MSE for bronchial asthma. Medical and social examination for bronchial asthma

Bronchial asthma - serious illness. Disability, bronchial asthma, if present, depends on the form of the disease, the severity and nature of its course. In some cases, disability bronchial asthma may take place.

What is bronchial asthma

By bronchial asthma we mean a type inflammatory disease chronic, which occurs in the respiratory tract. T lymphocytes, eosinophils and mast cells are involved in this disease. The disease leads to shortness of breath and wheezing, coughing and a feeling of heaviness in the chest. This is most pronounced early morning or in the second half of the night.

With this disease, obstruction of the bronchial tree is also observed. In general, it is partially or completely reversible (spontaneously or with treatment). In some cases, without timely and appropriate treatment, the disease leads to dangerous complications.

Exists a large number of factors provoking the onset of the disease. Among them are the following:

1. Hereditary (genetic factors). If one of the parents is sick, the probability of the child getting sick will reach 30%, if both are sick - 75%.
2. Presence of prolonged contact with allergenic substances.
3. Chronic lung infection.
4. Serious stress or other prolonged psycho-emotional stress.
5. Availability increased tone in the parasympathetic division of the ANS.
6. Presence of endocrine disorders.
7. Some features of child development.

Increased levels of immunoglobulins E, food and drug allergies, frequent illness ORZ, passive smoking also contribute to the occurrence of asthma.

There is a division of bronchial asthma into several types:

• immunological (exogenous, atopic);
• non-immunological (endogenous);
• mixed.

In addition, the disease is classified according to severity:

• light form;
• moderate severity;
• severe form.

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Disability due to bronchial asthma

Bronchial asthma is a disease that lasts a long time and is often completely incurable. In severe forms, asthma can lead to extremely serious complications, which can affect the quality and rhythm of a person’s life as a whole, making it impossible to work in a number of areas, and necessitating the need for constant specific treatment or even leaving.

Often the mild degree of the process is almost unnoticeable. Attacks are extremely rare, and between exacerbations the disease does not manifest itself in any way. Gradually, the frequency of attacks becomes greater, the condition worsens, and performance decreases even during periods between exacerbations. All this does topical issue about disability.

There are three groups of disability (depending on the person’s condition):

• the first group is heavy;
• second group - average;
• the third is easy.

Each group is given if the course of the disease meets certain criteria.

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Assignment of disability group

A patient with bronchial asthma may receive III group disability if he has a mild or moderate degree of the disease. In such cases, the patient often receives hormonal therapy.

Usually to establish of this type groups are guided by the following characteristics:

• inability for a person to engage in usual work activities;
• respiratory failure(its symptoms appear during normal physical activity);
• restrictions on the ability to move independently and self-service;
• forced change of activity, reduction in work volumes.

For disability group II, a person must suffer from the second or third degree of severity of the disease, and there must be a pronounced deterioration in general well-being.

For its appointment, we are guided by the following criteria:

• development of heart failure;
• the presence of severe respiratory failure (its symptoms appear even with a slight physical activity);
• severe disturbance of peripheral circulation;
• serious limitation of self-care and physical activity in general;
• the presence of other diseases (malfunctions of the endocrine system due to hormone therapy, which leads to the development diabetes mellitus, and etc.);
• inability to perform professional tasks;
• need to continue professional activity at home.

Patients suffering from a progressive severe form of the disease can receive Group I disability. When making appointments, they are guided by the following indicators:

• development severe complications internal organs;
• severe heart failure;
• pronounced respiratory failure (patients suffer from shortness of breath even at rest, and pulmonary emphysema is observed);
• ineffectiveness of treatment for the disease, asthma progresses with constant worsening;
• self-care and movement without assistance is limited, the person requires outside care;
• inability to exercise labor activity.

Headings

It is quite common for patients to be given disability due to bronchial asthma. This disease may have different shape and the severity of the course, cause complications and accompanying illnesses– MSEC pays attention to all this; each aspect can influence its decision.

Main characteristics

To register a disability for bronchial asthma, several conditions must be met and careful preparation is required.

Analysis of changes that have occurred in the body since diagnosis. In order to become disabled, it is not enough just to have a disease. Great importance have disturbances in the functioning of body systems to which it led. This is especially true for bronchial asthma, which is not an indication for disability and does not directly lead to it. Such violations include frequent complications that accompany it: suffocation, attacks of which can be frequent and prolonged; cardiac or pulmonary failure; inflammation in the lungs that has chronic form; patient's dependence on hormones.

The diagnosis is usually made in a clinic at the place of residence, while the development of the disease occurs quite slowly, but a complete cure is rare.

On initial stages the patient is quite successfully helped by modern medicines, capable of stopping asthma attacks, thanks to which a person is able to maintain for quite a long time wellness. From time to time it is necessary inpatient examination and treatment. Over the years, the patient usually feels a deterioration in health, a decrease in the ability to work, and active image life.

After deciding to receive disability, the first thing you should do is consult your doctor. He must give a referral to undergo an internal medical commission and a certificate intended for a medical and social examination, even if the doctor does not find grounds for registering disability. In any case, he will be able to change the treatment strategy; if the current one is not effective enough, he can refer you for additional consultation with related specialists.

The internal medical commission, a referral to which can be given by a pulmonologist or therapist, includes a number of laboratory research, radiography, electrocardiography and stenography, examination by specialists. Depending on the severity of the disease and existing complications, additional diagnostic measures. For example, long-term use of hormonal drugs requires a conclusion about the functioning of the adrenal glands.

Having completed your visit to all the specialists to whom you have been referred, having passed all the tests and received their results, you should return to your attending physician. Based on the results obtained, they will enter the necessary data into the patient’s chart, after which he will be able to issue a referral for medical examination. If there is a disagreement with the patient and the doctor does not see any reason for an examination, he will make a note “At the request of the patient.”

Next, you need to make an appointment at the ITU Bureau at your place of residence. On the day that will be appointed, you will need to appear at the commission for a direct examination. On your person, in addition to those received medical certificates and directions, you need to have an identity document and a compulsory medical insurance policy.

During the examination, experts will ask about your well-being, living conditions, characteristics of work activity and other details that, together with the provided medical information, will help to create a complete picture of the patient’s condition and make the necessary decision. As a result passing the ITU a disability group will be assigned or denied. Every patient has the right to challenge the decision received at the Main Regional Bureau. If this result is not satisfactory, then it is necessary to go to court.

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Disability groups for bronchial asthma

If the patient has a mild or average degree severity, which leads to limitation of a person’s ability to self-care, movement and work, is usually given the third group of disability. At the same time, some restrictions are imposed on working conditions. Such people are prohibited from working in hazardous industries, in dusty, gas-filled rooms where access to fresh air is limited. If an employee is forced to work in conditions that are contraindicated for him, then his qualifications should be reduced, and the volume of daily activities in production reduced.

Patients whose disease is of moderate and high severity and is accompanied by pronounced disturbances in the functioning of the respiratory, circulatory and endocrine systems may become disabled in the second group. Their underlying disease is often accompanied by diabetes, renal failure. It is difficult for such people to take care of themselves, learn something new and work. In production, workplaces must be specially equipped for such disabled people. If professional skills allow, it is possible to work at home.

The severe course of the disease, which only progresses and has irreversible complications, gives grounds for assigning the patient the first group of disability. Labor activity, if possible, is with significant restrictions.

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Benefits provided

Already upon diagnosis, a patient with bronchial asthma is entitled to free medications.

It is usually much easier for children to get them: it is enough, while registered, to consult an allergist or pulmonologist. For adults, you will need a certificate from Pension Fund that the right to free receipt no medications were lost.

Patients with bronchial asthma require rehabilitation treatment. This is quite difficult to do in urban conditions, so such people are entitled to vouchers for Spa treatment. Such a rehabilitation program in pulmonology is aimed at ensuring control over the course of the disease in its non-acute phase using the least amount of medications.

People with this disease can count on receiving additional living space.

Current legislation provides for a number of benefits related to children and their guardians.

These include the following:

• free travel on public transport;
• benefits for housing and communal services;
• children under 15 years of age have the right to preventive products, which in this case include milk;
• a patient with a disability has the right to free travel once a year to the place of treatment;
• children with bronchial asthma and their parents are given the opportunity to purchase treatment vouchers at a reduced price;
• mothers whose children have disabilities are entitled additional leave, as well as a work schedule that does not include night shifts or overtime.

Asthma is a severe chronic disease affecting the bronchopulmonary system. Asthma causes a significant narrowing of respiratory tract. The patient develops a characteristic shortness of breath after physical exertion. The disease may be accompanied by prolonged attacks of suffocation. But the presence of such a diagnosis in itself does not constitute grounds for a person to receive disability. In addition, it is necessary to collect and provide a number of documents.

What documents will be required?

You will need:

passport of a citizen of the Russian Federation or a document replacing it;

documents confirming health status.

referral for medical and social examination;

compulsory health insurance policy

Instructions

Identify changes in your well-being that have occurred since your diagnosis. It is not the disease itself, but its consequences that play a role important role in determining the disability group. Doctors Special attention pay attention to such factors as long-lasting and frequent attacks of suffocation, an inflammatory process in the lungs, which is chronic. Dependence hormonal drugs, heart or pulmonary failure are also serious complications of bronchial asthma, which may be grounds for disability.

As a rule, there is no sharp jumps as the body's condition deteriorates, the disease progresses slowly. Thanks to modern medicines, asthma attacks are stopped for a long time, and the patient for a long time has no complaints. More than one year passes from the moment of illness before it becomes impossible to continue to lead an active lifestyle and work activity as before. The patient must be registered in his clinic, periodically undergoing examination in the hospital.

If you decide to apply for disability, start by talking to your doctor. He may suggest a different treatment regimen or recommend consulting with specialists from other fields of medicine. Even if, in the opinion of the doctor, there are no grounds for determining at least the third group of disability, he cannot refuse to issue a referral for a medical and social examination.

To undergo a medical commission, obtain a special form from a pulmonologist or therapist on which you enter the results of the doctor’s examination. The required minimum includes sputum culture and analysis, urine analysis, ECG, spirography, chest X-ray, general and biochemical tests blood, as well as a blood sugar test. Everyone who passes the commission must be examined by a cardiologist, surgeon, and neurologist. Additional Research may be prescribed for severe forms of the disease. Thus, a conclusion about the functioning of the adrenal glands is mandatory for those who take drugs containing hormones for a long time.

After the results of the tests and examination by doctors, you need to see a therapist again. He makes the necessary entries in the patient’s chart, and then sends it to the medical examiner. If there is a disagreement between the doctor and the patient, then the reason for the examination will be stated “at the request of the patient.”

The medical examination takes place at the Bureau of Medical and Social Examination, where you must register in advance. To the appointment you should take with you your passport, referral to the commission and certificates from the clinic, compulsory medical insurance policy.

After studying the information provided ITU experts They will ask a series of questions about the quality of life, the characteristics of work, their well-being, and then assign a disability group to something, or make a negative decision. To challenge the results, you must contact the Main Bureau of the region, the next instance is the court.

Disability group for bronchial asthma

When determining the disability group, they are guided by general state health, a person’s ability to care for himself independently, his ability to work and interact with other members of society.

3rd group. With an average degree of the disease, group 3 is assigned, which involves restrictions on work. This may be a shortened working day or contraindications to work in dusty, poorly ventilated areas.

2nd group. If the impairment of pulmonary function is of moderate degree, group 2 is given. Indications are also hormonal disorders, disruptions in the functioning of the endocrine system, in the functioning of the pancreas. Work is possible either remotely or under special conditions.

1 group. In the presence of irreversible changes in the body, characteristic of a severe form of the disease, group 1 is established.

Education: Moscow medical school them. I. M. Sechenov, specialty - "General Medicine" in 1991, in 1993 " Occupational diseases", in 1996 "Therapy".

Although asthma is a incurable diseases, only some of the many patients will be able to receive disability due to asthma. It simply does not occur to most patients to “get registered,” even if restrictions caused by the threat of an attack of suffocation interfere with full life, and monthly expenses on inhaled drugs eat a hole in family budget. But even if you do not plan to determine your disability group in the near future, you should know in advance the official position of medicine regarding your diagnosis - as well as the recommended training and working conditions.

Is asthma grounds for disability? Asthma is a disease with no social stigma. As a rule, patients do not experience problems with employment, because to prevent asthmatic attack It is enough to maintain basic hygiene in the room. Medical and social examination does not consider asthma in itself to be a sufficient reason to establish disability or even limited ability to work. There are several reasons for this:

• The disease is controlled with medications and an appropriate lifestyle. As a rule, the patient retains control over all areas of his life, attacks are blocked by medications, prevented by caution, proper nutrition and special gymnastics. This is different from chronic diseases that cannot be controlled with medication.
• The status remains unchanged for a long time. Asthma is determined by early stages, when a person is faced primarily with mild attacks, much less often with moderate suffocation. In such an “infancy” state, the disease can exist for decades, especially with correct, continuous treatment.
• The disease is not accompanied by chronic inflammatory processes or severe deficiency respiratory system. Patients who are interested in whether they are disabled if they have asthma are sure that persistent cough and wheezing is evidence of a fatal process in the respiratory organs. Fortunately, there is no such connection, which means the patient can work, study, and play sports without fear. Seizure prevention is sufficient to protect internal organs from premature wear.

So is it even worth applying for disability for asthma? The answer to this question depends on the severity and speed of deterioration. Frequent choking is especially dangerous in combination with other chronic diseases. To recognize a person as incapacitated, a doctor requires full clinical picture, in which asthma often becomes just one of many unfavorable factors.

What disability group can you count on for asthma?

A patient with asthma who is experiencing particular difficulties can count on any of three disability groups, depending on the severity of the disease. Timely identification of your group allows, among other things, timely acceptance of additional measures precautions - and thereby slow down the development of the disease.

Third group

There is an opinion that people with asthma do not give disability of the third group, otherwise it would have to be issued to all patients suffering from this disease. This is fundamentally incorrect, since the criteria for obtaining the third group clearly define the difference between “ordinary” and complicated asthma:

• Frequent attacks of suffocation, even with drug treatment.
• Fixed cases of hospitalization for recovery after an attack and (or) prevention of the next severe attack.
• Increased sensitivity to dust, allergens, etc., hence an increased risk of an asthmatic attack.

Thus, the criteria for the third group correspond to a disease of moderate severity. Accordingly, it will be necessary established diagnosis with a confirmed severity of the disease. If the medical history meets the established standard, disability for bronchial asthma will be issued immediately. At the same time, a restriction applies to children: even if signs of the disease appear regularly, the diagnosis is fully confirmed only six months after the start of observation.

Features of the third group:

• Limited physical activity. This factor is especially important for children, since a regular physical education lesson will be dangerous for a child suffering from asthma attacks. As a replacement for the standard program, special gymnastics is provided, but often physical education teachers simply exempt such children from classes. This means that control physical development The child you will have to do on your own. For adults with asthma disabilities, these restrictions are primarily advisory in nature. The third group will become an obstacle if you want to get a job that involves intensive physical labor– but such activity will in any case be contraindicated for you due to health reasons.
• Possibility to apply for reduced working hours. This “privilege” is not available in all areas of work, and it is recommended to use it only if general mode aggravates the course of the disease.
• Special requirements for working and study conditions. If you or your child has asthma, a disability rating may be assigned to ensure that employers (or teachers) will respect your fair demands regarding the condition of your work or school environment. Regular wet cleaning, ventilation, preventing the accumulation of dust - basic conditions on which you have every right to insist. At the same time, you will have to abandon the types of activities in which you have to inhale chemical fumes yourself - such work does not leave the opportunity to organize proper working conditions.

Bronchial asthma and “initial” disability are a practical combination that allows you to pay sufficient attention to your health without giving up rich life. Timely identification of the third group allows timely measures to be taken to stop further progress of the disease.

Second group

Among the patients who want to know whether disability with bronchial asthma is given in Russia, there are many patients who experience increased difficulties in various fields life. Their condition is characterized by the following factors:

• Asthma is complicated chronic illnesses vital systems. The most common complications are from the lungs and endocrine system, cardiovascular failure, diseases of the digestive tract.
• Forced reduction in physical activity. Even light loads may provoke. The patient is forced to remain motionless for a long time, which leads to muscle atrophy.
• Declining self-care skills. Almost inevitable deterioration caused by rapidly worsening physical limitations.

In this case, disability for bronchial asthma should be obtained as soon as possible. The second group is placed soon after confirmation of the dynamics of the disease. It is impossible to cope with a condition of such severity on your own, therefore it is necessary to use the measures and services offered by the Ministry of Health:

• Regular hospital treatment. Patients in the second group cannot be content with the usual preventive measures, they need close attention from doctors.
• Treatment in sanatoriums and resort-type sanatoriums. Physiotherapy, Fresh air, special diet– all this helps to significantly improve the patient’s quality of life.
• Homeschooling for children. Disability of the second group due to bronchial asthma in children leaves no opportunity to attend school or kindergarten. Studying at home will allow you to keep up with your peers, and in some ways even surpass them.

If a patient with the second group does not receive proper treatment, after a few years his condition will inevitably worsen.

First group

The most severe, first group of disability for asthma is established by a combination of the following factors:

• Irreversible changes in the lungs, respiratory system, heart. Heavy chronic diseases, which cannot be cured, become the basis of the diagnosis.
• Frequent attacks, shortness of breath in the absence of provoking factors. The patient has difficulty breathing, even when sitting or lying quietly.
• Minimal mobility. The person cannot walk because... begins to choke and is unable to perform even preventative exercises.

At this stage, the question is no longer about how to get disability due to asthma - most likely, this will be suggested by the doctors themselves. It is much more difficult to develop treatment tactics that can at least make the patient’s life a little easier. In each case, measures are taken individually. Regardless of the specifics of the diagnosis, a patient with the first group is recognized as disabled, and therefore receives the right to a social pension.

How is disability registered?

To get on the register, you need to contact your local ITU Bureau(medical and social examination). Disability due to bronchial asthma is issued upon provision of the following documents:

• Referral for examination received from a doctor general practice(therapist for adults, pediatrician for children). The doctor may insist that you have no grounds for registration of disability, but even in this case, you have every right to receive a referral.
• Medical confirmation of asthma diagnosis with complete information about the characteristics of the course of the disease.
• A bypass sheet from an endocrinologist, surgeon, cardiologist, neurologist and therapist (pediatrician).
• Results of the surveys. The current list is clarified with the therapist.
• Identity document (passport or birth certificate).
• Compulsory health insurance policy.

You should also attach all available hospital extracts if you were treated for this profile. After analyzing the data you provided, the commission members will issue a verdict, which can be challenged in judicial procedure, if you consider it unfair.

Conclusion

Now you know what disability group is given for asthma - and what you need to do to officially approve your status. Disability allows you not to serve. Have you ever thought about registering for disability before? Do you consider the conditions for assigning such a status fair for patients with asthma? Share your opinion in the comments.

Bronchial asthma is one of the ten most common diseases. This disease affects about 10% of the world's population. Since the disease is very difficult to treat, the question of whether bronchial asthma gives disability remains relevant for many years.

Bronchial asthma is a disease that can limit normal life not only adults, but also children. This disease is quite long-lasting and a short time can go from more mild stage in the middle, and sometimes in severe form. The disease is dangerous because therapeutic treatment very often it does not have the desired effect, and sometimes it can cause complications. Children are most often affected by this. However, they can “outgrow”, and over time the disease may recede or become milder.

When a disease is diagnosed, regardless of the patient’s age, he is required to be registered at the clinic. The doctor monitors the patient, noting the course of the disease, deterioration or improvement of his condition. All this is recorded in medical documents and is a confirmation of how this disease progresses.

With frequent shortness of breath, periodic attacks, systematic outpatient or inpatient treatment and simply if the symptoms of the disease constantly worsen, you should think about undergoing medical examination and receiving a disability group for asthma.

Documents for registration of disability due to asthma

When wondering how to get disability due to asthma, you need to objectively take into account your well-being. Before applying for disability, you should definitely consult a doctor. Analyze your health and how the disease develops. If there are all the prerequisites that the illness does not allow you to live a full life, then according to the law, if the patient insists on registering a disability, the doctor must issue a referral for medical examination.

In order to undergo a medical and social examination and register disability for asthma, you need to prepare a number of documents:

• statement;
• passport;
• the patient’s consent that his data will be processed;
• the patient's medical record or outpatient card;
• referral to ITU;
• insurance policy;
• extracting epicrisis from hospitals or clinics;
• radiograph;
• results of medical examinations.

If a child is sent to ITU and he is under 14 years old, then a birth certificate is attached instead of a passport.

Research results required for submission to ITU

Before passing a medical examination, you must pass necessary tests. To do this, the attending physician issues a referral for a series of laboratory tests. Typically the list includes:

• general, biochemical and blood test for sugar;
• sowing and general analysis sputum;
• Analysis of urine;
• spirography;
• electrocardiogram of the heart.

How the commission works

The basis for conducting MSE is the patient’s statement. After it is registered with the appropriate package of documents, a decision is made on when the meeting will be held (date, time). The patient is informed about this in writing. If you need to add any documents, they are indicated in the same invitation.

Based on the examination of the submitted documents, it is also possible to refuse to conduct a medical and social examination. In this case, the patient or his representative must be notified in writing about this within three days.

An important point is the examination itself. After a complete study of all documents and a personal examination of the patient, the commission makes a final decision and enters its result into an expert report.

When the patient requires additional examinations, he must be notified about this. If he refuses to conduct such an examination, then a corresponding entry is made in the medical report.

When all examinations are fully completed, the work of the commission resumes. Analyzing the information received, the commission decides whether the patient is recognized or not recognized as disabled.

The decision made is announced to the patient in front of all members of the commission. If necessary, the reason for this decision is explained to the patient in detail.

Disability groups for asthma

Depending on the development of the disease and a number of indicators, based on the conclusion of the commission, disability for bronchial asthma is given as the third, second and first groups. Each condition and degree of the disease has its own disability group, regardless of the gender and age of the patient. After all, if the symptoms are the same in both an adult and a child, the disability group is determined to be the same.

First disability group

This group is prescribed for severe asthma. When neither medicine nor hormone therapy do not give results and the disease progresses. Such a course of the disease is a good reason to apply for disability.

1. The disease continues to get worse despite treatment.
2. There are significant breathing problems, both during movement and at rest. There is constant shortness of breath.
3. There are difficulties with the functioning of the heart.
4. Serious complications in the functioning of internal organs are observed.
5. Absolute disability.
6. Due to the inability to move independently, the patient requires constant care.

Disability of the second group

Obtaining this group is possible for the second and third degrees of bronchial asthma. It appears like this:

1. Significant impairment of the respiratory system even with minimal physical activity.
2. Heart problems appear.
3. There are some disturbances in the peripheral circulation.
4. There is a threat of the influence of hormonal drugs on the development of diabetes mellitus.
5. A sharp limitation in self-service.
6. Inability to carry out work tasks.
7. Ability to work only in special conditions.

Third disability group

This disability group is assigned if asthma is mild to moderate. You can get it with the following symptoms of the disease:

1. If with a small physical activity respiratory failure is felt.
2. It is impossible to carry out usual work activities.
3. There are restrictions on independent movement or self-care.
4. There is a need to make changes to work activity or to completely change it.

After the end of the period for which the disability was issued, the patient must undergo a second medical and social examination and confirm his group.

Only if a patient with bronchial asthma feels much better and the disease has become more mild degree the disability group may be revised or cancelled.