Many people with disabilities do not understand the need for a re-examination procedure, especially in cases of disability attributed to them in childhood or associated with severe irreversible changes in the body. Re-examination is necessary not only to confirm the previously established disability, but also to adjust the rehabilitation program, control the dynamics of changes in the state of health. Re-examination of a child’s disability is especially important for organizing optimal living conditions and rehabilitation. The developed rehabilitation system allows you to fully integrate into society.
In addition, a disabled person of group 3 receives monthly allowances, benefits and other payments, which greatly facilitates the solution of many problems that a sick person faces. With other disability groups, the value of state support is even more significant. Therefore, the re-examination procedure is an important moment in the life of a person with disabilities.
The procedure and terms for re-examination of disability
Re-examination is carried out in the manner prescribed by federal law with a frequency determined depending on disability groups. Currently, the following rules for passing this procedure apply:
• A person with disabilities of group 3 is required to undergo a re-examination once a year.
• A person with disabilities of group 2 must come for re-examination 1 time during the year.
• Persons with disabilities of group 1 must undergo a re-examination 2 times during the year.
• Children with disabilities undergo the procedure once before the end of the period for which disability is determined.
In case of perpetual disability, a second examination can be done by writing a statement in person or on behalf of the legal representative. In addition, the institution providing treatment and preventive care can also refer to the procedure for re-examination of disability in case of a change in the patient’s state of health.
You can go through the procedure in advance, but for re-examination earlier than two months before the end of the period of disability, you must have a personal statement or referral to a medical organization that monitors the course of a citizen's illness.
The re-examination procedure is also carried out at home. For this, it is necessary that the attending physician make special marks in the direction.
Main and Federal Bureau of Medical and Social Expertise
Re-examination of a disability group is carried out on the basis of medical and social examination, which is carried out free of charge at the bureau of medical and social examination at the place of residence, the main bureau and the Federal Bureau.
The Federal Treasury Institution “The Main Bureau of Medical and Social Expertise” (PKU GB ITU) is a regional service for conducting expert examination, as well as providing a range of rehabilitation and health services.
PKU GB ITU performs the following functions:
• Organizes a re-examination in the event of filing an appeal against the conclusion of an expert commission with a bureau at the place of residence.
• Carries out ITU in situations where a special medical examination is needed.
• Carries out a statistical analysis of data on the number and demographic composition of citizens with disabilities and contacting the bureau.
• Develops measures for the prevention and prevention of disability.
• Supervises the activities of each bureau.
The Federal Bureau of Medical and Social Expertise (ITU FB) is a federal service for conducting expert examination, as well as providing a range of rehabilitation and health services. In addition, the tasks of the ITU FB include providing quality prosthetics.
The Federal Bureau organizes control over the activities of other bureaus, may appoint and carry out a repeated examination, change or cancel decisions made by employees of other bureaus.
Citizens who do not agree with the conclusions of the commissions of the main bureaus may file a complaint with the Federal Bureau, where a new examination will be appointed. Here ITU and consultations are held in the direction of the main bureaus in situations when it is necessary to obtain its expert opinion or if it is necessary to conduct a complex type of medical examination.
Medical and social examination procedure
The examination procedure is organized by employees of the expert group of the bureau. A survey of the person applying for examination is carried out, his social, domestic, psychological and labor characteristics are examined. The medical documentation of the disease is being studied. Based on the assessment of all the data received, a decision is made to establish disability, extend it, or change the disability group.
If, as a result of the commission, an improvement in the health, working ability, and social and domestic adaptation of a citizen was revealed, then the disability group can be changed. A person with a disability of group 2, in case of improvement of indicators of the state of health and living conditions, may receive a disability group of 3 during re-examination .
The conclusion of the commission shall be announced to the citizen in the presence of all members of the expert composition and shall be entered into the act of the examination. The document also includes a number of information and references on the basis of which a conclusion was made.
If necessary, additional examinations are carried out at the medical organization or the Federal Bureau. In the situation of a citizen's refusal from the program of additional examinations, this information is noted in the act, and the decision is made on the basis of the available information.
The examination procedure can be carried out at home if, due to the state of health, a person cannot come to the bureau. For this, a decision of the relevant bureau or direction of the medical institution where the citizen is being monitored, or the hospital where the treatment is carried out, is necessary.
ITU expert opinion
ITU's conclusion is the result of the work of an expert commission. The composition of the commission's specialists depends on the bureau and its profile. The examination of the main office is carried out by four doctors of different profiles, an expert on rehabilitation work, a social worker and a psychologist. The staff of the bureau at the place of residence includes the same specialists as the main bureau, but the number of doctors of various profiles is less (three medical workers). Commissioners make decisions based on a majority vote.
The composition of the expert commission depends on the head of the bureau, who decides on the participation of one or another specialist in the ITU procedure. Also, a citizen sent for examination to the bureau has the right to attract additional experts, but subject to payment for their work. The decision of these members of the expert commission will influence the final conclusion of ITU.
ITU experts draw up a conclusion on the basis of the medical documentation provided, after examining the citizen, discussing all the information received collectively. After the announcement of the decision, the experts of the commission give explanations on the conclusion made to the citizen who applied to the bureau.
Appeal of ITU Conclusions
In a situation where the decision of the expert committee of the bureau during the re-examination of disability seems unreasonable, you can file an appeal against the bureau at the place of residence where the examination was held. Within three days, the application will be sent to the main bureau, where on the basis of the results of the new examination a conclusion is made. In the event of disagreement with the conclusion of the main bureau, an appeal is sent to the Federal Bureau. In connection with the appeal, a second examination will be carried out and a final decision will be determined.
The conclusion of the federal bureau can be appealed only in court.
To appeal the conclusion of the bureau, you must write a statement indicating:
• The names of the particular bureau for which the application is being addressed.
• Personal data (last name, first name, middle name, address of residence, contact information) of the applicant.
• Personal data of the representative.
• The subject of the complaint about the examination.
• Requests for re-examination.
• Dates of application.
How to get through ITU?
Based on the results of the re-examination, disability is extended or removed, the disability group changes, which entails a change in the IDP, the amount of benefits and allowances.
For a successful examination, it is important not only to collect all the necessary documents and test results, but also psychologically prepare for the procedure. The decision is made by the members of the expert team on the basis of the assessment of disability, while the impression that the citizen makes on the members of the commission plays an important role. Therefore, one cannot behave aggressively or be offended by incorrect questions. The answer should be calm and accurate. Moreover, the reaction of embarrassment to the question will be much better than impatience and anger. The most frequently asked questions to which you need to be prepared include:
• Questions about the course of the disease.
• Questions about disability (availability of work, comfort of working conditions, etc.).
• Questions about the ongoing treatment (undergoing IPR procedures, reasons for refusing the recommended types of diagnostics, etc.).
• Issues related to the characteristics of the functioning of the body.
• Questions about the financial condition of family members, in order to identify the possibility of the patient participating in expensive rehabilitation programs that are not subject to state subsidies.
Re-examination of disability, documents required for ITU
To undergo a re-examination of disability, you must have a passport of a citizen of the Russian Federation, a work book, a referral from the clinic at the place of residence for the examination procedure, an outpatient card, IPR with instructions on how to perform. It is also necessary to write and take with you a statement to the head of the bureau about the re-examination. If during the year prior to the re-examination procedure, consultations were conducted with specialists or treatment was carried out in a hospital, then the relevant documentation must be provided by a specialist expert team. With some documents, it is better to make copies to provide if necessary.
Children with disabilities undergo the re-examination procedure in almost the same manner as the initial examination. The list of required documents is the same, but a certificate of disability and IPR is added. When re-examining a child’s disability, the presence of:
• Birth certificates of a child or passport (if the child reaches the age of 14).
• Outpatient card.
• Certificates of education or certificates from the educational institution where the training takes place.
• Conclusions of specialists of a narrow orientation, extracts from hospitals.
• A document confirming disability;
• IPR.
Disability extension
Before extending disability, you must contact the medical institution at the place of residence. Mandatory presence of a passport, medical insurance policy, ITU certificate of disability, outpatient card, discharge from the hospital (if there was treatment), IPR. The medical professional will write out a referral for examination, as well as for the necessary procedures and tests. You need to visit the bureau and sign up for the nearest date by the end of the period of disability for re-examination. After this, you need to contact your doctor for the underlying disease, which will give an opinion for the expert commission. It is also required to be examined by two narrow specialists, to whom the local therapist will refer. After receiving the results of the analyzes and passing the consultation of all doctors, you should again go to the appointment with a therapist, who will enter the information in the certificate and write out the direction for the IHC (military medical commission). Further, with all references and copies of the main documents, you can go to the ITU procedure.
In case of refusal to extend the disability, a certificate is issued that indicates the result of the examination and the grounds for refusal. The decision of the bureau can be appealed to the Federal Bureau or in court.
Re-examination of child disability
Re-examination of a child’s disability takes place in a slightly different order than in adults. Mandatory presence of one of the parents. The list of required documents is different. In addition, a disability group cannot be established, since in childhood the general category “disabled child” is assigned.
For the procedure, the direction of medical institutions is necessary. Re-examination takes place no earlier than two months before the expiration of the disability, but no later than the specified date of the medical and social examination. Inpatient monitoring to extend a child’s disability is not necessary. An individual rehabilitation program is also advisory; the implementation of all the measures indicated in it is not a prerequisite for re-examination of disability.
Very often, upon reaching 18 years of age, a re-examination recognizes the ability to work. This is due to the fact that when establishing adult disability, the main focus is not on impaired body functions, but on assessing the ability to move independently, self-care, work, etc.
Disability without reevaluation
There is a list of diseases in which disability is established without specifying the period of re-examination.
These diseases include:
• Diseases of the internal organs.
• Neuropsychiatric disorders.
• Anatomical defects.
• Eye diseases.
Moreover, disability without re-examination is established no later than two years after the initial recognition of disability for diseases of this list.
Disability without re-examination can also be established if the expert commission has identified the impossibility of improving the health status, rehabilitation of a person and reducing the limitations of his life. In this case, no more than four years should pass after the initial examination of disability.
In order to establish disability without a period of re-examination, there should also be no positive dynamics in the rehabilitation carried out before the appointment of ITU. The relevant data are indicated in the direction of the examination.
In addition, the re-examination procedure is not assigned to women after 55 years and men after 60, and permanent disability is established.
According to experts of social protection, it is better to undergo a re-examination even in case of perpetual disability, in order to identify the deteriorating health status or the need to replace the prosthesis in time.
If the federal bureau checks the decisions of the main bureau, then in case of disability without a period of re-examination, ITU can still be appointed.
Failure to re-examine disability
In case of failure to appear on the medical-social examination procedure, the payment of pension will be suspended for three months. If a disability is confirmed by the medical and social examination services within the specified period, pension payments will resume from the day the disability is re-recognized.
In the situation when the re-examination was missed for a good reason, the payment of pensions will be appointed from the day of re-examination of disability, including payments for the missed period. The duration of the period during which the pension payments were not made does not matter. Moreover, if the expert commission has established a different degree of disability, then payments for the missed period will be made according to the previous system of calculation.
The resumption of payments is made automatically after the receipt of the relevant documents by the Pension Fund, which is sent by the specialized medical and social examination service and confirms the procedure for re-examination.