Where to complain if they don’t give you a group for a disabled person, they didn’t give you a disability, where to complain. They don’t give you a disability, where to complain? If you are denied a disability

Hello, Alexey.

What is the procedure for assigning disability?

The procedure is clearly regulated by the Rules for recognizing persons as disabled (Resolution of the Government of the Russian Federation dated February 20, 2006 No. 95). In accordance with current legislation, a person applying for disability, in mandatory must undergo a medical and social examination (MSE), to which he is sent by the medical and preventive institution where the corresponding diagnosis was made and which provides the necessary medical and preventive actions in relation to this citizen. In addition to such treatment and preventive organizations, the right to refer to MSE has the authority social protection population and the body implementing pension provision.

MSA is necessary to accurately determine the degree of disability, its structure and the possibility of full or partial rehabilitation. In your case, most likely, the referral should have been issued by the local pediatrician at the clinic visited by the child at his place of residence.

After passing the medical examination, a person recognized as disabled is issued a certificate confirming the fact of disability. If disability is denied, at the request and request of the person, he may be given a document indicating the grounds for the refusal - the results of the examination.

Has your child undergone this examination? If so, were all degrees of limitations and impairments specified in the Rules for Recognizing Persons with Disabilities taken into account during the examination? On what grounds was it refused? Unfortunately, you provide too little information regarding your situation.

I would like to clarify right away, because the assignment of the category “disabled child” can be carried out for any of the degrees of violations, which are differentiated in detail in the Rules. Degrees are assessed based on age category child, the need for his social protection and rehabilitation, as well as taking into account International classification diseases. A comprehensive assessment of the child’s condition based on a huge amount of data and collected information is the main task of specialists conducting a medical and social examination.

Grounds for recognizing a child as disabled

If the developmental pathology associated with the cleft upper lip and palate, congenital, disability must be established. However, as stated above, there must be pronounced pathologies and restrictions associated with impaired health, vital activity, and the need to implement social protection measures for the child.

At the same time, children with maxillofacial pathologies are most often given recommendations regarding the assignment of disability already during the initial examination. If the pathology is congenital, this recommendation should be issued directly in the maternity hospital when it immediately becomes clear that the functions of sucking and swallowing are impaired or impossible.

What to do if you are denied disability?

If you are denied disability at the local level, i.e. an employee of the institution does not issue a referral to ITU, you need to contact this bureau yourself. You must have on hand all the documents confirming the violations and restrictions associated with this pathology.

If you have passed the ITU, but do not agree with the decision of the body, you can submit a written application requesting an appeal and review of the decision:

to the institution that conducted the examination;
to the main bureau of medical and social examination;
to the relevant social protection authority.

If you choose the first option, keep in mind that within 3 days your application will still be sent to the ITU main office. At the same time, everything will be applied to it Required documents and decisions on this issue at the appropriate level. The ITU Bureau, no later than a month from the date of registration of the application, must conduct a re-examination and, based on its results, make a second decision.

If a refusal is received from the ITU main bureau, the application for appeal will need to be sent to the Federal Bureau of Medical and Social Expertise. The decision must be made no later than one month from the date of registration of the citizen’s application. The final authority for appealing a decision of the Federal Bureau of ITU is the court.

Sincerely, Natalia.

Sometimes the situation develops in such a way that a person becomes completely or partially disabled. Health problems go so far that he has to register for disability because he is unable to fully provide for his physical and social needs.

Related materials:

Certificate of refusal

To obtain disability, citizens of the Russian Federation must undergo a medical and social expert commission. However, referrals for medical and social examination are issued in district clinic. And problems can arise already at this stage. Doctors may refuse to issue a referral, citing this themselves different ways. For example, a patient who has undergone complex operation for aortic valve replacement, they refused to issue a certificate for the ITU because he was unemployed. The therapist justified it this way: they did not take sick leave, and only those who were unable to work for 4 months received referrals. Similar situations, unfortunately, not uncommon. To receive a referral for a medical and social examination in form No. 088/u-06, you can contact the authorities - the therapist did not give it, go to the head of the department, the deputy head physician for examination or the head physician of the clinic. If none of the doctors helped you, ask them for a certificate of refusal to refer you to ITU.

If it was not possible to reach mutual understanding at the clinic, then the person can contact the social security authority or the pension fund. If you have everything in your hands medical documents, confirming a violation of body functions, then these organizations have every right to issue a referral to ITU. True, they can refuse there too - don’t despair, ask for a certificate of refusal.

Having an official refusal in hand, you have the right to independently contact the ITU Bureau. If the examination determines that a citizen has all the signs of disability, he will receive an appropriate certificate. With this document you will need to go to the clinic again to receive the coveted referral in form No. 088/u-06. And with this delivery slip, you again undergo a medical and social examination, which will officially assign you a disability category.

Appealing decisions

Let’s assume that a person has collected all the certificates, passed the ITU and received an official refusal to receive disability. Citizens who do not agree with this verdict can always appeal the ITU decision. Within a month after the refusal at the local ITU bureau, the patient or his legal representative must write and submit it to the bureau that conducted the medical and social examination, or to the main bureau.

No later than 30 days after receipt of the application, the Main Bureau for the subject of the federation must conduct its own medical and social examination. If the decision is again not in favor of the patient, then he can appeal it - he needs to write an appeal again and submit it to the Main Bureau or directly to the Federal Bureau of ITU.

Remember that any decision of the medical expert commission can be appealed! Moreover, if you are denied at the federal level, you can always go to court.

Going to court

If the ITU at all levels refused to obtain a disability, and the citizen considered this decision to be illegal, then he (or his legal representatives) can appeal it in court. However, it makes sense to first contact independent medical and social experts. Independent experts will help you understand how great your chances of winning in court are: they will evaluate your medical documentation and advise you on what additional examinations can be carried out. Of course, independent specialists do not work for free, so it is very important to soberly weigh your chances and assess your financial capabilities before the trial.

If you do not want to turn to independent specialists, then during the judicial review you can submit an application for a forensic medical examination, in direct accordance with Article 79. Civil Procedure Code Russian Federation.

According to Article 196 of the Civil Code of the Russian Federation, you have the right to go to court within three years from the date of the Main Bureau’s refusal to establish disability.

When filing a lawsuit against unlawful actions of the ITU bureau, you can simultaneously write letters of complaint to Roszdravnadzor and the Prosecutor's Office. It is possible that in this case the examination at the federal level will be carried out more thoroughly and the decision will be made in your favor.

Those who are afraid of starting a lawsuit without a lawyer should contact the League for the Defense of Patients' Rights (http://ligap.ru), they provide pre-trial consultations and help draw up a statement of claim to the court.

According to paragraph 42 of the “Rules for recognizing a person as disabled,” approved by Decree of the Government of the Russian Federation No. 95 dated February 20, 2006, in case of disagreement with the bureau’s decision to recognize a citizen as a disabled person or to refuse to recognize him as a disabled person, the citizen (his legal representative) has the right appeal this decision to the Main Bureau in month period on the basis of a written application submitted to the bureau that conducted the medical and social examination, or to the Main Bureau (in Veliky Novgorod this is the State Budgetary Institution MSE for the Novgorod Region, Ministry of Labor of Russia, 173001, Veliky Novgorod, Tikhvinskaya St. 12, building 1 ).

A citizen (or his legal representative) can submit an application in person or by post, attaching the following documents:

1. Identity document of the citizen (passport);

2. A document on the results of a medical and social examination (certificate of disability or the degree of loss of professional ability to work, or a certificate from the bureau on the results of a medical and social examination in case of non-recognition as a disabled person).

A sample application for appeal can be obtained from the registry, the bureau that conducted the medical and social examination, or the Main Bureau. In addition, a sample application is posted on the website of the State Budgetary Institution MSE for the Novgorod Region of the Ministry of Labor of Russia in the section “For Citizens/Application Forms”.

The bureau that conducted the medical and social examination of the citizen sends it with all available documents to the Main Bureau within 3 days from the date of receipt of the application. The Main Bureau, no later than 1 month from the date of receipt of the citizen’s application, conducts a medical and social examination and, based on the results obtained, makes an appropriate decision.

If a citizen appeals the decision of the Main Bureau, the chief expert on medical and social examination for the Novgorod region, with the consent of the citizen, may entrust the conduct of his medical and social examination to another group of specialists from the Main Bureau.

In case of disagreement with the decision of the Main Bureau, the citizen (his legal representative) has the right to appeal this decision within a month to the Federal Bureau on the basis of a written application submitted by the citizen (his legal representative) to the Main Bureau, which conducted the medical and social examination, or to the Federal Bureau (127486, Moscow, Susanina st., 3).

The Federal Bureau, no later than 1 month from the date of receipt of the citizen’s application, conducts a medical and social examination and, based on the results obtained, makes an appropriate decision.

Also, decisions of the bureau, the Main Bureau, the Federal Bureau can be appealed to the court by a citizen (his legal representative) in the manner established by law Russian Federation.

If a significant amount of time has passed since the last examination (more than 30 days) and changes have occurred in the citizen’s health status, then to resolve the issue of

advisability of repeated referral for medical and social examination, it is recommended to contact medical organization at the observation location.

Additionally we inform:

Recognition of a person as a disabled person is carried out during a medical and social examination based on a comprehensive assessment of the state of the citizen’s body based on the analysis of his clinical, functional, social, professional, labor and psychological data using classifications and criteria approved by order of the Ministry of Labor and Social Protection of the Russian Federation dated December 17, 2015

No. 1024n “On classifications and criteria used in the implementation of medical and social examination of citizens by federal government agencies medical and social examination".

The conditions for recognizing a citizen as disabled are:

· impairment of health with a persistent disorder of body functions caused by diseases, consequences of injuries or defects;

· limitation of life activity (complete or partial loss by a citizen of the ability or ability to provide self-care, move independently, navigate, communicate, control one’s behavior, study or engage in work);

· the need for social protection measures, including rehabilitation.

The presence of only one of the above conditions is not a sufficient basis for recognizing a citizen as disabled.

A boy with a “clawed paw” was deprived of his disability because of a computer

President of the interregional charitable public organization "Hunter Syndrome" Snezhana Mitina gave Miloserdia.ru an example of how the new disability criteria are applied in practice: “Our patient had his disability removed at the age of 18 on the grounds that he was studying in college to become an IT specialist. He has colossal contractures ( limitation of mobility in joints - approx. edit.). He cannot lace his shoes or button his shirt or jacket himself. They buy him sweatshirts, Velcro shoes, jeans with elastic; without such clothes he cannot dress and undress himself.”

ITU staff asked this man to type some text on a computer. “His hands are curled with contracture, in medical parlance it’s called clawfoot.” But he uses the knuckles of his little fingers to type texts very quickly. Although he cannot open a carton of milk or bottled water on his own. He was not asked to pick up a fork or do any other basic things. They simply determined that he was compensated and removed his disability,” said Mitina.

According to Order of the Ministry of Labor No. 1024, a patient is recognized as disabled if the “disorder of body functions” is assessed at 40-100%, and the “limitation of life activity” reaches either 2-3 degrees in one category, or 1 degree in two or more.B Appendix to the order, each disabling disease has four degrees of “severity”, depending on how much it affects the “functions of the body”: these are “minor impairments” (10-30%), “moderate impairments” (40-60% - III group disability), “pronounced impairments” (70-80% - group II), “significant expressed impairments” (90-100% - group I).

“Categories of life activity” are understood as the ability for self-care, the ability to move independently, the ability to orientate, the ability to communicate, the ability to control one’s behavior, the ability to learn, the ability to labor activity. The limitation of these categories is measured in three degrees.

President of the Union of Patients and Patient Organizations rare diseases", President of the MBOO "Hunter Syndrome" Snezhana Mitina. Photo by Nikolay Fedorov from solidarnost.org

“Every morning his blood pressure is very high, and he must either lie down until 12 o’clock in the afternoon, or, if he gets up, go to the ambulance. The medical and social examination told him: it’s okay, just go to bed early,” she added.

“Everything is fine with your child”

Most often, parents of children with diabetes complain about the removal of disability. After all, after 14 years, according to Order 1024, they can independently monitor their blood sugar levels and calculate the amount of insulin administered.

Order of the Ministry of Labor No. 1024, which establishes a new procedure for determining disability, classifies “persistent disorders of body functions” as a percentage, and also sets out a scheme by which “the degree of severity of limitations in categories of human life activity” should be assessed. It is on the basis of these two parameters that a decision is made to establish disability.

The first of them is purely medical. The second characterizes the patient's social capabilities.

To help experts, various guidelines. For example, “Criteria for assessing disability in ITU institutions”, “Handbook for medical and social examination of persons under 18 years of age”, etc.

“According to the document, it turns out that by the age of 14, a child suffering from diabetes must learn to control the course of the disease, count bread units, assess the adequacy of the amount of insulin administered, be able to analyze glucose levels and develop tactics in each specific situation. They expect more from him than from the attending physician,” the head of the Nizhny Novgorod Diabetes League told Novaya Gazeta. Vladimir Sentyalov.

Head of the Nizhny Novgorod Diabetes League Vladimir Sentyalov with his staff. Photo from moidiabet.ru

This is exactly the situation I encountered Svetlana Petrovna from Saint-Petersburg. Her fourteen-year-old son Andrei was first diagnosed diabetes. “On January 22, we are taken by ambulance to the Rauchfus hospital. Andrei’s sugar level was 31, which is against the norm of 5.9,” Svetlana Petrovna told Miloserdiy.ru. Andrei spent a month in the hospital, the doctors had great difficulty in selecting his insulin doses. “For the first time in her entire practice as the head of the endocrinology department, as she said, a patient was transferred from one ultra-long insulin to another. The first one didn’t fit,” recalls the boy’s mother.

The medical and social examination, which took place in March, required further examination. “The endocrinologist wrote that the course is very labile, it is difficult to choose the dose, and that the child cannot do this on his own,” says Svetlana Petrovna. However, the boy was denied disability: “Everything is fine with your child, we do not assign him a disability.”

The appeal did not help. The city ITU bureau again sought an answer from the boy as to why he could not give himself injections and count grain units. “But how could a child with newly diagnosed diabetes learn this so quickly if his sugar level is constantly “jumping”? And no one in our family suffered from this, where could he get such an experience,” says my mother. She still managed to get a second examination at the city bureau, for this she now has to collect all the documents in a new circle.

The ITU does not know how to spell the word “mucopolysaccharidosis”

Is the composition of experts always adequate to the disease with which a person comes for a medical and social examination?

“A mother comes to submit documents, and they immediately tell her that her child’s disease is spelled with several errors, because the word “cystic fibrosis” is spelled differently. And our disease is called “mucopolysaccharidosis”, cystic fibrosis is a different disease. And they start very interesting questions that have nothing to do with mucopolysaccharidosis or the child,” said Snezhana Mitina. - If the child is still “light” and the disease has not “eaten” him too much, then they say that there are no grounds for disability, because the loss of body functions is not so great that the child is assigned the status of a disabled child.<…>If a child has severe disorders, then moral pressure is put on the mother. Specialists who have no training at all in rare diseases intimidate mothers with bad prognoses. And instead of rehabilitation, they usually offer social institutions.”

President of the Diabetic Society for Support of Disabled Children (St. Petersburg) Mikhail Vorobyov. Photo by Mikhail Kireev from spbdnevnik.ru

As the president of the “Diabetic Society for Supporting Disabled Children” from St. Petersburg told Miloserdiy.ru Mikhail Vorobiev, “most often the ITU commissions don’t even have an endocrinologist, there is a therapist, there is a surgeon, a psychologist, but there is no endocrinologist.”

Mother of a four-year-old girl with visual impairment Anastasia Dimina wrote“VKontakte” that the commission they passed in February included only pediatricians. “They looked at the papers and said they would send the documents to the chief ophthalmologist at the main bureau. And in three weeks they will call us with a decision. Is this legal? How is it - they will make a decision without seeing the child?” - she is surprised.

Looks completely healthy

Why not differentiated approach to the definition of disability and the needs of a disabled child? This question is asked on your Facebook page President of the Without Barriers Foundation Svetlana Nosacheva.

“My child appears to be completely healthy, except for one problem. After an unsuccessful operation in our hospital (the femoral neck was broken), one of her legs became shorter than the other by only 1.5 cm. This is almost not noticeable, sometimes only when she gets tired, she begins to limp... She doesn’t take medications now, she doesn’t need care, but for the rest of her life she needs special shoes and rehabilitation... Otherwise, this will lead to future disability and joint replacement,” she writes.

“My child needs only 50,000 per year. But there are very difficult children, they need more, they need constant care, dear technical means rehabilitation, constant classes with teachers and doctors,” continues Nosacheva.

Establishing disability for children is viewed one-sidedly: it implies payment of a pension, rehabilitation, Spa treatment, housing and communal services benefits, transport benefits, care for a disabled child. But not all disabled children need a full “social package”. At the same time, completely denying disability to a child who needs constant rehabilitation is also unfair, Svetlana believes.

A similar opinion was expressed in an interview with Miloserdiyu.ru Mikhail Vorobiev. In his opinion, for children, as for adults, there should be different groups disability. “We need a more competent approach,” Vorobiev emphasized.

ITU representatives: everything is fine

We turned to several regional ITU Main Bureaus with a request to explain, using the example of one or two specific diseases, how exactly the impairment of body functions in combination with the degree of disability is assessed as a percentage. In addition, we asked to answer the question for which groups of diseases, based on the experience of the ITU, the new criteria have been worked out in detail, and for which - insufficient detail, and this creates difficulties in the work.

According to employees of the FKU GB MSE in the Tula region, order No. 1024 “objectifies, specifies and introduces uniform approaches to assessing the severity of impaired body functions and criteria for determining disability, including for children, and also minimizes corruption risks.” The subjective factor in conducting a medical and social examination and establishing disability is now excluded, the letter states.

“The order allows us to objectively resolve issues of establishing disability and does not cause difficulties in making decisions for specialists from medical and social examination institutions,” the Tula ITU believes.

IN FKU GB ITU for the Vladimir region believe that the new criteria are adapted to European standards. They “do not expand or reduce the possibilities for determining disability, but provide an opportunity to minimize the subjective approach.”

Interest calculation example

As an example of the use of quantitative assessment of dysfunction of the body, Vladimir specialists cited two diseases:

“Radical nephrectomy for nephroblastoma T2N0M0 from 2016. According to clause 14.3.1.11 of the appendices to classifications and criteria, during the first 5 years after radical removal of nephroblastoma at stages 1 and 2, quantification corresponds to 60% or moderate dysfunction of the immune system, disability group 3 is established.

Amputation stump right upper limb at the level of the forearm from 2016. According to clause 13.2.3.5, it corresponds to 50% or moderate impairment of statodynamic functions, disability group 3 is established. It is necessary to distinguish dysfunction of one limb from a violation of the general statodynamic function.”

“Often citizens do not have the conditions to establish disability: one or another pathology is present, but there are no dysfunctions of the body as a whole, and, accordingly, restrictions on life activity, for example, after operated heart defects without symptoms of heart failure of the corresponding degree,” the ITU notes.

Procedure for appealing ITU decisions

Appealing the decision of the Bureau of Medical and Social Expertise

A citizen (his legal representative) can appeal the decision of the bureau to the main bureau within a month on the basis of a written application submitted to the bureau that conducted the medical and social examination, or to the main bureau.

The bureau that conducted the medical and social examination of the citizen sends it with all available documents to the main bureau within 3 days from the date of receipt of the application.

The Main Bureau, no later than 1 month from the date of receipt of the citizen’s application, conducts a medical and social examination and, based on the results obtained, makes an appropriate decision.

If a citizen appeals the decision of the main bureau, the chief expert on medical and social examination for the relevant constituent entity of the Russian Federation, with the consent of the citizen, may entrust the conduct of his medical and social examination to another group of specialists from the main bureau.

The decision of the main bureau can be appealed within a month to the Federal Bureau on the basis of an application submitted by the citizen (his legal representative) to the main bureau that conducted the medical and social examination, or to the Federal Bureau.

Decisions of the bureau, the main bureau, the Federal Bureau can be appealed to the court by a citizen (his legal representative) in the manner established by the legislation of the Russian Federation.

Practical advice:

It is irrational to appeal the decision of the primary bureau directly to the court, since there are no specialists in medical and social examination in court and a competent judge as an arbitrator will be forced to resort to the advisory assistance of experts from the main bureau - just spend money on a lawyer. Therefore, it is more rational to appeal the decision of the primary bureau to a higher main bureau. The addresses and work schedule of the main bureaus in all regions of Russia can be found here. In addition, litigation can last for years (you have to pay for the services of a lawyer), and an examination at a higher-level Main Appeals Bureau is carried out within a maximum of 1 month...

Additionally:

Currently, a 3-level ITU system has been created in the Russian Federation: the ITU Bureau, the Main ITU Bureau and the Federal Bureau. In case of disagreement with the decision of the bureau, the citizen has the right to appeal this decision within a month to the main bureau on the basis of a written application. The application must be submitted to the bureau where he was examined, or to the main bureau. The decision of the main bureau can be appealed to the Federal Bureau (127486, Moscow, Susanina St., 3) within a month from the date of its adoption. The application is submitted to the main bureau that conducted the examination, or to the Federal Bureau. In addition, decisions of the bureau, the main bureau and the Federal Bureau can be appealed to the court in the manner prescribed by the legislation of the Russian Federation.