Order 302n of 12.04 11. We draw up a referral for a periodic medical examination. What is said in the new edition of the normative act on the passage of medical examinations

How order 302n regulates the procedure for conducting preliminary, periodic and mandatory medical examinations, who is obliged to undergo medical examinations by order 302n, we will figure it out in the article.

From the article you will learn:

How order 302n regulates the procedure for passing medical examinations

Medical examinations are subdivided into:

preliminary;
periodic;
extraordinary.

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Applicants undergo a preliminary examination. The main purpose of the survey is to obtain data on the health status of a future employee who will be engaged in certain activities. Periodic examination reveals risks occupational diseases from employees working in adverse working conditions.

Practice question

When it is necessary to carry out a mandatory medical examination of an employee

The answer was prepared jointly with the editors

Nina Kovyazina answers Deputy Director of the Department medical education and personnel policy in healthcare of the Ministry of Health of Russia

Carry out medical examinations of employees if their work is associated with harmful or dangerous working conditions, traffic, food industry, catering, as well as a number of other areas of activity. Also perform physical examinations for employees under the age of 18. For more information on who should undergo medical examinations and when, read our recommendation.

Employees subject to mandatory medical examination

Employees performing certain types of work undergo mandatory medical examinations at the expense of the organization. This category of personnel includes, in particular:

employees engaged in work with harmful or hazardous working conditions, including underground work (Art. , Labor Code of the Russian Federation);

employees engaged in work related to traffic, (Art. and Labor Code of the Russian Federation, Law of December 10, 1995 No. 196-FZ);

employees of enterprises Food Industry, catering and trade, water supply facilities, treatment-and-prophylactic and children's institutions ( );

departmental security officers ( ).

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Order 302n on the passage of medical examinations was issued on April 12, 2011 by the Ministry of Health and Social Development of Russia. The document approves the list of harmful and / or dangerous production factors and work in the performance of which must be carried out mandatory preliminary and periodic medical examinations(surveys). In addition, order 302n on conducting medical examinations established the procedure for preliminary and periodic examinations of workers who are engaged in heavy production or work in harmful / dangerous working conditions.

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Order on approval of the plan of mandatory periodic medical examination
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Order 302n along with Labor Code is the main document that the employer should be guided by in matters of passing medical examinations by employees. Appendix No. 1 contains a list of dangerous, harmful production factors, in the presence of which employees are subject to mandatory medical examinations. Appendix No. 2 contains a list of professions that are subject to periodic inspection... Appendix No. 3 indicates the procedure for conducting the survey.

Medical examination by order 302n

Hazardous and harmful factors by profession in order 302n are subdivided into chemical, biological, physical and factors of the labor process, harmful factors include, for example, such as:

dust of animal, vegetable origin with admixtures of silicon dioxide, poisonous fish, plants, animals (biological);
ethane, methane, propane, ethylene, paraffins (chemical);
ultraviolet radiation, electromagnetic field (physical);
static load, work with optical devices (refers to the factors of the labor process).

In order 302n on medical examination in Appendix No. 1, the information is given in the form of a table, which indicates the harmful factors and frequency of inspections, the names of the medical specialists who conduct the examination are presented, the main and additional studies are described. The table should be used taking into account the relevant notes and explanations.

The table in Appendix No. 2 is compiled in a similar way. The frequency of examinations, the types of work whose employees undergo medical examinations... In order 302n, the most significant is Appendix No. 3.

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It should be borne in mind that these lists of factors and professions are not exhaustive. Some employees are subject to examinations on the basis of other norms of the current law. Taking into account articles 69 and 226 of the Labor Code of the Russian Federation employees are sent for medical examinations under the age of 18. And on the basis of article 298 of the Labor Code of the Russian Federation - shift workers.

Practical situation

The requirements for medical examinations have been tightened. Who should be sent to doctors now

The answer was prepared jointly with the editors of the magazine ""

Julia DEVYATKOVA answers,
lawyer, expert of the "Personnel business" magazine

For each employee who has not passed the mandatory medical examination, the company will be fined 130,000 rubles. At the same time, employers and supervisory authorities have no consensus on when certain categories of workers should undergo medical examinations. For example, whether medical supervision is needed for those who work on the computer or use official vehicles. The Supreme Court takes the side of the examiners in controversial situations.

How order 302n on medical examinations is applied in the work

Order 302n, with amendments and additions, regulates the procedure for passing medical examinations. Section II of Appendix No. 3 describes the procedure for each type of inspection. To undergo a medical examination when applying for a job (on the basis of order 302n), the applicant is given a referral. The legislation does not approve a unified form for such a direction, the employer has the right to develop and approve the form independently.

The mandatory information that must be present in it is indicated in paragraph 8 of Appendix No. 3 to the order of the Ministry of Health 302n. The same referral form can be used for periodic and unscheduled examinations.

... Based on the results of the examination, the medical institutions issue an appropriate conclusion. Requirements for the availability of information in it are specified in clause 13 of Appendix No. 3 of the order in question.

When sending an employee for a medical examination, he should be issued a document (referral standard sample from the order form 302n), which he must transfer to a medical facility when passing doctors. Depending on the information provided in the direction, appropriate medical specialists and analyzes are assigned.

Based on the results of the completed medical examination (preliminary when applying for a job or periodic) the employee is issued an opinion to be handed over to your employer. The conclusion determines the level of a person's health and helps to establish whether a given employee is able to work in a position without harm to his health.

There is a legislative document - Order No. 302n dated 04/12/11, which prescribes for which persons, medical examinations are mandatory, and also determines the procedure for carrying out this procedure. The same order has in the appendix typical referral form that can be used for decoration.

A sample of this form of referral for a medical examination, established by order No. 302n, can be downloaded at the bottom of the article in word format. We also offer to download the referral form for preliminary and periodic medical checkup.

Video - How to send an employee for a medical examination when applying for a job (what you need to know)

How to make a referral correctly?

Each organization must have in place such a document as a list of the contingent with a list of those persons who are required to undergo medical examinations. Workers should be notified on the need for medical examinations and their frequency. This list is the basis for issuing a referral to an employee for a medical examination.

The procedure for conducting inspections, prescribed in order No. 302n, identifies those mandatory items that must be present in the direction, including:

information about the company that is the employer (name, form of ownership, OKVED);
data on the medical institution with which an agreement on the provision of medical services has been concluded (name, address, OGRN);
type of inspection (preliminary, periodic);
data about the employee to be examined;
position or type of work performed;
hazards and hazards established for these jobs or positions.

The drawn up referral form for a preliminary or periodic medical examination is signed by a person representing the interests of the organization in this matter.

To warn occupational diseases, the emergence and spread of infectious diseases, to determine the suitability of employees to perform the assigned work, preliminary (before the start of work) and periodic (in the process of work) medical examinations are carried out.

According to which order of the Russian Federation are mandatory medical examinations carried out?

To provide without hazardous conditions and labor protection, the employer conducts medical examinations of employees, payment of the costs of their conduct is carried out by the employer.

Mandatory medical examinations are carried out in accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n (hereinafter referred to as the Order).

Who undergoes a medical examination on order 302n?

Periodic medical examinations take place in mandatory only some categories (parts 1, 2, article 213 of the Labor Code of the Russian Federation), in particular:

workers who perform work in harmful as well as hazardous conditions;

workers performing work related to the movement of transport, including employees of subways;

workers in the food industry;

employees of trade organizations and Catering;

workers of waterworks;

workers of medical organizations;

workers of children's institutions;

workers engaged in the production and circulation of food products;

workers providing hairdressing and beauty services in public utilities;

medical workers, rescuers, other personnel of the water park located in the water zone.

The frequency of the medical examination

The frequency with which periodic medical examinations are carried out is determined by the factors of the working environment that affect the employee, or by the type of work.

Periodic medical examinations are carried out within the time frame established by the Order.

Employees under the age of 21 undergo medical examinations annually, the rest of the employees are subject to medical examinations once every 1-2 years.

Medical examination by order 302n: which doctors to undergo

Medical examinations are carried out by state, private organizations licensed to conduct medical examinations. To conduct a periodic medical examination, the organization creates a commission of doctors, acting on a permanent basis.

Depending on the conditions of implementation labor activity, as well as taking into account the recommendations of specialist doctors, other doctors are involved in the medical examination, in particular, an otorhinolaryngologist, dermatovenerologist, neurologist, ophthalmologist, allergist.

Medical diagnostics

All employees who are subject to periodic medical examinations carry out laboratory and functional studies in the form of:

clinical analyzes of urine and blood;

fluorography or chest x-ray;

biochemical screening.

Working women are annually examined by an obstetrician-gynecologist with obligatory research: bacteriological and cytological.

For women, a study of the mammary glands is also provided by means of mammography or ultrasound once every 2 years. This requirement applies to women over the age of 40.

Depending on the conditions of employment, ultrasound, spirometry, blood tests, including hormonal, and other specific medical examinations can be performed additionally.

Guarantees for employees during medical examination

The employee who is obliged to undergo a medical examination retains his place of work, position and wage(Article 185 of the Labor Code of the Russian Federation).

Consequences of failure to pass a medical examination

Since the passage of the medical examination is the duty of the employee, in case of failure to fulfill this obligation or the identification of contraindications for performing work based on the results of the medical examination, the employee is not allowed to work (paragraph 4 of part 1 of article 76 of the Labor Code of the Russian Federation). During the entire period of inadmissibility to work, the employee is not entitled to wages. But if the employee did not pass the medical examination through no fault of his own, the period during which the work is not performed is paid to him as a simple one.

Since the date of its original publication, the order 302n itself on the passage of medical examinations has never been changed or supplemented, but in 2013 and 2015 changes were made to its appendices.

Compared to the original edition, the following changes have been made to the annexes:

the list of hazardous and harmful production factors has been expanded, for example:
added to chemical factors welding aerosols with manganese- and silicon-containing compounds;

in biologicals, the number of allergens, infected material has been significantly expanded and hepatitis B, C and AIDS viruses have been added, etc .;

a new section on ionizing radiation and increased gravitational overloads, etc., has been added to the physical;

the number of specialist doctors performing medical examinations has increased (dentists, allergists, endocrinologists have been added to the sections where they were not originally there);

an increase in the number of additional contraindications for work in certain conditions (for example, in electromagnetic fields) and for certain types of work (for example, for work in remote geographic areas and for work with machine tools);

a completely new section of substances and compounds, united by a chemical structure, causing various kinds of diseases (section 1.2 of chemical factors) has been added, and the list of pesticides has been significantly expanded (section 1.3.2).

Contingent list by order 302n

The contingent of workers who, in accordance with the order of the Ministry of Health and Social Development dated 12.04.2011 No. 302n, should be sent for a medical examination, is formed from the list of positions and professions, upon employment for which employees are subject to a medical examination.

Everyone who is busy is sent for inspection:

in harmful and dangerous working conditions ( chemical production, ionizing radiation, etc., a complete list of factors is indicated in Appendix No. 1);

for a certain type of work (at height, under water, underground, etc., a complete list is given in Appendix No. 2).

The contingent list is a mandatory document and must contain:

the names of positions and professions for which compulsory and periodic medical examinations are carried out in accordance with the current legislation (Appendix No. 2);

harmful and dangerous working conditions (Appendix No. 1). Necessary clarification: all working conditions are determined based on the results special assessment working conditions.

Due to the fact that the form of the document is not legally approved, it can be made in the form of a list, order 302n with the change in 2019 on the medical examination permits this.

Harmful production factors by profession

Each profession has its own harmful working conditions, however, order 302 of the Ministry of Health does not provide for a referral for medical examination by profession as such. But it provides for the presence or absence of harmful and hazardous production factors, such as elevated level electromagnetic radiation and reduced physical activity from the computer operator.

According to order 302n, harmful production factors by profession are:

chemical;

biological;

physical;

conditions of the labor process associated with the performance of work in certain conditions and with certain substances that can harm health or lead to the death of a person.

The presence or absence of specific harmful working conditions is determined based on the results of a special assessment of working conditions carried out in accordance with Federal law dated 28.12.2013 No. 426-FZ. Exhaustive lists of harmful factors are set out in Appendix No. 1 to Order 302n on the passage of medical examinations.

List of employees by order 302n

The list of employees according to order 302 is compiled each time employees are sent for periodic medical examinations.

This document is drawn up on the basis of the "Contingent ..." (302n dated 04/12/11 of the Ministry of Health and Social Development, referral for a medical examination) and includes:

FULL NAME. employee, his profession or position.

The name of the harmful or hazardous production factor.

The name of the structural unit.

How to get a referral for a medical examination on the 302n form

According to the norm, which was approved by order 302n of 04/12/11 of the Ministry of Health and Social Development, a referral for a medical examination is issued during an interview for employment, while the candidate must sign for receiving a referral to special journal... The referral is issued by an employee performing documenting hiring and firing employees.

In the direction by order 302n, the following must be indicated:

The name of the organization that issued the referral.

Ownership and 8-digit code economic activity according to OKVED.

Name medical organization, the actual address of its location and the OGRN code.

Type of medical examination (preliminary or periodic).

FULL NAME. a person entering or working employee.

Date of birth of the person applying for the job (employee).

The name of the structural unit (if any) in which the candidate (or current employee) will be employed.

The name of the position (profession) or type of activity.

Harmful and hazardous production factors, as well as the type of work in accordance with the approved "Contingent of workers".

The referral is signed by the employee who issued the referral, indicating his position, surname, initials.

Final act of physical examination

In accordance with order 302n, a medical organization, upon completion of a periodic medical examination by employees, together with representatives of the employer and Rospotrebnadzor, draws up a final act by order 302n, which indicates:

Date of preparation;

employer name;

the name of the medical organization;

the percentage of employees covered by periodic medical examinations;

a list of newly diagnosed chronic somatic diseases with an indication of the class of diseases;

the results of the implementation of the recommendations of the previous final act;

recommendations for the implementation of a complex of recreational activities;

lists of employees who have not completed, have not undergone a periodic medical examination, as well as those for whom a persistent degree of disability and other indicators have been established (the full list is in paragraph 43 of the procedure for conducting preliminary medical examinations by order 302n).

The final act on order 302 is approved by the chairman of the commission, who certifies it with the seal of the medical organization.

Order 302 on medical examinations establishes the rules for compulsory medical examinations of employees entering work and already working at the enterprise. You will learn how to organize such inspections from our article.

What is said in the new edition of the normative act on the passage of medical examinations

According to Art. 213 of the Labor Code of the Russian Federation, the need to undergo preliminary and regular medical examinations is provided for employees associated with traffic Vehicle(for example, drivers) or working in harmful / dangerous conditions. As indicated in para. 12 h. 2 tbsp. 212 of the Labor Code, the organization of such medical examinations is entirely the responsibility of the employer, including its material support.

The procedure for passing preliminary / periodic medical examinations, as well as lists of factors and work affecting the frequency of examinations, are established by order of the Ministry of Health and Social Development dated 12.04.2011 No. 302n about medical examination with attachments - according to law such inspections should be carried out at regular intervals. In order to protect the health of the population, medical examinations are mandatory:

catering workers;

employees associated with water supply networks;

citizens working in medical and children's institutions.

What is indicated in Appendix 1 and Appendix 2 to Order 302n of the Ministry of Health

In Appendices 1 and 2 to order 302n on medical examinations contains exhaustive lists of production factors, types of work and types of professions, the presence of which in the employee's labor activity indicates the need for a medical examination.

In particular, in Appendix 1, hazardous production factors are divided into the following groups:

Chemical, if during work there is contact with chemicals that have:
pronounced negative effects on the human body (for example, carcinogens, silicates, welding aerosols);

combined chemical structure (eg ammonia, formaldehyde, ketones, arsenic);

certain economic purposes (for example, pesticides, polymers, dyes).

Biological (e.g. materials contaminated with microorganisms, biotoxins).

Physical (for example, electromagnetic field, ionizing radiation).

Related labor processes(for example, strenuous physical activity, working with a microscope / magnifying glass).

Appendix 2 indicates the frequency of medical examinations, the participation of doctors of a certain qualification and the types of medical research carried out, depending on the work performed, which has a harmful / hazardous effect on health. So, for example, according to the order 302n medical examination should be carried out annually when performing steeplejack work and participating in fire hazardous industries. You will definitely need to be examined by such specialists as a neurologist, otorhinolaryngologist, ophthalmologist.

Features of medical examination by profession

Preliminary medical examination by order of 302n will allow you to weed out applicants who have diseases that are contraindicated for a particular profession. So, for example, people with a history of the following pathologies cannot be accepted for the position of a crane driver:
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hernias that can be impaired;

encephalopathy;

persistent hearing impairment;

disruption of the vestibular analyzer;

high myopia;

frequent relapses of thrombophlebitis of the veins of the lower extremities.

Moreover, if the applicant for the position did not pass a medical examination in his chosen profession (there is an opinion of the medical commission on unsuitability), then the money spent by the employer to pay for the services of the medical institution for this examination will not be collected from the failed employee. After all, the Labor Code does not provide for the possibility of recovering losses that were caused to the employer due to failure to conclude employment contract.

Objectives of medical examinations

The main purpose of conducting a preliminary medical examination before concluding an employment contract with an applicant for the position is to determine whether his state of health corresponds to the work entrusted to him. This examination will also help to identify early occupational diseases in advance.
Medical examinations can be carried out by any medical institution of any form of ownership that has issued an appropriate license. Employers, production activities which is associated with hazardous (harmful) working conditions, traffic, provision of catering services, trade, maintenance of water supply networks, as well as children's and medical institutions are required to conclude an agreement with the selected medical organization for mandatory medical examinations.

In addition, it must be borne in mind that a mandatory preliminary medical examination is carried out when hiring minors. In this case, it does not matter in what area the employer operates. For such persons, after their employment, then periodic medical examinations must be carried out annually until they reach the age of 18.

The employer issues an order on the sequence of passing medical examinations and draws up lists of names of those employees who must pass them. The lists are drawn up 2 months before the date of the examination of employees, previously agreed with the medical institution. On the basis of the lists received, the medical institution draws up a calendar plan, which is agreed with the employing organization.

10 days before the expected start date of medical examinations, the employer introduces each employee from the list to the approved medical organization calendar plan medical examination. On the eve of the medical examination, the employer issues referrals to employees. The examination is carried out by a medical commission headed by an occupational pathologist.

Order of the Ministry of Health and Social Development dated 12.04.2011 No. 302n established the procedure for conducting mandatory medical examinations at enterprises whose activities:

associated with harmful / hazardous working conditions;

directly related to traffic;

is aimed at providing medical, pedagogical services, as well as catering services, etc.

This normative act also contains exhaustive lists of harmful production factors and types of work, the performance of which involves the mandatory conduct of medical examinations at a specified frequency.