Approved by the Order of the Government of the Republic of Tajikistan of March 30, 2013, No. 146

Procedure for examination of temporary disability of citizens in treatment and prevention facilities

1. General provisions

1. The procedure for examination of temporary disability of citizens in treatment and prevention facilities (further the Procedure) regulates procedure for examination of temporary disability of citizens in treatment and prevention facilities, including, procedure for the organization and activities of the medico-consulting commissions, determination of adverse days of temporary disability, depending on features of diseases, procedure for issue of leaf of disability in case of diseases and injuries, poisonings (some other consequences of impact of the external reasons), procedure for issue of leaf of disability on care of the sick family member, procedure for issue of leaf of disability in case of quarantine, procedure for issue of leaf of disability in case of prosthetics, procedure for issue of leaf of disability on pregnancy and childbirth, procedure for filling of leaf of disability, making the medical certificate about the state of health.

2. In this Procedure the following concepts are used:

- temporary disability - condition when in connection with disease or professional activity traumatized, leading to destruction of separate functions of organism and interfering accomplishment, also has temporary, removable character;

- examination of temporary disability of citizens - type of medical examination which tasks consist of assessment of the state of health of the person and efficiency of inspection and treatment, possibility of continuation of labor activity and determination of terms of temporary loss of efficiency of citizens;

- leaf of temporary disability - the document confirming temporary disability and temporary release of the citizen from work and granting the right to benefit for temporary disability from means of the national social insurance from the subjects authorized by this Procedure;

- the medical and advisory commission - the body operating under treatment and prevention facilities, intended for permission of disputable, difficult questions of examination of working capacity, check of correctness of the carried-out inspections, the established diagnosis, issue and prolongation of sick leave notes, making the medical certificate for health reasons and social position, and also the direction in Public service of social and medical examination with permanent restriction of working capacity.

2. Procedure for conducting examination of temporary disability of citizens

3. Expertize of temporary disability of citizens is carried out by doctors of medical medical institutions and primary health care, including clinics scientific and research establishments of system of the Ministry of Health and Social Protection, medical institutions which are under authority of other companies and organizations and subjects of private medical activities having conditions for implementation of examination and treatment of patients according to this Procedure.

4. Expertize of temporary disability of citizens is not carried out from the following subjects:

- organizations of emergency medical service;

- blood transfusion institutions;

- receptions of medical institutions;

- centers of inspection and treatment of athletes of medical and sports dispensaries;

- boarding houses, rest houses and other sanatorium organizations and clinics;

- healthcare institutions of special type (centers of medical prevention, bureau of forensic medical examination, medicine of emergencies, catastrophic crashes);

- state supervision bodies behind medical and pharmaceutical activities and sanitation;

- organizations of specialized medical activities of level of clinics (pre-hospital).

5. As a result of examination of temporary disability in case of detection of indications the leaf of temporary disability of single form approved by the Ministry of Health and Social Protection of the Republic of Tajikistan and the Agency of social insurance and pensions under the Government of the Republic of Tajikistan is issued to the citizen.

6. Leaves of disability are issued in case of the diseases and injuries, poisonings and some other cases connected with temporary disability during passing of treatment, need to care of the sick family member, during quarantine, prosthetics in the conditions of medical institution, during maternity leave, adoption/adoption of the newborn child;

7. The leaf of disability is issued to the persons who are citizens of the Republic of Tajikistan, and also constantly or temporarily living in the territory of the Republic of Tajikistan to the foreign citizens and stateless persons (further - citizens) working according to employment contracts, government employees, lawyers, individual entrepreneurs and other categories of persons at which the disease or injury came within 12 calendar days from the date of termination of work according to the employment contract, implementation of office or other activities or during the period from the date of execution of an employment agreement about day of its cancellation.

8. The leaf of disability is issued by the following health workers:

- attending physicians of the public medical institutions;

- the doctors who are engaged private medical hospitalization of level, having the license for medical activities including works (services) in examination of temporary disability (further - the doctors practising private medicine);

- the attending physicians of specialized (antitubercular) sanatoria, rehabilitation centers who are engaged in examination of temporary disability;

- attending physicians of clinics of research establishments, including clinics of research establishments of prosthetics or prosthetic engineering;

- experienced doctors of the companies and medical institution according to these rules.

9. Health workers do not issue disability leaves:

- average health workers;

- doctors of departments, sectors, auxiliary offices (tomography, offices of phytotherapy, ultrasound, X-ray, laboratory, etc.) regardless of patterns of ownership;

10. Issue of leaves of disability is performed in case of presentation of the passport or document it replacing. If the citizen works for several employers, the leaf of disability is issued on principle place of employment.

11. Issue and prolongation of leaf of disability is performed by the health worker after survey of the citizen and data recording about state of his health in the medical record of the ambulatory (stationary) patient proving need of temporary release from work.

12. The leaf of disability is issued and closed in one medical institution. In case of the direction of the citizen on treatment in other medical organization the leaf of disability can be prolonged and closed by the medical organization in which observation of the citizen continued.

13. To the citizens who are out of place of registration at the place of residence (in the place of stay, temporary residence), the leaf of disability is issued prolonged) with the permission of the chief physician of the medical organization with the corresponding entry in the medical record of the addressed ambulatory (stationary) patient or the document of level of hospitalization.

14. At duration of temporary disability the leaf of disability is issued taking into account the days (no more than 3 days) necessary for driving to place of registration at the place of residence (in the place of stay, temporary residence).

15. The documents confirming temporary disability of citizens during their stay abroad (after the legalizirovanny translation), according to the decision of the medical commission of the medical organization (further - the Commission) can be replaced with leaves of disability of the sample established in the Republic of Tajikistan.

16. The Ministry of Health and Social Protection of the Republic of Tajikistan, other medical institutions having rights of issue of leaves of disability according to established procedure, are provided with leaves of temporary disability authorized structural divisions of the national social insurance, gratuitously.

3. Procedure for creation and activities vrachebno - the advisory commissions

17. The medical and advisory commission is created on the basis of the order of heads of treatment and prevention facilities and consists of the chairman, the secretary and members which number shall constitute odd number.

18. In need of the Commission the workers having relation to it who are not her members are involved.

19. The commission performs the activities in the form of the meetings held at least two times a week.

20. The decision of the commission is made by a majority vote her members, the taken-out conclusion is entered in primary medical documentation, and also the book of accounting of decisions of the Commission.

21. The commission, depending on the state of health of the citizen established as a result of inspection and examination from representation of the attending physician makes the following decisions:

- about the prolongation of leaves of disability according to the procedure established by this Procedure;

- about difficult and matters of argument of examination of temporary disability;

- about the direction of the patient for the State medico-social examination;

- about transfer to other work of able-bodied persons or providing persons with the corresponding work with limited working capacity for health reasons;

- about the direction on treatment out of administrative and territorial unit limits;

- about release of pupils of comprehensive high schools from transitional and final examinations;

- about release of pupils of average, incomplete averages, the high special and higher schools from classes in physical culture;

- issue of the conclusions about possibility of provision to students of average special and highest institutions of academic leave on medical indications;

- the decision difficult and matters of argument in case of determination of professional working capacity of persons occupied at works with harmful or dangerous working conditions;

- about need on need on the additional square or about allocation first of all the living space connected with the state of health;

- concerning examination of disability based on the petition of medical institution, Social Insurance Fund, law enforcement agencies, military commissariats.

22. The doctor having the highest qualification degree and work experience in examination of temporary disability is appointed the commission chairman.

23. In organizations of primary health care by the commission chairman it is appointed - the deputy manager of organization on the connected kind of activity and in hospitals - the deputy manager of organization by medical part.

24. In medical institutions with different activities the Commission is created at the expense of doctors of adjacent specialties.

25. The commission chairman within the powers performs the following functions:

- carries out quality check and efficiency of the carried-out medical and diagnostic measures;

- controls timely involvement of physicians of adjacent specialties on meeting of doctors, use of the replaced medical hospital technology, the direction of patients on hospitalization;

- estimates process of acceleration of diagnostics and treatment;

- checks justification of issue of leaves of disability (medical information on the state of health);

- carries systematically out instruktivno - organizational work on increase in level of knowledge and professional skills of staff of organization concerning disability examination.

26. The structure of the Commission shall consist of doctors not below the first qualification (except for the secretary).

27. For the purpose of assessment of activities of the Commission, and also for consideration difficult and matters of argument of examination of disability, check of correctness of the conducted examinations, the made diagnosis, opening and prolongation of leaf of temporary disability, pronouncement of the medical certificate about the state of health and social position, also for the direction of patients with permanent loss of working capacity in State medical diagnostiko - social body are organized the Central medical and advisory commissions (further the Central commissions) under the Ministry of Health and Social Protection of the Republic of Tajikistan, managements of health care of the Gorno-Badakhshan Autonomous Region, areas, the city of Dushanbe, the city/district centers of health.

28. The central commissions are created by orders of the Minister of Health and Social Protection of the Republic of Tajikistan, chiefs of managements of health care of the Gorno-Badakhshan Autonomous Region, areas, the city of Dushanbe, the city / district centers of health.

29. The central commission within the powers has the right to request from the Commission all information and documentation connected with the activities.

30. The medical and consulting Commission (irrespective of activities form) shall represent quarterly to the Central commission of the Ministry of Health and Social Protection of the Republic of Tajikistan the analytical report about the activities.

4. Procedure for determination of days of probable temporary disability depending on features of diseases

31. Days of probable temporary disability depending on features of diseases according to appendix it is determined by this Procedure.

5. Procedure for issue of leaf of disability in case of diseases and injuries, poisonings (some other consequences of impact of the external reasons)

32. In case of out-patient treatment of diseases (injuries), poisonings and other conditions connected by temporary loss by citizens of working capacity, the health worker solely issues disability leaf one-timely for the term of 1-3 calendar days.

33. If the term of temporary disability exceeds 3 days, the leaf of disability is issued based on the decision of the Commission.

34. The leaf of disability is in accordance with the established procedure issued by the decision of the Commission before working capacity recovery, but for the term of no more than 4 months.

35. For the purpose of reducing level of primary disability, in case of possibility of recovery of health of the patient on representation of Public service of medical labor examination the leaf of disability can be prolonged for 2 months.

36. In case of diseases (injuries) when treatment is performed in out-patient and polyclinic conditions, the leaf of disability is issued in day of establishment of temporary disability for the entire period of temporary disability, including non-working festive and the days off.

37. Issue of leaf of disability for last days when the citizen was not examined by the health worker is not allowed, it is strictly forbidden.

38. To the citizens who asked for medical care after the termination of working hours (change), at will, date of release from work in leaf of disability can be specified from the next calendar day.

39. The leaf of disability is issued to the citizen sent to the medical organization from health center and recognized disabled from the moment of the address to health center in the presence of the medical documents confirming his disability.

40. To the citizens needing treatment in the specialized medical organization, the leaf of disability is issued directly in the specialized medical organization. In exceptional cases the leaf of disability is issued by the health worker in case of the direction of the citizen in the specialized medical organization of the corresponding profile for treatment continuation.

41. The disability leaf on number of the days necessary for journey but which is not exceeding 4 months is issued to the citizen who is temporarily disabled, directed to consultations (inspection, treatment) in the medical organization which is outside the administrative area for the decision of the Commission which directed it.

42. In case of the statement of the citizen after hospitalization the leaf of disability is issued for the entire period of hospitalization, and for the citizens who are out of place of registration at the place of residence (in the place of stay, temporary residence), taking into account days for journey to place of registration. In case of continuation of temporary disability the leaf of disability can be prolonged for 1-3 calendar days. The leaf of disability is issued in day of the end of hospitalization.

43. The leaf of disability is issued to the citizens directed by a court decision to medicolegal or forensic-psychiatric examination, recognized disabled from the date of revenues to examination.

44. In some cases (difficult urological, gynecologic, proktologichesky and other researches, manipulations, procedures) in case of out-patient treatment by intermittent method the leaf of disability can be issued according to the decision of the Commission for days of carrying out the corresponding research (manipulation, the procedure).

45. In case of approach of temporary disability during leave non-paid, maternity leaves, child care leaves before achievement of age of 3 years by it the leaf of disability is issued from the date of the end of the specified leaves in case of the proceeding temporary disability.

46. In case of temporary disability of the persons which are on child care leave before achievement of age by it 3 years, working at conditions of part-time or at home the leaf of disability is issued in accordance with general practice.

47. In case of temporary disability in connection with disease (injury, poisoning) of the citizen which came during annual paid leave, the leaf of disability is issued according to this Procedure.

48. To the citizens directed by the medical organizations and governing bodies of health care to treatment in clinics of research establishments (institutes) of balneology, physical therapy and rehabilitation, the leaf of disability is issued by the health worker based on the decision of the Commission for the period of treatment and journey to the place of treatment and back. In case of the corresponding medical indications the leaf of disability is prolonged by the attending physician of the specified clinics.

49. The leaf of disability is not issued to citizens:

- to the citizens hospitalized in hospitals without the direction of the family doctor in planned procedure;

- asked for medical care in the medical organization if they do not reveal signs of temporary disability;

- undergoing medical examination, physical examination or treatment in the direction of military commissariats;

- being in custody or administrative detention;

- having periodic medical examinations (inspections), including in the centers for occupational diseases;

- pupil of educational institutions initial professional, average professional and higher education and organizations of postgraduate professional education;

- traumatized in case of crime execution;

- to the staff of law enforcement agencies, graduate students, interns, workers involved to short-term works, pupils (school students, students) who are in places of detention;

- in case of disease (injury), received in alcohol intoxication.

50. In case (injuries, poisonings) pupils of educational institutions initial professional, average professional and higher education and organizations of postgraduate professional education for release from study the reference is issued.

51. In case (injuries, poisonings) pupils of educational institutions initial professional, average professional and higher education and organizations of postgraduate professional education during paid works when passing work practice, and also in case of accomplishment of work on the employment contract by them the leaf of disability is issued according to this Procedure. In the specified cases at the request of the citizen the statement from the medical record of the ambulatory (stationary) patient or the document of level of hospitalization is issued.

52. In case of loss of leaf of temporary disability, its copy is issued after submission of the reference from accounts department of place of employment on nonpayment of the salary.

6. Procedure for issue of leaf of disability on care of the sick family member

53. The disability leaf on care of the sick family member is issued by the health worker to one of family members (guardian) who is actually performing leaving.

54. The leaf of disability is issued on care of the sick family member:

- the child aged up to 18 years - in case of out-patient treatment or joint stay of one and family members (guardian) with the child in stationary treatment and prevention facility for the entire period of acute disease or exacerbation of chronic disease;

- the child aged up to 18 years - in case of out-patient treatment or joint stay of one and family members (guardian) with the child in stationary treatment and prevention facility for a period of up to 10 days on each case at disease duration on care of the sick child also issues the reference of form No. 138/at);

- the children aged up to 18 years infected with human immunodeficiency virus, having serious illness of blood, malignant new growths, burns - for the entire period of joint stay with the child in stationary treatment and prevention facility;

- children aged up to 18 years - in case of their disease connected with vaccine-challenged complication for the entire period of out-patient treatment or joint stay of one of family members (guardian) with the child in stationary treatment and prevention facility;

- the children aged up to 18 years having diseases owing to radiative effects on parents

- for all the time of disease;

- 18 years - are more senior in case of out-patient treatment for a period of up to 3 days.

55. If necessary the disability leaf on care of the sick child can be issued to alternately different family members within the terms established this Procedure.

56. In case of disease of two and more children one leaf of disability on care of them is at the same time issued.

57. In case of disease of the second (third) child in the period of disease of the first child the disability leaf issued on care of the first child is prolonged before recovery of all children without offsetting of the days which matched with days of release from work on care of the first child. At the same time in leaf of disability start and end dates of disease, names, age of all children are specified.

58. The leaf of disability is not issued in the following cases:

- for chronic patients during remission;

- during leave and leave non-paid;

- during maternity leave;

- during child care leave before achievement of age by it 3 years.

59. In case of disease of the child when mother (other family member who is actually performing child care) does not need release from work (annual paid leaves, maternity leave, child care leave before achievement of age by it 3 years, leave non-paid, output or non-working holidays and another), the disability leaf on child care (in case it continues to need leaving) is issued from the date of when mother (other family member who is actually performing child care) get to work.

7. Procedure for issue of leaf of disability in case of quarantine

60. In case of temporary discharge from work of the citizens contacting to infectious patients or the citizens revealed as bacillicarriers, the leaf of disability is issued by the infectiologist, and in case of its absence - the attending physician. Discharge duration from work in these cases is determined by the approved terms of isolation of the persons who had infectious diseases and adjoining to them.

61. In case of quarantine the disability leaf on child care up to 7 years, visiting preschool educational institution, or for the family member recognized in accordance with the established procedure as incapacitated is issued by the attending physician who performs observation of the child (for the family member recognized in accordance with the established procedure as incapacitated), to one of the working family members (guardian) for the entire period of quarantine based on the reference of the epidemiologist.

8. Procedure for issue of leaf of disability in case of prosthetics

62. To the citizens directed by the medical organization to prosthetics in stationary specialized agency, the leaf of disability is issued by this medical organization for the period of journey to the place of prosthetics. The issued leaf of disability is prolonged by the health worker of stationary specialized agency for the entire period of prosthetics and time of driving to place of registration at the place of residence (in the place of stay, temporary residence).

63. To the citizens who are fitting a prosthesis in out-patient and polyclinic conditions, the leaf of disability is not issued.

9. Procedure for issue of leaf of disability on pregnancy and childbirth

64. The disability leaf on pregnancy and childbirth is issued by the doctor the obstetrician-gynecologist, and in case of its absence - family doctors. Issue of leaf of disability on pregnancy and childbirth is made in 30 weeks of pregnancy one-timely lasting 140 calendar days (70 calendar days before childbirth and 70 calendar days after the delivery).

65. In case of polycarpous pregnancy the disability leaf on pregnancy and childbirth is issued in 28 weeks of pregnancy one-timely lasting 180 calendar day (the 70th calendar day before childbirth and 110 calendar days after the delivery).

66. If the woman in case of the appeal to the medical organization refuses at the scheduled time receipt of leaf of disability on pregnancy and childbirth for maternity leave, its refusal is fixed in medical documentation. In case of the repeated address of the woman before childbirth behind disability leaf on pregnancy and childbirth for registration of pregnancy-related absence and childbirth the leaf of disability is issued for 140 calendar days (for 180 calendar days - in case of polycarpous pregnancy).

67. In case the diagnosis of polycarpous pregnancy is established in labor, leaf of disability on pregnancy and childbirth is issued in addition for 40 calendar days by the medical organization where there was childbirth.

68. In case of the complicated childbirth the disability leaf on pregnancy and childbirth is issued in addition for 16 calendar days by the medical organization where the woman in labor stayed on the registry.

69. In case of the childbirth which occurred during from 22 to 30 weeks of pregnancy, the disability leaf on pregnancy and childbirth is issued by the medical organization where there was childbirth, for a period of 156 calendar days.

70. In case of termination of pregnancy in case of term up to 22 complete weeks of pregnancy, the birth dead fruit or the live fruit which did not worry the first 6 complete days (168 hours), the leaf of disability is issued according to Chapter II of this Procedure for the entire period of disability, but for the term of at least three days. If the newborn worried the first 6 complete days (168 hours), leaf of disability on pregnancy and childbirth is issued for a period of 156 calendar days.

71. In case of approach of maternity leave during finding of the woman in annually main or additional paid leave, child care leave before achievement age of 3 years the disability leaf on pregnancy and childbirth is issued in accordance with general practice.

72. Including from substitute mother the leaf of disability is issued to the woman who adopted the child aged up to 3 months from the date of adoption for the period up to 70 calendar days (in case of simultaneous adoption of two or more children - for 110 calendar days) since the birth of the child.

73. When holding procedure of extracorporal fertilization the leaf of disability is issued to the woman by the medical organization having the license for medical activities including works (services) in obstetrics and gynecology and examination of temporary disability, for the entire period of treatment (stimulation, superovulation, puncture of ovary and transfer of embryo) before determination results of the procedure and journey to the place of the medical organization and back.

74. In cases when the medical organization which was carrying out procedures ekstrakorporalno of fertilization has no license for performance of work on examination of temporary disability, the leaf of disability is issued to the woman by the medical organization on its place of registration at the place of residence (in the place of stay, temporary residence) based on the statement (reference) from the out-patient card issued by the medical organization which was carrying out procedures of extracorporal fertilization.

75. In case of transaction of termination of pregnancy the leaf of disability is issued for a period of 1 up to 3 days including in case of termination of pregnancy of small term.

10. Procedure for filling of leaf of disability

76. The face of the form of leaf of disability is filled with the health worker in case of presentation by the citizen of the passport.

77. Records in leaf of disability are carried out in Tajik by ball pen of blue color.

78. The corrected or crossed out text is confirmed by the record "corrected to trust", the signature of the attending physician and seal of the medical organization. Prints of seals and stamps of the medical organization shall be accurate and correspond to the name specified in the charter of the medical organization.

79. In case of registration of leaves of disability in some medical organizations (the psychiatric, narcological organizations, the centers for prevention and fight against AIDS and infectious diseases, etc.) special seals or stamps without specifying of profile of the organization can be used.

80. Entering more than two corrections into leaf of disability is not allowed. In the presence of more than two corrections the leaf of disability is considered spoiled and instead of it the new leaf of disability is issued.

81. When filling back of the form of leaf of disability:

- in the line "home address" the place of registration at the place of residence is specified (in the place of stay, temporary residence);

- in the line "place of employment" the full or abbreviated name of the organization is specified.

- in the line "surname of the doctor" the surname of the health worker who issued disability leaf is specified;

- in line "is issued" the number, month (in cursive script), year of issue of leaf of disability is specified. At the request of the citizen time of issue of leaf of disability is specified;

- in the line "receipt of the receiver" the signature of the citizen who received disability leaf is appended.

82. In the upper part of the form of leaf of disability and in back of the form of leaf of disability depending on that, the disability leaf for the first time is issued or is continuation earlier issued, the corresponding record is emphasized.

83. When filling the face of leaf of disability:

- in the line "Primary — Continuation of Leaf No." the corresponding underlining becomes and number of primary leaf of disability is specified;

- in the line "Name and Address of Medical Institution or Its Stamp" required data are completely specified;

- in line "Is issued" the number, month (in cursive script) and year of issue of leaf of disability is specified. At the request of the citizen time of issue of leaf of disability is specified;

- in the line "Surname, Name, Middle Name of Disabled" the surname, name and middle name of disabled are specified completely;

- in the line "Age" the number of complete years is specified;

- in the column "Muzh. / Wives." the corresponding underlining becomes;

- in the line "Basic in Combination" - if the citizen works for several employers (in combination), on the first leaf of disability the word "basic" is underlined, on other leaves of disability the word "in combination" is underlined and series and number of the leaf of disability issued for representation on principle place of employment is specified; if the citizen works for one employer, the word "basic" is not underlined;

- in the line "Specify the Disability Reason" the disability reason is emphasized (disease, injury, occupational disease or its aggravation, labor accident or its consequences, care of the sick family member, quarantine, vaccine-challenged complication, aftercare in sanatoria, maternity leave) and the entry repeating the underlined reason of disability is made. Data on prosthetics are in addition specified. In case of change of the reason of disability date of change is specified;

- in the line "Mode" the type of the ordered medical and guarding mode is specified: stationary, out-patient, sanatorium;

- in the line "Marks about Violation of the Mode" date of violation, its type (non-compliance with the ordered mode, untimely appearance on appointment, appearance at work without statement, unauthorized withdrawal from hospital, departure on treatment to other administrative area without the permission of the attending physician is specified, refusal of the direction or untimely appearance in VKK organization and another) and the signature of the attending physician is appended. If violations of the mode were not, this column is not filled in;

- in the table "Release from Work" it is specified:

- in the column "From What Number" in the Arab figures - number, month and year from which the citizen is exempted from work;

- in the column "On What Number Inclusive" in cursive script - number and month inclusive on which the citizen is exempted from work;

Disclaimer! This text was translated by AI translator and is not a valid juridical document. No warranty. No claim. More info