Why is it advisable to undergo periodic medical examinations? The procedure for organizing medical examinations at the enterprise. Who sends for periodic medical examination and how?

The employer’s obligation to organize a preliminary and periodic medical examination of the enterprise’s employees is established by Article 213 of the Labor Code of the Russian Federation and Order of the Ministry of Health and Social Development dated April 12, 2011 No. 302n. The examination is carried out at the expense of the employer, and the employee retains his average monthly salary. Periodic medical examinations are carried out for:

• identifying diseases that may make an employee unfit for work;
• tracking the dynamics of changes in health status;
• timely detection of occupational diseases.

Where to get a medical examination

The choice of medical institution is unlimited. An employer can enter into an agreement with both a public and private clinic. The only condition is that the organization must have the right to conduct preliminary and periodic inspections, as well as to examine professional suitability (Appendix to the licensing regulations medical activities, approved by Decree of the Government of the Russian Federation dated January 22, 2007 No. 30).

The procedure for conducting periodic medical examinations of employees

Let’s take a step-by-step look at how the results of a periodic medical examination of an organization’s employees are carried out and documented.

1. Compiling a list of employees. It must be sent within 10 days by registered mail with notification to the territorial body of Rospotrebnadzor.
2. Drawing up lists of names (based on the list of contingents). They must be approved 2 months before the date of examination and sent to the medical institution.
3. The medical organization, within 10 days after receiving the list of names, draws up a calendar plan for conducting a periodic medical examination. It must be agreed upon with the employer.
4. Concluding an appropriate agreement with a medical institution indicating the agreed schedule and timing of the examination.
5. Drawing up an Order to conduct a medical examination and familiarizing the team with it against signature. It should contain the following information:
   • Name of the organization;
   • date and order number;
   • reference to regulations;
   • a medical organization that will conduct a medical examination;
   • examination schedule;
   • the person responsible for conducting the medical examination;
   • list of employees subject to medical examination.
6. Issuing referrals to employees for a medical examination. It must indicate the working conditions, which will help the medical commission select criteria for assessing health status and make a decision on continuing work.
7. After the inspection and receipt of test results, a conclusion is drawn up for each employee. It is signed in two copies - one for the employee, and the other remains in the institution that conducted the medical examination.
8. Within 30 days after completion of the medical examination, the medical center, representatives of the employer and the sanitary-epidemiological service draw up a final report. After approval by the chairman of the medical commission, the act is printed in four copies: for the medical institution, the employer, the territorial body of Rospotrebnadzor and the occupational pathology center for research purposes and statistics.
9. The results of preliminary and periodic medical examinations are recorded in the employee’s personal medical record.

Who should undergo a medical examination

Article 213 of the Labor Code of the Russian Federation and the Order contain detailed information about which categories of workers must undergo periodic inspection without fail. But the legislator does not prohibit sending representatives of other professions for examination if an agreement is reached between management and the team.

Regular medical examinations are mandatory for persons under 21 years of age, as well as people who work:

• in harmful and dangerous production;
• at work at heights;
• in transport (drivers, machinists, etc.);
• in the field of catering;
• in educational and children's institutions;
• in pharmaceutical, medical and sanitary institutions (spas, saunas and laundries);
• in beauty salons that provide hairdressing and cosmetology services;
• in the cleaning service;
• in the field of water supply;
• at livestock enterprises and poultry farms.

These categories of employees must be examined at least once every 1-2 years, while the frequency depends on the working conditions and production environment and is detailed in Appendix No. 1 to the Order.

Responsibility

Workers who have not been tested specified deadlines, can be:

• suspended from work from the working day following the last day of undergoing a medical examination for the organization’s unit (paragraph 12, part 2, article 212 of the Labor Code of the Russian Federation);
• brought to disciplinary liability in accordance with the Labor Code of the Russian Federation and the internal labor regulations of the organization.

During the period of suspension from work, the employee’s salary will not be accrued (Article 76 of the Labor Code of the Russian Federation).

Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation establishes that admission to work without undergoing a mandatory periodic medical examination entails the imposition of a fine:

• For legal entities: from 110,000 to 130,000 rubles;
• for officials: from 15,000 to 25,000 rubles.

Periodic medical examinations of enterprise employees and psychiatric examinations are mandatory for representatives of certain professions. The proposed material considers normative base on this issue and the procedure for conducting such events.

Periodic medical examinations in 2018 - 2019: regulatory framework

Periodic examinations of workers are a set of medical preventive measures carried out at established intervals aimed at preventing the occurrence, establishing the presence and preventing the spread of infectious and non-infectious diseases. occupational diseases.

Labor Code of the Russian Federation in Art. 213 established the obligation to conduct periodic inspections for workers employed in industries with hazardous and hazardous conditions labor. Their list is contained in Appendix 2 to the order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n (hereinafter referred to as order No. 302n).

There is a contradiction between the Labor Code of the Russian Federation and Order No. 302n. The order contains a list of not only dangerous professions, but also production factors, which may be an indication for a medical examination. But the presence of a factor does not always lead to the occurrence of harmful or dangerous conditions for the employee. For example, a special assessment may establish that a properly organized working day, ventilation, etc. reduce the impact of harmful factors to zero.

Explanations on this matter were given by Rostrud in a letter dated February 28, 2017 No. TZ/942-03-3: the need for inspection stems solely from the presence of harmful/dangerous conditions, which is established special assessment conditions.

Law “On the sanitary and epidemiological welfare of the population” dated March 30, 1999 No. 52-FZ in paragraph 2 of Art. 34 provides for the right of regional and local authorities authorities to expand the list of professions subject to mandatory medical examinations (letter of Rospotrebnadzor dated November 7, 2017 No. 09-23004-17-16).

The Government of the Russian Federation, in Resolution No. 695 dated September 23, 2002, defined psychiatric examination as mandatory for certain categories of workers and regulated its procedure.

What types of medical examinations are there and are they mandatory?

There are 3 main types of medical examinations: preliminary, periodic and unscheduled.

Preliminary ones are carried out only at the employment stage. They, like periodic medical examinations, are not mandatory for all categories of workers, but only for those that are directly indicated in the normative legal acts. These are the workers:

• under the age of 21 according to clause 17 of order No. 302n;
• employed in hazardous and hazardous industries listed in Appendix 2 to Order No. 302n;
• workers in children's educational institutions on the basis of clause 9, part 1, art. 48 of the law of December 29, 2012 No. 273-FZ;
• water supply facilities of medical organizations and a number of others under Art. 213 Labor Code of the Russian Federation.

If preliminary inspections are a stage of employment, then periodic inspections are carried out with the regularity specified in regulations. For certain categories of employees, such examinations may be scheduled at certain times during the day. Refusal to undergo a medical examination or failure to complete it on time will lead to refusal of employment or the employee’s inadmissibility to work in accordance with Art. 76 Labor Code of the Russian Federation.

Special mention should be made of unscheduled inspections. They are also carried out if there is a referral from the employer, but at the request of the employee or the request of the sanitary and epidemiological authorities.

NOTE! An attempt to undergo an inspection on your own, without a referral, and to bring documents for payment to the employer cannot be considered a legal passage of an unscheduled inspection and should not be paid for from the organization’s budget, since this contradicts the procedure established by Order No. 302n.

How to conduct and organize a medical examination according to Order No. 302n

In Art. 34 of the Labor Code of the Russian Federation and Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302, the responsibility for creating conditions for medical examinations and paying for them rests with the employer. To do this, the employer:

• enters into an agreement with a medical organization that undertakes to provide medical services, including medical examinations, to employees of the enterprise;
• no later than 2 months before the upcoming examination, forms and submits to the medical institution a list of employees who will be required to undergo a medical examination;
• no later than 10 days before the upcoming inspection, sends a contingent list to the territorial sanitary and epidemiological inspection body and introduces workers to calendar plan compiled by a medical organization no later than 2 weeks before the upcoming examination;
• against signature, issues a referral to employees to undergo a medical examination (about its preparation - see the article Referral to a medical examination from the employer).

The employee, in turn, must receive a direction against his signature and set time come to the medical facility for examination, having a referral with you. Upon completion of all necessary studies and inspections, the periodic inspection will be considered completed and a conclusion will be drawn up.

Mandatory examinations under Government Decree No. 695 on psychiatric examination

Art. 213 of the Labor Code of the Russian Federation provides for mandatory psychiatric examination of workers working with sources increased danger or in hazardous conditions. The list of such sources and factors was determined by the Government in Order No. 377 dated April 28, 1993. For the most part, it is identical to those contained in Order No. 302n.

IMPORTANT! You should not confuse the participation of a psychiatrist in a medical examination and a psychiatric examination - these are different procedures. Moreover, the presence of a certificate from a psychiatric clinic stating that the employee is not registered does not cancel the obligation to undergo a mandatory examination every 5 years.

Pursuant to Order No. 695, sometimes erroneously referred to as Psychiatric Examination Order 695, it is carried out special commission created based on the decision of local health authorities. At the request of the commission, the medical institution must provide the information requested by the commission about the employee’s health. The commission makes a decision on an employee’s suitability for work in high-risk conditions by a simple majority of votes.

In Resolution No. 695, psychiatric examination refers to procedures carried out on the direction of the employer, indicating the type of activity and the source of danger with which the employee works.

The period of examination cannot exceed 20 days from the moment the employee applies to the commission. The decision is made no later than 10 days from the date of receipt of the last necessary information and can be appealed in court.

It remains to be concluded that regular inspections are not mandatory for all categories of workers, but those who are required to undergo them by law cannot be allowed to work without a document confirming the fact of their completion.

"Kadrovik.ru", 2013, N 11

PERIODIC HEALTH EXAMINATIONS OF EMPLOYEES

The concept of a medical examination (examination) came after the concept of “medical examination” in 2006 (corresponding changes to the Labor Code of the Russian Federation were introduced by Federal Law No. 90-FZ of June 30, 2006), but its content did not lose its meaning. The current Russian legislation does not define a medical examination or certification, but the etymology of this phrase, as well as the purpose of the event in question, make it possible to reveal its meaning: a medical examination is a study of a person’s health by a professional medical worker. The term “examination” presupposes professional, expert confirmation of conclusions about the state of health of the person being examined, a certain consolidation of the result of the examination, i.e., the issuance of an appropriate certificate.

The term “medical examination” is most succinctly formulated in Art. 65 Federal Law dated November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in Russian Federation"and is a set of methods of medical examination and medical research aimed at confirming a person’s state of health, which entails the onset of legally significant consequences. In-depth medical examinations are periodic medical examinations with an expanded list of medical specialists participating in them and the examination methods used. Clinical examination is a set of measures, including a medical examination by doctors of several specialties, and the application of the necessary examination methods, carried out in relation to certain groups of the population in accordance with the legislation of the Russian Federation.Also, the legislation of the Russian Federation establishes cases when the passage and conduct of a medical examination, medical examination and clinical observation are mandatory (Article 46 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”) As for periodic medical examinations, it is carried out to monitor the health status of employees, identify occupational diseases, promote preventive and rehabilitation measures, to prevent accidents at work. Regular medical examinations are carried out throughout the entire period of the employee’s employment with the employer at specific time intervals. The frequency of their implementation depends on the types of harmful and (or) dangerous production factors that affect the employee, and on the type of work he performs. One of the types of periodic medical examination is a pre-shift/pre-trip/pre-flight medical examination, which is carried out before the start of the working day (shift, flight) of the employee directly driving the vehicle, in order to identify signs of exposure to harmful and (or) dangerous production factors, conditions and diseases, impeding the implementation labor responsibilities, including alcohol, narcotic or other toxic intoxication (Article 46 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”). This type A medical examination is carried out to identify employees who, for medical reasons, cannot be allowed to drive a vehicle based on considerations of traffic safety and the health of the driver and passengers. To conduct such a medical examination medical worker must undergo training, receive a certificate, and the medical organization must have the appropriate license (Order of the Ministry of Health of the Russian Federation dated March 11, 2013 N 121n). The time during which the pre-trip medical examination is carried out is included in work time driver (Article 185 of the Labor Code of the Russian Federation).

You should know it. A fairly accurate definition of a medical examination, according to the author, is as follows: this is a complex of medical interventions that identify pathological conditions, diseases and risk factors for their development. Medical examination is divided into the following types: preventive, preliminary, periodic, pre-shift/pre-trip, post-shift/post-trip. In addition to these procedures, there is also a medical examination, in-depth medical examination and medical examination.

Note. Types of medical examination are defined in Art. 213 Labor Code RF.

In accordance with the Order of the Ministry of Health and social development Russian Federation dated April 12, 2011 N 302n “On approval of Lists of harmful and (or) hazardous production factors and work, during which preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers, those employed in heavy work and in work with harmful and (or) dangerous working conditions" (hereinafter referred to as Order No. 302n) on January 1, 2012, rules came into force obliging employers to conduct periodic medical examinations at their own expense. However, this applies to cases where workers actually have hazardous working conditions.

According to Order N 302n, mandatory medical examinations affect workers employed in the fields of education, healthcare, and the medical industry. Catering, construction, transport, consumer services and other areas in which the employee is exposed to harmful factors (clauses 1, 4.3, 12, 14 - 27 of Appendix No. 2 "List of work during which mandatory preliminary and periodic medical examinations are carried out ( examinations) of workers" to Order No. 302n).

This Order establishes a List of harmful and (or) dangerous production factors, in the presence of which mandatory (preliminary) and periodic medical examinations (examinations) are carried out, a List of works during the performance of which mandatory (preliminary) and periodic medical examinations (examinations) of workers are carried out, and The procedure for conducting mandatory (preliminary) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions, from January 1, 2012. When comparing documents regulating medical examinations before 2012, It is clear that the Order has increased the list of harmful factors and specified the procedure for conducting medical examinations.

We list the main features of the new procedure for conducting medical examinations:

1. The contingent of employees who need to undergo a medical examination is determined and approved by the organization independently, without coordination with various departments and must be sent to the territorial body within 10 days federal body executive power, which is authorized to carry out federal state sanitary and epidemiological supervision (clauses 19, 21, part III “Procedure for periodic inspections” of Appendix No. 3 to Order No. 302n).

2. The frequency of medical examinations has changed: before January 1, 2012, examinations had to be carried out at least once every two years, and currently the frequency of their conduct is reflected in Order N 302n - for various harmful and dangerous production factors, for different types work during which periodic medical examinations are carried out - from once a year to once every two years (Appendices No. 1, No. 2 to Order No. 302n). It should be noted that employees under the age of 21 must undergo periodic inspections annually (clause 17, part III “Procedure for periodic inspections” of Appendix No. 3 to Order No. 302n).

3. The list of persons undergoing examinations at occupational pathology centers and medical institutions equivalent to them has changed. These are participants in emergency situations, workers exposed to harmful and (or) hazardous substances, production factors exceeding the maximum permissible concentration/permissible limit, workers with a preliminary diagnosis of an occupational disease, employees with persistent consequences of industrial accidents and other persons - when making an appropriate decision by a medical commission (clause 37, part III “Procedure for periodic examinations” of Appendix No. 3 to Order No. 302n).

4. It is considered mandatory to issue an employee a referral from the employer when sending him for a periodic medical examination (clauses 7, 8, part II “Procedure for preliminary examinations” of Appendix No. 3 to Order No. 302n).

5. It is mandatory for the medical institution to issue a health passport for the employee (clause 10.2, clause 10, part II “Procedure for preliminary examinations” of Appendix No. 3 to Order No. 302n).

7. For women over 40 years old, mammography or ultrasound of the mammary glands is mandatory once every two years (link 1 to Appendix No. 1 to Order No. 302n).

8. The format of the final report based on the results of medical examinations has been changed, and it must be stored in a medical institution for 50 years (clauses 43 - 45, part III “Procedure for periodic examinations” of Appendix No. 3 to Order No. 302n).

9. The chairman of the medical commission should be an occupational pathologist, and the commission should be composed of medical specialists who have undergone advanced training in the specialty "occupational pathology" (clause 5 of part I " General provisions"Appendix No. 3 to Order No. 302n).

10. The order introduced new forms of documents for medical examinations - a referral for a medical examination, a medical report on the results of the medical examination, an employee’s health passport, a final report based on the results of medical examinations, etc. (clauses 7, 8, 10.2, 12 - 14 Part II "Procedure for preliminary inspections", paragraphs 42 - 45 Part III "Procedure for periodic inspections" of Appendix No. 3 to Order No. 302n).

In general, it can be noted that Order No. 302n contains changes to medical regulations for conducting periodic medical examinations, but it cannot be considered that it has radically changed the previously existing practice. The conduct of medical examinations was previously documented by other regulations, which became invalid on January 1, 2012.

Order No. 302n (clause 3.5 of Appendix No. 1, clauses 19, 20, part III “Procedure for periodic examinations” of Appendix No. 3 to the Order) states that organizations must conduct medical examinations based on the certification of employees’ workplaces . Certification of workplaces gives a detailed description of working conditions in the workplace.

Conducting medical examinations is the responsibility of the employer, this applies to certain labor legislation categories of workers (in accordance with paragraph 11, part 2, article 212 of the Labor Code of the Russian Federation). But the employee is also required to undergo such medical examinations. This is enshrined in Art. 214 of the Labor Code of the Russian Federation, according to which employees must undergo mandatory preliminary and periodic medical examinations, and extraordinary examinations upon the direction of the employer. This condition may be specified by the collective agreement of the organization in which the employees work. If an employee refuses to undergo a medical examination, the organization must remove him from work, which is reflected in Art. 76 Labor Code of the Russian Federation. During the period of suspension from work (preclusion from work), the employee’s wages are not accrued, except in cases provided for by the Labor Code of the Russian Federation or other federal laws (Article 76 of the Labor Code of the Russian Federation), this period is not included in the length of service giving the right to annual paid leave ( Article 121 of the Labor Code of the Russian Federation). If the employer is at fault in this situation, then the time the employee is suspended is paid as downtime; this is regulated by Art. 76 Labor Code of the Russian Federation.

Periodic medical examinations must be carried out during working hours and paid in the amount of the employee’s average earnings (paragraph 11, part 2, article 212 of the Labor Code of the Russian Federation).

Those working in hazardous working conditions are entitled to at least 7 calendar days of annual additional paid leave, increased wages - in the amount of at least 4% of the salary and reduced working hours - no more than 36 hours per week (Article 92 of the Labor Code of the Russian Federation, clause 1 Decree of the Government of the Russian Federation of November 20, 2008 N 870 “On the establishment of reduced working hours, annual additional paid leave, increased wages for workers engaged in heavy work, work with harmful and (or) dangerous and other special conditions labor").

If employees have received voluntary health insurance (VHI) policies at the expense of the organization, this does not cancel preliminary and periodic medical examinations of employees working in hazardous working conditions. If a medical institution serving an organization under VHI has a license to conduct medical examinations, as well as to examine professional suitability, a separate agreement can be concluded with it additional agreement on conducting a medical examination of the organization’s employees.

The conduct of medical examinations is controlled by the territorial body of Rospotrebnadzor, where the employer sends a list of employees subject to examination within 10 days from the date of its approval (clause 21, part III "Procedure for periodic examinations" of Appendix No. 3 "Procedure for mandatory preliminary examinations (upon admission) to work) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions" to Order No. 302n). Upon completion of the medical examination, the medical institution, together with Rospotrebnadzor, draws up a final report based on the results of the examinations, one copy of the report is sent to the employer, and the other copies are sent to the territorial body of Rospotrebnadzor and to the territorial center of occupational pathology (clauses 42, 45, 46, part III of Appendix No. 3 to Order No. 302n), which assesses the relationship between identified suspicions of occupational diseases and working conditions of workers (clause 41, part III of Appendix No. 3 to Order No. 302n). Then the results of the inspections are summarized at the regional and federal levels, which makes it possible to assess their quality (clause 33, part III of Appendix No. 3 to Order No. 302n).

If during a medical examination an employee is diagnosed with an occupational disease, it must be confirmed by a medical organization that has a license that allows for an examination and confirmation of the connection of the disease with the profession. An occupational disease is considered to be one included in the national list of occupational diseases (this list was approved by Order of the Ministry of Health and Social Development of the Russian Federation dated April 27, 2012 N 417n “On approval of the List of Occupational Diseases” in accordance with clause 15 of Article 14 of Federal Law N 323- Federal Law "On the fundamentals of protecting the health of citizens in the Russian Federation"). If an occupational disease is confirmed, the employee must be sent to the territorial bureau of medical and social examination to determine the degree of loss of professional ability. He can receive either a disability group or a percentage of loss of ability to work and, therefore, will receive a disability pension or a salary supplement (Resolution of the Government of the Russian Federation of February 20, 2006 N 95 “On the procedure and conditions for recognizing a person as disabled”, paragraph 14 h II, paragraph 15, part III). Costs for medical care patients with occupational diseases are borne by the Social Insurance Fund if the employee was insured and the organization contributed funds for him to the Social Insurance Fund (Article 8, 15 Chapter II of the Federal Law of July 24, 1998 N 125-FZ "On Compulsory Social Insurance from accidents at work and occupational diseases"). Thus, the organization does not bear direct costs in this case; its responsibility is indirect.

If the employer does not pay for medical examinations and does not provide compensation for harmful working conditions to the employee, the latter may apply to the trade union committee, the labor dispute commission of your organization or in state inspection by work.

In case of violation of the legislation on conducting compulsory medical examinations of workers, the penalties provided for violation of the legislation on labor and labor protection, Art. 5.27 of the Code of the Russian Federation on Administrative Offenses dated December 30, 2001 N 195-FZ.

Thus, an official can be fined in the amount of 1,000 to 5,000 rubles, individual entrepreneur without forming a legal entity - for 1000 - 5000 rubles. or be subject to administrative suspension of activities for up to 90 days, a legal entity may be fined in the amount of 30 thousand to 50 thousand rubles. or be subject to administrative suspension of activities for a period of up to 90 days (Part 1 of Article 5.27 of the Code of Administrative Offenses of the Russian Federation of December 30, 2001 N 195-FZ). Violation of labor and labor protection legislation by an official who was previously subjected to administrative punishment for a similar administrative offense entails disqualification for a period of one to three years (Part 2 of Article 5.27 of the Code of Administrative Offenses of the Russian Federation of December 30, 2001 N 195-FZ).

Let us examine in detail the procedure for conducting medical examinations of enterprise employees, taking into account the changes that came into force in 2018.

Read our article:

Medical examinations of enterprise employees in a new way in 2018

A medical examination (MO) is a comprehensive examination of an employee in order to identify negative changes in his health and determine his suitability to perform job duties. First of all, a medical examination is necessary for personnel who are exposed to harmful and hazardous production factors (HAPF) in the workplace. The list of such factors and the procedure for undergoing medical examinations by employees are established by Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

In March 2018, the approved changes came into force. It was expanded (clause 20 of Appendix No. 2): instead of employees of social shelters and nursing homes, employees of organizations must now be sent to the Ministry of Defense social services providing social services:

• V stationary form social services;
• semi-stationary form of social services;
• in the form of social services at home.

The procedure for conducting a medical examination in Appendix No. 3, as well as the requirements for documents confirming its completion, have not changed.

Article 213 of the Labor Code of the Russian Federation - medical examinations

Mandatory medical preliminary and periodic examinations: organization of implementation

As we mentioned above, the procedure for conducting medical examinations is determined by Appendix 3 to Order of the Ministry of Health and Social Development No. 302n.

A preliminary medical examination is carried out upon hiring. It allows:

• assess the employee's ability to perform professional features without harm to health;
• promptly identify the initial ones and prevent their development.

The algorithm is as follows:

1. The employer issues it to the person applying for work, indicating the position, profession or type of work, as well as a list of those present at the workplace.

2. A person applying for a job submits the following documents to the medical organization:

• direction;
• passport (or other standard identification document);
• decision of the medical commission (in cases provided for by the legislation of the Russian Federation).

3. The preliminary inspection is considered passed when:

• the person applying for work was examined by all medical specialists;
• All laboratory and functional studies were performed.

4. After passing the medical organization’s medical examination, which must be signed by the chairman of the medical commission indicating his last name and initials. The document is certified by the seal of a medical organization, which prepares a conclusion in two copies. The first is attached to the outpatient card, the second is given to the person who has undergone a medical examination.

For what purposes are mandatory periodic medical examinations carried out?

Download and use in your work, with which you can quickly determine which employees to send for a periodic medical examination this year, create a list of contingent, a list of names and referrals for a medical examination.

Who should undergo periodic medical examination

The following employees must undergo periodic preventive medical examinations.

1. Those exposed to harmful or dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out.
2. Performing work specified in the list, during the performance of which mandatory preliminary and periodic medical examinations of workers are carried out.
3. . If these jobs involve persons under 21 years of age, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).
4. Involved in underground work. Such employees undergo periodic medical examinations annually (clause 12 of Appendix 2 to Order No. 302n).
5. Employed in organizations Food Industry, public catering and trade, waterworks, medical organizations and children's institutions (Article 213 of the Labor Code of the Russian Federation). The frequency of medical examinations for specific professions is given in Appendix No. 2 to Order No. 302n.
6. Athletes. They undergo medical examinations annually (Article 348.3 of the Labor Code of the Russian Federation).
7. Persons under 18 years of age. They undergo medical examinations annually (Article 266 of the Labor Code of the Russian Federation).

The List specifies the jobs and professions during which workers must undergo mandatory preliminary and periodic medical examinations, regardless of what is established at these workplaces and the availability of vocational training.

*If the listed jobs involve persons under 21 years of age, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).

Medical examinations should be carried out already in the presence of harmful or dangerous production factors specified in the list at the workplace, and their level does not matter.

The following factors are exceptions:

• 3.5. - ;
• 3.8., 3.9. - air temperature;
• 3.12. - light environment;
• 4.1. - physical overload;
• 4.4.1., 4.4.2., 4.4.3.- sensory loads.

For these factors, medical examinations are carried out only if working conditions are classified as harmful or dangerous based on the results of the special assessment assessment.

When hiring, for example, accountants, programmers, management personnel and others office employees, which are more than 50 percent of working time, the employer is obliged to send them for a medical examination (clause 3.2.2.4 of the List of harmful and (or) dangerous production factors approved by Order No. 302n). The frequency of MO is once every two years.

Passing a periodic medical examination

The procedure for conducting periodic medical examinations is regulated by Order No. 302n. The algorithm is as follows:

1. The employer is subject to periodic medical examinations, which indicates:

• name of the employee’s profession or position according to the staffing table;
• name of the harmful production factor.

Then this document is sent within 10 days to the territorial body of Rospotrebnadzor at the actual location of the employer (clause 21 of the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n).

2. Based on the approved list of contingent indicating the VOPF, as well as the type of work.

Approved lists are sent to the medical organization. This must be done no later than two months before the start date of the examination agreed with the medical institution. The medical organization, within 10 days from the date of receipt of the name list, draws up a calendar plan for conducting periodic medical examinations.

3. The employer familiarizes employees with the Moscow Region calendar plan. This must be done no later than ten days before the start of the event.

4. The employer provides employees with directions for a medical examination. They indicate:

• employer's name;
• form of ownership and type economic activity according to OKVED;
• name of the medical organization, actual address its location and OGRN code;
• type of medical examination - periodic;
• last name, first name, patronymic, date of the employee;
• Name structural unit;
• name of position, profession or type of work;
• VOPF.

The referral is signed by an authorized representative of the employer, indicating his position, surname and initials. All directions are issued against signature, and records are kept.

5. On the day of the medical examination, the employee submits to the medical organization:

• direction;
• passport or other standard identification document;
• health passport (if available);
• decision of the medical commission that conducted a mandatory psychiatric examination (in cases provided for by Russian legislation).

Periodic medical examination is considered completed if all medical specialists have examined you and all laboratory and functional tests have been completed.

Who pays for periodic medical examinations?

The employer is obliged to conduct periodic medical examinations at his own expense and enter into an agreement with a medical organization licensed to conduct preliminary medical examinations. A permanent medical commission is formed in the medical organization. It is headed by an occupational pathologist. The medical organization is responsible for the quality of medical examinations.

Example of a contract for a medical examination

How are the results of periodic medical examinations of the organization’s employees recorded?

After passing the medical examination, the medical organization issues a conclusion. It states:

• date of issue;
• last name, first name, patronymic, date of birth, gender of the employee;
• employer's name;
• name of the structural unit, position, profession or type of work;
• name of the VOPF;
• MO result (medical contraindications identified, not identified).

The conclusion is signed by the chairman of the medical commission. The document is certified by the seal of a medical organization, which prepares a conclusion in two copies. The first is attached to the outpatient card, the second is given to a person who has undergone a medical examination. Data on the passage of the MO is entered into.

The medical organization, within 30 days after the completion of periodic medical examinations, summarizes their results. Then, together with the territorial bodies of Rospotrebnadzor and representatives of the employer, it compiles in four copies, which are sent within five working days from the date of approval:

• employer;
• to the center of occupational pathology of a constituent entity of the Russian Federation;
• to the territorial body of Rospotrebnadzor.

One copy of the final act is kept in the medical organization for 50 years.

Extraordinary medical examination

Extraordinary medical examinations are carried out on the basis of medical recommendations specified in the final report of the medical examination.

• at work with harmful or dangerous working conditions, including underground;
• at work related to traffic;
• athletes ();
• working in food industry organizations, public catering and trade, water supply facilities, medical organizations and child care institutions, etc.

The employer has the right to send an employee to an extraordinary medical examination in the following cases:

• at the request of the workers themselves (Article 219 of the Labor Code of the Russian Federation);
• in accordance with the recommendations of specialists who participated in preliminary or periodic examinations, as well as for epidemiological indications;
• in accordance with ;
• according to the conclusion of the territorial bodies of Rospotrebnadzor with mandatory justification in the direction of the reasons;
• when a case of nosocomial infection is detected, by decision of specialists from Rospotrebnadzor authorities and institutions.

In the absence of the grounds listed above, the employer does not have the right to send the employee for an extraordinary medical examination without his consent.

Attention

An employee is obliged to immediately notify his immediate or superior manager about a deterioration in his health, including the manifestation of signs of an acute occupational disease (Article 214 of the Labor Code of the Russian Federation). The employer, if there are clear signs indicating a decrease in the employee’s ability to work, can send him for an extraordinary medical examination.

Responsibility for failure to undergo a medical examination in the organization

The employer is responsible not only for timely organization through own funds Ministry of Defense of workers, but also for the admission to work of persons who have not undergone a preliminary or periodic examination, or who are not allowed to work for medical reasons. If inspectors of regulatory authorities establish such a fact, the employer may incur administrative liability.

According to Part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, the fine will be as follows:

• for officials - from 15,000 to 25,000 rubles;
• for persons carrying out entrepreneurial activity without forming a legal entity - from 15,000 to 25,000 rubles;
• for legal entities - from 110,000 to 130,000 rubles.

The amount of the fine is calculated based on the number of employees who have not completed the mandatory training. If due to lack of medical examination the employee's health will be seriously harmed or his death will occur, the officials will bear the consequences (Article 143 of the Criminal Code of the Russian Federation).

Periodic medical examinations in 2019 (Order of the Ministry of Health dated April 12, 2011 No. 302n, Articles 212, 213 of the Labor Code of the Russian Federation) are carried out, as before, to monitor the health status of workers and reduce the number of injuries at the enterprise. Periodic medical examination (order 302n establishes the rules of the process) is carried out when exposed to certain harmful factors for specific types of work activity.

When and why are periodic medical examinations performed?

The order of the Ministry of Health on periodic medical examinations establishes specific terms for the procedure, which depend on what harmful factor affects the employee and the degree of its danger.

Dates for medical examination medical institution determined at least once every two years, for some influencing factors and types of activities - at least once a year. Workers under 21 years of age must be tested every year. The Occupational Pathology Center carries out procedures at least once every 5 years.

The order to conduct periodic medical examinations of employees provides for checking for the following risks:

1. Chemical (those whose content in the air of the employee’s place of work and on his skin can be measured, including elements of a biological nature derived through chemical synthesis - antibiotics, vitamins).
2. Biological (pathogens, spores, microorganisms with pathogenic properties).
3. Physical (ionizing and non-ionizing radiation, vibration, noise, high or low ambient temperature).
4. The severity of the work process (static and dynamic load, posture during work, weight of loads).
5. Intensity of the work process (degree of load on the senses, voice, degree of density of sound and light signals).

Periodic medical examinations 2019 (order 302n) are necessary for:

Measures to ensure the safety of workers’ health are carried out on a planned basis, and are approved accordingly local act employer.

There is no template for an administrative document defined at the legislative level; it can be generated arbitrarily.

The order for periodic medical examinations must:

• approve the date or schedule for the implementation of procedures;
• identify the person responsible for the process;
• provide information about the medical institution;
• explain responsibility for failure to pass;
• oblige heads of departments to ensure attendance in accordance with the lists;
• familiarize the participants in the process against signature;
• inform about the employee responsible for execution;
• Attach a list of employees who need to be examined.

The document is signed by the head of the institution.

Sample order for periodic medical examinations

Who should undergo treatment and which doctors?

To conduct periodic medical examinations, the employer determines a list of employees (depending on the harmful factors affecting them and the type of work in which they are employed).

The list for medical examination should include the following employees:

• those who are influenced harmful factors production from approved administrative document Ministry of Health list;
• those, work activity which are associated with the list of types of work and professions provided for in the same document;
• related to transport (Article 213 of the Labor Code of the Russian Federation);
• workers in the food industry, catering and trade, medical and child care institutions, and water supply facilities (Article 213 of the Labor Code of the Russian Federation);
• athletes (Article 348.3 of the Labor Code of the Russian Federation);
• under 18 years of age (Article 266 of the Labor Code of the Russian Federation).

The list of medical specialists and tests that an employee needs to undergo during a periodic medical examination is established depending on the type of work included in the list by the Ministry of Health, as well as the influencing factors.

The medical institution forms a medical commission chaired by an occupational pathologist who has a valid certificate, and also approves the composition of the commission.

The list of doctors who must examine the employee during a periodic medical examination is given in the table.

The procedure is carried out medical institutions any form of ownership that has the appropriate right.

Who sends for periodic medical examination and how?

The procedure for referral for medical examination is strictly defined. It consists of the following actions by the employer:

• compiles a list of employees, including the name of the type of work and the influencing factor;
• approves the list of the contingent subject to examination (a sample order for undergoing a periodic medical examination - below) and sends it to the territorial agency of Rospotrebnadzor in the region of location;
• sends a list of the contingent and a list of employees by name to the medical institution that will conduct the procedure 2 months before its start;
• introduces employees to the calendar plan at least 10 days before their start;
• provides a referral indicating the name of the employer, form of ownership and type of activity according to OKVED, name of the medical institution, type of examination, full name, position, type of work of the employee and influencing factors;
• Based on the results, draw up a joint final act and receive one copy of it.

Guarantees for employees when undergoing a medical examination

The Labor Code of the Russian Federation in Article 185 provides certain guarantees for employees participating in the medical examination procedure. During the period of examination, the employee must retain his place of work and the average salary.

If markers of an occupational disease are detected, the employee is sent to an occupational pathology center and for the duration of the examination in this center, the employee also retains the average salary.

Consequences of failure to undergo a medical examination

The Labor Code of the Russian Federation has made it the employer's responsibility to conduct inspections, and for a number of categories of employees to undergo them. Violation of these provisions will result in sanctions for both parties.

Punishment for the employee

Labor Code of the Russian Federation in Art. 214 directly states the employee's duty. If he is given notice of the procedure, but he refuses, the employer removes the employee from performing functions until the examination is completed. Wage no payment is made for this period. Provided and disciplinary liability in the form of a reprimand, reprimand or dismissal.

Punishment for the employer

If control authorities identify employees at an enterprise who have not passed a medical examination, the employer faces a fine in accordance with Part 3 of Art. 5.27.1 Code of Administrative Offenses of the Russian Federation:

• 15,000-25,000 rubles - for an official;
• 15,000-25,000 rubles - for individual entrepreneurs;
• 110,000-130,000 rubles - for a legal entity.

The amount is calculated based on the number of employees who did not undergo the procedure.

If, due to the lack of a medical examination, an employee is seriously harmed or death occurs, the official will be held liable under Art. 143 of the Criminal Code of the Russian Federation with imprisonment for up to 5 years.

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