - climate, chemical and physical factors, the degree of nervous and physical activity, combined with the work; 3) the principle the integrity of the organism (a comprehensive accounting of all diseases and the degree of loss or security of employment functions testify); 4) preventive examination in the struggle for reduction of disability by transferring the long and often ill at work corresponding to their state of health.
When defining disability, it is necessary to accurately diagnose disease thorough examination of the patient; to clarify the influence of the environment of the enterprise, shop, office premises, atmospheric conditions, lighting, etc., the work on the functional state of the patient and his compensatory opportunities; to examine specialized on the main forms of disease, and therefore are cardiology, tuberculosis, eye, cancer, mental health, trauma and other commissions. The conditions in which he worked, patients should be examined with the participation of specialists with good knowledge of production,doctors health units, health centers, supervisors and craftsmen workshops, foremen of collective and state farms, Directors of HR departments, etc. It is an away session of VTEC.
Medical labor expert Commission (VTEK) are administered by the social security institutions of the Union republics, but are organized on the basis of medical institutions according to the territorial principle. Following the expert Commission: a) city, district and inter-district General type with three doctors - therapist, surgeon, neurologist (one of them is the Chairman of the Commission), the Union representative and a representative of the social security authorities; b) specialized commissions, city and inter-district, to determine disability of patients suffering from tuberculosis, eye, cancer, mental diseases, heart diseases, injuries, etc. In each Committee includes two doctors of this specialty and third - therapist or neuropathologist, and one representative from the trade unions and social security authorities. The Chairman of the Commission appointed doctor principal in the Commission's degree; C) regional, territorial and Republican VTEC and Central (Moscow and Leningrad) city Commission in part 4 of doctors-experts. When a large number of examinations in the area and the region offers several similar commissions, but essentially they all constitute a single Commission. As the highest body of the examination of a territory, region, Republic, such commissions have the final say. At the head is the Chairman; he is simultaneously the chief expert of the Republic, territory, region, Moscow and Leningrad.


Activity of expert committees is regulated by the regulation on VTEC (approved by the councils of Ministers of the Union republics), which set out the basic principles, objectives and structure of the commissions, the method of survey conducting and legal situation of the work of the commissions; instructions for definition of invalidity groups with the list of diseases in which a group of disability is established in perpetuity (instructions approved by the Ministry of health of the USSR, the trade unions and agreed with the Ministry of social Affairs); the instructions of the ministries of social security of the Union republics. In its work, VTEC also guided by the manuals and methodological guidelines, developed by scientific-research institutions examination of working capacity and productivity of persons with disabilities.
The expert Commission included: a) establishing the degree of disability and the definition of disability (see Disability); b) determining the degree of disability of workers receiving any damage or injury related to their work, to compensate the caused damage;
b) identification of causes of disability due to General disease, occupational disease, employment injury, disability since childhood, disability, coming to work, wound, contusion, injury received while defending the USSR or in the performance of duties of military service, and others;
g) a decision on the employment guidelines, based on which the disabled person must be arranged on work (see Employment), and monitoring of working capacity of disabled persons; e) giving opinions on needs in special vehicles with manual control; f) establishment of indications for referral of persons with disabilities in special vocational schools; g) definition of the indications for free travel on public transport invalids of the great Patriotic war.
The ability examination is conducted only after appropriate treatment and long-term medical supervision. In cases where the doctor becomes clear that vocational rehabilitation of the patient by curing is impossible, it fills together with chief of Department direction to VTEC. This document is approved by VPC or the head of the medical institution.
In expert commissions on each patient fills in the act of examination, similar history. Extract from the statement shall be sent to the organization, paying the pension. To the hands of the disabled receive a certificate of VTEC, which highlights the group of disability, the term of the next recertification and labour recommendation.
To conduct examination in a hospital patient is sent to the Department of medical labor expertise at the Republican and regional hospitals.
Development of problems of medical labor expertise is conducted research institutions examination of working capacity and productivity of persons with disabilities. In the RSFSR and the USSR, two Central Moscow (a branch in Rostov-on-don) and Kharkiv; in Leningrad, and Odessa. Besides a scientific research institutes prepare doctors-experts. At the Central doctors improvement Institute (Moscow) is the Department of medical labor expertise. Institutions have a clinical Department on key medical specialties (internal medicine, surgery, neurology, psychiatry, tuberculosis and ocular disease) and consultants in other medical specialties, and also all necessary diagnostic laboratory and experimental workshops. Institutions publish manuals, guidelines on topical issues of medical labor expertise.
In cooperation with leading research institutes of health institutions examination hold Republican scientific-practical conferences and seminars on diagnostics, clinic and labour expertise. In institutions has postgraduate studies in the basic medical Sciences and clinical residency, which prepares the scientific and practical workers in the field of medical assessment and organization of work of persons with disabilities. Cm. also the ability to work.