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Accident without disability. Establishing the percentage of loss of general disability

An accident at work sometimes leads to serious consequences for the physical and / or emotional health of the worker, and in some cases, the result can be a complete loss of ability to work. Payment for the medical care necessary for the employee, as well as a set of measures for subsequent rehabilitation, is financed directly by the enterprise.

Injuries that qualify as occupational injuries often occur during:

performance of direct official duties;
finding a staff member on a business trip;
overtime, lunch breaks, on the way to or from work.

The duties of the manager include not only material compensation for all expenses for restoring the health of the victim, but also the payment of the due allowance, and in addition, other stipulated costs, such as compensation for disability. Calculations must be made in accordance with applicable regulations as well as local federal requirements.

Determination of the degree and type of work capacity

Proper execution of the entire package of documents is a guarantee that the employer will avoid serious legal consequences in the future for violating labor laws. An exhaustive list of work-related injuries is contained in Art. 227 of the Labor Code of the Russian Federation.

In case of disability, the following degrees of consequences are distinguished:

temporary;
constant;
partial;
complete.

By definition, working capacity means the totality of all available intellectual, as well as psychophysical properties and abilities of the human body. This means that a citizen is able to perform certain activities to the extent that is expected from a representative of a particular profession.

For this reason, there are three types of readiness to cope with the task:

general degree;
professional level;
special work capacity.

In the first case, we are talking about the ability to cope with any unskilled work, and in the second - to work as a specialist in a particular profession. A special type provides for the presence of special skills and health in order to perform specific tasks in special conditions for the implementation of their duties. The above options for the degree of disability are often calculated as a percentage of the maximum possible level.

Consequences of disability at work

An additional classification, when there is a loss of ability to work at work, provides for the following distinctions on important grounds:

labor production activity;
maintaining a specific degree of working suitability;
the likelihood of full recovery of physical health.

When a persistent or permanent loss of general working capacity and professional at the same time is determined, then this affects the determination of the severity of the harm caused to the injured employee. The correct and objective determination of the degree of loss of working capacity allows you to entrust the specialist with the task with which he is able to cope without damage, as well as negative consequences for his physical well-being.

In addition, a permanent disability, whether permanent or temporary, entails the assignment of a degree of disability. For this reason, the victim may face a number of legal circumstances. These include:

full / partial suspension from production activities;
referral to professional retraining in another specialty;
the appointment of pension or additional security in the form of regular benefits;
accrual of various social benefits designed to maintain a decent quality of life.

Loss of ability to work at work

The loss of temporary disability at work indicates that the condition of the victim will eventually improve or recover to its original level. Occupational diseases are the most common cause of partial incompetence. When the disease acquires a chronic, untreatable character, the employee is completely unfit to cope with official duties, which entails the registration of a disability group.

The complete loss of professional ability to work is associated with strong psychological consequences for the employee of the enterprise. Legal Solutions lawyers are ready to lend a helping hand to ensure adequate protection of the rights of the victim. The interests of the client will be fully respected, and compensation for the damage caused to the emotional and physical health of the citizen will help, at least partially, restore justice.

If you have been injured at work or have an occupational disease, you are entitled to benefits or compensation. Who will receive how much or will not receive at all will be decided by the institution of medical and social expertise under the new rules recently signed by Prime Minister Mikhail Kasyanov.

Who is better to be - sick or healthy?

Conditions are getting tougher

One of my friends once decided to jump from a parachute. As a result, he landed badly and broke both legs. When the private company where he worked found out about the incident, they decided to pay for the operation free of charge. A few months later, he left the hospital and sued the management of the unfortunate company in order to receive compensation for an injury at work. The skydiver lost the case and was also fired from his job. The story is instructive, but that's not the point. Those rules that were before pushed the employee and the employer head-on. The former all the time tried to attribute any bruise to an industrial injury, and the latter refused to recognize people without an arm or leg as disabled. And all because the employer had to pay for treatment and compensation. Now this function is taken over by the Social Insurance Fund.

Another key point: the new rules more clearly spell out in which cases disability is established, and in which it is not. “It used to be like this,” says Elena Andreeva, deputy head of the labor relations department of the Ministry of Labor, “a person, after graduating from a technical school, received, say, a diploma of a plumber. But for the last 10 years he worked in a company, sitting on his home phone. And then he breaks his leg and demands compensation, because he is a mechanic by profession and cannot work. But this has nothing to do with his current occupation: he is quite capable of performing his duties while sitting at home. So now compensation will be paid in relation to the work in which the victim is now.

In normal cases (fracture, sprain, etc.) it is 15% of the salary. If a person cannot work at all, he will receive 100%. If the injury is so serious that now the employee will have to limit their activities, it is realistic to get from 40% to 90%. How much - will be established by the medical and social expertise.

Complain if possible

According to the new rules, it turns out that people who become disabled in the workplace will receive less. Previously, the victim was paid a salary, pension and compensation for the amount of harm. Now it will be only a pension and, if necessary, payment for treatment.

Depending on how badly you have suffered, the Ministry of Labour, the Ministry of Health and the Social Insurance Fund will decide whether you need treatment in a sanatorium, surgery, retraining for a new specialty or not. If it decides what is needed, the Social Insurance Fund will pay.

In addition, another significant change was introduced to the rules: now the victim and the insurer will have equal conditions for appealing their position. That is, before the employee could demand compensation, but the one who should pay it to him could not. Now they can sue each other. By the way, in addition to the court, you will also be heard at the Main Bureau of Medical and Social Expertise and the local department of social protection. The Bureau even set a strict deadline for making a decision - a month from the date of receipt of the application.

And the last thing that many of us now have to put up with. As you know, some people do not have enough one salary and have to earn extra money in several places. So, if a person is injured, then he draws up compensation for himself in all, say, three jobs. On one it turns out 60%, on the other - 40%, on the third another 40%. As a result, it turns out that, having become disabled, he receives more than when he was healthy. Now officials have introduced a restriction: no matter how many jobs the victim has, he should receive no more than 100% compensation in total.

The latest rules in this regard were issued in 1994. How long the new document will last is unknown. Wait and see.

RULES FOR ESTABLISHING THE DEGREE OF LOSS OF PROFESSIONAL WORK CAPABILITY AS A RESULT OF WORKING ACCIDENTS AND OCCUPATIONAL DISEASES

I. General provisions

1. These Rules determine the procedure for establishing by institutions of medical and social expertise the degree of loss of professional ability to work by persons who have received damage to their health as a result of accidents at work and occupational diseases (hereinafter referred to as victims).

2. The degree of loss of professional ability to work is established as a percentage at the time of examination of the victim, based on an assessment of the loss of the ability to carry out professional activities due to an accident at work and an occupational disease, in accordance with the criteria for determining the degree of loss of professional ability to work, approved by the Ministry of Labor and Social Development of the Russian Federation according to agreement with the Ministry of Health of the Russian Federation and the Social Insurance Fund of the Russian Federation.

3. Simultaneously with the establishment of the degree of loss of professional ability to work, the institution of medical and social expertise, if there are grounds, determines the need of the victim for medical, social and professional rehabilitation, and also recognizes the victim as a disabled person.

4. Examination of the victim is carried out in the institution of medical and social expertise at the place of his residence or at the place of attachment to the state or municipal medical and preventive healthcare institution (hereinafter referred to as the healthcare institution).

If, in accordance with the conclusion of the health care institution, the victim cannot come to the medical and social examination institution for health reasons, the examination may be carried out at home or in the hospital where the victim is being treated.

5. The institution of medical and social expertise is obliged to familiarize the victim in an accessible form with these Rules.

6. Citizens who have been injured not in the performance of labor duties, the degree of loss of professional ability to work is established by the institutions of forensic medical examination.

II. Examination of the victims

7. Examination of the victim in the institution of medical and social expertise is carried out on the basis of the request of the employer (insured), the insurer, by decision of the court (judge) or at the independent request of the victim or his representative when submitting an act on an accident at work or an act on an occupational disease.

8. The employer (insured) submits to the institution of medical and social expertise the conclusion of the body of state expertise of working conditions on the nature and working conditions of the victims that preceded the accident at work and occupational disease.

9. The health care institution shall carry out the necessary diagnostic, therapeutic and rehabilitation measures and, based on their results, issue a referral to the victim to the institution of medical and social expertise for examination to determine the degree of loss of professional ability to work. The referral contains data on the state of health of the victim, reflecting the degree of dysfunction of organs and systems, the state of the compensatory capabilities of his body and the results of the therapeutic and rehabilitation measures taken.

In some cases, before revealing signs of permanent loss of professional ability in the victim, the healthcare institution may send him to the institution of medical and social expertise to determine the need for certain types of rehabilitation.

10. If it is necessary to examine using special methods or equipment, obtain additional data, the institution of medical and social expertise sends the victim for additional examination to a medical, rehabilitation or other institution, requests the necessary information, examines the working conditions of the victim, his social and living conditions and accepts other measures.

11. If the victim refuses additional examination, an expert decision on the degree of loss of professional ability to work is made on the basis of the available data, about which a corresponding entry is made in the victim's examination report.

12. On the basis of the documents and information received, the personal examination of the victim, the degree of loss of his professional ability to work is determined, based on the assessment of the professional abilities, psychophysiological capabilities and professionally significant qualities that the victim has, which allow him to continue to perform professional activities that preceded an accident at work and an occupational disease, of the same content and in the same volume, or taking into account the reduction in qualifications, the reduction in the volume of work performed and the severity of labor in ordinary or specially created production conditions.

Under specially created production conditions is understood the organization of work, in which the victim is set a reduced working day, individual production standards, additional breaks in work, appropriate sanitary and hygienic conditions are created, the workplace is equipped with special technical equipment, systematic medical supervision and other measures are carried out.

13. An expert decision on the degree of loss of professional ability to work is made in the presence of the victim by a simple majority of votes of the specialists who conducted the examination.

14. If the victim has experienced a complete loss of professional ability to work due to a pronounced violation of body functions in the presence of absolute contraindications for performing any type of professional activity, even under specially created conditions, the degree of loss of professional ability to work is 100 percent.

15. In the event that the victim, due to a pronounced violation of the functions of the body, can perform work only in specially created conditions, the degree of loss of professional ability to work is established from 70 to 90 percent.

16. If the victim, as a result of an accident at work and an occupational disease, can continue professional activities under normal working conditions with a pronounced decrease in qualifications or with a decrease in the volume of work performed, or if he has lost the ability to continue professional activities due to a moderate impairment of bodily functions, but can in normal under production conditions to perform professional activities of lower qualification, the degree of loss of professional ability to work is established from 40 to 60 percent.

17. If the victim can continue his professional activity with a moderate or slight decrease in qualifications, or with a decrease in the amount of work performed, or if working conditions change that lead to a decrease in earnings, or if the performance of his professional activity requires more stress than before, the degree of loss is established. professional capacity for work from 10 to 30 percent.

18. The degree of loss of professional ability to work in case of repeated accidents at work and occupational diseases is determined at the time of examination for each of them separately, regardless of whether they occurred during the period of work for one employer or different employers, taking into account the professional knowledge and skills of the victim and generally cannot exceed 100 percent.

19. When re-examining the victim after carrying out rehabilitation measures, specialists of the institution of medical and social expertise, when establishing the degree of loss of professional ability to work, take into account damage to health due to an accident at work and occupational disease, the ability to perform work in a profession obtained as a result of training or retraining, the ability of the victim to perform professional activity preceding an accident at work and an occupational disease, taking into account his professional knowledge and skills.

In case of evasion (refusal) of the victim from the implementation of the recommended rehabilitation measures, the issue of the degree of loss of professional ability to work is considered taking into account the ability to perform any labor activity.

20. When determining the degree of loss of professional capacity for work of the victim, the need of the victim for medical, social and professional rehabilitation is determined.

21. The conclusion of the institution of medical and social expertise on the need for medical, social and professional rehabilitation is drawn up taking into account the potential capabilities and abilities of the victim to carry out professional, domestic and social activities and is drawn up in the form of a rehabilitation program for the victim as a result of an accident at work and an occupational disease.

The rehabilitation program of the victim determines the specific types, forms, volumes of necessary rehabilitation measures and the timing of their implementation.

The rehabilitation program for the victim is drawn up within one month after the adoption of an expert decision in the form approved by the Ministry of Labor and Social Development of the Russian Federation in agreement with the Ministry of Health of the Russian Federation and the Social Insurance Fund of the Russian Federation.

22. The data of the examination of the victim and the expert decision are recorded in the minutes of the meeting and the act of examination of the victim, which are signed by the head of the institution of medical and social expertise, the specialists who conducted the examination, certified by the seal of this institution and stored with all medical documents for 10 years in the specified institution.

23. The results of the examination are announced to the victim in a form accessible to him by the head of the medical and social examination institution in the presence of the specialists who made the expert decision. The specialists who made the expert decision give explanations to the victim or his representative.

24. A certificate from the institution of medical and social expertise on the results of establishing the degree of loss of professional ability to work, and, if necessary, a rehabilitation program are issued to the victim against receipt.

25. An extract from the examination report indicating the results of establishing the degree of loss of professional ability to work and the rehabilitation program of the victim within 3 days after their execution are sent to the employer (insured) or insurer, and are also issued to the victim if the examination was carried out at his request.

III. Re-examination of victims

26. Re-examination of the victim is carried out in the manner prescribed for determining the degree of loss of professional ability to work as a result of accidents at work and occupational diseases.

27. The term for re-examination of the victim in determining the degree of loss of professional ability to work is set after six months, one year or two years based on an assessment of the health status of the victim and a forecast for the development of his compensatory and adaptive capabilities.

The degree of loss of professional capacity for work of the victim is established indefinitely in the event of irreversible consequences of damage to health due to an accident at work and an occupational disease with a persistent impairment of professional abilities and opportunities to perform production activities.

28. If the victim misses the deadline for the next re-examination, the degree of loss of professional capacity for work for the missed period is established if there is a referral from the employer (insured), insurer, or a court (judge) order.

29. Re-examination of the victim earlier than the deadlines specified in paragraph 27 of these Rules is carried out in the event of: a change in the state of health of the victim in the presence of a referral from a healthcare institution or a personal appeal of the victim or his representative to the institution of medical and social examination and medical documents confirming this change; revealing the facts of an unreasonably issued decision (including on false documents) or appealing the decision of the institution of medical and social expertise in the prescribed manner by the injured, employer (insured person), insurer.

30. The institution of medical and social expertise conducts an examination in the order of dynamic monitoring of the implementation of rehabilitation measures to assess their effectiveness within the time limits established by the program for the rehabilitation of the victim.

IV. Appeal against the decision of the institution of medical and social expertise

31. The victim, his representative, employer (insured) or insurer, in case of disagreement with the decision of the institution of medical and social expertise, may appeal against it by submitting a written application to the institution that conducted the examination of the victim, or to the main bureau of medical and social expertise, or to the body of social protection of the population of the subject of the Russian Federation.

The Bureau of Medical and Social Expertise, which conducted the examination of the victim, within 3 days from the date of receipt of the application, sends this application with all documents to the main bureau of medical and social expertise.

32. The Main Bureau of Medical and Social Expertise, within a month from the date of receipt of the application, conducts a re-examination of the victim and, based on the results, makes a decision.

The decision of the main bureau of medical and social expertise may be appealed within one month to the social protection authority of the population of a constituent entity of the Russian Federation, which may entrust the re-examination of the victim to another staff of specialists of the required profile of the specified institution.

33. The decision of the institution of medical and social expertise may be appealed to the court in accordance with the procedure established by the legislation of the Russian Federation.

DECISION OF THE GOVERNMENT OF THE RUSSIAN FEDERATION N 789 of October 16, 2000 ON THE APPROVAL OF THE RULES FOR ESTABLISHING THE DEGREE OF LOSS OF PROFESSIONAL WORK CAPACITY DUE TO OCCUPATIONAL ACCIDENTS AND OCCUPATIONAL DISEASES

In accordance with the Federal Law "On Compulsory Social Insurance against Occupational Accidents and Occupational Diseases" (Collected Legislation of the Russian Federation, 1998, N 31, Article 3803), the Government of the Russian Federation decides:

1. To approve the attached Rules for establishing the degree of loss of professional ability to work as a result of accidents at work and occupational diseases.

2. The Ministry of Labor and Social Development of the Russian Federation, in agreement with the Ministry of Health of the Russian Federation and the Social Insurance Fund of the Russian Federation, approve:

criteria for determining the degree of loss of professional ability to work as a result of accidents at work and occupational diseases;

a form of rehabilitation program for victims of industrial accidents and occupational diseases.

3. The Ministry of Labor and Social Development of the Russian Federation and the Ministry of Health of the Russian Federation provide the necessary explanations on issues related to the application of the Rules approved by this resolution.

4. To recognize as invalid the Decree of the Government of the Russian Federation of April 23, 1994 N 392 "On approval of the Regulations on the procedure for establishing by medical and labor expert commissions the degree of loss of professional ability to work as a percentage of workers who have been injured, an occupational disease or other damage to health associated with the performance their labor duties" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 1994, N 2, art. 101).

Chairman of the Government of the Russian Federation M. KASYANOV

Employability is the ability of a citizen to perform professional duties of proper quality and volume. Termination of activity due to illness or accident is called the loss of ability to work.

Disability

A citizen cannot work due to a health disorder. Such impossibility is defined as disability. Lead to this:

Acquired acute and chronic diseases;
congenital anomalies;
Pathologies as a result of traumatism;
Occupational morbidity.

There are the following types of disability:

General and professional - depends on the type of employment;
Temporary and permanent - from the duration of the disease;
Partial or complete - from the severity of violations.

Persistent or permanent

The state of the body, in which there is a long-term disorder of functions, the impossibility of a complete recovery is called permanent disability. This concept is equated to the term disability.

The reasons for permanent loss are:

Chronic pathology;
Congenital anomalies and hereditary diseases;
Consequences of injuries, accidents and poisoning associated with production.

With an unfavorable prognosis of professional activity and health, they give a referral from the clinic where the patient is being served to a meeting of the territorial bureau of medical and social expertise (ITU) for examination.

Do you have any work restrictions?

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Yes, but I continue to work 18%, 3 vote

05.12.2018

Temporary

The state when a violation of the functions of the body as a result of illness or injury does not allow you to start work in a relatively short period is a temporary disability. Under the influence of medical measures is reversible. Sick leave is issued temporarily for the period of treatment. It is needed for:

Official confirmation of the absence of the employee.
Securing payments.
Analysis of the causes and terms of disability at the medical site, in the organization.

Partial

Completely or partially lost functions of the body are observed during disability with a temporary or permanent nature.

The victim is unable to perform job duties for a relatively short time. But due to the severity of the disease, he is not exempt from work, but is transferred to easier work within the organization. This is a partial disability.

“The sister of the treatment room suffered damage to the tendon of the thumb of the left hand. For 21 days she cannot go for procedures, but her state of health allows her to see her at the clinic. After a full recovery, the specialist will be transferred to his previous position.

With a persistent partial loss, the employee is not able to work as usual. Therefore, on the recommendation of the medical commission, the employer reduces qualifications or changes working conditions, reducing the tension and length of the day.

“In connection with the amputation of the finger on the machine, the locksmith was assigned a disability group. The victim is unable to perform professional duties due to the injury. But a worker can do lighter work in the same factory.”

Such a change of activity leads to dequalification and a decrease in earnings, but has a favorable labor outcome.

Complete

This type implies the impossibility of performing any work.

With a complete temporary loss, a positive outcome of the disease is observed. The patient is given a bulletin until the final recovery, then the employee begins his professional duties.

“The organization's accountant is hospitalized with acute appendicitis for emergency surgical treatment. The specialist completely loses the ability to work, but for a short period of time - 10 days. The patient is given a bulletin, and after recovery, she proceeds to the previous type of activity.

Complete permanent loss, on the contrary, has a poor prognosis in terms of treatment and work. In such cases, a disability group with a contraindication to work is established.

“The patient has a neoplasm of the pancreas, for which he receives appropriate therapy. The impossibility of a cure is the reason for referral to the ITU for examination for a group. The severity of the condition is a contraindication to any work.

Labor restrictions

The main categories of human life activity are defined in the normative acts on the purpose of disability. In addition to labor, there are 6 more categories:

Self care;
Movement without assistance;
Orientation in space and time;
Communication with others and strangers;
Controlling your behavior
Learning skill.

Each of them, after causing harm to health, has limitations to varying degrees. With a particular disease, there are violations only in one or several areas at once.

“In a patient suffering from a mental illness, changes are observed in almost all categories, with the exception of independent movement. The following issues are logged:

Cannot take care of himself;
Not oriented in space and time;
Difficulties in communicating with family and others;
Cannot control actions, conversation, movements;
Due to a decrease in intelligence, he does not learn;
Unable to perform simple activities.

Depending on the severity of violations, the categories have 3 degrees.

Easy - there are restrictions on the main profession. But with a change in qualifications, volumes, complexity, it is possible to continue the work experience.

Medium - there is a permit to work with the help of unauthorized persons and with the use of assistive devices.

Extreme severity - a citizen is not able to perform the simplest work or it is forbidden to work, because there are contraindications due to significant changes in health.

In the conclusion of the ITU, the group of disability, established contraindications, conditions for working activity are indicated. Disability groups have different restrictions.

“The patient was assigned a group with 1 degree of restriction to work. This means that it is allowed to work, but it is necessary to change the working conditions or tension.”

General

Under the general working capacity is understood the performance of simple work that does not require special qualifications. Violation of the state of health due to a pathological process, due to which a person cannot go to work and perform official duties, is called permanent disability.

The conclusion on this type of loss is given by the doctors of the Bureau of Forensic Medical Examination. In the course of expert actions, the state of the victim is established and the relationship with the incident is revealed. Conducted to evaluate and determine:

Consequences of traffic accidents;
The level of damage in case of industrial injury;
Harm when attacked;
Unintentional actions of medical staff and other persons.

Examination by experts is appointed only at the request of the court.

How is the degree of disability determined?

The degree of loss of professional ability to work is set as a percentage. This type of loss is recorded when an employee of a certain specialty, after an occupational disease or injury at the enterprise, is not able to continue to perform professional duties.

The function of determining the degree belongs to the ITU regional bureaus on the basis of the legislative acts of the Russian Federation.

In cases of temporary disability, the assessment of the degree is carried out on a commission in a medical institution. The composition includes:

Deputy Head for Clinical and Expert Work - Chairman of the Commission;
Heads of departments;
Doctors are specialists.

Registration of incapacity for work

An official document confirming the temporary fact of the inability to work is a sick leave. The responsibility for registration lies with the attending physician of the medical institution where the patient is observed. The doctor alone issues a document for half a month. If necessary, the bulletin is extended for a meeting of the medical commission, where the patient is sent.

Depending on the severity of the disease, a citizen is on sick leave for up to 10 months, with certain pathologies up to a year.

According to the conclusion of the chairman of the commission, a patient with persistent health disorders, a negative prognosis in the clinical and labor aspects, is sent for examination to the ITU bureau.

At the examination, a citizen is assigned a disability, and depending on the degree of severity of disability, a group is determined.

Required documents

The patient for the meeting of the commission at the ITU must arrive at the appointed time and have on hand:

Passport or other proof of identity, original and copy.
Extract from the medical history, registration form No. 027 / y. Issued in a medical institution at the place of observation.
Referral to the ITU by a medical organization providing medical and preventive care, registration form No. 088 / y-06.
Hospital sheet.
For working citizens, a copy of the work book, certified by the personnel department at the place of work.
Card of a patient receiving medical care on an outpatient basis, registration form No. 025 / y.
Help with information about working conditions.
If a citizen is sent for re-examination, then a copy of the previous ITU conclusion.
Certificate of pension insurance, copy and original.

Competent authorities

Registration of temporary loss is the responsibility of a medical institution that has a license to operate and an examination of disability. To extend sick leave, a meeting of the medical commission is held.

A permanent loss is registered by the regional bureaus of medical and social expertise at the place of residence of the patient. To challenge the decision to award a disability and a group, citizens should contact the ITU Main Bureau for the subject or the Federal Authority for Russia.

In litigation and assessment of general disability, documents are submitted to the territorial department of the Bureau of Forensic Medical Examination at the place of stay.

Percentage of incapacity for work

The assessment of the loss of general and professional ability to work is carried out according to special tables as a percentage of the initial level of ability to work. The examination is carried out by specialists of the Bureau of Medical and Social and Forensic Medical Examination.

A complete loss is 100% and is recorded with persistent functional impairment.

The interval from 70 to 90% corresponds to significant disability. In these cases, it remains possible to perform work only in special conditions.

If the victim works under normal conditions, but with a decrease in his qualifications or tension, this is an insignificant degree of violation, equal to a decrease in working capacity from 40 to 60%.

From 10 to 30% - the minimum decrease in working capacity. The victim continues to work at the same place, but with a reduction in working hours.

Payments and benefits

Depending on the type of disability, a citizen has social security.

According to the sick leave, the average salary at the place of employment is paid. The position is retained for the patient.

Disability registration entitles you to the following benefits:

Getting free qualified medical care.
Free rehabilitation.
Discounted drug coverage.
Compensation for housing and utility bills in the amount of 50%.
Job security.
Annual paid vacation.
Reduced working hours for disabled people of the first and second groups.
Additional payments to Chernobyl victims - Chernobyl liquidators.
Payment of pensions, allowances, sums insured.

Conclusion

If a person has a case of incapacity for work, then, depending on the type and degree of disorders of the body's functions, the state guarantees free medical care, rehabilitation and special benefits.

Establishing the percentage of loss of general ability to work is one of the types of forensic medical examination designed to assess the damage done to a person’s health, as a result of which he loses the ability to work, providing himself with a livelihood. This type of research is used in the process of legal proceedings in cases related to situations dangerous to human life and health. This examination is one of the most demanded, as its results are relied upon when sentencing the guilty party and assigning compensation and cash payments.

The percentage of loss of general working capacity is established in the following cases:

To assess the consequences of road incidents and disasters, as well as other traffic accidents.
To determine the level of damage received as a result of an industrial injury, as well as as a result of man-made disasters at work.
To establish the severity of injuries inflicted during an attack and attempted murder.
To establish the severity of harm caused to human health through the fault of a medical worker or other officials.

The harm caused to health is measured as a percentage of the conditional indicator of general ability to work. In general, a distinction is made between general, professional and special work capacity. The general ability to work is understood as the performance of simple operations that do not require special qualifications, that is, such operations, the implementation of which may be hampered by an injury that has consequences. Professional performance means the ability of a given person to carry out qualified activities in some profession - for example, work as an economist. Special performance means the qualification of a person to work in a particular specialty. For example, the profession of "economist" includes a whole set of specialties - economic analysts, banking specialists, financiers, accountants, and so on.

There is also a distinction between temporary and permanent disability. Temporary disability occurs as a result of diseases and injuries that can be cured - for example, uncomplicated limb fractures, soft tissue injuries, minor injuries, and so on. Permanent disability occurs if the injuries and injuries (or their consequences) are not subject to complete recovery. For example, amputations of limbs or a decrease in intelligence and impaired coordination resulting from a traumatic brain injury. The percentage of loss of general ability to work is measured relative to the persistent consequences of the injuries received.

To calculate this indicator, the forensic medical examination relies on a normative document, namely, a table of percentages of permanent loss of general ability to work. This table is an appendix to the Order of the Ministry of Health and Social Development, which approves the criteria for determining the size and severity of harm to human health.

According to the above table, the specialist who establishes the percentage of loss of general ability to work determines the harm caused to human health and identifies the corresponding percentage of loss. The table contains the most common consequences of injuries, poisoning and other external influences, for which the corresponding values of disability are indicated, expressed as a percentage.

Functional disorders of human organs are classified in the table according to the systemic principle. It highlights the following areas where the consequences of an incident may be observed:

Central nervous system and peripheral nervous system.
Digestive organs.
organs of vision.
Respiratory system.
Hearing organs.
The cardiovascular system.
Urogenital system.
Soft fabrics.
The musculoskeletal system.

According to the notes indicated in the table, in the event of a violation of the function of two or more organs of the same system, the percentage of total disability is determined according to one of the criteria that reflects the most pronounced damage. In case of damage to several body systems, the percentage of disability is added, however, the total indicator should not exceed 100 percent. In the table, the percentages for each case are displayed in increments of five units. The most severe (from seventy to one hundred percent) consequences of injuries, poisoning and other effects include the following:

Paralysis, severe dementia, epileptic seizures recurring at least once a week, aphasia, apraxia, agnosia ataxia, severe cerebellar and vestibular disorders - 100%.
A pronounced decrease in strength and range of motion in the limbs, a significant impairment of the ability to coordinate, a strong decrease in intellectual abilities - 75%.
Severe disorders of movement and sensitivity in both legs, a significant violation of the functions of the pelvic organs, pronounced bedsores and trophic ulcers - 100%.
Trophic ulcers, lack of sensitivity and movements in the joints of the legs - 70%.
Loss of both seeing eyes - 100%.
Absence of a nose, entailing a change in the face of the victim - 70%
Congestion in the lung (or in both parts of the lung), cirrhosis of the liver, ascites, respiratory rhythm disturbance, effusion in the pericardial cavity and / or pleura - 90%.
Obstruction of the pharynx as a result of poisoning with caustic poisons, wounds or burns - 90%.
Absolute immobility of the spine, sharp deformation of the spine - 70%.
Absence of the upper limb - 80% (for the right hand) and 75% (for the left).
Absence of a leg or stump at the level of the upper third of the thigh - 70%.
Absence of the jaw - 80%.
Complete lack of language - 70%.
Resection of the stomach to compensate for the consequences of trauma - 80%.
Absence of the forearm - 70% (65% for the left hand).

The table also displays violations of the functioning of the systems and organs of the body, as well as the consequences of injuries that cause a slight loss of the opportunity to carry out their professional activities. The mildest functional disorders that cause a low percentage of loss of general ability to work (from five to ten percent) include:

Cicatricial trichiasis, keratitis, conjunctivitis, inversion of the eyelid of one eye, not causing vision loss - 5%.
The same for two eyes - 10%.
Removal of an eyeball that did not have vision - 5%.
Decreased visual acuity by one tenth - 5%.
The presence of rough scars on the tongue, which are the result of injury, frostbite or burns that make it difficult to eat - 5%.
Scars on the body (including the scalp), occupying from 2% to 4% of the body surface - 10%.
Absence of the nail phalanx - 10%.
Absence of the big toe - 10%.
Moderate peripheral damage to the hypoglossal, facial or trigeminal nerve, which caused a violation of their function - 5%.
Violation of reflexes and / or sensitivity as a result of damage to the lumbar and / or sacral plexus and its nerves (without movement disorder, paresis, atrophy, contractures) - 5%.
Non-concentric narrowing of vision in one eye - 5-10%.
Partial ptosis (drooping of the upper eyelid) of one eye - 10%.
Purulent inflammation of one ear - 5%. Inflammation of both ears - 10%.

Persistent loss of general ability to work is one of the criteria for determining the severity of harm caused to the health of the victim. However, persistent disability deprives the victim of the opportunity to earn - partially or completely. As a result, determining the percentage of disability may be the reason for the appointment of an independent examination.

The basis for conducting an examination to establish the percentage of loss of general ability to work may also be the infliction of harm to the health of the victim through the fault of a medical worker, as well as other officials responsible for the safety of the people entrusted to them.

Examination to establish the percentage of loss of general ability to work is carried out only by court order. When carrying out expert measures, the specialist takes into account all the materials of the case. The presence of any chronic diseases is not taken into account when determining the percentage of loss of general ability to work that occurred as a result of an incident, attack, accident or catastrophe.

If the injuries were inflicted on a minor who did not have an income at the time of the injury, the court may recover from the perpetrator only compensation for the costs of caring for the victim, his treatment and prosthetics (if any), to provide the victim with enhanced nutrition. The court may also secure for the victim the right to compensation for losses incurred due to disability upon reaching the age of sixteen by the plaintiff.

When establishing the percentage of loss of general working capacity for disabled people, the loss is assessed as for a practically healthy person, regardless of the disability group.

What documents should be provided to the expert to determine the percentage of loss of general ability to work

Document proving the identity of the initiator of the examination.
Court ruling.
All available medical documents, including the certificate of examination of the Medical and Social Expert Commission.
Act on an accident at work or an act of investigation of an accident. To determine the percentage of loss of general ability to work as a result of a road accident - a certificate from the traffic police.
If necessary, the results of other examinations.

The legal framework governing the process of establishing the percentage of loss of general ability to work

Order No. 194n of the Ministry of Health and Social Development of the Russian Federation of April 24, 2008 "On the approval of the Medical criteria for establishing the severity of harm caused to human health."
Appendix to this order - "Table of percentages of permanent loss of general ability to work resulting from poisoning, injuries and other effects on the human body."

Questions answered by a specialist in the process of establishing the percentage of loss of general ability to work

What is the total percentage of loss of general ability to work?
What percentage of the loss of general ability to work corresponds to this functional disorder?
What is the percentage of total disability caused by this particular incident?
What is the highest percentage of disability among functional disorders of the organs of one system of the body?
What functional systems were disrupted?
What disorders or injuries were taken into account when determining the percentage of loss of general ability to work?

Cost and terms

Forensic examination

Judicial examination is carried out according to the decision of the court. In order to appoint an examination to our organization, it is necessary to submit an application for the appointment of an examination and attach an information letter to it indicating the details of the organization, the possibility of performing an examination on the issues raised, the cost and duration of the study, as well as the candidates for experts, indicating their education and work experience. This letter must be certified by the seal of the organization and the signature of its head.
Our specialists prepare an information letter within one working day, after which we send a scanned copy of it by e-mail. Also, if necessary, the original letter can be picked up at the office of our organization. As a rule, the court does not require the original information letter, it is enough to present a copy of it.
Information letter writing service is provided for free.
Out-of-court research

Out-of-court research is carried out on the basis of an agreement for 100% prepayment. The contract can be concluded both with a legal entity and with an individual. To conclude an agreement, it is not necessary to be present at the office of our organization, in this case, the transfer of all documents, including an expert opinion, will be carried out using the services of postal operators (Dimex, DHL, PonyExpress), which will take no more than 2-4 business days.
Reviewing the expert opinion

A review is necessary in cases where it is necessary to challenge the conclusions of the examination, in order to then re-examine. The conditions for concluding a contract for peer review are exactly the same as for an extrajudicial study.
Obtaining written expert advice (reference)

The certificate is not a conclusion, it is informational in nature and contains answers to questions that do not require a full study, but allow you to assess the feasibility of a full-fledged examination.
The conditions for concluding a contract for a certificate are exactly the same as for an extrajudicial investigation.
Obtaining preliminary expert advice

Our specialists are ready to answer any of your questions regarding the conduct of forensic and out-of-court examinations, assess the feasibility of conducting an examination, assist in formulating questions for a study, inform you about the possibility of conducting a particular analysis, and much more.
The consultation is carried out on the basis of a written request.
To do this, you must fill out an online application form (or send us a request by e-mail), where you should describe the circumstances of the case in as much detail as possible, formulate the goals that you want to achieve with the help of an examination, preliminary questions, if possible, attach all possible documents and descriptions of objects.
The more detailed you are about the circumstances of the case, the more productive the help of an expert will be.
Additional services

Reducing the time for the production of expertise by half

30% to the cost

Departure of an expert within the city of Moscow to inspect objects, take samples for research, participate in a court session or other events requiring the presence of an expert

Departure of an expert within the Moscow region

Departure of an expert to other regions of Russia

Transport and travel expenses

Preparation of an additional copy of the expert opinion

Legal advice on issues not related to the conduct and appointment of examinations

from 5 000 rub.

Drafting a claim

Experts

Expert psychiatrist

She graduated from the Russian State Medical University with a degree in Pediatrics. She was a member of the student scientific society in psychiatry. In November 2011, she passed certification at the Central Attestation Commission under the Moscow Department of Health (at the Department of Psychiatry, Narcology and Psychotherapy of the FPDO MSUMD) with the assignment of the first qualification category in psychiatry. In 2012, the second qualification category in psychiatry was assigned. In 2013, she attended refresher courses in psychiatry at the Department of Social and Forensic Psychiatry of the First Moscow State Medical University. I. M. Sechenov and advanced training courses in psychotherapy at the Department of Psychiatry, Narcology and Psychotherapy of the FPDO MGMSU.

Expert psychiatrist, full member of the Professional Psychotherapeutic League, member of the Board and Academic Secretary of the Russian Psychoanalytic Society

She graduated from residency in psychiatry at the Moscow Research Institute of Psychiatry of the Ministry of Health of the Russian Federation. During her postgraduate studies at the Moscow Research Institute of Psychiatry of the Ministry of Health of the Russian Federation, she worked on the problem of the occurrence of cognitive-behavioral disorders with prolonged use of benzodiazepine tranquilizers and cyclodol in patients with schizophrenia. Passed advanced training in the specialty: psychoanalytic psychiatry at the State Scientific Center for Social and Forensic Psychiatry. V.P. Serbian; specializing in psychotherapy at the Russian State Medical University. N.I. Pirogov of the Ministry of Health and Social Development of the Russian Federation. She studied at Moscow State University. M.V. Lomonosov under the program "Psychological counseling and psychodiagnostics of personality"; at the Moscow Institute of Economics, Politics and Law under the program "Modern psychoanalysis, psychoanalytic psychotherapy, psychoanalytic counseling". Conducts professional activities in the field of personality psychodiagnostics, psychological counseling and psychoanalytic psychotherapy, scientific activities in the framework of seminars and conferences in the field of modern psychoanalysis.

The need of victims for medical and social assistance, medical rehabilitation and other types of assistance is established for a certain period, including for persons of retirement age

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For the victim at work, who first applied to the MSEC, the percentage of loss of professional ability to work is established from the date the documents are received by the MSEC, regardless of the date the fact of the occurrence of an occupational disease or labor injury was established.

The disability group for the victim due to an industrial injury or occupational disease is established indefinitely in the cases provided for by the Instruction on the establishment of disability groups.

The degree of loss of professional ability to work for the victim as a percentage is established indefinitely, regardless of age in the case of:

- anatomical defects, persistent irreversible morphological changes and disorders of the functions of organs and systems of the body,
— inefficiency of rehabilitation measures,
— an unfavorable prognosis for the restoration of working capacity due to an accident at work or an occupational disease with a persistent impairment of professional abilities.

The need of victims for medical and social assistance, including treatment, medical rehabilitation, provision of medicines and medical products, bed and underwear, bedding, hygiene products, wigs, spa treatment, technical and other means of rehabilitation (prostheses , orthoses, orthopedic shoes, sticks, crutches, wheelchairs, anti-decubitus mattresses and pillows, etc.), glasses, ocular prosthetics, contact lenses, dental prosthetics, special medical care, permanent outside care, household services, hearing aids, additional nutrition, and other types of assistance is established for a certain period, including for persons of retirement age.

When determining the degree of loss of professional capacity for work of the victim, the need for medical, social and professional rehabilitation is determined in percentage terms.
The decision of the MSEC on the need for the victim in medical, social and vocational rehabilitation is taken taking into account the rehabilitation potential and prognosis, the potential and abilities of the victim to carry out professional, domestic and social activities and is drawn up in the form of drawing up an individual rehabilitation program (hereinafter - IPR) as a result of an accident on production or occupational disease. The IRP defines the specific types, forms, volumes of necessary rehabilitation measures and the timing of their implementation, which cannot be less than those determined by the State Standard Program for the Rehabilitation of the Disabled.

Control over the implementation of the IPR is carried out by MSEK together with representatives of the Industrial Accident Insurance Fund.

Determination of the degree of loss of professional ability to work in percent

Determination of the degree of loss of professional ability to work as a percentage is carried out in accordance with the principles indicated above.

With a complete loss of the ability of the victim at work to self-service and the need for constant outside care or assistance ( I-A or I-B disability group) are set 85 - 100 percent loss of professional ability to work.

With severe violations of the functions of the body, leading to a significant limitation of life while maintaining the ability to self-service, and the absence of the need for constant outside care or assistance ( II group of disability) and the possibility of performing professional activities only in specially created production conditions, the degree of loss of professional ability to work is set within 65 - 80 percent.

With moderately severe violations of body functions ( III disability group), if the victim can, under normal production conditions, perform professional work with a pronounced decrease in qualifications or with a decrease in the volume of work performed, or if he has lost the ability to continue professional activities due to moderate impairment of bodily functions, but can, under normal production conditions, continue professional activities of a lower qualification, degree loss of professional ability to work is set within 30 - 60 percent.

If disability is not established for the victim at work, if he can, under normal production conditions, perform professional work with a moderate or slight decrease in the complexity of work, or with a decrease in the volume of work performed, or when working conditions change, leading to a decrease in earnings, or if the performance of his professional activity requires a greater workload than before, the percentage of loss of professional ability to work should not exceed 25 percent, and with a combination of several injuries or occupational diseases - 40 percent.

The terms for the repeated medical and social examination of the MSEC of the victims and the procedure for appealing their decisions are determined in accordance with the Regulations on the procedure, conditions and criteria for establishing disability.

Tatyana 11/14/2015

established for her husband 3gr. indefinitely due to injury. And the percentage of disability is 60 for only 2 years. Please answer our question. Will disability be established indefinitely or is it necessary to undergo an examination every 2 years, if indefinitely, what is needed for this. Sorry to bother you, but we can't find the answer anywhere.

Glushenkova Nadezhda 16.07.2013

I, Glushenkova Nadezhda, have been disabled of the 1st group by production since 1971 from Kazakhstan. I have no two legs and my right arm. At the moment I live in Russia, Omsk region, district of Poltavka, street 1, Vostochnaya 4. I also need a wheelchair. But how did I apply to our social security, so that I would be allocated a wheelchair and sent for protization.

Establishing the percentage of loss of general disability

But I'm being sent to kamisia to do PRP. As they explained to me, I would refuse to make a tram, but they will do it due to illness. Explain, please, can it be so.

Forensic medical experts need to establish the degree of permanent loss of general ability to work when qualifying the severity of bodily injury, when its severity is determined not by danger to life, but by the outcome of the injury, since the size of permanent disability is a criterion for its severity.

In addition, the need to determine the permanent loss of general and professional disability arises when the question is raised of material compensation for harm to health caused by damage due to domestic or transport injuries, as well as in civil claims against parents for the maintenance of children, against children from sick or disabled parents, in divorce cases, etc.

Working capacity is generally understood as a set of physical and spiritual capabilities of a person, depending on the state of health and allowing him to engage in labor activity.

Distinguish between general, professional and special work capacity.

General capacity for work is called the ability of a person to unskilled work.

Professional ability to work - the ability of a person to work in a particular profession.

Special ability to work means that a person can work in a certain specialty (for example, not just a builder, but a builder-installer, not just a doctor, but a surgeon or radiologist, etc.).

In accordance with the current criminal, civil and labor legislation, compensation for harm caused by damage to health is carried out by compensating for losses incurred by the victim in connection with the loss or decrease in wages.

Legislative base of the Russian Federation

The amount of losses, in turn, depends on the degree of disability of the subject affected by the damage.

"Instruction on the production of a forensic medical examination in the USSR" (1978) requires that examinations of the determination of permanent disability be carried out only by a commission. The commissions working under the Bureau of Forensic Medical Examination consist of a forensic medical expert and experienced doctors (surgeons, therapists, neuropathologists, etc.). The task of these commissions is to resolve issues about the presence of permanent disability and its degree, establishing a causal relationship between injury and the degree of disability, the need for spa treatment, additional nutrition, outside care, prosthetics, etc.

Examinations of establishing a permanent loss of general and professional disability are carried out by court order.

As a result of disability, disability develops, which can be either persistent (i.e., permanent) or temporary (i.e., such that after a certain period of time the health of the victim and his ability to work are restored).

The determination of temporary disability is carried out by the attending physicians of hospitals and polyclinics and medical control commissions (VKK) of medical institutions. They issue a sick or injured person with a certificate of temporary disability or a certificate, after which the person returns to his previous job. Permanent disability and its size (the degree and nature of disability) are determined, in addition to forensic medical experts, as well as medical labor commissions (VTEC). The task of the VTEK is to determine the permanent disability that occurred as a result of diseases or injuries received in connection with production activities.

In addition to differences in the reasons for determining the permanent disability of VTEK and in forensic medical examination, there is a difference in the principles for assessing the amount of disability: VTEK evaluates it in relation to three disability groups and as a percentage, while forensic medical experts, based on requirements of the courts, determine the size of permanent disability only as a percentage in relation to full capacity for work, which is taken as 100%.

To determine the amount of permanent loss of general ability to work, use the table developed by the Main Directorate of State Insurance of the Ministry of Finance of the USSR dated May 12, 1974 No. 110 “On the procedure for organizing and conducting a medical insurance examination”).

The amount of permanent loss of professional ability to work is set individually, taking into account the state of health, the characteristics of the profession, etc., since for different people approximately the same damage can have different outcomes. In addition, the compensatory and adaptive capabilities of different people are also not the same, which depends on age, education, professional skills, time elapsed since the injury, etc.

When determining the amount of permanent loss of professional ability to work, the recommendations of the Ministry of Social Security of the RSFSR for VTEK on the procedure for determining professional ability to work are taken into account.

Forensic medical expert commissions determine the amount of permanent disability after a thorough examination of the victim and the study of his medical documents (in the original) and the circumstances of the case. Such an examination of the victim is carried out only after the outcome of the damage has been determined.

The Rules for the Forensic Medical Determination of the Severity of Bodily Injuries stipulate that in disabled persons, permanent disability due to an injury is determined as in practically healthy people, regardless of disability and its group. In children, permanent disability is established according to the same rules.

Lecture Search

The procedure for determining the degree of loss of professional ability to work

The degree of loss of professional ability to work is determined by a specially authorized body- State Service of Medical and Social Expertise. ITU institutions operate in the system of social protection bodies of the population of the Russian Federation (Article 8 of the Federal Law of November 24, 1995 No. 181-FZ “On the Social Protection of Disabled Persons in the Russian Federation”).

The degree of loss of professional ability to work as a result of accidents at work and occupational diseases is determined according to the rules approved by the Decree of the Government of the Russian Federation of October 16, 2000 No. 789.

According to these rules, the victim is sent for examination to the ITU institutions after the medical institution has carried out a complex of medical, diagnostic and rehabilitation procedures and their results allow us to draw a preliminary conclusion about a permanent loss of professional ability to work. Information about the condition of the victim, reflecting the degree of dysfunction of organs and systems, should be attached to the direction of the medical institution for examination of the victim in the ITU institutions.

The ITU institution conducts an examination of the victim, taking into account the information specified in the act in form No. H-1 or the act on the case of an occupational disease, as well as in other documents provided by the employer. Specialists of the ITU institution issue an expert opinion based on the documents received and a personal examination of the victim. The degree of loss of professional ability to work is determined on the basis of an assessment of the victim's professional abilities and professionally significant qualities that allow him to perform work in his former specialty (qualification). The rules provide for the possibility of establishing from 10 to 100% loss of professional ability to work.

The fact that disability has been established must be confirmed by an act of examination of the victim. The act is signed by the head of the ITU institution, the specialists who carried out the examination, and certified by the seal of the institution.

The victim is given a certificate of the results of the examination, and an extract from the examination report is sent to the employer and the executive body of the FSS of Russia.

The institution of medical and social expertise found that the employee I.I. Ivanov has lost 30% of his professional ability to work.

Therefore, the amount of the lump-sum insurance payment will be:

30 000 rub. x 30% = 9000 rubles.

A one-time insurance payment is made to the victim no later than one calendar month from the date of its appointment. In the event of the death of the insured, the payment is made to his dependents within two days from the date the employer provides the executive body of the FSS of Russia with all the documents necessary to assign such a payment.

Monthly insurance payments. The amount of the monthly payment is determined based on the average monthly earnings of the victim. The average earnings are calculated for the previous 12 months of work that caused damage to health, up to the month in which the accident occurred or the diagnosis of an occupational disease was established. At the choice of the victim, earnings can be taken into account for the last 12 months of work that caused damage to health, up to the month in which the degree of disability was determined by the ITU agency.

As you can see, the main difference between the calculation period for determining the monthly insurance payment and the same period for calculating temporary disability benefits is that in the first case, only months of work that caused damage to health are taken into account.

The average monthly earnings are determined as follows: all payments received by the employee in the billing period are summed up, and the result is divided by 12.

And if the work that caused damage to health lasted less than 12 months? In this case, you need to divide all the earnings actually received for the months of work that caused damage to health by the number of these months. If some months are not fully worked out, they are replaced by the previous fully worked months or are excluded from the calculation if replacement is impossible.

How to determine whether such a replacement is possible in the billing period or not? Let's look at this with specific examples.

The worker I.I. Ivanov On June 10, 2004, an occupational disease was established. The calculation period for determining the average monthly earnings is the period from June 1, 2003 to May 31, 2004.

The work that caused damage to health lasted from September 15, 2003 to May 31, 2004 inclusive (8 months 16 days). Until September 15, 2003, the work was not related to an employee's occupational disease. Therefore, the period from June 1 to September 14, 2003 is excluded from the calculation.

The incompletely worked September 2003 (from the 14th to the 30th) is also not taken into account, since it is impossible to replace it with the previous fully worked months.

Thus, the average monthly earnings are determined for the period from October 1, 2003 to May 31, 2004.

Let's change the conditions of the previous example. Let's say the work that caused the occupational disease lasted from March 15, 2003 to May 31, 2004 inclusive (14 months 17 days).

The settlement period is from June 1, 2003 to May 31, 2004. In it, the employee worked only half of June 2003 - from the 1st to the 15th. In this case, the unworked part of June can be replaced by the fully worked part of May 2003.

Thus, the average monthly earnings are taken into account in total for May 2003 and for the period from July 1, 2003 to May 31, 2004.

note

Earnings for calculating the monthly insurance payment include all amounts received by the employee for performing work under an employment contract, on which insurance premiums for compulsory social insurance against industrial accidents and occupational diseases were accrued.

To determine the amount of the monthly insurance payment, you need to multiply the average monthly earnings by the percentage of loss of professional ability to work.

Assigned monthly insurance payments are not recalculated in the future. There are three exceptions to this rule:

change in the degree of loss of professional ability to work;
changing the circle of persons entitled to receive payments;
indexation of payments taking into account the level of inflation 5 .

The maximum monthly payment currently cannot exceed 30,000 rubles. for a full calendar month. This is established by Article 16 of the Federal Law of February 11, 2002 No. 17-FZ "On the budget of the Social Insurance Fund of the Russian Federation for 2002" 6 (hereinafter - Law No. 17-FZ).

The ITU agency found that staff member I.I. Ivanov lost his professional ability to work by 60% due to an accident at work.

The average monthly earnings of I.I. Ivanov - 60,000 rubles.

The amount of the monthly insurance payment will be:

60 000 rub. x 60% = 36,000 rubles.

Since the amount of the payment is limited by the maximum limit, I.I. Ivanov will receive 30,000 rubles a month.

The victim receives monthly payments during the entire period for which the loss of professional ability to work is established. Only the period of temporary incapacity for work due to an accident at work or occupational disease is excluded from it, since during this time the victim receives the appropriate allowance.

On March 30, 2004, employee I.I. Ivanov was injured due to an accident at work. On May 31, 2004, the specialists of the ITU institution, who carried out the examination of I.I. Ivanov, established the degree of loss of professional ability to work in the amount of 50% for a period of 6 months. The sick leave was closed on June 30, 2004.

Thus, I.I. Ivanov is to receive temporary disability benefits for the period from March 30 to June 30, 2004. He will start receiving monthly insurance payments from July 1, 2004.

Insurance benefits for dependents. In the event of the death of the insured person, insurance payments are received by his dependents (Article 7 of Law No. 125-FZ). First of all, these are disabled persons who were dependent on the deceased or had the right to receive maintenance from him by the day of the insured event. Disabled dependents generally include minors, as well as persons who have reached the age for retirement. Disabled dependents are also persons with disabilities.

If the child of the insured was born after his death, he is also entitled to receive insurance payments.

Dependents are considered to be family members of the deceased who were not working at the time of his death in connection with caring for his children, grandchildren, brothers or sisters under the age of 14 or who have reached this age, but recognized as needing outside care. At the same time, the ability to work of family members who provide care does not matter.

And, finally, the dependents of the deceased have the right to receive insurance payments if they become disabled within five years from the date of his death.

note

Dependents can be not only relatives. They may be persons who were not related to the deceased, but lived together with him. The main thing is to confirm in court the fact of being dependent. Dependence of the children of the deceased is assumed by virtue of the law, so it is not necessary to confirm it.

The amount of a one-time insurance payment due to dependents is 30,000 rubles. This amount is divided between the wife (husband) of the deceased (regardless of whether she (he) was dependent on him) and other dependents.

The amount of the monthly payment is determined based on the average monthly earnings of the deceased. Pensions and benefits that he received during his lifetime are also taken into account. The amount received excludes the shares attributable to the victim himself and able-bodied persons who were dependent on him, but who are not entitled to receive insurance payments. The remaining amount is equally divided among the dependents of the victim who are eligible for insurance benefits.

note

The total amount of monthly insurance payments to all dependents cannot exceed 30,000 rubles.

34.2. Methodology for determining the size of permanent disability

(Clause 12, Article 12 of Law No. 125-FZ and Article 16 of Law No. 17-FZ).

The average earnings of the deceased was 25,000 rubles. His dependents were: an able-bodied wife, a mother aged 70 and two children aged 15 and 16. Three dependents - a mother and children - are entitled to monthly insurance payments, and a wife, mother and children are entitled to a lump sum insurance payment.

Calculate the share of the lump sum insurance payment due to each dependent. Shares are determined based on the total amount of 30,000 rubles. The amount of the lump-sum insurance payment will be:

30 000 rub. : 4 pers. = 7500 rubles.

Now let's calculate the amount of the monthly insurance payment.

First, determine the share due to each recipient:

25 000 rub. - (5000 rubles x 2 people) \u003d 15,000 rubles.

Thus, 15,000 rubles. - the total amount of the monthly insurance payment that will be received by three dependents - the mother and two children of the deceased.

The terms during which dependents are entitled to receive insurance payments are established by clause 3 of Article 7 of Law No. 125-FZ.

Minors receive monthly insurance payments up to the age of 18, and if they study full-time, then until graduation, but not more than 23 years.

Old-age pensioners (women from 55, men from 60) will receive monthly insurance payments for life, and disabled people - during the period of disability. At the same time, insurance payments do not affect the amount of the pension (for old age or disability) received by these persons.

Persons who do not work in connection with the care of children, grandchildren, brothers or sisters of the deceased who have not reached the age of 14 receive insurance benefits until the said dependents are 14 years old. If dependents are at least 14 years of age but require outside care, their caregivers receive benefits until the dependents' condition changes.