The Ministry of Health of Russia has prepared a draft order specifying the procedure for conducting mandatory medical examinations of employees, which is posted on the official website for posting information on the preparation by federal executive authorities of draft regulatory legal acts and the results of their discussion http://regulation.gov.ru/ .

The project involves making changes to Appendix No. 3 to the order of the Ministry of Health and social development Russian Federation dated April 12, 2011 No. 302n “On Approval of Lists of Harmful and (or) Dangerous production factors and work, during the performance of which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers employed in hard work and in work with harmful and (or) dangerous working conditions. Draft order:

• The list of documents that must be submitted to a person applying for a job at a medical organization for a medical examination is being expanded.
• The obligation to issue a health passport for an employee is removed from a medical organization.
• Medical organizations that have conducted preliminary and periodic medical examinations provide access to information about the health status of the employee, including the results of these examinations, with the consent of the employee, to the Social Insurance Fund.
• The conclusion based on the results of the preliminary (periodic) medical examination will have to be drawn up in 5 copies (additional copies, with the consent of the employee, can be provided to the employer, as well as to the medical organization to which the employee is attached for medical care, and the Social Insurance Fund).
• The final act, which is drawn up based on the results of periodic medical examinations, must be signed by a representative of the employer and a specialist from Rospotrebnadzor, after which it is approved by the chairman of the medical commission.
• The final act will need to be drawn up in 5 copies within 5 working days from the date of approval of the act to the employer, to the center of occupational pathology of the constituent entity of the Russian Federation, to the territorial body of the federal executive body authorized to exercise federal state sanitary and epidemiological supervision, the Social Insurance Fund. One copy of the final act is stored in the medical organization that conducted periodic examinations for 50 years.
• The Center for Occupational Pathology of a subject of the Russian Federation summarizes and analyzes the results of periodic medical examinations of workers employed in work with harmful and (or) dangerous working conditions on the territory of this subject of the Russian Federation and sends generalized information to the Center for Occupational Pathology of the Ministry of Health of Russia.

The Russian Ministry of Health has developed draft orders on a new procedure for conducting mandatory medical examinations of workers:

• employed in hazardous industries;
• food industry organizations Catering and trade, waterworks, medical organizations, children's institutions and some other employers.

According to the department, the development of a new procedure for medical examinations for pests is caused by the need to bring the current regulations on medical examinations in line with federal laws dated November 21, 2011 No. 323-FZ"On the fundamentals of protecting the health of citizens in the Russian Federation" and dated December 28, 2013 No. 426-FZ"O special evaluation working conditions".

Thus, the project developers have established a unified classifier of harmful and (or) hazardous production factors. In addition, chemicals are structured into groups, taking into account the characteristics of the effect on the body, thereby reducing the list of chemicals in the air itself. working area in the workplace, in the presence of which employees need to conduct inspections.

It is envisaged that mandatory periodic medical examinations of workers working in harmful and (or) dangerous working conditions are carried out in occupational pathology centers starting from at least 10–15 years of experience (depending on the nature of the influencing production factors).

The project has optimized the composition of specialist doctors participating in examinations, excluded expensive, time-consuming and uninformative examinations, and adjusted the lists of general and additional medical contraindications, taking into account ICD-10.

If the project is accepted, then the current order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n will be declared invalid.

As for the procedure for conducting medical examinations of workers in epidemiologically significant professions (now they are included in pp. 14–26 List of works, approved. by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n), then they are supposed to be removed from the general list and a separate procedure for medical examinations should be developed for them.

Thus, the draft order approves not only the procedure for conducting and recording the results of mandatory medical examinations, but also the form, procedure for issuing and issuing a personal medical book (including the requirements for maintaining a personal medical book in electronic form).

The draft provides for the frequency of medical examinations, reduces the list of doctors conducting medical examinations (the list includes only two doctors - a dermatovenereologist and an infectious disease specialist, while a dentist and an otorhinolaryngologist are excluded).

Based on the results of the medical examinations, the medical organization draws up a final act. The final act is drawn up by the general practitioner in 3 copies, approved by the chief physician and certified by the seal of the medical organization.

Admission to work upon completion of the medical examination is issued by the therapist.

On March 26, 2016, the order of the Ministry of Health of Russia dated June 15, 2015 N 344n "On the mandatory medical examination of drivers" comes into force. Vehicle(candidates for drivers of vehicles). The order regulates the rules for passing a medical examination of drivers and candidate drivers.

A list of doctors and procedures has been determined during a medical examination, a positive conclusion on which the driver must receive. The number of doctors depends on the category of driver's license, which requires a medical certificate.

List of doctors for medical examination of drivers of categories A, A1, B, BE, B1, M:

• Ophthalmologist;
• Psychiatrist;
• Expert in narcology;
• Neurologist (only with the direction of a therapist);

Procedures:

• Electroencephalography (only by referral from a neurologist);
• (only in the direction of a narcologist);

Thus, for drivers of these categories, in general, the conclusion of only four specialists is required, however, not everything is as rosy as it looks at first glance. More on this below.

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List of doctors for medical examination of drivers of category C, CE, C1, C1E, D, DE, D1, D1E, Tm, Tb:

• Therapist or general practitioner;
• Ophthalmologist;
• Psychiatrist;
• Expert in narcology;
• Neurologist;
• Otolaryngologist;

Procedures:

• Electroencephalography;
• Determination of the presence of psychoactive substances in the urine (only in the direction of a narcologist);
• Qualitative and quantitative determination of carbohydrate-deficient transferrin in blood serum (only in the direction of a narcologist);

Payment

The new procedure clearly states that the medical examination is carried out at the personal expense of drivers. This will affect citizens working as drivers of vehicles. Physical examination is no longer the concern of the employer.

Medical examination rules

Visit at least three medical centers to pass a medical examination

According to the new rules for passing a medical examination of psychiatrists and narcologists, you can only go through medical organizations of the state or municipal health care system at the place of residence or place of stay of the driver. That is, in commercial organization It is impossible to obtain the conclusion of a psychiatrist and a narcologist.

Moreover, you will additionally have to go around two medical institutions, and their choice is limited by the place of residence or stay. And do they all work on weekends? By the way, the law does not require registration at the place of residence if registration at the place of residence is in the same subject of the Russian Federation as the place of residence. That is, if the “registration” is in some remote settlement, but you live and work in the district center, you will either have to go for a certificate from a narcologist and psychiatrist to the city where you live, or register at the place of stay.

In accordance with the new rules for passing a medical examination, drivers will have to plan a route in advance, prepare funds and allocate a lot of time for this purpose.

The simplest example for category "B" drivers and if everything goes according to plan. First, in the 1st institution, get a card from the therapist and go through an ophthalmologist, then go to the psychoneurological dispensary at the place of residence for an examination with a psychiatrist, then to the narcological dispensary at the place of residence to the narcologist, and finally, with the results, return to the 1st institution to the therapist, who if the examination is positive, it will issue a medical certificate to the driver.

Periodic medical examinations under the new order in 2018 mean medical examinations taking into account the innovations of 2015-2017years, which made medical examinations mandatory for those employees who risk hearing loss in the workplace due to increased production noise. You will learn more about the organization of medical examinations, taking into account the latest requirements for them, later in the article.

What's new in the procedure for conducting periodic medical examinations in 2017-2018

In accordance with the order of the Ministry of Health of Russia dated 05.12.2014 No. 801n, which entered into force on February 16, 2015, changes were made to the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n, which at the legislative level in terms of periodic medical examinations were introduced:

• new medical contraindications associated with hearing loss for the admission of an employee to work;
• new hazardous production factors associated with noise;
• classification of degrees of hearing loss for workers exposed to industrial noise.

About hazards in production read our article .

So, to harmful physical production factors in the form of general vibration (clause 3.4.2 of order No. 302n), one more justification for regular medical examinations has been added in the form of persistent, lasting over 3 months, hearing loss of various etiologies, with the exception of cases of complete hearing loss. The frequency of medical examinations of employees in this case is once every 2 years.

Once a year, as well as when hiring, employees working with industrial equipment that are a source of noise should be checked by doctors (clause 3.5 of order No. 302n).

To additional medical contraindications for work in which periodic medical examinations are indicated (Appendix 2 to Order No. 302n), persistent (over 3 months) hearing loss was added:

• for steeplejack workers (clause 1);
• personnel serving powerful electrical installations over 42 V alternating current and 110 V direct current(clause 2);
• workers who are employed in areas remote from the nearest medical care (clause 4);
• employees working directly on equipment with open moving mechanisms (clause 10);
• employees working in gas masks (clause 13);
• motorcycle drivers - with complete deafness in one ear (clause 27.1).

In 2018, by order of the Ministry of Labor of Russia No. 62n dated February 6, 2018 and the Ministry of Health of Russia No. 49n, a change was made to the wording of one of the paragraphs of Appendix 2 to the order of the Ministry of Health and Social Development No. 302n:

Clause 20 of Appendix 2	Edition previous	Edition current
	Work in preschool educational organizations, orphanages, organizations for orphans and children left without parental care (persons replacing them), boarding school educational organizations, health educational organizations, including sanatorium type, children's sanatoriums, year-round holiday camps, as well as social shelters and nursing homes	Work in pre-school educational organizations, orphanages, organizations for orphans and children left without parental care (persons replacing them), boarding schools, health educational organizations, including sanatoriums, children's sanatoriums, year-round recreation camps, as well as organizations social service providing social services in the stationary form of social service, semi-stationary form of social service, in the form of social service at home

Results

In 2017-2018, periodic medical examinations are carried out taking into account additional requirements introduced in 2015. These innovations have added to the number of general medical contraindications for admission to work hearing loss in those industries that are associated with increased noise. The frequency of medical examinations for workers employed in hazardous industries with increased noise is at least once a year.

You will find more information about medical examinations during employment in our article. .

Greetings, dear friends! In continuation of the topic about changes in the Lists of harmful and / or hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n (Appendices No. 1 and 2), which were discussed in this note, we will reveal the legislator's plans to amend the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers employed in hard work and in work with harmful and / or dangerous working conditions, also approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n (Appendix No. 3).

So, not so long ago, a draft order of the Ministry of Health of Russia was published on the Federal Portal of Draft Regulatory Legal Acts, changing the procedure for conducting mandatory medical examinations of workers. You can download the text of the draft order below.

At the moment, the project on medical examinations is undergoing an independent anti-corruption expertise. Public discussions on the project will last until February 1, 2017, so if you want to take part in the discussions, you are here.

Overview of the draft new procedure for medical examinations

According to the changes, a list of documents is established that a person entering a job needs to undergo a preliminary medical examination.

If earlier, in order to undergo a preliminary medical examination, a candidate for worker had to have a referral and a passport with him, now, if the changes are adopted, also a copy of the medical record of an outpatient from medical institution, to which he is attached, as well as in the cases provided for, the decision of the medical commission that conducted the mandatory psychiatric examination.

The draft also establishes that the conclusion based on the results of the medical examination should be drawn up medical organization in 5 copies:

• 1st immediately after the completion of the examination is issued to the person entering the job, or who has completed the passage of a periodic medical examination;
• The 2nd is attached to the outpatient's medical record, issued by the medical organization in which the medical examination was carried out;
• 3rd is sent to the employer;
• 4th is sent to a medical organization to which the employee is assigned for medical care;
• 5th, with the consent of the person entering the work (employee), - to the Social Insurance Fund, provided financial support in the current year, the insured's expenses at the expense of the amounts of insurance premiums for the mandatory social insurance from accidents at work and occupational diseases for mandatory periodic medical examinations.

According to the draft, the final act, which is drawn up by a medical organization based on the results of a periodic medical examination, will have to be signed by a representative of the employer and a specialist territorial authority authorized to carry out sanitary and epidemiological supervision, after which - to be approved by the chairman of the medical commission.

The final act will also be issued in 5 copies (instead of 4). The fifth copy of the final act will be sent to the FSS of Russia, subject to financial support for the current year's expenses of the insured at the expense of the amount of insurance premiums for compulsory social insurance against industrial accidents and occupational diseases for mandatory periodic medical examinations.

The draft order also provides for other changes, which you can find in the MS Word file.

DOWNLOAD PROJECT

Let me remind you that here you can download the current version of order 302n.

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To be continued...