RESOLUTION OF THE MINISTRY OF LABOUR AND SOCIAL PROTECTION OF THE REPUBLIC OF BELARUS AND MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS

of August 14, 2015 No. 51/94

About the documents necessary for investigation and accounting of labor accidents and occupational diseases

Based on paragraph two of Item 2 of the resolution of Council of Ministers of the Republic of Belarus of January 15, 2004 No. 30 "About investigation and accounting of labor accidents and occupational diseases", subitem 7.1.5 of Item 7 of the Regulations on the Ministry of Labour and Social Protection of the Republic of Belarus approved by the resolution of Council of Ministers of the Republic of Belarus of October 31, 2001 No. 1589 "Questions of the Ministry of Labour and Social Protection of the Republic of Belarus", subitem 9.1 of Item 9 of the Regulations on the Ministry of Health of the Republic of Belarus approved by the resolution of Council of Ministers of the Republic of Belarus of October 28, 2011 No. 1446 "About some questions of the Ministry of Health and measures for implementation of the Presidential decree of the Republic of Belarus of August 11, 2011 No. 360", the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus POSTANOVLYAYUT:

1. Establish document forms, necessary for investigation and accounting of labor accidents and occupational diseases, according to appendices 1-15.

2. Approve the enclosed Instruction about procedure for filling, maintaining and document storage, necessary for investigation and accounting of labor accidents and occupational diseases.

3. Recognize invalid:

the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of January 27, 2004 No. 5/3 "About establishment of the document forms necessary for investigation and accounting of labor accidents and occupational diseases" (The national register of legal acts of the Republic of Belarus, 2004, No. 24, 8/10530);

the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of April 2, 2007 No. 51/28 "About modification and amendments in the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of January 27, 2004 No. 5/3" (The national register of legal acts of the Republic of Belarus, 2007, No. 106, 8/16253);

the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of December 28, 2010 No. 179/180 "About introduction of amendments to the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of January 27, 2004 No. 5/3" (The national register of legal acts of the Republic of Belarus, 2011, No. 61, 8/23674);

the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of March 29, 2012 No. 46/29 "About introduction of amendments to the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of January 27, 2004 No. 5/3" (The national register of legal acts of the Republic of Belarus, 2012, No. 45, 8/25255);

the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of September 3, 2013 No. 92/80 "About introduction of amendments to the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of January 27, 2004 No. 5/3" (The national legal Internet portal of the Republic of Belarus, 24.09. 2013, 8/27899);

the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of May 13, 2014 No. 25/34 "About entering of amendment into the resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of January 27, 2004 No. 5/3" (The national legal Internet portal of the Republic of Belarus, 27.06.2014, 8/28797).

4. This resolution becomes effective after its official publication.

 

Minister of Labour and Social Protection of the Republic of Belarus

M. A. Shchetkina

Minister of Health of the Republic of Belarus

V.I.Zharko

 

Appendix 1

to the Resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of August 14, 2015 No. 51/94

Form

Register of patients (victims) who received industrial injury

______________________________________________________

   (name of the organization of health care)

 

№ payment order	Date, time of receipt (appeal) to the organization of health care	Surname, own name, middle name (if that is available) the patient (victim)	Birth date	Residence (place of stay)	The name and the location of the organization in the territory of which there was injuring, the insurer	Position (profession) of the patient (victim)	Nature of injury (damage localization, its danger to life, consequence) and weight of injury, date of issue of the conclusion about weight of industrial injury	Mark about informing the organization in the territory of which there was injuring, the insurer about industrial injury with indication of surnames and initials of persons which transferred and accepted information (phone number of the insurer)
1	2	3	4	5	6	7	8	9

 

Appendix 2

to the Resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of August 14, 2015 No. 51/94

Form

_________________________________

(name of the organization of health care)

Conclusion about weight of industrial injury

 __________________________                  _________________ 
       (place of creation)                           (date)

1. Surname, own name, middle name (if that is available) the victim ____________________________________________________________________________

____________________________________________________________________________

2. Floor ________ 3. Birth date _______________________________________________

4. Residential address (place of stay), _____________________________ phone

____________________________________________________________________________

5. The name and the location of the organization in the territory of which there was injuring, the insurer, position (profession) of the victim ____________________________________________________________________________

____________________________________________________________________________

6. Date, time of the address of the health care which was injured in the organization ______________

____________________________________________________________________________

7. Data on damages of the victim:

7.1. the diagnosis with indication of nature of injury, its localization __________________________

____________________________________________________________________________

7.2. code on the International Statistical Classification of the diseases and problems connected with health, _______________________________________________________

____________________________________________________________________________

____________________________________________________________________________

8. Information on availability or absence at the injured alcohol intoxication or the condition caused by consumption of drugs, psychotropic substances, their analogs, the toxic or other stupefying substances, ____________________________________________________________________________

____________________________________________________________________________

9. Weight of industrial injury ____________________________________________

(treats heavy, does not treat heavy)

____________________________________________________________________________

Specialist doctor of _______________ ___________________

                   (signature)   (initials, surname)

                M.P.

Manager of structural division of _______________ ___________________

                                        (signature)    (initials, surname)

                                       M.P.

Head (deputy manager) of _______________ ___________________

                                           (signature)  (initials, surname)

 

 

Appendix 3

to the Resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of August 14, 2015 No. 51/94

Form

_________________________________

  (name of the organization,

_________________________________

     insurer)

The protocol on determination of degree of contributory guilt from labor accident, occupational disease

                                                      _____________ №__________

                                                          (date)

                                           _____________________________________________

                                                   (place of creation of the protocol)

Us, the authorized officer of the organization, the insurer (the insurer - physical person),

____________________________________________

            (position (in case of its availability)

____________________________________________________________________________

(surname, own name, middle name (if that is available)

authorized representative of labor union (other representative body of workers)

__________________________________________________________________

(surname, own name, middle name (if that is available)

circumstances and accident causes, occupational disease (unnecessary to cross out), event ________________________________ are considered

    (date)

with ___________________________________________________________________________

(surname, own name, middle name (if that is available), profession

____________________________________________________________________________

                      (position), place of employment of the victim)

1. It is determined that actions _______________________________________________

                             (actions of the victim, which are specified

____________________________________________________________________________

promoted origin or increase in the harm done to his health)

are recognized as rough imprudence ______________________________________________

                                          (surname, victim's initials)

2. In case of assessment of actions of the victim are considered _________________________________

                                                (are specified

____________________________________________________________________________

circumstances which were considered in case of recognition of rough imprudence

____________________________________________________________________________

                             victim)

3. Contributory guilt degree __________ percent is determined.

Authorized officer of the organization,
the insurer (the insurer - physical person) _______________                    ___________________

                                              (signature)                       (initials, surname)

Authorized representative of labor union
 (other representative body of workers) _______________                     ___________________

                                              (signature)                       (initials, surname)

Appendix 4

to the Resolution of the Ministry of Labour and Social Protection of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of August 14, 2015 No. 51/94

N-1 form

 

	I CLAIM
	________________________________________
	(position (in case of its availability)

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