Will order 1024 ITU be changed. The Ministry of Labor “overestimated” the disabled: experts on new criteria for disability

After monitoring the application of classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination, approved. Order of the Ministry of Labor and Social Protection of the Russian Federation of September 29, 2014 No. 664n, in fact after a year of application, Order of the Ministry of Labor and Social Protection of the Russian Federation No. 1024n of December 17, 2015 approved new classifications and criteria used in the implementation of medical and social examination citizens by federal state institutions of medical and social expertise.
On February 2, the Order of the Ministry of Labor and Social Protection of the Russian Federation dated December 17, 2015 No. 1024n “On the classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination” (Order No. 1024n) came into force.
A change in the approach to determining disability has led to the fact that during the re-examination, not all citizens with disabilities remained in this status. At the same time, the subjective factor was not excluded during the medical and social examination and the establishment of disability. It turned out that many seriously ill citizens, most of whom were children, were not recognized as disabled and did not receive appropriate treatment and rehabilitation opportunities.
The main purpose of issuing Order No. 1024n was to specify approaches to assessing the severity of impaired body functions and criteria for establishing disability, including for children, to clarify the wording of impaired functions, which should have eliminated their unequal interpretation in different regions and further objectified approaches to medical treatment. social expertise.
Order No. 1024n included such diseases and defects that occur in children as insulin-dependent diabetes mellitus occurring in childhood, cleft lip and palate (cleft lip and palate), phenylketonuria, bronchial asthma occurring in childhood.
The new Order No. 1024n defines the main types of persistent disorders of the functions of the human body caused by diseases, the consequences of injuries or defects, and the degree of their severity, as well as the main categories of human life and the severity of the limitations of these categories.
As in Order No. 664n, six main groups of types of persistent disorders of the functions of the human body have been identified: violations of mental functions; violations of language and speech functions; violations of sensory functions; disorders of neuromuscular, skeletal and movement-related functions; violations of the functions of the cardiovascular, respiratory, digestive, endocrine systems and metabolism, the blood system and the immune system, urinary function, the function of the skin and related systems; violations caused by physical external deformity.
The algorithm for estimating the severity of persistent impairments to the functions of the human body due to diseases, the consequences of injuries or defects has also been saved - in percentages in the range from 10 to 100, with a step of 10%. There are still four degrees of severity of persistent violations of the functions of the human body - I degree - violations in the range from 10 to 30%, II degree - violations in the range from 40 to 60%, III degree - violations in the range from 70 to 80%, IV degree - violations in the range from 90 to 100%.
There is no fundamental difference in the establishment of disability groups. But, in Order No. 1024n there is no clear statement of the criteria that would be understandable not only to an ITU specialist, but also to an ordinary citizen or doctor of a medical organization who referred a patient to ITU.
Suppose, according to paragraph 8 of Order No. 1024n, the criterion for establishing disability is a health disorder with II or more pronounced degree of persistent impairment of the functions of the human body (in the range from 40 to 100 percent), due to diseases, the consequences of injuries or defects, leading to restriction 2 or 3 degrees of severity of one of the main categories of human life activity or 1 degree of severity of two or more categories of human life activity in their various combinations that determine the need for his social protection.
According to paragraph 9, the criteria for establishing disability groups are applied after the disability has been established for a citizen in accordance with the criterion for establishing disability, provided for in paragraph 8 of this. And then specifically for disability groups, the categories of life activity corresponding to a particular disability group are not indicated.
Thus, paragraph 10 states: the criterion for establishing the first group of disability is a violation of human health with IV degree of severity of persistent violations of the functions of the human body (in the range from 90 to 100 percent), due to diseases, consequences of injuries or defects.
Clause 11 states: the criterion for establishing the second group of disability is a violation of human health with III degree of severity of persistent impairment of body functions (in the range from 70 to 80 percent), due to diseases, consequences of injuries or defects.
Paragraph 12 states: the criterion for establishing the third group of disability is a violation of human health with II degree of severity of persistent violations of body functions (in the range from 40 to 60 percent), due to diseases, the consequences of injuries or defects.
In paragraph 13. The category "disabled child" is established if the child has II, III or IV degree of severity of persistent violations of body functions (in the range from 40 to 100 percent) caused by diseases, the consequences of injuries and defects.
That is, Order No. 664n clearly indicated the correspondence between the severity of persistent violations of the functions of the human body and the severity of restrictions on the categories of human life activity.
In Order No. 1024n there is no clear concept that the II degree of severity of persistent violations of body functions (in the range from 40 to 60 percent) can correspond to the 1st degree of severity of two or more categories of human life activity in their various combinations.
For example, when establishing the third disability group, persistent impairments of statodynamic functions of the II degree of severity (in the range from 40 to 60 percent) may correspond to 1 degree of severity of the category of movement and self-service (or 1 degree of severity of the category of labor activity and movement), etc.
It would be clearer if the old criteria were left in Order No. 1024n, adding only a range of percentages.
For children, as well as in Order No. 664, and in Order No. 1024n, there is also no clear concept for establishing the category of a disabled child.
Thus, according to paragraph 13 of the new Order No. 1024n, the category "disabled child" is established if the child has II, III or IV degree of severity of persistent violations of body functions (in the range from 40 to 100 percent) caused by diseases, consequences of injuries and defects. From which it can be understood that a child, like an adult, should have a disability group.
Order No. 1024n, as well as Order No. 664n, includes the most common diseases. But, in Order No. 1024n, they indicated that “if the annex to these classifications and criteria does not provide for a quantitative assessment of the severity of persistent violations of a particular function of the human body due to diseases, the consequences of injuries or defects that the person being examined, then the severity of persistent violations functions of the human body in percentage terms is established by the federal state institution of medical and social expertise in accordance with paragraphs three - six of this paragraph based on the clinical and functional characteristics of diseases, the consequences of injuries or defects that caused the above violations, the nature and severity of complications, stage, course and prognosis pathological process. That is, it still remains unclear where to get the clinical and functional characteristics of diseases that are not in the List. Probably, as before, from the generally accepted classifications of dysfunctions adopted in clinical practice, of which there are many. That is, it turns out - again a subjective approach.
Thus, on the one hand, the New Classifications and Criteria corrected many shortcomings of the previous classifications and criteria. On the other hand, there are many questions that require clarification on the part of higher organizations on the part of federal institutions of medical and social expertise.

MINISTRY OF LABOR AND SOCIAL PROTECTION OF THE RUSSIAN FEDERATION

ORDER

ON CLASSIFICATIONS AND CRITERIA,

USED IN THE IMPLEMENTATION OF MEDICAL AND SOCIAL EXAMINATION

MEDICAL AND SOCIAL EXPERTISE

In accordance with subparagraph 5.2.105 of the Regulations on the Ministry of Labor and Social Protection of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 19, 2012 N 610 (Collected Legislation of the Russian Federation, 2012, N 26, Art. 3528; 2013, N 22, 2809; N 36, item 4578; N 37, item 4703; N 45, item 5822; N 46, item 5952; 2014, N 21, item 2710; N 26, item 3577; N 29 , item 4160; N 32, item 4499; N 36, item 4868; 2015, N 2, item 491; N 6, item 963; N 16, item 2384), I order:

1. Approve the attached classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination.

2. Recognize invalid the order of the Ministry of Labor and Social Protection of the Russian Federation of September 29, 2014 N 664n "On the classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination" (registered by the Ministry of Justice of the Russian Federation 20 November 2014, registration N 34792).

M.A.TOPILIN

Approved

order of the Ministry of Labor

and social protection

Russian Federation

CLASSIFICATIONS AND CRITERIA,

USED IN THE IMPLEMENTATION OF MEDICAL AND SOCIAL EXAMINATION

CITIZENS BY FEDERAL STATE INSTITUTIONS

MEDICAL AND SOCIAL EXPERTISE

I. General provisions

1. Classifications used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination determine the main types of persistent disorders of the functions of the human body due to diseases, the consequences of injuries or defects, and the degree of their severity, as well as the main categories of human life and degree the severity of the limitations of these categories.

2. The criteria used in the implementation of the medical and social examination of citizens by federal state institutions of medical and social examination determine the grounds for establishing disability groups (the category "disabled child").

II. Classifications of the main types of persistent disorders

functions of the human body and the degree of their severity

3. The main types of persistent disorders of the functions of the human body include:

disorders of mental functions (consciousness, orientation, intelligence, personality traits, volitional and incentive functions, attention, memory, psychomotor functions, emotions, perception, thinking, high-level cognitive functions, mental functions of speech, sequential complex movements);

violations of language and speech functions (oral (rhinolalia, dysarthria, stuttering, alalia, aphasia); written (dysgraphia, dyslexia), verbal and non-verbal speech; impaired voice formation);

violations of sensory functions (vision; hearing; smell; touch; tactile, pain, temperature, vibration and other types of sensitivity; vestibular function; pain);

disorders of neuromuscular, skeletal and movement-related (static-dynamic) functions (movements of the head, trunk, limbs, including bones, joints, muscles; statics, coordination of movements);

violations of the functions of the cardiovascular system, respiratory system, digestive, endocrine systems and metabolism, blood and immune systems, urinary function, skin function and related systems;

violations caused by physical external deformity (deformities of the face, head, torso, limbs, leading to external deformity; abnormal openings of the digestive, urinary, respiratory tract; violation of body size).

4. The degree of severity of persistent violations of the functions of the human body due to diseases, the consequences of injuries or defects, is estimated as a percentage and is set in the range from 10 to 100, in increments of 10 percent.

There are 4 degrees of severity of persistent violations of the functions of the human body:

I degree - persistent minor violations of the functions of the human body due to diseases, consequences of injuries or defects, in the range from 10 to 30 percent;

II degree - persistent moderate violations of the functions of the human body due to diseases, consequences of injuries or defects, in the range from 40 to 60 percent;

III degree - persistent pronounced violations of the functions of the human body due to diseases, consequences of injuries or defects, in the range from 70 to 80 percent;

IV degree - persistent, significantly pronounced violations of the functions of the human body, caused by diseases, the consequences of injuries or defects, in the range from 90 to 100 percent.

The degree of severity of persistent violations of the functions of the human body, caused by diseases, consequences of injuries or defects, is established in accordance with the quantitative assessment system provided for in the appendix to these classifications and criteria.

If the annex to these classifications and criteria does not provide for a quantitative assessment of the severity of persistent violations of a particular function of the human body due to diseases, consequences of injuries or defects that the person being examined, then the severity of persistent violations of the functions of the human body in percentage terms is established by the federal state institution medical and social expertise in accordance with paragraphs three - six of this paragraph based on the clinical and functional characteristics of diseases, the consequences of injuries or defects that caused the above violations, the nature and severity of complications, the stage, course and prognosis of the pathological process.

In the presence of several persistent violations of the functions of the human body due to diseases, consequences of injuries or defects, the degree of severity of each of these violations in percentage is separately assessed and established. First, the maximum percentage violation of a particular function of the human body is established, after which the presence (absence) of the influence of all other persistent violations of the functions of the human body on the most pronounced violation of the function of the human body is determined. In the presence of the specified influence, the total assessment of the degree of dysfunction of the human body in percentage terms may be higher than the most pronounced violation of the functions of the body, but not more than 10 percent.

Cerebral vascular pathology is characterized by a significant polymorphism of clinical manifestations, including dyscirculatory, focal and cerebral disorders, which requires, in most specific cases, an individual approach to quantifying the severity of persistent impairments of human body functions caused by cerebrovascular diseases. Cerebrovascular diseases often occur on the basis of atherosclerosis, hypertension, complicated by chronic cerebrovascular insufficiency (encephalopathy), acute cerebrovascular accident in the system of internal and vertebral arteries. In the development of cerebrovascular insufficiency, many factors are attached importance: atherosclerosis of the vessels of the brain, aortic arch and brachiocephalic branches, stenosis, bends and deformities of the extra- and intracranial sections of the carotid arteries, anomalies in the structure of cerebral vessels, etc. Methodological bases for assessing disability in people with cerebrovascular diseases determined by a complex set of pathomorphological changes and pathophysiological mechanisms of cerebrovascular accident. The severity of the latter depends on the location and nature of the lesion of the vessel, the topic of the focus, its depth and extent, the degree of damage to nerve cells and pathways. Among the pathomorphological substrates, the following are of primary importance: vascular changes - atherosclerotic plaques, aneurysm, thrombosis, pathological tortuosity, vasculitis; changes in the substance of the brain - heart attack, hemorrhagic infarction, hemorrhage, edema, dislocation and wedging, cerebral scar, brain atrophy, cyst. Pathophysiological mechanisms are presented as:

changes in the vascular system - arterial hypertension, hypotension, angiospasm, vasoparesis, insufficiency of collateral circulation, the phenomenon of stealing, increased permeability of the blood-brain barrier, cardiovascular and respiratory failure, metabolic and regulatory disorders - hypoxia, hypercoagulability, tissue acidosis, isothermia, etc.

The course of a vascular disease of the brain (progressive, stationary or stable, relapsing) is determined depending on the dynamics of the process, the rate of its progression, or the period of exacerbation. Vascular disease of the brain is often characterized by a progressive course, while it is necessary to take into account the rate of development of the vascular process. It is necessary to distinguish between a slowly progressive course with chronic cerebrovascular insufficiency and a rapidly progressive course with the development of II, III degree of chronic cerebrovascular insufficiency with pronounced focal and cerebral changes. When assessing the nature of the recurrent course of cerebral vascular pathology, it is necessary to take into account the frequency of exacerbations: rare exacerbations with an interval of more than a year; exacerbations of average frequency - 1-2 times a year; frequent exacerbations - 3-4 times a year. The duration of transient disorders of cerebral circulation is determined: short-term duration (seconds, minutes, up to one hour); medium duration (2-3 hours); long duration (from 3 to 23 hours). The clinical prognosis in vascular pathology of the brain is aggravated by emerging cerebral crises, transient cerebrovascular accidents, strokes, i.e. the diversity of the clinical course and outcomes of vascular pathology determine a diverse clinical prognosis (favorable, unfavorable, doubtful). The latter depends on many factors - the nature and course of a general vascular disease (atherosclerosis, hypertension), the state of the main and intracerebral arteries, the possibilities of collateral circulation, early diagnosis, the type and degree of dysfunction, etc.

Vascular pathology of the brain can lead to the following violations of the basic functions of the human body: violations of statodynamic functions due to paralysis, paresis of the extremities, vestibular-cerebellar, amyostatic, hyperkinetic disorders, etc.; violations of sensory functions (reduced visual acuity, hemianopsia, concentric narrowing of the visual field, sensorineural hearing loss, etc.); visceral and metabolic disorders, eating disorders, blood circulation, respiration, etc.; disorders of mental functions (mnestic-intellectual decline, motor, sensory, amnestic aphasia, dysarthria, anartria, agraphia, alexia, disorders of praxis, gnosis, etc.).

The listed violations can be manifested in severity by all four degrees of severity of persistent violations of body functions: minor, moderate, pronounced, significantly pronounced.

The leading clinical manifestations of vascular pathology of the brain are movement disorders (hemiplegia, hemiparesis, paraparesis of the lower extremities, vestibular-cerebellar, etc.), leading to varying degrees of disturbances in statodynamic function and restrictions on the ability to move independently. When assessing the degree of restriction of movement of patients with this pathology, the following are taken into account:

a complex of clinical and functional indicators characterizing the degree and prevalence of disorders of the motor function of the lower extremities or their segments - the amplitude of active movements in the joints of the extremities (in degrees), the degree of decrease in muscle strength, the severity of the increase in muscle tone, statics, coordination of movements, the main function of the lower extremities, the nature of the gait, the use of additional means of support when walking;

a complex of clinical and functional indicators characterizing the degree and prevalence of disorders of the motor functions of the upper limb or its segments - the volume of active movements in the joints of the limb (in degrees), the degree of decrease in muscle strength, the severity of the increase in muscle tone, coordination of movements, the main static-dynamic function of the upper limb - grip and retention of objects;

a set of indicators characterizing the functional state of the vestibular analyzer (caloric, rotational tests);

a complex of electromyographic signs indicating the nature and severity of changes in the bioelectrical activity of muscles;

a complex of biomechanical indicators (walking pace, double step duration, etc.) with the calculation of the walking rhythm coefficient as a general indicator of the degree of movement restriction severity.

"On the classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination"

(Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2012, N 26, Art. 3528; 2013, N 22, Art. 2809; N 36, Art. 4578; N 37, Art. 4703; N 45, Art. 5822; N 46, Art. 5952; 2014, N 21, item 2710; N 26, item 3577; N 29, item 4160; N 32, item 4499; N 36, item 4868; 2015, N 2, item 491; N 6 , item 963; N 16, item 2384)

Order of the Ministry of Labor 1024n dated 12/17/2015 with changes:

I order:

Approve the attached classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination.
Recognize invalid the order of the Ministry of Labor and Social Protection of the Russian Federation of September 29, 2014 N 664n "On the classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination"
(registered by the Ministry of Justice of the Russian Federation on November 20, 2014, registration N 34792).

Minister M.A. Topilin

Approved by order of the Ministry of Labor
and social protection of the Russian Federation
dated December 17, 2015 N 1024n

CLASSIFICATIONS AND CRITERIA,
USED IN THE IMPLEMENTATION OF MEDICAL AND SOCIAL EXAMINATION
CITIZENS BY FEDERAL STATE INSTITUTIONS
MEDICAL AND SOCIAL EXPERTISE
List of changing documents
(as amended by the Order of the Ministry of Labor of Russia dated July 5, 2016 N 346n)

I. General provisions

II. Classifications of the main types of persistent disorders of the functions of the human body and the degree of their severity

3. The main types of persistent disorders of the functions of the human body include:

disorders of mental functions (consciousness, orientation, intelligence, personality traits, volitional and incentive functions, attention, memory, psychomotor functions, emotions, perception, thinking, high-level cognitive functions, mental functions of speech, sequential complex movements);
violations of language and speech functions (oral (rhinolalia, dysarthria, stuttering, alalia, aphasia);
written (dysgraphia, dyslexia), verbal and non-verbal speech; voice disorder)
violations of sensory functions (vision; hearing; smell; touch; tactile, pain, temperature, vibration and other types of sensitivity; vestibular function; pain);
disorders of neuromuscular, skeletal and movement-related (static-dynamic) functions (movements of the head, trunk, limbs, including bones, joints, muscles; statics, coordination of movements);
violations of the functions of the cardiovascular system, respiratory system, digestive, endocrine systems and metabolism, blood and immune systems, urinary function, skin function and related systems;
violations caused by physical external deformity (deformities of the face, head, torso, limbs, leading to external deformity; abnormal openings of the digestive, urinary, respiratory tract; violation of body size).

There are 4 degrees of severity of persistent violations of the functions of the human body:

I degree- Persistent minor violations of the functions of the human body due to diseases, consequences of injuries or defects, in the range from 10 to 30 percent;
II degree- Persistent moderate impairment of the functions of the human body due to diseases, consequences of injuries or defects, in the range from 40 to 60 percent;
III degree- persistent pronounced violations of the functions of the human body due to diseases, consequences of injuries or defects, in the range from 70 to 80 percent;
IV degree- Persistent, significantly pronounced violations of the functions of the human body due to diseases, consequences of injuries or defects, in the range from 90 to 100 percent.

If the annex to these classifications and criteria does not provide for a quantitative assessment of the severity of persistent violations of a particular function of the human body due to diseases, consequences of injuries or defects that the person being examined, then the severity of persistent violations of the functions of the human body in percentage terms is established by the federal state institution medical and social expertise in accordance with paragraphs three to six of this paragraph based on the clinical and functional characteristics of diseases, the consequences of injuries or defects that caused the above violations, the nature and severity of complications, the stage, course and prognosis of the pathological process.

III. Classifications of the main categories of human life and the severity of the restrictions of these categories

a) ability to self-service;

b) ability to move independently;

in) ability to orientate;

G) ability to communicate;

e) the ability to control one's behavior;

e) ability to learn;

and) ability to work.

6. There are 3 degrees of severity of restrictions for each of the main categories of human life:

a) the ability to self-service - the ability of a person to independently fulfill basic physiological needs, perform daily household activities, including the use of personal hygiene skills:

1 degree- the ability to self-service with a longer expenditure of time, the fragmentation of its implementation, reducing the volume using, if necessary, auxiliary technical means;
2 degree- the ability to self-service with regular partial assistance of other persons using, if necessary, auxiliary technical means;
3 degree- inability to self-service, the need for constant outside help and care, complete dependence on other people;

b) the ability to move independently - the ability to independently move in space, maintain body balance when moving, at rest and when changing body position, use public transport:

1 degree- the ability to move independently with a longer expenditure of time, fragmentation of performance and a reduction in distance using, if necessary, auxiliary technical means;
2 degree- the ability to move independently with regular partial assistance of other persons using, if necessary, auxiliary technical means;
3 degree- inability to move independently and needing the constant help of others;

in) orientation ability - the ability to adequately perceive the person and the environment, assess the situation, determine the time and location:

1 degree- the ability to orient only in a familiar situation independently and (or) with the help of auxiliary technical means;
2 degree- the ability to orientate with regular partial assistance of other persons using, if necessary, auxiliary technical means;
3 degree- inability to orientate (disorientation) and the need for constant help and (or) supervision of other persons;

G) ability to communicate - the ability to establish contacts between people through the perception, processing, storage, reproduction and transmission of information:

1degree- the ability to communicate with a decrease in the rate and volume of receiving and transmitting information, the use, if necessary, of auxiliary technical means of assistance, with an isolated lesion of the hearing organ - the ability to communicate using non-verbal methods of communication and sign language translation services;
2 degree- the ability to communicate with regular partial assistance of other persons using, if necessary, auxiliary technical means;
3 degree- inability to communicate and the need for constant help from others;

e) the ability to control one's behavior is the ability to self-awareness and adequate behavior, taking into account social, legal and moral and ethical standards:

1 degree- periodically occurring limitation of the ability to control one's behavior in difficult life situations and (or) constant difficulty in performing role functions affecting certain areas of life, with the possibility of partial self-correction;
2 degree- a constant decrease in criticism of one's behavior and the environment with the possibility of partial correction only with the regular help of other persons;
3 degree- inability to control one's behavior, the impossibility of its correction, the need for constant assistance (supervision) of other persons;

e) learning ability - the ability to a purposeful process of organizing activities to acquire knowledge, skills, abilities and competencies, gain experience in activities (including professional, social, cultural, domestic nature), develop abilities, gain experience in applying knowledge in everyday life and form motivation lifelong learning:

1 degree- the ability to learn and receive education within the framework of federal state educational standards in organizations engaged in educational activities, with the creation of special conditions (if necessary) for education by students with disabilities, including training using (if necessary) special technical means training, determined taking into account the conclusion of the psychological-medical-pedagogical commission;
2 degree- the ability to study and receive education within the framework of federal state educational standards in organizations engaged in educational activities, with the creation of special conditions for obtaining education only according to adapted educational programs, if necessary, homeschooling and / or using distance learning technologies using (if necessary ) special technical training aids, determined taking into account the conclusion of the psychological-medical-pedagogical commission;
3 degree- the ability to learn only elementary skills and abilities (professional, social, cultural, everyday), including the rules for performing only elementary purposeful actions in the usual household sphere or limited opportunities for the ability to such learning due to the existing significantly pronounced violations of body functions, determined taking into account the conclusion of the psychological-medical-pedagogical commission;

and) ability to work - the ability to carry out labor activities in accordance with the requirements for the content, volume, quality and conditions of work:

1 degree- the ability to perform labor activities in normal working conditions with a decrease in qualifications, severity, tension and (or) a decrease in the volume of work, the inability to continue working in the main profession (position, specialty) while maintaining the ability to perform labor activities of a lower qualification under normal working conditions;
2 degree- the ability to perform labor activities in specially created conditions using auxiliary technical means;
3 degree- the ability to perform elementary labor activity with significant help from other persons or the impossibility (contraindication) of its implementation due to the existing significantly pronounced violations of body functions.

7. The degree of limitation of the main categories of human life is determined on the basis of an assessment of their deviation from the norm, corresponding to a certain period (age) of human biological development.

IV. Criteria for establishing disability

8. The criterion for determining disability for a person aged 18 years and older is a health disorder with II or more pronounced degree of persistent impairment of the functions of the human body (in the range from 40 to 100 percent), caused by diseases, the consequences of injuries or defects, leading to a restriction 2 or 3 degrees of severity of one of the main categories of human life activity or 1 degree of severity of restrictions on two or more categories of human life activity in their various combinations, which determine the need for his social protection.

The criterion for establishing disability for a person under the age of 18 is a health disorder with II or more pronounced degree of persistent impairment of the functions of the human body (in the range from 40 to 100 percent), caused by diseases, the consequences of injuries or defects, leading to the restriction of any category of human life and any of the three degrees of severity of restrictions for each of the main categories of life activity, which determine the need for social protection of the child.

(clause 8 as amended by the Order of the Ministry of Labor of Russia dated July 5, 2016 N 346n)

V. Criteria for establishing disability groups

9. Criteria for establishing disability groups are applied after a citizen's disability has been established in accordance with the criterion for establishing disability, provided for in paragraph 8 of these classifications and criteria.

10. The criterion for establishing the first group of disability is a violation of human health with IV degree of severity of persistent violations of the functions of the human body (in the range from 90 to 100 percent), due to diseases, consequences of injuries or defects.

11. The criterion for establishing the second group of disability is a violation of human health with III degree of severity of persistent disorders of body functions (in the range from 70 to 80
percent) due to diseases, consequences of injuries or defects.

12. The criterion for establishing the third group of disability is a violation of human health with II degree of severity of persistent impairment of body functions (in the range from 40 to 60 percent), due to diseases, consequences of injuries or defects.

13. The category "disabled child" is established if the child has II, III or IV degree of severity of persistent violations of body functions (in the range from 40 to 100 percent) caused by diseases, the consequences of injuries and defects.