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Ministry of Justice

Republic of Tajikistan 

 On April 28, 2022 No. 219

ORDER OF THE GOVERNMENT OF THE REPUBLIC OF TAJIKISTAN

of April 26, 2022 No. 177

About the Procedure for conducting medico-social examination

According to article 28 of the Code of health care of the Republic of Tajikistan and article 57 of the Law of the Republic of Tajikistan "About regulatory legal acts" the Government of the Republic of Tajikistan decides:

1. Approve the Procedure for conducting medico-social examination it (is applied).

2. Declare invalid the order of the Government of the Republic of Tajikistan of October 2, 2012 No. 543 "About the List of the medical indications granting the right to handicapped children up to 18 years on receipt of social pension".

3. Enact this resolution since May 1, 2022.

Prime Minister of the Republic of Tajikistan

Emomalii Rahmon

Approved by the Order of the Government of the Republic of Tajikistan of April 26, 2022, No. 177

Procedure for conducting medico-social examination

1. General provisions

1. The procedure for conducting medico-social examination (further - the Procedure) establishes conducting medico-social examination of determination of working capacity, temporary and long disability, group and the reasons of disability, duration of disability, carrying out repeated survey, and also order of registration of sick leave notes of patients and disabled people. Medico-social examination is performed taking into account overall assessment of condition of organism, based on the analysis of kliniko-functional, household, social, professional, labor and mental indicators of the examined person.

2. Disability, the reasons, duration, time of its origin, degree of disability and need of person for social protection is established by conducting medico-social examination.

3. Medico-social expertize is carried out from Public service of medico-social examination (further - Service) which is authorized state body of medico-social examination.

4. Medico-social expertize professional bolezny is carried out on the basis of the conclusion of Public institution "Republican clinical center of occupational diseases".

5. Military-medical examination for the purpose of determination of suitability to the military service (equated to them) and training in specific military specialties, and also determinations of the reason of disability and disease of the military personnel in connection with passing of military service are carried out according to the procedure, established by the Government of the Republic of Tajikistan.

6. In this Procedure the following basic concepts are used:

- social limitation (disadaptation) - inability (in connection with violation of functions and restriction of vital activities) to be implemented in the daily life;

- inability to conduct independent life - lack of social communications and to need the help of other persons;

- social requirement - need in social protection or belonging to vulnerable group the formed basis for determination of groups of disability;

- criteria of vital activities - availability of possibility of self-service, movement, orientation, self-checking, communication with the world around, training, and also accomplishment of labor activity;

- the capability to move - opportunity to move effectively (to go, run, break barriers, to use transport). Evaluation criterion - feature of walking, the movement speed, distance which there passes patient, capability independently to use transport, in case of movement to need assistance;

- capability to self-service - capability it is effective to carry out daily household activities and to satisfy the requirements without other faces. Evaluation criterion - period of time during which the help - the temporary help is necessary (at least once a month), the continuous help (several times a month), the permanent help (in week several times - the planirovanny help, or several times a day - not the planirovanny help);

- orientation in space - capability independently to determine the place in space and in time, and also to have data on surrounding objects. The main components of orientation are feelings of sight and hearing. Orientation is estimated in the normal state of activities of mentality and the speech. Evaluation criterion - to differentiate capability external similarities of people and objects at the increasing distance and in different conditions (in case of availability or lack of barriers, acquaintance with the environment), capability to differentiate voices and informal conversation (to be guided on voice) - in case of availability or lack of violations and extent of compensation of violation of perception of informal conversation by other methods (the letter and other, not oral forms), need of use of technical means for orientation and assistance in daily activity (in life, study and on production);

- communicative capability - ability to communicate with people and to improve the regular social relations (in this case do not mean termination of the relations, connected with violation of mental activities). The main communication method is informal conversation, auxiliary methods are reading, the letter, not oral forms of communication (imitation). Evaluation criterion - feature of group of people with which communication, and also need of assistance for training process and labor activity is possible;

- self-checking capability - self-control capability within moral and precepts of law of the environment. Evaluation criterion - capability to realize itself and to respect the established social norms, to compare people and objects, to understand the relations between them, it is correct to perceive, retell, equally treats regular and unusual circumstances, to observe personal security and hygiene;

- the capability to study - perception capability, to study, send the talents and opportunities (household, cultural, professional) to purposeful training process;

- the capability to study profession - the capability to seize theoretical and practical knowledge, skills of specific profession. Evaluation criterion - capability will study in the regular or specially created conditions (special educational institutions, in group, training of the house), to perceive program amount, time and the mode of training, the capability to seize various professional levels or separate work, need for use of special tutorials, and the help of people around;

- capability to labor activity - set of physical and moral capacities of the person which determines the state of health of the person for further accomplishment of labor activity;

- professional suitability - capability it is high-quality to perform work on specific profession which provides sales terms of labor activity in certain industrial space according to requirements of production loads, the working schedule and the production circle. Evaluation criterion - preserving or loss of professional suitability, opportunity to work at professional level in other spheres equal to former profession, to estimate amounts of works and positions, opportunity to be engaged in case in the regular or specially created conditions;

- working capacity violation - basic reason of social insufficiency which can arise in case of activity restriction, at the same time without concerning other levels of activity.

2. Rules of conducting medico-social examination

7. The service carries out medico-social expertize gratuitously based on comprehensive assessment of the state of health, extent of violation of functions and restriction of activity, taking into account psychological state, repeated and social re-examination, environment, and also professional factors.

8. The service in the presence of the bases (indicators) on limitation of activity of the patient establishes the reason and time of approach of disability, determines extent of loss of professional suitability (as a percentage), develops the individual program of rehabilitation for each disabled person.

9. Violation of working capacity and restriction of activity is estimated in percentage ratio. For the purpose of streamlining of estimative process on various indicators "functional degrees" will be determined by five-point scale according to which (from 0 to 4) it will be equal to 100% and the interval between points will constitute 25% including:

- functional degree 0 - natural state of indicator;

- functional degree 1-easy violation of functions or limit of vital activities (from 1 to 25%);

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