When you need to undergo a medical examination. Medical examinations of employees - the procedure for conducting mandatory, periodic and extraordinary medical examinations. Step-by-step instructions for passing a medical examination when applying for a job

The procedure for passing a medical examination at the enterprise - a procedure established by law for the examination of an employee in order to determine his state of health and physical ability to perform assigned work. For which categories of workers passing medical examinations is mandatory, how all this is carried out, we will tell in this article.

Classification of medical examinations, the purpose of their passage by employees of the enterprise

When providing citizens with jobs, the employer is obliged to create and ensure safe working conditions, as well as labor protection for employees (part 1 of article 212 of the Labor Code of the Russian Federation). In particular, at the expense of the enterprise's budget, the manager is obliged to organize medical examinations, which are divided into the following types (paragraph 11, part 2, article 212 of the Labor Code of the Russian Federation):

Mandatory preliminary - are carried out when applying for a job.
Mandatory periodic - carried out in the process labor activity.
Extraordinary - organized on the basis of medical recommendations for a certain category of workers (part 1 of article 213 of the Labor Code of the Russian Federation), as well as on the initiative of the employees themselves (paragraph 11 of part 1 of article 219 of the Labor Code of the Russian Federation). As a rule, the need for an extraordinary medical examination arises in connection with the deterioration of the employee's well-being in the process of work.
Compulsory psychiatric - carried out by the employer (including at the request of the employee).
Other mandatory medical examinations: preventive (conducted, for example, before vaccination), daily (for employees food production), pre- and post-trip (for transport drivers) and others.

The goals of medical examinations at the enterprise

The objectives of the mandatory preliminary and periodic medical examinations carried out at the enterprise are disclosed in Appendix No. 3 "Procedure for conducting ..." (hereinafter - the Procedure), approved. by order of the Ministry of Health and Social Development of the Russian Federation “On approval of lists ...” dated April 12, 2011 No. 302n (hereinafter - order No. 302n).

So, by virtue of part 2 of the Procedure, mandatory preliminary medical examinations are necessary:

to establish the conformity of the physical or other condition of a person entering a job with the work function entrusted to him;
detection of any diseases at an early stage of their development in order to successfully treat them (disease prevention).

By virtue of part 3 of the Order periodic medical examinations carried out with the aim of:

Examinations aimed at determining the mental health of an employee are mandatory if a person is admitted to activities that pose a danger or involve exposure to factors harmful to a person (part 7 of article 213 of the Labor Code of the Russian Federation). The purpose of this medical examination is to identify contraindications for performing this kind of work, a detailed listing of which contains a list of medical psychiatric contraindications, approved. Decree of the Government "On the implementation of the Law ..." dated April 28, 1993 No. 377.

Categories of employees for whom medical examinations are mandatory

In Art. 65 of the Labor Code of the Russian Federation provides for a list of documents that citizens applying for a job must present to the employer. There is no indication in the law that all potential employees must submit a certificate from a medical institution. However, for certain categories employees undergoing medical examinations and presenting an appropriate conclusion is prerequisite upon employment.

These employees include:

persons under the age of majority (Article 69 of the Labor Code of the Russian Federation);
workers involved in labor on a rotational basis(Article 298 of the Labor Code of the Russian Federation);
citizens employed in the regions of the Far North and areas equated to them (Article 324 of the Labor Code of the Russian Federation).

An exhaustive list of harmful and dangerous factors at work, as well as professions and types of labor activity, for which the passage of both preliminary and periodic medical examinations is mandatory, is contained in Annexes No. 1 “List of harmful ...” (hereinafter referred to as the List of factors) and No. 2 “ The list of works, when performing ... "(hereinafter - the List of works), approved. Order No. 302n.

Activities foreseen in the List of Works

In particular, jobs/professions for which medical examinations are mandatory include:

related to being at a height or servicing lifting equipment (cranes, lifters, steeplejacks);
produced in explosive industries;
carried out in departments and services where the use of weapons is allowed (guards, collectors);
produced on equipment with open moving structural elements (turners, millers);
produced underground (mining engineers, miners);
performed at food enterprises, food warehouses and bases associated with direct contact with food during their manufacture, storage and transportation (cooks, confectioners, sorters, packers);
carried out in medical institutions different type(doctors, nurses, paramedics);
associated with school and preschool education of children in organizations of all kinds (teachers, educators, child psychologists);
aimed at providing household services(hairdressers, attendants, massage therapists);
associated with the management of vehicles (drivers, machinists).

In addition to the above, the List of Works also contains other types of activities that, in the event of a physical or other illness of their performer, may pose a threat to the health and life of not only the employee himself, but also those around him.

Note: if an employee refuses to undergo a medical examination that is mandatory for his profession, the employer does not have the right to allow him to perform a labor function (paragraph 12, part 2, article 212 of the Labor Code of the Russian Federation).

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The organization of medical examinations of employees is carried out in the following sequence ...

Before sending their employees for a preliminary or periodic medical examination, the employer must take a number of organizational actions:

Conclude an agreement on the provision of services with a medical organization. It should be noted that mandatory preliminary and periodic medical examinations are carried out within the walls of medical institutions that have permission to conduct such examinations (clause 4 of the Procedure). In this organization, a commission should be formed and operate on a permanent basis from among medical specialists who have a valid certificate in the specialization "Occupational pathology" (clause 5 of the Procedure).
Make a list of the contingent, which includes representatives of professions (positions) provided at the same time staffing enterprises and the List of works. A list of harmful factors / conditions at work must also be compiled in accordance with the "List of factors" (clauses 19, 20 of the Order).
Send the contingent list no later than 10 days from the date of its approval by the manager to territorial body Rospotrebnadzor for approval (clause 21 of the Order).
Based on the list of the contingent, draw up a list of names of employees for whom medical examinations are mandatory (clause 22 of the Procedure). The list approved by the head is sent to the medical institution 2 months before the date of the medical examination agreed by the parties (clause 23 of the Procedure).
Agree with the medical institution the last calendar plan drawn up, which must be developed within 10 days from the date of receipt of the list of names and at least 14 days before the medical examination (clause 25 of the Procedure).
Familiarize employees for whom the passage of a medical examination is mandatory with the agreed calendar plan 10 days before the examination (clause 26 of the Procedure).
Issue directions for examination on the basis of the list of the contingent (clause 8 of the Procedure) and hand them over to employees before they undergo a medical examination (clause 24 of the Procedure).

In the event that the employer decides not to renew the contract with the medical institution, but to use the services of another organization, he must send a written request to transfer the medical records of employees according to the submitted inventory to a new medical institution (clause 36 of the Procedure).

The procedure for conducting mandatory preliminary and periodic medical examinations of employees in accordance with order No. 302n

The medical institution, on the basis of an agreement concluded with the employer, is responsible for the quality of the activities for the medical examination of employees, which the direct head of the enterprise is obliged to organize (clause 6 of the Procedure). Before applying to an authorized medical institution, an employee must receive a properly executed referral from the employer. Only on the basis this document a citizen can undergo an examination at the expense of the employer - both when applying for a job, and in the process of its implementation (clause 7 of the Procedure).

IMPORTANT! Mandatory medical examinations, including extraordinary ones, are carried out with the employee retaining the place of work and the average salary for the entire time spent on the examination (paragraph 11, part 2, article 212 of the Labor Code of the Russian Federation).

Passing preliminary medical examinations

The algorithm for passing an examination by an employee when visiting a medical organization provides for the following steps:

Presentation by the employee of the documents necessary for passing the inspection (clause 9 of the Procedure):
- referrals from the employer;
- passports;
- health passports (if any);
- conclusions of a psychiatric examination (in cases required by law).
Registration of documentation for the examined employee (clause 10 of the Procedure):
- a medical record containing the conclusions of doctors, the results of laboratory tests and other studies, as well as the conclusions of previous examinations;
- health passport (if it has not been issued earlier) - this document contains information about the medical institution, the employee and his employer, data on harmful factors at work and the time of working with them, and also duplicates the entries made in the medical record.
Examination of the employee by specialist doctors and the performance of all necessary studies provided for by the List of Factors and the List of Works for a specific category of employees (clause 11 of the Procedure).
Drawing up a conclusion based on the results of a medical examination of an employee (clause 12 of the Procedure). The document is drawn up in 2 copies, signed by the chairman of the medical commission, certified by the seal of the medical institution and handed over to the citizen (clauses 13, 14 of the Order).

Passing periodic medical examinations

In the course of the labor activity of employees, the employer is obliged to conduct regular periodic examinations within the time limits stipulated by the List of Factors and the List of Works (paragraphs 15-16 of the Procedure). At the same time, the Procedure determines such terms only for employees under the age of 21, who are examined annually (clause 17 of the Procedure).

Periodic medical examinations are carried out, as a rule, in large numbers, on the basis of lists compiled by the employer indicating the type of work performed by employees and listing negative factors of production (clause 19 of the Procedure).

The procedure for the periodic review is as follows:

Visit by an employee on the specified calendar plan day of the medical institution and presentation of a medical card and health passport (clause 28 of the Procedure). In the event that the employee does not have these documents, they are drawn up at this stage (clause 29 of the Procedure).
Examination of the employee by all medical specialists, as well as carrying out laboratory and other studies provided for this category of employees when working in adverse conditions specified in the List of Works and the List of Factors (clause 30 of the Procedure).
Drawing up a medical report (clause 31 of the Order).

Based on the results of the survey, the employee is assigned a dispensary group number. The medical record of the examined employee indicates the measures recommended for the prevention of possible occupational diseases, and if they are detected, for treatment and further rehabilitation (clause 32 of the Order).

In the event that the doctors of a medical institution, based on the results of a medical examination, have suspicions that an employee has an occupational disease, he should be sent to an occupational pathology center or another organization authorized to conduct an examination and establish a connection between the profession and the disease. In addition, the medical institution is obliged to notify the territorial body of Rospotrebnadzor about this (clause 40 of the Procedure). If it is difficult to make a diagnosis, the employee is also sent to the above-mentioned center for additional examination (a. 41 of the Order).

Final act on the results of a periodic medical examination

Within a month after the completion of the periodic medical examination (but no later than 30 days later), the medical institution summarizes the results of the examination of employees and, together with the territorial body of Rospotrebnadzor, draws up the final act (clause 42 of the Procedure). The act contains comprehensive information about the periodic medical examination carried out, a list of which is contained in clause 43 of the Procedure. The document is signed by the chairman of the commission of medical specialists and certified by the seal of the medical institution (paragraph 44 of the order).

The final act is drawn up in 4 copies, 3 of which are sent to:

employer
to the center of occupational pathology of the subject of the Russian Federation, on the territory of which the medical examination was carried out;
to the territorial body of Rospotrebnadzor.

The fourth copy of the act is subject to mandatory storage in the medical institution that conducted the medical examination for 50 years (clause 45 of the Procedure).

Let's summarize. The employer must, at his own expense, arrange for employees to undergo mandatory medical examinations if the work they perform is accompanied by exposure to factors harmful to health and is contained in the List of Factors and the List of Works. At the same time, the law defines an exhaustive list of categories of workers who need to obtain a medical certificate not only during the period of work, but also during employment.

The head of the enterprise, before obliging an employee to undergo an examination, must take a number of organizational actions and conduct preparations together with a medical institution that conducts examinations of workers. The employee is obliged, on the basis of the referral received, to visit the medical institution on the day specified in it and undergo an examination, otherwise he will not be allowed to work. For the period of mandatory medical examinations, the employer must not only retain the employee's position, but also pay for this time in the amount of average earnings.

List of doctors for periodic medical examination depends on what position the surveyed employee occupies, as well as on his gender. In our article you will find information about the standard list of doctors who will need to appear in order to confirm that your health condition meets the stated requirements, and about the procedure for passing medical examinations.

Which categories of employees are required to undergo periodic medical examinations

Taking care of the health of employees is one of the most important responsibilities of an employer. In accordance with Art. 213 Labor Code Russian Federation, are required to undergo a medical examination (both before entering a job, and subsequently, with a certain frequency):

workers employed in the performance of work characterized by the presence of harmful and / or dangerous production factors;
specialists working in the field related to the implementation of traffic;
workers working in the field Catering, medical and children's institutions, as well as some other organizations closely related to the provision of services to the population;
employees under the age of 21;
other categories of workers, the list of which is established by federal and local legislation.

In accordance with Part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, non-compliance by the employer this requirement entails the imposition of a fine, the amount of which can reach 130,000 rubles.

The procedure for preparing for the mandatory periodic medical examination

The sequence of actions of the employer aimed at organizing and conducting a periodic medical examination is as follows:

What documents are drawn up during a periodic medical examination, who pays for it

In contrast to the initial medical examination, which the employee undergoes before entering into contract of employment with the employer, when passing a periodic medical examination, a certificate drawn up in the form No. 086 / y or No. 001-GS / y is not required. Based on the results of a periodic examination of an employee in a medical organization, a conclusion is drawn up containing the following information:

date of issue of the document;
Full name of the person who passed the inspection;
name of the employing organization;
the name of the structural unit in which the employee works, as well as the exact name of his position;
a list of harmful and hazardous production factors that have a direct impact on his health;
the result of the examination and the conclusion of the doctor issued based on its results indicating the presence or absence of contraindications for the employee to perform the declared type of work.

This document must be signed by the chairman of the medical commission and certified by the seal of the healthcare institution. Also, the results of the passed medical examination are indicated in the health passport, which is kept by the employer.

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All costs for employees to undergo medical examinations, as well as laboratory and functional studies, in accordance with the provisions of Art. 213 of the Labor Code, fall on the employer. Regardless of which medical institution (public or private) will conduct a medical examination, the employer must conclude an agreement with him for the provision of appropriate services, the cost of which depends on the number of employees examined and the rates established by the clinic management.

Passing a medical examination by order of 302n - which doctors you need to visit

The procedure for conducting a periodic medical examination of employees of the enterprise is determined by the provisions of the order of the Ministry of Health and Social Development of the Russian Federation “On approval of the lists ...” dated 12.04.2011 No. 302n. In accordance with Art. 5 of section I of the said normative act, a medical examination must be carried out by members of a permanent medical commission, which includes:

occupational pathologist;
medical specialists who have completed an advanced training course in the specialty "occupational pathology", or doctors who have a valid certificate in this specialty.

The composition of this commission is approved by the order of the chief physician of the health care institution that provides medical examination services for employees of the enterprise.

Wherein list of doctors for medical examination depending also on the sphere in which the employee works, and the conditions for the implementation of his labor activity. Appendix No. 1 to Order No. 302n lists a list of harmful and dangerous production factors, in the presence of which an employee must undergo a health check by medical specialists. The same annex contains a list of doctors who must examine workers working in certain conditions, as well as the frequency of such examinations. In addition, the document contains an exact list of laboratory and functional studies, the conduct of which allows you to make the most objective and accurate conclusion about the health status of the employee.

List of doctors for re-examination at work

The list of doctors who need to be visited by an employee of the enterprise when he undergoes a medical examination is provided to him directly at the enterprise by the person responsible for the implementation of the medical examination and coordination of the process of its conduct. Depending on the position of the worker, this list may include:

otorhinolaryngologist;
dermatovenereologist;
ophthalmologist;
allergist;
oncologist;
urologist;
gynecologist;
surgeon;
endocrinologist;
neurologist;
orthopedist;
dentist;
infectious disease specialist;
mammologist (for women over 40), although in some cases a visit this specialist is replaced by the obligatory passage of the mammography procedure, followed by its presentation to the gynecologist.

IMPORTANT! The link of the 3rd list, specified in Appendix 1 to Order No. 302n, establishes the obligation of the employee to undergo an examination by a therapist, psychiatrist and narcologist. The legality of this norm is confirmed by the decision of the Supreme Court of the Russian Federation “On the refusal to recognize ...” dated December 18, 2012 No. AKPI12-1363.

The list of mandatory tests that every employee undergoing a medical examination must pass includes:

general analysis of urine and blood;
fluorography.

Note: this list may be supplemented by other types of examinations and analyzes (depending on the position held by the employee).

Who conducts a medical examination before the start of the working day or shift

In accordance with paragraph 4 of part 2 of Art. 46 of the Law "On the Fundamentals of Health Protection ..." dated November 21, 2011 No. 323 in order to identify the impact of dangerous and harmful production factors, as well as the presence of diseases that prevent the normal implementation of labor activity, some categories of workers (for example, drivers of vehicles transporting passengers ) are required to undergo a daily inspection before going to work. Unlike a periodic medical examination, this event does not take much time. Conducts it, in accordance with part 8 of the appendix to the order of the Ministry of Health of the Russian Federation “On approval of the procedure ...” dated December 15, 2014 No. 835n, a health worker with a higher or secondary medical education or a healthcare facility licensed to provide medical services(including medical examinations).

So, some categories of workers are required to undergo both primary and periodic medical examinations, during which their state of health is checked as doctors general practice, as well as narrow-profile specialists. The list of doctors, the examination of which is a prerequisite for the employee to carry out further work, laboratory tests and other studies, as well as a description of working conditions, the impact of which entails the need for regular examinations, are established by the provisions of the order of the Ministry of Health and Social Development No. 302n. On the basis of this document, a list of doctors is formed for each position, which should be visited by the employees occupying it.

All workers who by their kind professional activity are required to have a personal medical book, periodically must undergo medical examinations. The timing of medical examinations for employees of different enterprises and institutions varies.

REGULATORY BASIS FOR PASSING MEDICAL EXAMINATIONS

The volume and frequency of medical examinations is regulated by the order of the Ministry of Health of the USSR dated September 29, 1989 No. 555 “On improving the system of medical examinations of workers and drivers of individual vehicles” (as amended on March 14, 1996), and for residents of Moscow also by the Decree of the Government of Moscow dated December 28 .1999 No. 1228 "On mandatory preventive medical examinations and hygienic certification". The procedure for conducting preliminary and periodic medical examinations of employees is determined by the order of the Ministry of Health and Medical Industry of the Russian Federation of March 14, 1996 No. 90 (as amended on February 6, 2001).

Employees can undergo a medical examination in any medical institution (hereinafter referred to as HCI) that has the appropriate license (professional suitability examination, preliminary and periodic examinations) and relevant specialists.

The results of preventive medical examinations are entered in the personal medical book (hereinafter referred to as the medical book) on the appropriate page using a standard stamp and are certified by the seal of the health facility. The stamp must contain the name of the health facility, type, date, number and result of the study, which are certified by the signature of the person responsible for its conduct. The stamp and seal must be legible. The results of examinations entered into the medical record by hand (without using a standard stamp) are not counted.

EMPLOYEES OF THE FOOD INDUSTRY, CATERING ENTERPRISES, FOOD TRADE

When applying for a job

for this category of workers include: examination by a therapist and fluorographic examination of the chest organs, examination of feces for helminthiases and protozooses, scraping for enterobiosis - 1 time per year; examination by a dermatovenereologist, blood test for syphilis, bacterioscopic examination for sexually transmitted diseases - 2 times a year.

Employees associated with the production, storage, transportation and sale of cream and confectionery products, upon admission to work, in addition to the above, undergo an examination by a dentist, an otolaryngologist and a study for the carriage of staphylococcus aureus (nasopharyngeal swab), in the future - an examination by a dentist, an otolaryngologist 2 times a year.

Bacteriological examination for carriage of pathogens of intestinal infections, a blood test for typhoid fever, a smear examination for carriage of staphylococcus aureus are subsequently carried out only according to epidemiological indications.

Note.Financing of measures for the passage of preliminary, periodic medical examinations, hygienic training and certification of workers, and, consequently, payment for the registration of a medical book, art. 213 of the Labor Code Russian Federation assigned to the employer. Therefore, even if a potential employee, having received a medical book paid for by the employer, does not subsequently conclude an employment contract with this organization, it is impossible to force him to work off the expenses incurred by the employer. The Labor Code does not provide for the possibility of recovering from a potential employee losses caused by the failure to conclude an employment contract.

RA WORKERS OF PRESCHOOL EDUCATIONAL INSTITUTIONS

When applying for a job the volume of preventive medical examinations is: examination by a therapist and dermatovenereologist, blood test for syphilis, bacterioscopic test for sexually transmitted diseases, fluorographic examination of the chest, test for the carriage of pathogens of intestinal infections, serological examination for typhoid fever, stool test for helminthiases and protozooses , scraping for enterobiasis.

Periodic medical checkups for this category of workers include: examination by a therapist and fluorographic examination of the chest organs, examination of feces for helminthiases and protozooses, scraping for enterobiosis - 1 time per year; examination by a dermatovenereologist, blood test for syphilis, bacterioscopic examination for sexually transmitted diseases - 4 times a year.

EMPLOYEES OF GENERAL EDUCATIONAL INSTITUTIONS, INSTITUTIONS OF PRIMARY AND SECONDARY VOCATIONAL EDUCATION

When applying for a job

Periodic medical checkups

DO EMPLOYEES NEED TO BE VACCINED?

All workers from among the decreed contingents must be vaccinated against diphtheria (vaccination is carried out once every 10 years). In addition, workers under the age of 35 who have not been ill, unvaccinated or vaccinated once must be vaccinated against measles.

Information about vaccinations is entered on the appropriate page of the medical book using a standard stamp containing the name of the health facility, the name and series of the vaccine, and the date of vaccination. The stamp is certified by the signature responsible person and the seal of LPU.

If there are temporary or permanent contraindications to vaccination, an entry about this is made by the general practitioner in the medical book.

If an employee has been vaccinated against these diseases or has suffered them, but does not have documentary evidence of this, he should donate blood to test for immunity to these infections. Based on the results of such an examination, the therapist makes a conclusion about the need for vaccination.

WORKERS OF PHARMACY INSTITUTIONS

When applying for a job the volume of preventive medical examinations is: an examination by a therapist and a dermatovenereologist, a blood test for syphilis, a bacterioscopic examination for sexually transmitted diseases, a fluorographic examination of the chest organs.

Periodic medical checkups include: examination by a therapist and dermatovenereologist, blood test for syphilis, bacterioscopic examination for sexually transmitted diseases, fluorographic examination of the chest organs - 1 time per year.

UTILITIES WORKERS (EXCEPT SWIMMING POOLS)

Periodic medical checkups include: examination by a therapist and fluorographic examination of the chest organs - 1 time per year; examination by a dermatovenereologist, blood test for syphilis, bacterioscopic examination for sexually transmitted diseases - 2 times a year.

POOL MANAGERS

Periodic medical checkups include: examination by a therapist and fluorographic examination of the chest organs, examination of feces for helminthiases and protozooses, scraping for enterobiosis - 1 time per year; examination by a dermatovenereologist, blood test for syphilis, bacterioscopic examination for sexually transmitted diseases - 2 times a year.

note. Employees who carry out certain types activities, including those associated with sources of increased danger (with the influence of harmful substances and adverse production factors), as well as those working in conditions of increased danger, undergo a mandatory psychiatric examination at least once every five years in the manner established by the Government of the Russian Federation.

EMPLOYEES OF ORGANIZATIONS OF NON-FOOD (INDUSTRIAL) TRADE, PASSENGER TRANSPORT

When applying for a job the volume of preventive medical examinations is: examination by a general practitioner, examination by a dermatovenereologist, blood test for syphilis, bacterioscopic examination for sexually transmitted diseases, fluorographic examination of the chest organs.

Periodic medical checkups for these workers include: examination by a therapist and dermatovenereologist, blood test for syphilis, bacterioscopic examination for sexually transmitted diseases, fluorographic examination of the chest organs - 1 time per year.

SCHEME OF THE ORGANIZATION OF MEDICAL EXAMINATIONS

Conclude an agreement with a medical institution.
Issue an order on the organization of the order and frequency of medical examinations.
Compile lists of names of persons to be sent for medical examinations.
Give staff referrals to a medical facility.
Receive from the employee a conclusion signed by a doctor and certified by the seal of a medical institution, with the result of a medical examination.

The employer must draw up a list of names of persons who are required to undergo a medical examination, as well as timely send the employee for a medical examination. Usually, lists of employees are compiled jointly by an employee of the personnel department and a specialist in the labor protection service. And in the future, they control the timely passage of medical examinations.

Employees who have passed a preliminary or periodic medical examination and are found fit to work with harmful, hazardous substances and production factors are issued an appropriate conclusion signed by the attending physician and sealed by the health care facility.

If an employee has health problems and the medical commission has issued an appropriate conclusion, the employer, in accordance with Art. 73 of the Labor Code of the Russian Federation is obliged to transfer the employee to another job available in the organization that is not contraindicated for him for health reasons. If the employee does not agree to the transfer or the organization does not have the appropriate job, the employment contract is terminated under clause 8 of Art. 77 of the above code.

LETUKHICH E. V., Head of the Department of Hygienic Training, FGUZ “Center for Hygiene and Epidemiology in Moscow”, Candidate of Medical Sciences

Many professions are associated with dangerous or harmful factors that adversely affect a person's life. Some people do not have the opportunity to learn a particular craft at all for health reasons. To prevent industrial accidents and for the prevention of occupational diseases mandatory periodic medical examination. Consider the rules of its organization and determine the persons responsible for this.

Legislation on the medical examination procedure

The employer is fully responsible for labor safety. The law imposes on him the obligation to timely organize the passage of a medical examination when applying for a job or during the period of employment. The following legal documents govern this obligation:

TK RF.
Order of the Federal Ministry of Health of 2004 establishing a list of dangerous and harmful production work which require periodic medical examinations of employees.
Order of Rosminzdravmedprom, which contains information on the category of employees subject to mandatory medical examination, indicating its frequency.
Industry documents (sanitary rules and regulations).

The Labor Code obliges employers to organize a medical examination by an employee who must comply with the requirements of medical control. Violation of the rules by an employee or employer can lead to administrative liability. A periodic medical examination not passed on time will result in the removal of the employee from execution official duties. Moreover, if it is the fault of the employer, then the duration of downtime will be paid. Otherwise, the person will be left without wages.

The concept and goals of a medical examination

A medical examination is a set of measures and interventions that are aimed at diagnosing pathological conditions in a person and preventing the risks of developing occupational and other diseases. Periodic procedures are carried out in order to monitor the health of employees and reduce industrial injuries. For each, there are deadlines in which the employee is required to see a doctor.

Periodic physical examination pursues and timely response to changes in health status. It is thanks to such events that it is possible to recognize the development at the initial stages and begin timely treatment. The results of the survey may prompt the employer to transfer the employee to a less hazardous area of production. The verdict of the medical commission ultimately either confirms the fact that the employee is fit to perform his duties, or, conversely, does not allow him to do so.

Prerequisites for medical examination

Conducting periodic medical examinations is carried out at a certain time, which depends on the degree of danger of production factors and their type of harmfulness. It is possible to determine whether an employee is affected by any adverse conditions using the appendix to Order No. 302n.

Classification of dangerous and harmful production factors

Group of factors	Varieties
Chemical	Mixes and chemical substances, which are measured in the air of the working area and on human skin. These include substances of a biological nature obtained by chemical synthesis (vitamins, antibiotics, enzymes)
Biological	Pathogenic microorganisms, producers, spores and living cells, pathogens of infections and epidemiological diseases
Physical	Vibroacoustics, microclimate, non-ionizing and ionizing radiation, light environment
Severity of labor	Physical static and dynamic load, movement in space, working posture, weight of the load being moved and lifted manually
Labor intensity	Hearing stress, active monitoring of the production process, density of sound and light signals, stress on the vocal apparatus

Under the influence of at least one of the listed factors, a periodic medical examination should be carried out at least once a year.

Today, when applying for almost any position, it is necessary to undergo a preliminary medical examination. And this is not at all a whim of the employer. Preliminary and periodic medical examinations, in addition to employees exposed to hazardous and harmful factors, are employees:

treatment-and-prophylactic and children's institutions;
Food Industry;
trade;
Catering;
waterworks.

Mandatory inspection is carried out in order to protect the population from the emergence and spread of dangerous diseases.

Referral for medical examination

Preliminary and periodic medical examinations are regulated by Order No. 302n. In the first case, before being hired for a certain position, the employer issues a referral to the applicant, which contains data on the enterprise, the intended position and the nature of harmful or hazardous production factors (if any). The list of specialists and laboratory and functional studies that a future employee needs to undergo is established in accordance with the List of Works and Harmful Factors. The medical examination is considered completed if all prescribed procedures are completed. At this stage, a medical opinion is formed, which allows or prohibits the employee from taking a certain position. It is important to understand that in the event of a negative decision of the medical board, an employment contract cannot be concluded with the applicant.

Periodic medical examinations of employees are carried out within the time limits specified in the List of Works and Harmful Factors. Two months before the next medical examination, the employer is obliged to issue a referral to the employee. The employee undertakes to appear at the specified time.

Organization of periodic medical examinations

Before sending employees to a medical facility for a medical examination, the employer has to do several things. First of all, you need to make a list of the contingent of workers. This is a regulatory act of an enterprise containing information about the professions of employees that are subject to a preliminary or periodic medical examination. A sample of the established form for this document is not provided, but a list of data has been developed that should be indicated in it:

the position of the employee according to the staff list;
name of harmful or type of work.

This may also include Additional Information at the discretion of the employer. The list of contingents is approved once, until any changes occur at the enterprise (new jobs, improvement or deterioration of working conditions, reorganization). The finished document is sent to Rospotrebnadzor.

Name lists of persons are developed annually two months before the agreed date of the medical examination. It must indicate the length of service precisely in the conditions of the declared production factor. It should be noted that the passage of a periodic medical examination is carried out at least once every 2 years in a medical institution and once every 5 years in the center of occupational pathology. The lists are compiled separately.

Issue of the order

The company concludes an agreement with a medical institution, where employees will undergo regular medical examinations. After agreeing on the terms, surveys are drawn up, with which it is necessary to familiarize the employees. Each person from the surname list confirms the fact of informing with a personal signature. At the same time, the employee may be issued a referral for a periodic medical examination.

The need for planned preventive measures is confirmed by the issuance of an order, which is drawn up in an arbitrary form. Consider the approximate content of this document:

Order "On Periodic Medical Examination"

In accordance with Art. 212, 213, 266 of the Labor Code of the Russian Federation,

I ORDER:

Approve the lists of employees who are subject to mandatory medical examination in 2016. A schedule of preventive measures and a list of employees is attached.
Send the employees specified in the list to the medical institution "City Polyclinic No. 2" in accordance with the established schedule for undergoing a medical examination.
The heads of departments and subdivisions should not allow the specified employees to perform their official duties until the examinations have been passed.
Heads of departments and divisions to acquaint employees with the order under the signature.
Control over the execution of the order is assigned to Ivanov I.V.

After that, the full name of the director, his personal signature and applications with a surname list of persons who need to appear at the medical institution for medical examination are indicated. The order for periodic medical examinations is a mandatory document, which is drawn up on the basis of the Labor Code of the Russian Federation and the Order of the Federal Ministry of Health No. 302n.

The frequency of inspection for certain professions

As already mentioned, health monitoring of employees is carried out under the condition that the latter work in hazardous and hazardous industries, regularly visit clinics and representatives of professions who in one way or another come into contact with a large number of people. Mandatory periodic medical examinations are required for employees:

Food industry, food trade, public catering - twice a year, studies are carried out on infectious diseases and STDs, as well as analysis for the carriage of staphylococcus and other bacteriological studies. Once a year, fluorography, a consultation with a therapist and laboratory tests for the presence of helminths are prescribed.
Children's preschool, school and secondary professional, medical institutions - examination for the presence of STDs, infectious diseases and bacteriological studies are carried out up to 4 times a year. A general therapeutic commission with the passage of fluorography and laboratory tests is required once a year.
Pharmacies and non-food trade - once a year, an examination by a dermatovenereologist, a therapist, fluorography and laboratory tests are shown.
Communal services for the population and swimming pools - 2 times a year are examined for the presence of STDs and 1 time per year they undergo a standard medical examination. Vaccination against diphtheria is required.

It is worth noting that the number of examinations, regardless of profession, includes such procedures as fluorography, a blood test for syphilis, bacteriological studies for STDs, an examination by a narcologist and a psychiatrist. For women, a visit to the gynecologist is mandatory.

Medical examination of persons working in hazardous and hazardous industries

Depending on the category of hazardous factors, the deadlines for employees to pass the mandatory one should be taken into account that, regardless of the length of service and profession, the following persons are subject to an annual examination:

under 21;
employed in the Far North region (including in areas equated to them) from another locality;
working on a rotational basis.

Consider the frequency of medical examination depending on the working conditions (profession).

Medical examination for employees of hazardous (dangerous) production

Types of work (production), profession
Explosive fire	1 time per year
Using and carrying weapons	1 time per year
emergency services	1 time per year
Service electrical installations (over 42 VAC, over 110 VDC)	1 time in 2 years
In areas remote from honey. institutions	1 time per year
Work on machines and equipment with moving parts	1 time in 2 years
Underground and high-altitude works	1 time per year
Land transport management	1 time in 2 years
Underwater work in a gaseous environment (at normal pressure)	1 time in 2 years

Do not forget that there is a professional periodic medical examination, which is necessary to pass in the center of occupational pathology once every five years.

Medical examination before the start of the working day (shift)

Some employees, who are responsible for more than their own lives, undergo a small physical examination daily. This includes workers employed in hazardous and hazardous industries. Purpose: to control the state of health after labor day and fixing complaints about well-being. Drivers of all ground vehicles, as well as pilots, undergo periodic medical examinations at work. This time is included in the composition of the working day (shift) and takes 15 minutes at the most, unless, of course, there is a suspicion that the employee's condition is deteriorating. Procedures include measurement of pulse, pressure, general assessment of health status and reactions. Periodic medical examination of drivers without fail includes checking the clarity of consciousness. In the presence of alcohol or drug intoxication (which is confirmed or denied by express tests if necessary), the employee is removed from the flight. Medical exemption from performance job duties general malaise, pressure drops can also become.

The legislation made it mandatory to pass a pre-trip check of the condition of drivers for each enterprise or individual entrepreneur. Every employee in vehicle, which belongs legal entity undergoing a medical examination. The doctor or paramedic decides on the admission of the employee to work. Conclusion honey. personnel must be strictly observed.

Who pays?

In order for an employee to undergo a periodic medical examination, it is required to pay for preventive procedures. Who bears the cost of the medical examination? When hiring and carrying out labor activities, the costs of a medical examination are borne by the employer. This rule is regulated by the Labor Code of the Russian Federation (Article 213). The enterprise is free to independently choose a medical institution. Before concluding a contract with an organization, you should make sure of the following points:

the organization is licensed;
in the list of services and works in the appendix to the license, it is noted that the institution has the right to conduct medical examinations or an examination of professional suitability;
has all the necessary specialists on staff;
owns the required equipment;
provides services at the address specified in the license.

It is also necessary to clarify the procedure for examination by a narcologist and a psychiatrist. Often additional visits to dispensaries are required to obtain mental and physical health certificates. The cost of services is determined based on the number of required consultations and studies.

Even if the applicant does not find a job after passing the medical examination, the employer does not have the right to demand reimbursement of expenses. Deductions from wages or self-payment for preventive examinations are unlawful in relation to the employee. The employer is obliged to bear all expenses and, in addition, to keep the employee's salary for the duration of the medical examination within the average daily wage.

Periodic medical examination is an important event that allows timely diagnosis of occupational and socially dangerous diseases. Procedures are performed primarily in the interests of the employee. Both the employer and the employee should comply with the requirements of the law on passing medical examinations. Violations result in significant administrative fines.

The current legislation provides for a strict procedure for organizing medical examinations at the enterprise, the violation of which may lead to the employer being held liable. At the same time, it is also allowed to conduct a medical examination on the territory of the enterprise, which can have a sufficient number of advantages for both the employer and employees. It will be useful for all parties to the labor relationship to know how to properly ensure the passage of a medical examination at the enterprise, and how this process is organized.

What is a medical examination at the enterprise and the regulatory framework for their implementation

Under the medical examination, Russian legislation implies a procedure that is mandatory in some cases, consisting in an examination by a certain list of medical specialists, as well as passing a number of established tests. Wherein legislative regulation This issue is provided by a very wide range of regulations and documents. In particular, both employees and employers who wish to provide a medical examination at the enterprise should at least pay attention to the provisions of the following regulations:

Federal Law No. 323 dated November 21, 2011. The norms of this law establish the general principles and definition of a medical examination, the main types of medical examinations and other aspects of the said procedure.
Federal Law No. 52 dated 30.03.1999. This law considers in its provisions the basic principles by which measures are taken to protect the Russian population from adverse sanitary and epidemiological factors. And medical examinations at the enterprise are one of the important components of these protective measures.
Order of the Ministry of Health and Social Development No. 302n of 04/12/2011. This document contains the most complete list of harmful factors inherent in various professions and activities, and also establishes the relationship of various with the need to pass. Also, depending on each harmful factor, this order regulates not only the regularity of periodic medical examinations at the enterprise, but also directly the doctors and tests that must be passed by employees.
Order of Rospotrebnadzor No. 402 dated 05/20/2005. The regulatory provisions of this document establish the concept, its form, and also regulate the general principles of its design and situations in which employees, in addition to medical examinations at the enterprise, should issue a medical book.
Article 69 of the Labor Code of the Russian Federation. The provisions of this article of the Labor Code of the Russian Federation establish the possibility of conducting medical examinations in relation to certain categories of workers during their.
Article 213 of the Labor Code of the Russian Federation. The norms of the aforementioned article of the Labor Code regulate the issues of conducting medical examinations at the enterprise as a whole, and also establish a short list of positions for which this procedure is mandatory and cannot be ignored.

In general, there are a lot more normative documents governing the conduct of medical examinations by representatives of individual professions or organizations. For example, medical examinations of employees of the prosecutor's office, the Ministry of Internal Affairs or the FSB are mandatory and are carried out in a separate order - the relevant laws on each of the indicated structures can inform about the procedure for conducting medical examinations in these situations.

In general, it should be remembered that a medical examination in relation to a number of professions is a mandatory action that must be performed both when applying for a job and periodically with a certain regularity. Violation of the procedure for conducting a medical examination in this case may be the basis for holding the employer liable. But in relation to the employee, the legislation provides for the possibility of imposing certain sanctions.

So, if the medical examination was not passed by the employee through no fault of the employer, then the latter not only has the right, but is also obliged to remove the employee from work duties without saving him wages up to a medical examination.

The procedure for conducting medical examinations at the enterprise

Immediate legislative requirements that would strictly fix general order conducting medical examinations in simple organizations no - such an order may provide for on separate public services and to assume, for example, as in the case of the police, the imposition of additional disciplinary action on employees for failing medical examinations. But in general situations, the employer has the right to determine the procedure and methods for conducting a medical examination in an organization.

The main tool that serves to establish and consolidate such an order is the local regulations of the enterprise, as well as the provisions of the collective agreement or directly individual employment contracts with workers. At the same time, the employer has the right to establish the obligation to conduct medical examinations in relation to employees for whom they are not required from the point of view of the current legislation.

However, in any case, compensation for the costs of medical examinations must be provided by the employer in accordance with the provisions of the Labor Code. In general, in practice, there are several main options for organizing medical examinations at the enterprise:

Referral of employees for independent medical examinations to any accredited medical facility. In this case, the employer does not bear any responsibility for the preliminary conclusion of contracts with medical organizations and simply issues a referral to each employee for a medical examination. At the same time, the employee subsequently has the right to compensation for all costs associated with a medical examination from the employer directly. This method is usually used in small organizations where it is not possible to provide centralized labor protection measures.
Conclusion of an agreement on medical care employees and conducting medical examinations with a separate medical institution. If the organization assumes such a procedure for conducting a medical examination, then the employer concludes an agreement with a medical institution for conducting medical examinations. This approach can significantly reduce total costs the employer with a large staff, and also reduces the costs of the employees themselves - with such a centralized service, they do not need to confirm the costs of a medical examination, since it was initially paid by the employer. In addition, in these situations, medical examinations are often carried out without any queues and delays as soon as possible.
Exit medical examination. Some medical institutions offer services for medical examinations directly on the territory of the enterprise. This method allows minimizing the loss of actual labor time for employees to undergo a medical examination, but in itself is much more costly for the enterprise.
Organization of own medical complex. With regard to periodic medical examinations, only accredited medical institutions or organizations that have their own departmental hospitals can organize their passage directly on the territory of the enterprise. This is due to the fact that there are a lot of requirements for the qualifications of doctors and the range of tests necessary for a medical examination, and it is quite difficult to provide such a large staff of medical specialists with all the necessary equipment. However, in the context of daily medical examinations, for example, of drivers or miners, it is enough for an enterprise to have a specially equipped medical office with one accredited employee, which is much easier to do than to call doctors daily for a medical examination, or to send employees to a medical facility.

The direct procedure for organizing medical examinations may look something like this:

The employer fixes regulations conditions and principles of passing medical examinations by employees. At the same time, it is recommended to allocate the specification by positions, age of employees, their departments and maximize the accuracy of issuing referrals. The employer also appoints a person responsible for labor protection, who may be entrusted with the obligation to store documentation related to the medical examination and maintain appropriate logs.
The employer establishes the conditions for confirming the fact of passing a medical examination by employees. These may include both giving medical book for storage, if it is issued for employees, and the provision of only certificates of medical examinations, or copies of the said documents. In addition, the procedure for recording and storing the said documentation is established.
The person responsible for labor protection draws up a schedule for medical examinations. In this case, there may be two different key options for approaches. In one case, the person responsible for labor protection keeps records of the passage of medical examinations for each individual employee, issuing a referral for him when the next periodic medical examination is due. In another case, the enterprise sets general charts conducting medical examinations for individual departments or in general for all employees of the organization, which can significantly reduce the costs of time and documentary turnover associated with the implementation of the aforementioned procedures.
If an employee is identified who refuses or for other reasons does not undergo a medical examination on time, the employer must remove him from the performance of labor duties, and if the suspension period exceeds four months, he has the right to dismiss such an employee.

If the employee did not pass the medical examination due to the fault of the employer, then the latter cannot dismiss the said employee, and for the entire period of suspension, the employee must be kept his average salary.

The employer should take into account many other nuances associated with the conduct of medical examinations. In particular, he can establish the procedure for passing medical examinations at strictly designated times and in certain medical institutions. Violation given order by an employee, for example - passing a medical examination at the wrong time or in the wrong place deprives the latter of the right to receive medical examination compensation, but does not invalidate its results - the employer is obliged to accept a medical examination certificate in any case if it is properly executed in an accredited institution and in accordance with the list of doctors and tests necessary for passing.

Medical examination on the territory of the enterprise - is it possible, how to conduct

Separately, the possibility of conducting medical examinations at the enterprise should be considered directly. At the moment, many medical institutions offer the possibility of conducting medical examinations and taking tests on the territory of the organizations themselves, without the actual long separation of employees from work. This approach allows minimizing the costs associated with the absence of employees in the workplace, and also makes it possible to much more effectively control the inspection of all employees without exception.

Despite the fact that the cost of such services for conducting a medical examination on the territory of the organization, such a procedure has a number of advantages that can provide additional savings. So, as mentioned above - the time of separation of workers from labor process in this case will be minimal. In addition, in any case, the employer is obliged to ensure that the time spent by employees on medical examinations is recorded and paid - and the acceleration of the entire procedure as a result can seriously affect the costs of the employer.

But the most relevant medical examinations on the territory of the organization are directly for those areas of activity where employees are required to undergo not only primary or periodic medical examinations, but also daily examinations. So, this applies primarily to drivers and employees employed in underground work. In this case, the employer can either organize his own office with the hiring of a full-time specialist who has the right to conduct medical examinations, or, again, resort to the services of third-party medical institutions.

They, in turn, can either organize an office for themselves on the territory of the enterprise or use the office offered by the employer, or use other methods of field medical examinations. For example, now cars are quite common with a ready-made office equipped in the back, which has everything necessary equipment for quick and convenient inspections on the territory of any enterprise.