Sample form 088 y 06. What is a referral to ITU? What medical and preventive organizations issue it and how to get it? Name and address of the organization in which the citizen works

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Important update!

What does this paper look like?

If a person received a referral at a polyclinic or other medical organization, then the appearance and shape of this paper are subject to the rules. They are formulated in Order No. 77 of the Ministry of Health and Social Development of the Russian Federation:

1. Already in the direction itself, the results of previous examinations and studies, the estimated severity of the established disease and the disability that it may entail, as a percentage, are necessarily entered.
2. The results of rehabilitation measures and the actual purpose pursued by the issuance of the referral are also indicated in such a paper.

Directions issued by authorized pension and social security institutions are somewhat different in appearance due to the fact that they are subject to another regulatory act - order of the Ministry of Health and Social Development of the Russian Federation No. 874.

The differences are as follows:

1. The restrictions that the patient is forced to comply with, in this case, are considered not as a fact, and not from the point of view of working capacity, but from the standpoint of whether a person needs social assistance and protection.
2. The purpose of receiving the direction, as in the previous case, is written necessarily.

The procedure for registration for medical and social examination

The registration procedure for ITU consists of several stages:

Clarifications

Who directs?

Direction is issued:

• Medical institutions providing medical and preventive care (polyclinics, hospitals, including psychiatric ones).
• Organizations for the social support of citizens.
• pension funds.

Who issues the document?

The attending physician, the therapist of the local polyclinic - this is who most often directs citizens to undergo the ITU, based on studies of their health status or a sick leave that has been going on for about 10-12 months. But, if there is a corresponding desire, the patient can start this process on his own.

Paper of any other sample cannot be considered as a valid beginning of the procedure. An officially issued form in accordance with all regulatory standards is sent to the ITU center when an application is submitted by a citizen or his authorized representative.

Advice! For those situations where a citizen, due to his serious condition, does not have the physical ability to arrive at the institution and undergo an examination, the legislation provides for the possibility of undergoing a medical and social examination in a hospital hospital or at home.

Disability procedure

There are situations when an employee took a sick leave - and everything prolongs and prolongs it, and there are no positive changes in the condition of such a patient. In case of repeated repetition of a leaflet with an unchanged diagnosis, an employee of a medical organization is authorized to issue a referral to the ITU for the patient.

As you know, the standard validity of the sick leave is ten days. By decision of a council of doctors, it can be extended for up to thirty days, and sometimes up to 10 months, but not more than a year.

If within a year the patient's ability to work has not recovered, then the attending physician is obliged to send him for examination. The ITU commission will already decide whether a further extension of the sick leave is possible, or final rehabilitation is impossible, as a result of which the citizen acquires the status of a disabled person.

If a person was not satisfied with the results of the commission, then he has the opportunity by submitting an application to the appropriate higher authority. The statistics of this practice shows that at the highest level, the commission rarely refuses to recognize a citizen as a disabled person.

When this is issued, the infinitely extended sick leave is finally closed on the date preceding the day of the examination, and the verdict of the commission is also entered. All the days on which the patient passed the ITU are not considered absenteeism at work, however, they are not paid.

What to do if the clinic refuses to pass the examination?

For various reasons, health care institutions may refuse to issue a referral to the ITU. However, this does not mean at all that it will not be possible to pass the examination. In this case, it is not so difficult to protect your rights.

The fact is that for a long time, since 2005, the order of the Ministry of Health of the Russian Federation No. 535, deprived doctors of the opportunity to decide whether to give a referral or not. According to him, an employee of a medical institution must accept an application for ITU from a citizen, and then issue a referral. This document is already considered invalid, but this requirement is still relevant.

And if the therapist refuses to accept the application, it is quite possible to apply with a similar requirement, say, to the head physician of the clinic. In extreme cases, the local government has such a body as the Department of Health.

Important! If a citizen applied for a referral to the ITU, and he was refused, then you need to insist and make sure that the doctor of the appropriate authority writes about his refusal in the outpatient card of the patient (which contains summarized data from all studies and observations for many years).

The reason for this is that without a documented fixation of the refusal of a medical worker, it is impossible to appeal his current decision and further attempts to achieve his own at a higher level.

Conclusion

Health is a great value for every person. Recognizing the presence of serious illnesses is a difficult step for any person and a test for his environment.

And that is why citizens of the Russian Federation have the right to apply for specialized medical expertise as many times as they need. Defending your rights and needs for social protection is not only possible, but moreover, it is necessary.

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MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT
RUSSIAN FEDERATION

On approval of the form of referral for medical and social examination by an organization providing medical and preventive care

(as amended on October 28, 2009)

Repealed from December 8, 2018 on the basis of
joint order of the Ministry of Labor of Russia and the Ministry of Health of Russia
dated September 6, 2018 N 578n / 606n
____________________________________________________________________

____________________________________________________________________
Document as amended by:
by order of the Ministry of Health and Social Development of Russia of October 28, 2009 N 853n (Rossiyskaya gazeta, N 232, 04.12.2009) (entered into force on January 1, 2010).
____________________________________________________________________

In accordance with the Decree of the Government of the Russian Federation of February 20, 2006 N 95 "On the procedure and conditions for recognizing a person as disabled" (Collected Legislation of the Russian Federation, 2006, N 9, Art. 1018)

I order:

Approve form N 088 / y-06 "Referral for medical and social examination by an organization providing medical and preventive care" in accordance with the appendix.

Minister
M. Zurabov

Registered
at the Ministry of Justice
Russian Federation
March 12, 2007
registration N 9089

Appendix. Form N 088 / y-06. Referral for medical and social examination by an organization providing medical and preventive care

Appendix
to the order of the Ministry
health care
and social development
Russian Federation
dated January 31, 2007 N 77
(as amended as of January 1, 2010)
by order of the Ministry of Health and Social Development of Russia
dated October 28, 2009 N 853н, -
see previous edition)

Medical documentation

Form N 088/u-06

Revision of the document, taking into account
changes and additions prepared
JSC "Kodeks"

(approved by order of the Ministry of Health of Russia dated May 14, 1997 No. 141)

Form No. 088 / y-97 is filled out for persons sent for the first time to the ITU (including face-to-face consultations) and for disabled people sent for re-examination.

The procedure for filling out the “Referral to ITU” is determined by the Instruction introduced by order of the Ministry of Health of the Russian Federation of December 15, 1999 No. 06-23 / 6-2.

In the line "Date of issue" - indicates the date of issue of the referral to the person sent to the ITU or his legal representative.

In line 1 - the “full name” of the person being sent is indicated in full.

In line 2 - "Date of birth" - day, month and year of birth; "sex" - "m" or "f".

In line 3 - "Address of the patient" - the place of residence according to the passport.

Line 4 - "Disabled ___ group" - indicates the group of disability based on the available ITU certificate, or a dash if the patient is sent for the first time.

Line 5 - "Place of work" - indicates the name of the organization in which the sent person works at the time of filling out the referral. If a citizen does not work, an appropriate entry is made about this.

Line 6 - “Address of the place of work” - indicates the address of the organization in which the person sent on the day of opening the sick leave is working.

Line 7 - "Profession" - indicates the profession that was obtained through special education (engineer, teacher, construction technician) or the one in which there is the longest work experience and (or) the highest qualification.

Line 8 - "Position" - indicates the position in which the patient was occupied on the day the l / n was opened for him

Line 9 - “Under the supervision of a medical institution with ...” indicates the date of the initial filling out of the outpatient card of the patient in the health facility.

In line 10 - "History of the present disease" - during the initial registration of the referral to the ITU, details are given about the onset of the disease (the nature of the injury, injury), the course, the date of exacerbations (indicate the frequency and duration of exacerbations for 12 months preceding the referral of the patient to the ITU, information about the nature of the treatment performed (outpatient or inpatient, indicating the profile of the department), types of treatment (therapeutic, surgical, physiotherapy, etc.) When making a referral for re-examination, line 10 indicates information about the course of the disease for the period elapsed from the date of establishment disability groups.

Line 11 - “Results of the rehabilitation measures taken” - indicates information about the measures to restore the patient's ability to work and their effectiveness, or measures to implement an individual program for the medical rehabilitation of a disabled person when issuing him a referral for re-examination.

In line 12 - “Frequency and duration of temporary disability over the past 12 months” in the column “Numbers from ____ to ____”, the dates of opening and closing l / n are indicated, in the last line or under the line the total number of days of VN is indicated. If the patient does not work, then this section indicates the frequency of requests for medical care in health facilities and the name of the diseases for which the patient applied. In the column "Name of the disease" - on the line corresponding to the date of issue of the l / n, the name of the disease is indicated, for which the patient was recognized as temporarily disabled in the relevant period.

In line 13 - “Name of the profession and working conditions for the last year” - indicates the profession (position) that the patient was performing at the time of issuing him a l / n, as well as the predominant production factor, the severity of physical and neuro-emotional stress, etc. . Information is recorded from the words of the patient, if necessary, requested from the place of work.

In line 14 - "The condition of the patient when referring to the ITU" - when describing the objective status, each specialist describes in detail and consistently the patient's complaints, primarily related to the underlying disease (determining permanent disability), then others; the data of an objective examination of the patient by specialists are reflected with exhaustive completeness (conclusions of a therapist, neurologist, surgeon, oculist, and for women - a gynecologist are required).

In lines 15 - "X-ray studies", 16 - "Laboratory studies", 17 - "Additional research methods" - the results of studies confirming the established diagnosis of the underlying disease, and others that, to one degree or another, may influence the course of the underlying disease, are entered .

In line 18 "Diagnosis when referring to the ITU":

In paragraph 1 - "the main disease" - a detailed diagnosis is indicated in accordance with ICD-10, etiology, course features, stage, degree of functional impairment. When several diseases are combined, the disease that determines disability is indicated as the main one.

Clause 2 - “comorbidities” - indicates those diseases that are not decisive in the assessment of disability;

Clause 3 - "complications" - indicates the complications of the underlying disease.

In line 18.1 - "Violations of the basic functions of the body" (according to the adopted Classification dated 01.29.97 No. 1/30), the patient's violations are indicated in accordance with section 1.2 "Classification of violations of the main functions of the human body."

In line 18.2 - "Signs of disability" (according to the adopted Classification dated 01.29.97 No. 1/30) the patient's OB is indicated in accordance with section 1.5 "Classification of vital functions disorders".

In line 19 - “The basis for referral to the ITU: the presence of signs of disability; the end of the period of disability; early re-examination; the need to extend the l / n (underline) ”- the necessary is underlined. If it is necessary to extend the l / n, it is extended within the period established by clause 2.3. instructions "On the procedure for issuing documents certifying temporary disability".

Responsibility for the correct execution of the "Referral to ITU" lies with the chairman of the KEK. The direction to the ITU is signed by the members of the KEK, the date is indicated, the seal of the medical facility is affixed. The decision of the CEC to send the patient to the ITU is recorded in the card of the outpatient (inpatient) patient and in the account. No. 035 / y - 02 "Journal of accounting for clinical and expert work of health care facilities."

More on the topic The order of filling f. No. 088 / y-97 "Referral for medical and social examination":

1. The procedure for filling f. No. 088 / y-97 "Referral for medical and social examination"

• Form N 088 / y-06.
• Referral for medical and social examination by an organization providing medical and preventive care.

Form n 088 / y-06 referral for medical and social examination by an organization providing medical and preventive care Order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2007 77 (as amended on October 28, 2009) on approval of the form for referral for medical and social examination by an organization providing medical and preventive care medical and preventive care (2017). Relevant in 2017 | The law is simple!