Individual rehabilitation program for a disabled patient. Ypres disabled sample filling

Our country, being a full member of international organizations, was naturally called upon to comply with their normative provisions concerning the life of persons with disabilities, first of all, this is the "Standard Rules for Ensuring Equal Opportunities for Persons with Disabilities" of the United Nations. Thus, the state recognized the right of persons with disabilities to participate fully in public life and began work on their integration and adaptation in modern conditions.

But all people with physical limitations or limitations on intellectual development, despite the general name of the disabled, quite naturally have different opportunities for leading an active, independent life. It is impossible to equate the needs of, say, a disabled person in a wheelchair and a blind person. And even within the framework of one type of physical limitations, the interests, desires and simply life aspirations of specific people differ greatly. Therefore, the return of every disabled person to a fulfilling life it is an individual process. To take into account all the features of the rehabilitation of each disabled person, an Individual rehabilitation program was conceived.

An individual rehabilitation program for a disabled person is a list of rehabilitation measures aimed at restoring the disabled person's abilities to everyday, social, professional activities in accordance with the structure of his needs, the range of interests and the level of claims (excerpt from the Decree of the Ministry of Labor and Social Development of the Government of the Russian Federation No. 14 dated December 14, 1996 of the year).

What does a disabled person get from completing an IPR?

The main mechanism for the implementation of the rehabilitation of disabled people is an individual rehabilitation program for a disabled person.
At the moment, many aspects of the rehabilitation process are more effectively resolved and regulated with representatives of the authorities at all levels if the disabled person has an IPR. An example of employment can be cited, now not a single disabled person can register at the labor exchange as unemployed, without the IPR filled in on this account. This means that he cannot acquire a new profession for free, and then work as a financial source of subsistence (it is no secret that it is impossible to live normally on the current pension).
Branches are now being formed social rehabilitation people with disabilities are called upon to carry out the IPR in the section of social rehabilitation And if, for example, a clause on obtaining a secondary special or higher educationthen it becomes the concern of this department. Their specialists must find a suitable educational institution and solve all the difficulties that arise for a disabled person when entering and in the process of studying. Or another example, you are a disabled person - a wheelchair user and you need a ramp at the entrance of the house, you can, of course, write applications yourself and achieve this from local authorities... But if this item is included in your IPR, then the department of social rehabilitation of the disabled, where you are registered, will be called upon to resolve all issues with the installation of a ramp.
In general, the IPR formed for you is a way of solving your problems related to disability and the opportunity to implement your life goals and desires.

Legislative acts regulating the formation and implementation of the IPR.

The main legislative act regulating the rights and opportunities of disabled people is Federal Law No. 181 "On Social Protection of Disabled People in the Russian Federation" dated November 24, 1995. It was in it that the Individual Rehabilitation Program was first mentioned, as well as the very concept of rehabilitation of the disabled (Article 9). In addition to Article 11 of this Law, which is fully devoted to the Individual Rehabilitation Program, the IPR is also mentioned in Articles 8 "State Service of Medical and Social Expertise", 18 "Education and Training of Disabled Children", 19 "Education of Disabled People", 23 "Working Conditions for Disabled People", 25 “The procedure and conditions for recognizing disabled people as unemployed”, 29 “Sanatorium treatment for disabled people” and 32 “Responsibility for violation of the rights of disabled people. Dispute Resolution ”.
In general, Federal Law No. 181 defines the IPR, provides information that the IPR is developed by the State Service of Medical and Social Expertise, as well as that the basic rights of people with disabilities to education, the creation of necessary working conditions, sanatorium treatment, and and training is provided in accordance with the IPR. In addition, a disabled person cannot be recognized as an unemployed citizen without a completed IPR, and all disputes regarding the implementation of the IPR are resolved in court. Another important point noted in the Federal Law No. 181 is the mandatory implementation of the IPR by the relevant state authorities, bodies from local government, as well as organizations, regardless of organizational and legal forms and forms of ownership. And the fact that a disabled person himself has the right to choose the types of technical means of rehabilitation and rehabilitation services, and in the case of self-payment, receive compensation in cash

But Federal Law No. 181 did not define the form of the IPR, the procedure and conditions for the development, implementation and financing of the IPR. All these moments are reflected in the Decree of the Ministry of Labor and Social Development of the Russian Federation No. 14 of December 14, 1996 "On the approval of the approximate provision on the Individual rehabilitation program for a disabled person." It was determined that the IPR is issued in the form of a standardized card and the basis for the development of the IPR is the sequence, complexity and continuity of rehabilitation measures. Executive bodies of subjects Russian Federation have the right to approve the regional procedure for the development and implementation of the IPR.

Also, the legal basis for the formation of the IPR is the regulatory documents adopted in order to implement the Federal Law No. 181:

"Regulations on recognizing a person as disabled" and "Approximate regulations on the institutions of the state service of medical and social expertise" (approved by Decree of the Government of the Russian Federation of August 13, 1996 No. 965). "Fundamentals of the legislation of the Russian Federation" On the protection of public health "(adopted by the Supreme Soviet of the Russian Federation on July 22, 1993); The Law of the Russian Federation "On Employment of the Population in the Russian Federation" (as amended on March 22, 1996); The Law of the Russian Federation "On Education" (as amended on January 13, 1996); "Approximate regulation on a rehabilitation institution" (annex to the decree of the Ministry of Labor of Russia, the Ministry of Health of Russia, the Ministry of Education of Russia dated December 23, 1996, No. 21/417/515)

Where can I fill out an IPR card?

You can fill out the IPR card at the local branch of the bureau of medical and social expertise, this is a new structure formed on the basis of the Medical and Labor Expert Commissions (VTEKi). You can find them in your district polyclinic, although they are subordinate not to the Ministry of Health of the Russian Federation, but to the Ministry of Labor and Social Development of the Russian Federation. However, not all persons with disabilities are assigned to the local regional bureaus of the ITU, some categories of persons with disabilities, for example, people with mental retardation or children with disabilities can obtain a generated IPR card from their specialized ITU offices. Well, to make it easier to understand, you can apply for the IPR at the place where you received or will receive a certificate of disability.

IPR card filling procedure

To obtain an IPR, you need to contact your attending physician with a request to give a referral to the ITU bureau.
In order for you to develop an IPR, you need to submit an application in duplicate to the ITU bureau together with the referral of the attending physician

Sample application

In the bureau of medical and social expertise __________ district
From________________________________________________
(Full name)
from a disabled person ________ group,
residing at: ___________________________
__________________________________________________
(index and address without abbreviations)
telephone: ______________

Statement

I ask you to develop an individual rehabilitation program for me with the obligatory reflection in it of the following recommendations, measures, means and rehabilitation services:
Medical rehabilitation:
a) putting me on dispensary registration, carrying out outpatient examination (types, methods and frequency of outpatient examination);
b) hospital treatment (hospital profile and frequency of treatment in it);
c) drug supply (types of drugs and frequency of administration);
d) spa treatment (profile and frequency of treatment);
e) technical means of medical rehabilitation (prostheses, syringes, bandages, capacitive receivers and other similar means, their number and frequency of use);
f) the need for a specialized medical rehabilitation center (its profile and frequency of stay in it).
Etc.
Vocational and labor rehabilitation:
a) the necessity and possibility of preschool education;
b) the necessity and possibility of general education;
c) the need for and the possibility of vocational education (vocational school, secondary technical, higher school, postgraduate study);
d) types labor activityincluding home work;
e) volume and duration of work;
f) the need and the possibility of creating a special workplace, special working conditions.
Etc.
Social and household rehabilitation:
a) the need to improve living conditions (number of storeys, housing amenities, including an additional living room, according to the List of Diseases approved by the Government of Russia;
b) the need and medical indications for the use of room and stroller wheelchairs, special vehicles;
c) barrier-free design at the entrance of the house to the elevator and apartment at the place of residence, railings on the porch of the house, ramp;
d) technical aids in the apartment (handrails in the toilet and bathroom, corridor, etc., a lift for using the bathroom, a remote locking and intercom device for the front door of the apartment, etc.);
e) the need to use telephone communications.
Etc.

Date ________________ Signature _________________
On the second copy of a disabled person:
Documents for the development of IPR were obtained from ITU:
____________ ____________ ______________
Date Title Signature

In your application, you need to indicate those activities, facilities and services in all three types of rehabilitation (medical, professional and social), the recommendations of which you need to ensure you equal opportunities with other citizens.
Send one copy of the application together with the direction to the ITU bureau, requiring that the second copy be signed (that is, the registrar must make a mark on the acceptance of documents indicating the date, his position and leave a signature), which you leave to yourself in order, if necessary, to check the IPR developed for you ...
Also note that you can apply to the ITU bureau for the development of an IPR, regardless of the re-examination period (even if the disability is established for life, without a re-examination period).
An individual rehabilitation program for a disabled person must be developed no later than one month from the date of submission of your written application (according to the decree of the Ministry of Labor and Social Development of the Russian Federation "On Approval of the Model Regulations on an Individual Rehabilitation Program for a Disabled Person" dated 14.12.96).

What can be included in the completed IPR card?

The IPR map can be divided into several parts. It begins with detailed individual information about the disabled person. This section, in addition to personal data, includes the following information:

• educational level (general and professional);
• about professions and specialties, qualifications and work performed by the time of certification (if there is one or was);
• about social, household, socio-economic and socio-environmental status;
• about social and environmental conditions and sources of income.

The same section provides an assessment of the rehabilitation potential and a rehabilitation prognosis, and also provides indications for carrying out rehabilitation measures.
On the basis of objective data, an expert opinion is made and a rehabilitation program is formed.
The IPR card consists of three rehabilitation programs:

• medical rehabilitation programs;
• social rehabilitation programs;
• vocational rehabilitation programs.

Medical rehabilitation disabled people are carried out with the aim of restoring or compensating for lost or impaired human functions to a socially significant level. The rehabilitation process does not only involve the provision of medical care.
Medical rehabilitation includes:

• Rehabilitation therapy:
• mechanotherapy
• physiotherapy
• kinesiotherapy
• massage
• acupuncture
• mud and balneotherapy
• traditional therapy
• occupational therapy
• providing speech therapy assistance, etc.

2. Reconstructive surgery:
methods of cosmetology, organ-protective and organ-restorative surgery.

3. Prosthetics and orthotics, including the provision of prostheses, orthopedic and other aids, including the necessary fit, repair and replacement, as well as training in their use.

4. Provision of technical means of medical rehabilitation:

• urine bags
• colostomy bags
• hearing Aids
• provision of information services on medical rehabilitation

5 Sanatorium-resort treatment of disabled persons with disabilities is carried out by the social protection population; disabled people in need of treatment in specialized anti-tuberculosis sanatoriums - by health authorities; working disabled people - at the place of work from the funds of the Social Insurance Fund.

To section social rehabilitation can be included:

• The need to adapt housing to a disabled person:
• change of residence (floor, building)
• special equipment (adaptation) of the entrance, stairs, elevator
• change of housing layout
• expansion of doorways in the apartment, entrance
• special devices for using a bathroom, kitchen, furniture, household appliances
• redevelopment and installation of special switches, sockets, regulators, timers, signaling devices, other equipment
• special locks, latches, latches for vents, doors, curtains, balcony accessories
• providing emergency communication with the ambulance station, the dispatcher of the DEZ, the police, medical institution, relatives.
• other.
• Need for self-service household appliances:
• when performing personal hygiene procedures
• accessories in clothes and shoes for self-dressing
• when preparing and eating food
• when cleaning a room, washing dishes, washing clothes
• other
• The need for technical means of rehabilitation:
• personal means of transportation (walking sticks, crutches, strollers, vehicles, etc.)
• technical means and devices for self-service
• technical means and appliances for cooking
• technical aids for training and work activities (special furniture, manipulators, devices, equipment)
• other
• Teaching a disabled person to "life with a disability":
• self-service skills
• movement skills
• habitat orientation skills
• personal safety skills
• communication skills, including with the help of technical means
• the ability to independently carry out measures to prevent the development of one's illness, competently apply personal medical technical means of self-control, restore functions
• assistance in starting a family, training in family and marital relations
• training in cooking (including an individual diet)
• providing information on vital issues
• other
• Personal preservation training:
• personal safety rules when using household appliances and appliances in the house
• personal safety rules in the environment (on the road, at the dacha, at a party)
• safety rules, if necessary, use drugs, technical means
• other
• Training in social skills in housekeeping (budgeting, managing funds, visiting retail outlets, households and repair shops, a hairdresser, etc.).

7. Learning to solve personal problems:

• sex education
• birth control
• family building
• parenting
• psychological correction of family and household relations
• other
• Training of family members, relatives, acquaintances, employees at work (at the place of work of a disabled person) to communicate with a disabled person, to provide him with the necessary assistance.
• Training in social communication, assistance and assistance in organizing and conducting active leisure:
• visiting friends, relatives, acquaintances, entertainment institutions and places of recreation, cultural institutions
• practicing accessible sports
• provision of special devices for leisure activities (reading devices, gaming computers, special educational games, etc.)
• other
• Assistance in facilitating and providing the necessary prosthetic and orthopedic products, prosthetics and orthotics.
• Psychological assistance aimed at fostering self-confidence, dedication, improvement positive qualities, life optimism.
• Psychotherapeutic assistance aimed at correcting the relationship of the subject.
• Professional information, career guidance taking into account the results of rehabilitation.
• Consulting.
• Assistance in obtaining the necessary medical rehabilitation (rehabilitation therapy, reconstructive surgery, sanatorium treatment, technical means of medical rehabilitation).
• Assistance in obtaining additional education, a new profession, rational employment.

Vocational rehabilitation disabled person is a process and system of restoring the competitiveness of a disabled person in the labor market.
The vocational rehabilitation program includes the following activities and services:

• vocational guidance
• psychological correction
• training or retraining
• creation of a special workplace for a disabled person
• professional - production adaptation

As you may have noticed, many activities from the three rehabilitation sections overlap with each other. This is especially noticeable, for example, points 15 and 16 from the section of social rehabilitation, which clearly duplicate activities from medical and vocational rehabilitation. But here, unlike other points, only the assistance of social rehabilitation departments in obtaining a disabled person is recorded medical services and professional employment. Although, if these points are included in the section on social rehabilitation, it will not be superfluous and will allow you to put the situation in such a way that your department of social rehabilitation will apply for and negotiate on the implementation of the medical and professional section of the IPR.
Any rehabilitation program is not limited to the list of activities. It contains information about the performers of each event, the forms and volume of rehabilitation, the timing of its implementation and the predicted result. Also, it should reflect the results obtained and the reasons for non-fulfillment of one or another event in a timely manner.

What to do in case of contradictions with the bureau of medical and social expertise on filling out the IPR card?

The disabled person must sign each section of the IPR, thereby expressing agreement with the proposed rehabilitation measures. In case of disagreement with the content of the IPR (not all recommendations are taken into account or there is disagreement with some recommendations), a disabled person can appeal it by submitting an application to the Main Bureau of the ITU region. A copy of the IPR is attached to the application. Based on the examination and conversations with the disabled, a conclusion is made on controversial issues. If the claims are substantiated, then a new IPR card with new recommendations is formed, signed by the chairman of the expert commission and certified by the seal of the GBMSE region.
The decision of the GBMSE region can be appealed within a month to the regional Committee (or Department) of social protection of the region's population, which should instruct required composition specialists to conduct a control examination.
The next instance where a person who disagrees with the conclusions of the experts can turn is the court.
It should be noted that the rehabilitation measures of the IPR will be necessarily financed from the state and regional budgets, provided that they are included in the basic (federal and regional) program for the rehabilitation of disabled people. All other events included in the IPR are paid by the disabled person or his sponsors.
Also, a disabled person (or a person representing his interests) can refuse an individual rehabilitation program as a whole or from the implementation of its individual parts. But this frees the relevant state authorities, local self-government bodies, as well as organizations, regardless of organizational and legal forms and forms of ownership, from responsibility for its implementation and does not give a disabled person the right to receive compensation in the amount of the cost of rehabilitation measures provided free of charge.

Actions of a disabled person after filling out an IPR card?

After the IPR card is filled out for you and you agree with everything that is included in it, you and the head of the ITU bureau must sign three copies of the generated IPR card and certify them with a seal. One copy remains in the ITU bureau, the second is handed over to you, and the third is sent to the territorial body of social protection of the population to control the implementation of the IPR. Also, in some regions (in particular in the Samara region) you are given a tear-off coupon for the employment service, with which you can contact the local Employment Center and register as unemployed at the labor exchange. If such a coupon is not provided in your region, then you can contact this department with your copy of the IPR card. Many people with disabilities are afraid to get registered at the labor exchange, as they may lose regional pension supplements (if there are any in your region), but they will receive unemployment benefits, which more than compensates for these financial losses. True, with the payment of benefits, everything is not so simple, so try to immediately find out the whole mechanism for calculating unemployment benefits, taking into account your individual case. In addition, with the appropriate entry in the vocational rehabilitation section, you can undergo retraining, and then find a job through the labor exchange in the specialty you are interested in (for example, in such popular professions as a web designer or office manager). Moreover, if it is necessary for you, then the employment service must create a special job for you.

In addition, in the IPR card, next to each included event, there is a column "responsible for execution", which must be filled in and, most likely, one of the government departments will be put there. Here in this department, for the implementation of this event, you are dear.

IPR for parents of children with disabilities

Why do parents of children with disabilities need to fill out the IPR, and how can this help their children enroll in a general education school?
Unlike adults with disabilities, it is very difficult for a child with physical disabilities to enroll in a general education institution. The overwhelming majority of school administrators strive to send disabled children to study in specialized institutions (mainly boarding schools), or to send them to home education. And here the situation can be reversed only with the use of the IPR card. That is, if in a regular certificate of disability, almost no doctor writes a recommendation about the possibility of studying in a regular school in full-time form, then in the IPR card he can give a similar recommendation, since he has the opportunity to stipulate in writing all those conditions, if which is possible. And here parents can join the efforts of different departments: the department of social rehabilitation of children with disabilities, the local government and the school, since the formed IPR card is mandatory for all authorities. For example, for a child with visual impairments, the main obstacle to studying in a general education school is the lack of special educational literature in Braille in it. Here it is quite possible that the assistance of the department of social rehabilitation of disabled children, which with the financial resources of local authorities can provide this student with the necessary educational equipment, is quite possible.
But still, when forming the IPR map, ITU specialists are not willing to write recommendations for studying in a regular school. It requires persistence in the desire to place your child in a comprehensive school and not for home education.
Also, keep in mind that you, as the legal representative of your child, can participate in the development and implementation of the IPR.

Please answer the following question: Is the individual rehabilitation or habilitation program for a disabled person (IPRA) issued by federal state institutions of medical and social expertise a document on the basis of which the employer can, among other things, decide to dismiss the employee (clause 8, part 1 Article 77 of the Labor Code of the Russian Federation) if from the information of the IPRA section "measures of professional rehabilitation or habilitation" it follows that the employee's workplace does not meet the requirements established by this section. Please give detailed information about what the IPRA is for the employer, what he should do according to the information contained in the IPRA. Thank you!

Answer

Answer to the question:

The main normative act establishing the rules for recognizing a person as a disabled person and the procedure for conducting a medical and social examination is the Federal Law of November 24, 1995 No. 181-FZ "On social protection of disabled people in the Russian Federation."

To confirm disability, the employee must provide the following documents:

A certificate of medical and social examination, which indicates the group of disability and the degree of restriction of the ability to work;

Individual rehabilitation program.

The disability group and the degree of restriction to work are determined based on the results of a medical and social examination.

An individual rehabilitation program is developed for each disabled person.

It must be remembered that the IPR is mandatory for organizations, regardless of the organizational and legal forms and forms of ownership.

Thus, on the basis of the information specified in the certificate of medical and social expertise and the rehabilitation program, the employer is obliged to create appropriate working conditions for the disabled person and provide benefits specified by law.

The purpose of the section on vocational rehabilitation is:

• adaptation to the previous workplace;
• adaptation to the previous workplace with changed working conditions;
• getting a new profession (specialty);
• selection of a suitable workplace;
• creation of a special workplace.

See the recommendations listed in the individual rehabilitation program. According to article 73 of the Labor Code of the Russian Federation: an employee who needs to be transferred to another job in accordance with a medical certificate issued in the manner prescribed by federal laws and other regulatory legal acts of the Russian Federation, with his written consent, the employer must transfer to another job that the employer has, not contraindicated to the employee for health reasons.

If it is impossible to establish requirements for the equipment of a workplace for a disabled person from the rehabilitation program, then a request can be sent to MSEC with a request to provide appropriate clarifications.

If, in accordance with the medical opinion, the employee needs a temporary transfer to another job for a period of more than four months or a permanent transfer, then if he refuses to transfer or if the employer does not have an appropriate job, the employment contract is terminated in accordance with paragraph 8 of part 1 of Article 77 of the Labor Code. RF.

Details in the materials of the System Personnel:

Compensation and benefits

Individual rehabilitation program for a disabled person: should an employer take it into account?

Anna SLAVINSKAYA, lecturer in personnel records management, the Expert Training Center (Volgograd), member of the National Union of Personnel Officers

Key issues

• What is an individual rehabilitation program?
• Is it obligatory to implement an individual rehabilitation program?
• What is the responsibility for failure to fulfill the individual rehabilitation program?

What is an individual rehabilitation program

In the process of rehabilitation of a disabled person, it is important to take into account not only the disease and the degree of loss of one or another function, but also the life aspirations of a person, his abilities and character. This requires an individual rehabilitation program for a disabled person (hereinafter - IPR).

Individual rehabilitation program

This is a list of rehabilitation measures aimed at restoring the ability of a disabled person to everyday, social, professional activities, taking into account his needs, range of interests and level of claims.

1. Medical rehabilitation measures.This section specifies the surgical measures necessary for the disabled person, rehabilitation therapy procedures, spa treatment, prosthetics services.
2. Vocational rehabilitation activities.It explains whether a person with a disability needs vocational guidance and training services, employment assistance and work adaptation. In addition, in this section, doctors give recommendations on contraindications and available conditions and types of work. It is this section that must be carefully studied by the employer who recruits a person with disabilities.
3. Social rehabilitation activities.The paragraph lists the measures necessary for a disabled person for household, pedagogical, psychological, socio-cultural rehabilitation.
4. Technical means of rehabilitation.The section is filled in for those disabled people who need special devices: hearing aids, chairs, strollers, etc.
5. Conclusion on the implementation of the IPR.It is also carried out by the ITU staff after all the events indicated in the map.

The IPR should be developed automatically within 30 days after the disability is established. In reality, this does not always happen. In this case, in order to obtain an IPR card, you need to apply with an application to the ITU institution that carried out the survey. Then the ITU specialists will develop an IPR.

Is it mandatory to implement IPR

How can an employer find out that his disabled employee has refused to implement the IPR drawn up for him? When receiving an IPR card, a disabled person must sign in the line “I agree with the content of the IPR”. If this line contains an entry on the refusal of all or part of the proposed rehabilitation measures, all authorities and organizations that are obliged to carry out the planned measures are released from responsibility for their implementation. In addition, a disabled person is deprived of the right to receive compensation in the amount of the cost of rehabilitation measures provided free of charge.

If an employee with a disability did not present an IPR card at all or if it contains the mark “I disagree”, the employer has the right not to take into account the restrictions specified in this section. In this case, liability for non-compliance with the IPR recommendations does not come.

If the IPR card is drawn up and the employee agrees with its content, the implementation of these measures becomes mandatory for all authorities, government agencies and private organizations. This means that according to the IPR, a disabled person has the right to use the services medical centers, social rehabilitation institutions, employment centers, etc.

Example

In the IPR of a disabled person of the III group it is stated: "Labor by profession is available with a decrease in the volume of production activity." This means that such an employee needs to establish a part-time mode, reducing the length of the working day. But how do you determine how much to reduce the load? Neither the law nor the IPR says about this. For example, a reduced working time - no more than 35 hours per week is provided only for disabled people of I and II groups (). Therefore, with a disabled person of group III, the duration of work can be negotiated individually. It can be seven and a half hours a day or four hours.

Warns

Dmitry KAZANTSEV,

senior Legal Adviser, OJSC "Center for Economic Development" - B2B-Center (Moscow)

Sometimes, for fear of being refused employment, people with disabilities hide their status until an employment contract is signed. And after the signing of the documents, they insist on providing them with preferential working conditions. In such a situation, the employer is obliged to comply with the requirements of labor legislation and supplement the employment contract with the employee with increased guarantees.

What liability threatens for non-performance of the IPR

Failure to comply with the IPR is also considered a violation of labor laws. This may be followed by a punishment ():

• for officials - a warning or fine from 1000 before 5000 rubles;
• for individual entrepreneurs - a fine from 1000 before 5000 rubles;
• for organizations - a fine from 30 000 before 50 000 rubles.

A repeated violation under this article threatens ():

• officials - a fine from 10 000 before 20 000 rubles or disqualification for a period of one to three years;
• individual entrepreneurs - a fine from 10 000 before 20 000 rubles;
• organizations - a fine from 50 000 before 70 000 rubles.

Answers to your questions

Can a disabled employee not have an IPR card?

When applying for a job, an employee with a disability stated that he did not have an IPR card. Could this be? Does he need to get an IPR?
Evgeniya FEDOSEEVA, HR Specialist (Moscow)

Yes maybe. In practice, the IAP is not always developed automatically after an employee receives a disability. This may require an application to the ITU office. There are cases when ITU experts themselves propose to sign a refusal to draw up an IPR, claiming that it is ineffective and there is still no money to carry it out.

However, there is no mechanism, except for the IPR, that would take into account individual needs and the targeted orientation of rehabilitation measures. Almost all of them can be solved only if there is an IPR:

• acceptance of documents in institutions of higher and secondary vocational education;
• registration at the employment center;
• obtaining technical devices;
• creating special conditions for a disabled person at work, in an educational institution and even in the house where he lives.

Thus, if a disabled employee wants to receive rehabilitation services and technical means at the expense of the state, he needs to issue an IPR.

Does an employee have to present an IPR when hiring?

Is a disabled person required to present an IPR card when applying for a job?
Katerina ZUEVA, recruiting manager (Ufa)

No, I don't have to. In the list of documents that must be presented when applying for a job (), documents on disability, including the IPR card, are not indicated. This means that the employer can demand from the employee medical documents characterizing the state of health only if two conditions are present simultaneously:

1. Future work has a certain specificity, due to which certain requirements are imposed on the health of employees.
2. The need to submit medical documents is provided for by regulatory enactments.

That is, when it is necessary to undergo a preliminary medical examination when applying for a job, you cannot hide your disability. In other cases, the employee decides for himself whether to provide the employer with information about his disability or not.

Is it possible to hire a disabled person of III group for the position of an auxiliary worker?

Does the employer have the right to accept a disabled person of III group for the vacancy of an auxiliary worker?
Ivan PROSKURIN, Director (Moscow)

III group of disability implies the ability of an employee to work under normal conditions with a decrease in qualifications, severity, tension and (or) a decrease in the volume of work. If the work of an auxiliary worker can be organized in this way, the employer has the right to hire a disabled worker. Additionally, it is necessary to study the individual candidate's rehabilitation program (if available). It should also have no contraindications to this work.

Ask your question!

If you have a question, ask it now. You will receive the answer in the next issue.

Most Necessary Regulations

Document	Will help you
Administrative Code of the Russian Federation	Understand how an employer will be punished for refusing to create the working conditions necessary for a disabled person
Administrative Code of the Russian Federation	Understand what punishment threatens for non-compliance with labor legislation in relation to people with disabilities
	Find out what rights people with disabilities have
Labor Code of the Russian Federation	Find out that workers with disabilities are entitled to reduced working hours
Labor Code of the Russian Federation	Clarify what documents the employee must present when applying for a job
	View the IPR map
	Understand that IPR should be developed after disability is established

Remember the main thing

1 The rehabilitation program for a disabled person is being developed by the institution of medical and social expertise. It prescribes all the rehabilitation measures that a disabled person has the right to receive.

2 IPR should be developed automatically after disability is established. But often you need to submit an application for its registration.

3 The rehabilitation program is of a recommendatory nature. Therefore, a disabled employee may refuse to implement it.

4 If the IPR card is issued and the employee agrees with its content, the implementation of these activities becomes mandatory for all authorities, public and private organizations.

Regulation on recognizing a person as a disabled person (approved

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How can parents get a wheelchair for a disabled child? How to provide an elderly relative with adult diapers? What technical devices are required for the deaf?

There are things that a disabled person cannot do without. There are those who simply improve the quality of his life. In the language of doctors and lawyers, these subjects are called "technical means of rehabilitation." The state guarantees the free provision of many of them. Nevertheless, in order to get the necessary device quickly and without problems, certain "rules of the game" must be observed.

Wheelchair

Elena Zablotskis, a lawyer at the Center for Curative Pedagogy, told what steps parents should take to get the necessary type of wheelchair for a disabled child.

Step 1. Preparation for medical and social examination

The inclusion of any technical means of rehabilitation (TSR) in the individual program of rehabilitation or habilitation (IPRA) occurs in the process of medical and social examination (MSE).

After passing the ITU, a person receives two documents: a certificate of disability and an IPRA. In order for the last paper to be filled out correctly, this must be taken care of even when the family first turns to the child's attending physician about the establishment of disability.

According to the standard procedure, the child is sent for clinical examination to all necessary doctors. It is important for parents to make sure that all doctors write down their recommendations in as much detail as possible. If we are talking about a wheelchair, then a specialized doctor can be a neurologist, orthopedist, surgeon, and this specialist must in detail describe which stroller the child needs.

There is a document that doctors usually follow: this is the "List of indications and contraindications for providing disabled people with technical means of rehabilitation." It lists the diseases in which certain TCPs are issued, as well as contraindications in which the use of a particular technical device is prohibited to the patient. However, it is still necessary to remind the doctor to record the recommendations.

Elena Zablotskis advises not to limit yourself to visiting one specialist, but to contact different medical organizations, including non-state ones, that have an appropriate license. At the same time, the doctor making a referral to the ITU must be provided with absolutely all the collected recommendations, although he is not obliged to include each of them in the document, since he has the right to his own professional opinion.

Step 2. Medical and social examination

Having received the referral, the parents go to enroll the child on the ITU. It is important to attach to the document copies of those recommendations that were not included in it, continues Elena Zablotskis. Copies must be accompanied by a statement: we ask you to take into account the recommendations of such and such specialists during the ITU.

During the ITU, an Individualized Rehabilitation or Habilitation Program (IPRA) is drawn up. In the form of this document, there is a section on TSW, which is divided into three subsections for disabled children (two for adults). The first one is the TSR, which are provided from the federal budget and are included in the federal list. The second one is TSR, which are provided at the expense of the constituent entity of the Russian Federation (there is a separate list in each region), or at its own expense. The third is the services and means of rehabilitation, which can be purchased at the expense of maternity capital.

Parents need to familiarize themselves in advance with all the lists - both federal and regional, and with a list of what can be obtained from maternity capital. And then ask ITU - preferably in writing, registering your request as an incoming document - to include everything you need in the IPRA.

Why do this? Doctors do not always thoroughly study these lists, notes Elena Zablotskis.

In addition, parents should ensure that the characteristics of the required stroller are adequately reflected in the IPRA. This can be especially important for children with multiple developmental disabilities. A stroller that does not meet the child's needs raises the risk of secondary complications.

If the IPRA does not include the TSW with the characteristics necessary for the child, then this document can be appealed within a month. The basis for appeal is the recommendation of a specialist.

Step 3. Obtaining the technical aid

In the regions, the authorized body issuing TSW may be the Social Insurance Fund or the executive body of a constituent entity of the federation (department of social protection, for example).

A statement is being written: I ask you to provide me with such and such a TSR in accordance with the IPRA.

If there are strollers available that are suitable in their characteristics for a particular child, then one of them is selected. If they are not there, then the authorized body must hold a tender for the purchase of the corresponding wheelchairs.

This is where the IPRA recommendations come to the fore - how detailed they are. The parent can be told: there are only such strollers, take them, there will be no others. If the proposed stroller does not comply with the IPRA recommendations, then the parent writes a statement and simply states this fact. If the stroller is not suitable only from the point of view of the parent, then he will have to write in detail in his application why the stroller does not fit, maybe even go to the doctor again so that he can more accurately list the characteristics of the desired TCP.

It happens that the receipt of TCP is delayed. In this case, you need to complain to a higher authority, according to subordination, the lawyer advises. If you have already complained everywhere, and "things are still there," then you have to go to the prosecutor's office.

Step 4. If you bought the TCP yourself

You can buy a wheelchair for a disabled child yourself and then receive compensation from the state. Elena Zablotskis recommends that you first request in writing the amount of compensation for a specific type of stroller. This size is determined by the last purchase. That is, you will be given exactly as much money as the state spent on a similar product when it last purchased it.

If, after receiving an answer, the family decides to buy the TCP on their own, it is important to ensure that the purchase documents are properly completed. They should clearly show which stroller was purchased.

Then the family applies to the authorized body with a claim for compensation, with the purchase documents attached. If the payment of compensation is delayed, the lawyer again advises to write complaints or even contact the prosecutor's office.

Step 5. The wheelchair is broken

This situation is regulated by law. If the wheelchair is out of order, you need to contact the authorized body (the department of social protection or the FSS, depending on the region) with an application for a medical and technical examination. Experts will appreciate the TSR from the point of view of the possibility of its repair. Based on their conclusion, the wheelchair will be repaired at public expense, or a new one will be issued.

Parents can repair the TCP themselves, based on the conclusion of a medical and technical examination, and then receive compensation.

Indications and contraindications

According to the legislation, indications for obtaining a wheelchair can be persistent "pronounced" or "significantly pronounced" (II and I groups of disability) motor dysfunctions caused by diseases of the joints, spine, central and peripheral nervous system... Violations of the same degree of severity of the functions of blood circulation, respiration, digestion, metabolism, etc. As well as "moderate" disorders (III group of disability) associated with the amputation of one hip or two feet.

If there are "pronounced" violations in the functions upper limbs, as well as in case of systemic diseases of the musculoskeletal system and certain disorders of the circulatory and respiratory functions, the use of an electric wheelchair is recommended.

This type of TCP is contraindicated if a disabled person cannot sit. In addition, power wheelchairs cannot be used if the patient has a severe mental disorder or some other medical condition.

Terms for which wheelchairs are issued: indoor with manual drive - at least 6 years; walking with manual drive - at least 4 years; with an electric drive - at least 5 years.

Diapers for adults

The Sofia Charitable Foundation has prepared a road map for Miloserdiya.ru on how to get diapers for adults free of charge. The source of information is one of the Moscow territorial Social Service Centers.

Step 1

The general practitioner of the district polyclinic makes an entry in the card about the need to undergo the ITU. He also issues a "messenger sheet" with which the patient begins bypassing doctors to develop IPRA.

Step 2

IPRA is compiled in ITU Bureau... This document must be handed out together with a "pink" certificate of disability.

If a person does not agree with the IPRA content, he can appeal it to the higher ITU Bureau.

Step 3

Absorbent underwear and diapers are handed out at the TSW point of delivery at the territorial center of social services (TSSO) for IPRA When registering for service at the TCSO, you will need a passport, a certificate of disability, an IPRA, a passport of a trusted person receiving a TSR, SNILS, a medical policy.

When obtaining this type of TCP, only one difficulty may arise: it is issued once a month, at once for the entire month. Therefore, transport or assistants are needed for home delivery (this rule applies to the SCO that provided the information, perhaps elsewhere you can get absorbent linen and diapers more than once a month, but more often).

You can buy this type of TCP on your own, and then receive compensation at the selling prices of the Department of Labor and Social Protection, the exact amount must be found out already upon receipt of the TCP. Previously, prices varied, but now they practically do not differ.

Indications and contraindications

Diapers are given to people with disabilities with pronounced or significantly pronounced (II and I groups) violations of the elimination function. Contraindication is allergic reaction on the diaper material. The product can be used for no more than 8 hours.

Telephone device with text output.

Head of the Department of Rehabilitation of the All-Russian Society of the Deaf Alexander Ivanov told "Miloserdiya.ru" what "stumbling blocks" can be encountered when receiving technical means of rehabilitation for the deaf.

“At one time, we achieved that the federal list of technical means and services for disabled people, which are issued free of charge, include telephones with text output, televisions with teletext, hearing aids, light and vibration signaling devices,” he said.

Regional branches of the society are ready to assist disabled people in obtaining all these devices, as well as in obtaining sign language interpretation services, Ivanov recalled. Why is this help needed?

Medical and social examination staff can simply do not enter in IPRA a device necessary for a particular person. “Why does a deaf person need a telephone, they reason,” Ivanov explained. - We say that this is nonsense. After all, you can send SMS and video images. Mobile phones essential for the deaf. "

If a disabled person buys himself the necessary telephone device, he must be prepared for the fact that the size compensation may be very small. For example, 800 rubles, while phones with the necessary characteristics are much more expensive. Although, in some regions they buy sufficiently high-quality technical means for the deaf, the expert noted.

Alexander Ivanov recommends that you seek advice from the regional branches of the Society of the Deaf at the stage of preparation for the ITU and the preparation of the IPRA. The fact is that in addition to the federal list of TSRs issued to a disabled person at the expense of the state, each region has its own list. It is possible that some types of technical devices necessary for the deaf can be found there.

Ivanov also advises people with disabilities to come to the ITU accompanied by sign language interpreterto eliminate any misunderstanding on the part of the expertise staff.

The main thing is to do everything on time, because it is only possible to appeal against the ITU decision and make changes to the IPRA within a month.

As for obtaining a telephone device, in Moscow this type of TSR is provided by the Department of Social Protection, and in most regions by the Social Insurance Fund, Ivanov noted. These devices are issued in Moscow at the place of residence, in the Social Service Centers (CSO), he said.

Indications and contraindications

Telephone devices with a text output are issued in case of hearing impairment at levels I and II disability groups. Contraindication is "visual acuity of the single or better seeing eye less than 0.05 with correction and / or concentric narrowing of the visual field less than 10 degrees." The term of use of ТСР is at least 7 years.

What is IPRA?

According to ITU, an individual rehabilitation or habilitation program (IPRA) is an optimal set of measures for this person with disabilities, designed to restore or compensate for the impaired functions of his body, as well as help him to perform certain types of activities.

IPRA includes recreational activities, technical means of rehabilitation, as well as a number of services. The same name is also given to a document of the established form, which lists a set of measures, technical means and services required for a disabled person.

In case of disagreement with the content of the IPRA, a disabled person (or his legal representative) can submit a written application to the regional ITU Main Bureau.

If it is necessary to make additions or changes to the IPRA, a new referral to the ITU is issued.

There is a federal list of rehabilitation measures, technical means of rehabilitation and services, the provision of which the state guarantees to a disabled person. It includes the following items.

Rehabilitation measures:

1. Rehabilitation therapy (including medications).
2. Reconstructive surgery.
3. Spa treatment.
4. Prosthetics and orthotics, provision of hearing aids.
5. Professional training, retraining, advanced training.

Technical means of rehabilitation:

1. Support and tactile canes, crutches, supports, handrails.
2. Wheelchairs with manual drive (indoor, walking, active type), with electric drive, small-sized.
3. Prostheses and orthoses.
4. Orthopedic shoes.
5. Anti-decubitus mattresses and pillows.
6. Apparatus for dressing, undressing and grabbing objects.
7. Special clothing.
8. Special devices for reading "talking books" for optical correction low vision.
9. Guide dogs with a set of equipment.
10. Medical thermometers and blood pressure monitors with speech output.
11. Light and vibration signaling devices.
12. Hearing aids, including custom-made earmolds.
13. Teletext televisions for closed captioning programs.
14. Telephone devices with text output.
15. Voice-forming devices.
16. Special means for violations of the functions of excretion (urine and colostomy bags).
17. Absorbent linen, diapers.
18. Armchairs-chairs with sanitary fittings.

Services:

1. Repair of technical means of rehabilitation.
2. Maintenance and veterinary services for guide dogs.
3. Provision of Russian sign language translation services

Nina Kayshauri

The definition of the habilitation of disabled people is given in the Federal Law No. 181 of November 24, 1995. It sets out the principles of selecting individual programs for social, medical, psychological adaptation, and also provides a distinction between the terms "habilitation" and "rehabilitation".

The concept of rehabilitation and habilitation of disabled people

Stage 3: Fitness and wellness activities

They are held on the basis of the Children's and Youth Sports School, physical culture and sports clubs for the disabled, include their involvement in mass sports and sports events, competitions, etc.

Regular sports activities have a beneficial effect on the general physical condition of a person, and also help to recover faster after past illnesses and severe operations.

Stage 4: Social adaptation

With the help of social rehabilitation, attitudes are built in the family and society, taking into account the needs of the disabled person.

Includes two components:

1. Social and environmental orientation. It helps a disabled person to quickly adapt to new living conditions, taking into account his skills and abilities.

The help of psychologists and teachers is provided in the following cases:

• in determining the opportunities available to the disabled person for self-realization;
• assistance in enrollment in educational institutions and employment;
• assistance in establishing contacts with relatives and others;
• psychological assistance to the family.

2. Social and household habilitation. Helps to choose the most convenient pace of social and family life for a disabled person. This requires:

• train a disabled person to serve themselves;
• show the family the best option for living together and running a household, taking into account the skills of a disabled person;
• prepare housing for persons with disabilities to live in it.

Much attention is paid to the introduction of the ward into an environment where like-minded people are united by interests: circles, sections, creative teams, etc.

Comprehensive rehabilitation

Several specialists take part in its implementation, helping the disabled person to restore the skills acquired before the injury.

Comprehensiveness is one of the principles of carrying out rehabilitation measures. It involves the use of various rehabilitation measures with the participation of both medical personnel and psychologists, teachers, exercise therapy specialists, lawyers, etc. Depending on the volume and complexity of the tasks solved by rehabilitation, on the conditions, possibilities and individual indications for its implementation, it can be used different systems rehabilitation, which differ in the number of stages and the duration of treatment.

The choice is made in favor of those rehabilitation measures that are most effective and ensure the speedy recovery of the victim.

Features of rehabilitation and habilitation of disabled children

Children with disabilities have their own peculiarities in carrying out rehabilitation measures. The earlier the recovery procedures begin, the faster the restoration of lost skills or the acquisition of new ones will take place.

For this, the following types of rehabilitation and habilitation are used:

1. Medical. Includes massage, physiotherapy exercises and other types of health measures.

2. Household. Assistance in mastering new skills and abilities in everyday life.

3. Psychological. Various developmental activities are held for children.

4. Sociocultural: excursions, theaters, concerts and other leisure activities.

The peculiarity of such events is their complexity. It is necessary to restore the child's health and maximize his physical and mental abilities.

About financing habilitation programs

New procedure for establishing disability

With the entry into force of the new law, the procedure for establishing disability has changed.

Previously, mainly in the process of conducting an examination and establishing a disability group, only 2 criteria were used:

1. What is the disorder of body functions.
2. How limited is the usual level of life due to illness or injury:

• one definite function is partially or completely lost;
• is it possible for a person to do self-care or does he need regular medical and household care, etc.

Now medical and social expertise will be guided by only one criterion.

The basis for establishing a person's disability is a health disorder with a II or more severity of persistent disorders of body functions. Once a person has been identified as a disability, the criteria for establishing a disability group will apply.

Medical and social expertise also meets the principle of complexity. It is carried out on the basis of a comprehensive assessment of the state of the body based on the following data:

• Clinical and functional;
• Social household;
• Professional labor;
• Psychological.

If a person is officially recognized as a disabled person, then an individual rehabilitation or habilitation program will be assigned to him, and it will not only be prescribed, but also monitored.

Previously, a person's ability to communicate and learn, as well as to control their behavior, was taken as a basis. Now it will be given objective assessment loss of body functionality based on the results of a medical examination.

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Last changes

The draft budget for 2018 allocated 29.3 billion rubles. for the purchase of technical means of rehabilitation for the disabled. It is also planned to expand the envisaged list of TSRs with a total volume of up to 900 million rubles.

The state program "Accessible Environment" is being extended until 2025. In 2019, rehabilitation became its key aspect. Implementation will begin in 2021. In 2019, federal financial assistance was provided to 18 constituent entities of the Russian Federation.

The money will be allocated on co-financing terms for:

• purchases of equipment for rehabilitation centers,
• training of specialists,
• development of IS.

Our experts monitor all changes in legislation in order to provide you with reliable information.

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Rehabilitation of the disabled

March 2, 2017, 12:17 pm Oct 5, 2019 02:00