of January 31, 2012 No. 68
About medico-social examination in the Kyrgyz Republic
For the purpose of enhancement of regulatory framework in the field of medico-social examination the Government of the Kyrgyz Republic decides:
1. Approve Regulations on recognition of the citizen-faced with limited opportunities of health according to appendix.
2. Determine that references and statements from the act of survey of medico-social commissions of experts issued it is termless, as appropriate in the territory of the State Parties of the Commonwealth of Independent States which were part of the USSR till December 1, 1991 are accepted in the territory of the Kyrgyz Republic without legalization.
3. Recognize invalid:
- the order of the Government of the Kyrgyz Republic "About modification and amendments in some decisions of the Government of the Kyrgyz Republic" of February 3, 2005 No. 56;
- the order of the Government of the Kyrgyz Republic "About modification and amendments in some decisions of the Government of the Kyrgyz Republic" of June 5, 2006 No. 409;
- Item 9 of the order of the Government of the Kyrgyz Republic "About modification of some decisions of the Government of the Kyrgyz Republic" of July 8, 2004 No. 508;
- Item 5 of the order of the Government of the Kyrgyz Republic "About modification and amendments in some regulatory legal acts of the Government of the Kyrgyz Republic" of August 19, 2005 No. 388.
Approved by the Order of the Government of the Kyrgyz Republic of January 31, 2012 No. 68
1. This Provision according to the Law of the Kyrgyz Republic "About the rights and guarantees of persons with limited opportunities of health" determines recognition of the citizen by person with limited opportunities of health which is performed by territorial (interdistrict) medico-social commissions of experts (further - MSEK). Medico-social examination (further - expertize) is carried out for the purpose of establishment of structure and extent of restriction of activity of the citizen, and also determination of measures of rehabilitation and social protection.
2. The basis for recognition of the citizen by person with limited opportunities of health are the following conditions:
a) the violation of health with permanent disorder of functions of bodies and systems caused by the disease, consequences of injuries or defects which entailed activity restrictions (complete or partial loss by the citizen of capability or opportunity to perform self-service, to independently move, be guided, communicate, to control the behavior, to study or be engaged in labor activity);
b) need for measures of social protection, including rehabilitation.
3. The basis for recognition of the citizen by person with limited opportunities of health proceeds from complex assessment of state of his health and extent of restrictions of activity, assessment of kliniko-functional, social, professional and labor and psychological data according to this Provision.
4. Depending on extent of the restriction of activity caused by the permanent disorder of functions of bodies and systems which resulted from diseases, consequences of injuries or defects, to the citizen 18 years, recognized as person with limited opportunities of health are more senior, I, II or III groups of disability according to Chapter 23 this provision are established.
5. To the citizen aged up to 18 years the category "the child with limited opportunities of health" of the extent of restriction of activity much expressed, expressed, moderately expressed depending on expressiveness of extent of the restriction of activity caused by the permanent disorder of functions of bodies and systems which resulted from diseases, consequences of injuries or defects according to Chapter 24 this provision is established.
6. The citizen to examination is directed by the organization of health care after carrying out complete comprehensive physical examination using necessary diagnostic, functional testings, the corresponding recovery treatment, in the presence of the data testimonial of permanent violations of the functions of organism caused by diseases, consequences of injuries and defects. Carrying out physical examination in the organization of health care (stationary or out-patient) determines and the attending physician of the organization of health care solves on medical indications.
7. The direction of the organization of health care on MSEK is represented in forms according to appendices 1 and 2 to this Provision where the data on the state of health of the citizen reflecting extent of violation of functions of bodies and systems, and also results of the held medical and rehabilitation events are specified.
8. Citizens are more senior than 18 years go for survey not earlier than 4 months (120 days) from the date of approach of temporary disability or not earlier than 5 months with break (150 days) of temporary disability, in total within the last 12 months (in case of the same disease or disease, close to it).
9. Citizens with the diagnosis of tuberculosis and its recurrence go for examination not earlier than 6 months (180 days) from the date of approach of temporary disability depending on form, weight, prevalence of process and the clinical forecast, or no later than 10 months (300 days), in total within the last 12 months.
10. The citizens who are not occupied with work go for examination in accordance with general practice.
11. In case of the favorable clinical and labor forecast, efficiency of the carried-out treatment, when conducting examination of the citizen in four months from the date of approach of temporary disability, the leaf of disability can be extended by the decision of MSEK to complete recovery of working capacity, for the term of no more than 8 months on general duration from the date of approach of temporary disability.
12. In some cases (injuries, condition after reconstructive transactions) after 8 months in case of repeated survey, the leaf of disability can be prolonged according to the decision of MSEK up to 12 months.
13. Earlier direction on MSEK is allowed in case of indisputability of approach at the patient of signs of resistant disability with extent of restriction of activity. Degree of indisputability of approach of resistant signs of restriction of activity is determined by the attending physician of the organization of health care through the medical advisory commission (further - VKK) in case of sharply expressed extent of restriction of activity (at terminal patients).
14. The issue of establishment to the child of category "the child with limited opportunities of health" with determination of severity of restriction of activity is resolved after performing necessary complex treatment at least four months, except for indisputability of approach at the child of signs of permanent restriction of activity.
15. The citizen in the presence of required documents can address independently to MSEK in case of refusal of the organizations of health care from the direction for examination (in the presence of the refusal with indication of the reason in writing certified by official stamp and the signature of the director of TsSM of the organization of health care in the place of addition of the patient).
16. For timeliness, justification of the direction for examination, and also the organization of health care according to the procedure, established by the legislation of the Kyrgyz Republic bears responsibility for reliability and completeness of the data specified in the direction.
- the petition from the citizen of the established form;
- passport of the citizen of the Kyrgyz Republic (ID card);
- the reference of the established sample issued by law-enforcement bodies the coupon about temporary registration (BI-coupon);
- to children up to 18 years - the certificate of birth, the passport of the citizen of the Kyrgyz Republic (ID card) of parents or the legal representative;
- the certificate of release from places of detention;
- the residence permit - for foreign citizens and stateless persons if they have the permission to the permanent residence in the Kyrgyz Republic which is drawn up by the residence permit and issued by the state authorized body;
- the service record for persons occupied with labor activity (in the absence of the service record - the reference from Social fund of the Kyrgyz Republic (further - Social fund);
- the direction of the organization of health care - form No. 088/at;
- to citizens up to 18 years - the direction of the organization of health care of the child up to 18 years for medico-social examination in form according to appendix 1 to this Provision;
- to citizens 18 years - the direction of the organization of health care for medico-social examination in form according to appendix 2 to this Provision are more senior (direction effective period - up to three months from the date of filling);
- the out-patient map, statements of hospitalization, medical documents confirming disease (advisory proceedings, results of inspections);
- disability leaf - for the working citizens.
18. Copies of the specified documents join the act of survey of MSEK. In some cases for conducting examination of MSEK has the right to request additional documents.
a) the certificate on disease or the resolution of the military-medical commission of the State committee for defense of the Kyrgyz Republic (further - VVK of the State Committee for defense) or VVK of the relevant department;
b) the dismissal order from service.
20. For citizens, victims of radiation:
a) the source document (and the copy) with obligatory specifying of the period of accomplishment directly of work on it is radioactive the polluted territories and the bases for issue of this document confirming the fact of impact of radiation on this citizen:
- military ID;
- the certificate of the liquidator of consequences of catastrophic crash on the Chernobyl nuclear power plant (and other nuclear objects);
- the registration card of person which was affected by radiation;
b) the conclusion of Republican interdepartmental advisory council on establishment of causal relationship of the come disease and the disability connected with impact of radiation (further - RMES);
c) statements from the Center of professional pathology of the Ministry of Health of the Kyrgyz Republic.
a) conclusion of the Center of professional pathology of the Ministry of Health of the Kyrgyz Republic about availability of occupational disease;
b) act of investigation by Department of prevention of diseases and state sanitary and epidemiological surveillance of the Ministry of Health of the Kyrgyz Republic of case of occupational disease (poisoning) (form 362/at);
c) the sanitary and hygienic characteristic of working conditions represented by Department of prevention of diseases and state sanitary and epidemiological surveillance;
d) the certificate of employment, of conditions and nature of work issued by the employer.
22. Only the specialized organization of health care performing the activities according to the legislation of the Kyrgyz Republic - the Center of professional pathology of the Ministry of Health of the Kyrgyz Republic has the right for the first time to establish the diagnosis of occupational disease or intoxication.
23. In case of lack of the documents confirming labor mutilation or occupational disease, specified in Item of 21 this provision, the basis for conducting examination is the relevant decision of court which took legal effect about recognition of this case industrial injury or occupational disease.
24. In case of survey of citizens of MSEK carries out registration in base of the Enterprise information system of the public assistance.
25. Examination is the state service and is carried out according to the petition from citizens.
26. Expertize is carried out on the territory of servicing of MSEK according to the permanent address (registration) or temporary residence of the citizen, with obligatory registration in territorial authorities of internal affairs (BI-coupon).
27. The obligation of the chairman of MSEK includes acquaintance of the citizen (or his legal representative) with procedure for conducting examination.
28. Complex assessment of the state of health includes:
- studying and analysis of medical documents;
- clinical inspection of the patient, studying and data analysis of laboratory, tool, functional researches;
- pronouncement of the diagnosis with reflection in it nosological form of the basic and accompanying diseases, complication, stages of pathological process, the course of disease, nature and extent of violation of functions;
- assessment of extent of restrictions of its activity;
- joint discussion of the obtained data.
29. If the citizen cannot be for examination for health reasons, according to the conclusion of the organizations of health care expertize can be carried out at home, in hospital.
30. MSEK does not carry out expertize of the citizens who are in places of serving sentence.
31. The citizens with mental disturbances who are on forced treatment have the right to undergo survey in MSEK in accordance with general practice.
32. The decision on recognition of the citizen by person with limited opportunities of health or about refusal in establishment of disability is accepted by the complete list of the specialists making the expert decision, by a simple majority vote, on the basis of discussion of results of examination appears the chairman of MSEK in the presence of all experts.
33. In case of disagreement of the chairman or members of the commission with the made decision their special opinion is entered in the act of survey.
34. In cases when the chairman and members of the commission find it difficult to make the expert decision, the act of survey of MSEK with appendix of all available documents in five-day time from the date of conducting examination goes to authorized body in the sphere of medico-social examination.
35. In case of refusal the citizen (or his legal representative) from additional inspection and provision of required documents the expert decision is made based on the available data about what the corresponding entry in the act of survey of MSEK is made.
36. Timeliness and justification and issue of the conclusions of MSEK to the applicant, safety of medical documents the perpetrators which allowed the corresponding violation bear responsibility according to the legislation of the Kyrgyz Republic for quality of examination, reliability and completeness of the data specified in the act of survey of MSEK.
37. In the course and by results of medico-social examination the following documentation is drawn up:
- act of survey of MSEK;
- statistical coupon;
- individual program of rehabilitation;
- the statement from the act of survey of MSEK;
- reference of MSEK;
- magazine of protocols of meetings;
- magazine of registration and issue of references of MSEK.
38. The main data which formed the basis for adoption of the expert decision are entered in the act of survey of MSEK, the statistical coupon and the magazine of protocols of meetings. Documents and the conclusions of the consultants involved in conducting examination join the act. The act of survey of MSEK is certified by signatures of the chairman, members of MSEK and seal of MSEK. The impress of a seal shall be accurate.
39. Storage durations of the act of survey of MSEK, magazine of registration of protocols of meetings on survey - twenty five years.
40. MSEK certified by seal, signed by the chairman are issued to the citizen recognized as person with limited opportunities of health, or his legal representative during five-day term after survey under list:
- the reference of MSEK (in form according to appendices 3 and 4 to this Provision);
- the statement from the act of survey of MSEK (in form according to appendices 3 and 4 to this Provision);
- the detachable coupon of form No. 088 with results of examination;
- disability leaf with results of examination (for the working citizens).
The individual program of rehabilitation is issued after its development during conducting examination, but no more than one month.
41. If disability is connected with labor mutilation or occupational disease, the reference of MSEK and the statement from the act of survey of MSEK of results of determination of extent of loss of professional working capacity are issued to the examined person (as a percentage) where needs in additional types of the help are specified.
42. For rendering measures of social protection of MSEK can supplement the conclusion, specifying:
- extent of restriction of activity with indication of "Person with limited opportunities of health with defeat of the musculoskeletal device" - in cases of permanent motive violations (stump of the lower extremities, ankiloza, contracture of large joints of the lower extremities with the expressed malfunction of standing, walking, persistent paralyzes and the expressed paresis of the lower extremities);
- needs in permanent assistance, leaving, supervision in connection with expressiveness of violations of activity, with indication of: "needs permanent care" or "needs permanent care and supervision".
43. In case of loss of the reference of MSEK the duplicate of the reference is issued to MSEK at the request of territorial subdivisions of authorized body in the sphere of work and social development and Social fund. In case of the statement of the duplicate on the form of the reference of MSEK typographical number of the reference is crossed out and number of the reference of MSEK issued earlier according to entry in the act of survey in MSEK is specified. The duplicate of the reference is issued to person with limited opportunities of health.
MSEK creates the act of survey of MSEK which join:
- the statement of person with limited opportunities of health;
- request of the specified organizations about loss of the reference of MSEK.
Under the organization of accounting of forms of references of MSEK the issued duplicates of references are considered in the magazine of registration and issue of references as other.
44. MSEK monthly inform territorial subdivisions of authorized body in the sphere of work and social development and Social fund, by means of the database of the Enterprise information system of the public assistance on the citizens who received the status of person with limited opportunities of health.
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