Mandatory preliminary and periodic medical examinations. Mandatory medical examinations of employees

Medical examination is procedure for detecting occupational diseases in an enterprise that is controlled by law and is of particular importance to both the employer and the employee. Medical examination reveals pathologies and diseases that the employees themselves could simply not notice.

Regular prophylaxis allows you to timely avoid the spread of infectious diseases in the enterprise, occupational diseases workers, thus periodic medical examinations at the enterprise are very useful.

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General concepts

The definition of a medical examination entered the legal field after a similar concept "medical examination" in 2006 (these amendments to the Federal Labor Code were legislatively introduced on June 30, 2006 (N90-FZ)), however, its essence after these editions did not lose its original meaning.

The currently functioning federal law does not provide definitions for a medical examination, however, the origin of this combination of words, and in addition the essence of this event, make it possible to reveal its functional significance.

A medical examination is a professional examination of a patient by a health worker for diseases.

"Certification" means confirmed by examination patient health report, which includes all relevant outcomes of the primary survey.

The term "medical examination" is more clearly defined in Art. 65 of the Federal Law of November 21, 2011 N323-FZ and involves a set of measures for a medical examination and examination aimed at actually confirming that the patient's health is in any legally significant condition.

More advanced medical examinations are periodic medical examinations with an extended list of people participating in them. medical workers-experts and methods of examination used.

Periodic medical examinations should be carried out in order to monitor the well-being of employees of the organization, timely detect infectious diseases in the enterprise.

Read about the initial medical examination when applying for a job in our article.

In addition, to promote preventive and rehabilitative actions of employees that contribute to the prevention of diseases, to warn of any episodes associated with illness or injury at work.

Permanent medical examinations are carried out during all stages of the work of employees with the employer at certain short intervals. The cyclicity of their implementation depends on the harmfulness of the production conditions, which have a great impact on the production worker.

There is a fairly clear definition of a medical examination (examination): it is set of medical and medical measures that establish and determine pathologies, diseases and the conditions for their occurrence and further development.

The medical examination is divided into several categories: preventive, preliminary, periodic, pre-shift / pre-trip, post-shift / post-trip.

Inspections can be conducted exclusively in the main work time, i.e. be built into the schedule, and be paid in the amount of the employee's regular salary (paragraph 11, part 2, article 212 of the Federal Labor Code).

Medical examinations are supervised by the municipal department of Rospotrebnadzor. Employers send a list of their employees available for medical examination to this supervisory authority, within ten days from the date of its adoption(clause 21, part III, Addendum N3 to Order N302n).

After the end of the medical examination, the medical organization, together with the regulatory authority, draws up a final document with the results of the examination, after which one sample is sent to the employer, and the rest to the regional office of Rospotrebnadzor and the local center of occupational pathology.

If during the medical examination the employee had disease detected professional nature , then it must be confirmed by some licensed medical institution that has permission to carry out examinations and prove the relationship of specific diseases with specialties.

Who is required to undergo a medical examination at work and at whose expense?

After the order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 N302n, from January 1, 2012, the principles that oblige all employers to carry out regular medical examinations and pay for them at their own expense.

But this only affects those situations in which the employees of the organization actually have problems, for example, with hazardous production, or other difficult working conditions affecting the health of employees.

According with Order N302n Mandatory screenings apply to employees in the education, healthcare, medical, social, construction, automotive, home service, and other industries where employees may be exposed to harmful conditions.

A scheduled medical examination in an organization is carried out for occupational diseases, and therefore pregnancy is not a subject for dispute in this case - pregnant employees undergo a routine check-up just like all other employees.

Regulations on conducting medical examinations in the organization

The regulation on conducting medical examinations is a document that is a normative act that determines the frequency and cyclicity of mandatory medical examinations at the enterprise.

This document reflects not only scheduled, but also unscheduled inspections of employees in the organization. The document is being developed in accordance with current legislation, and in particular with special attention to the key requirements of the Federal Labor Code and orders of the Ministry of Health and Social Development. The document is drawn up in any form.

Sample Regulations on primary and periodic medical examinations download for free.

Frequency of inspections

Not so long ago, the frequency of medical examinations has changed. Until 01/01/12. there was a provision according to which inspections had to be repeated at intervals in no way at least once every 2 years.

But today, how often mandatory medical examinations should be carried out is displayed in Order N302n– various unhealthy working conditions, for various types of work for which these activities are carried out, – annually or up to every 2 years(Additions N1, N2 to Order N302н).

Employees of the enterprise working in production who have not reached the age of 21 are required to undergo such medical examinations every year, in accordance with clause 17, part III of Appendix N3 to Order N302n.

However, the individual frequency of examinations for each a separate enterprise depends from harmful working conditions. Periodic inspections are carried out when developing nominal lists, which indicate hazard factors, labor characteristics, etc. All this reflects the real state of affairs in the organization.

Article 219 of the Labor Code regulates legal relations in the field of emergency medical examinations.

An unscheduled medical examination is a type of medical examination that is not documented and not included in the relevant lists by the regulatory authorities.

An extraordinary medical examination can be carried out both at the request of an employee of the enterprise, and at the initiative of the employer, if he has suspicions of the employee's unsuitability.

One of the options for periodic medical examination is pre-shift / pre-trip inspection, held before the working day / shift / flight of the driver, to reveal the possible impact of harmful and unsafe for the work of the enterprise, probable working conditions, conditions or illnesses that interfere with the implementation of labor obligations.

Including the establishment of intoxication, if any, from alcoholic beverages, drug intoxication, as well as other toxic types of intoxication (Article 46 of the Law of the Russian Federation of November 21, 2011 N323-FZ).

Inspection is carried out at the beginning of each working day by a responsible employee. Periodic medical examination for drivers is carried out once every 2 years. The procedure for passing a medical examination of drivers is regulated by Order of the Ministry of Health of Russia dated June 15, 2015 N 344n.

Carrying out algorithm

An approximate algorithm for conducting a medical examination looks something like this:

The examination is carried out in a medical facility and is considered fully completed only after a complete visit to all doctors and passing all general laboratory tests.

Also, after the completion of all procedures, the client a conclusion is issued which he then passes on to his employer. The second copy remains forever in the medical facility and is pasted into the patient's medical record.

Employees of the enterprise who have not identified any pathologies that interfere with normal work receive a special conclusion from the medical board.

If any diseases were found in the employee, then they are also reflected in the conclusion, and then this employee there can be two ways out - it can either completely stop labor Relations with this organization, that is, simply quit or transfer to another position in the same organization.

The employer must offer alternative job, work on which does not contradict the medical indicators of this employee, in accordance with part 1 of article 73 of the Federal Labor Code.

List of medical specialists

The chairman of the medical commission may be appointed occupational pathologist, and the composition of the medical commission must include doctors-specialists-occupational pathologists who have passed the appropriate advanced training processes in their immediate specialty (paragraph 5, part I of Addendum N3 to Order N302n).

For all types of employees eligible for mandatory medical examinations, examinations by psychiatrists and narcologists are also inevitable (in accordance with reference N3 to Supplement N1 to Order N302n).

Who should be responsible for late medical examinations?

For regular medical check-ups the employer is responsible. This affects those types of workers that are specified in the current federal labor law(in accordance with paragraph 11, part 2, article 212 of the Federal Labor Code).

The employee is only required to pass scheduled checkups- this provision is fixed by article 214 of the Federal Labor Code, according to which employees are required to undergo mandatory periodic medical examinations by order of their direct management.

This requirement in some cases can be localized by mutual agreement within the company, all parties should be aware of the availability of such medical examinations when signing a collective act.

If an employee does not pass a periodic medical examination, what should I do? If the employee does not agree to conduct an inspection, the enterprise may temporarily remove him from his position or somehow remove him from work, in accordance with Article 76 of the Federal Labor Code.

During the period when the employee is suspended from work, the employee’s salary is not transferred, except for certain exceptional situations in accordance with Article 76 of the Labor Code.

This time period is not included in the length of service, which provides the opportunity for annual paid leave (Article 121 of the Labor Code).

If, under the specific conditions set, the employer is the initiator and culprit of the conflict, then the period of suspension of the employee is determined as a simple (according to article 157 of the Labor Code).

Penalty for not passing a periodic medical examination

The amount of fines has now increased significantly, and the attention of regulatory authorities to violations related to the organization and conduct of medical examinations has increased greatly in recent years.

To date, the penalties for officials for refusing a medical examination is 15-25 thousand rubles, for organizations - 110-130 thousand rubles(in accordance with part 3 of article 5.27.1 of the Federal Code of Administrative Offenses).

And at the same time, officials of regulatory authorities have the right, when compiling an accounting picture, to calculate all employees of the organization who did not visit doctors, which will eventually result in fines with multiple figures. This penalty is imposed on the entire company and try to there is no point in challenging it in court.

For example, in one of these cases, the employee argued that medical examinations were missed by the fact that the assessment of working conditions at the workplace (i.e. attestation) did not show any problems, and this saved the company's management from the need for constant medical checks.

The court did not accept this argument, t.to. the company belonged to the category of catering enterprises, and employees of such enterprises are subject to regular checks in accordance with part 2 of article 203 of the Federal Labor Code of January 2, 2000, article 23 of the fed. Law No. 29-FZ and clause 15.1 of SP 2.3.6. 1079–01.

As a result, the judgment the activity of the enterprise was suspended.

Do you need a psychiatrist for a physical examination, find out from the video:

X-ray examination for tuberculosis - large-frame chest fluorography (hereinafter - 1 time per year);

blood test for hepatitis C (hereinafter - 1 time per year);

blood test for hepatitis B not vaccinated (hereinafter - 1 time per year); vaccinated are examined after 5 years, then annually in the absence of revaccination;

a blood test for syphilis (hereinafter - according to indications);

examination of smears for gonorrhea (hereinafter - according to indications);

blood test for HIV infection (hereinafter - once a year).

Laboratory tests are carried out: a general blood test and a general urinalysis, then 1 time per year before a periodic medical examination.

Depending on the pathology that has appeared (detected) in medical workers, other diagnostic studies are carried out.

1.5. Persons with changes in the lungs of a tuberculous nature, as well as persons with purulent-inflammatory diseases, are not allowed to work.

1.6. Scheduled examination of medical personnel of surgical hospitals (departments) for carriage of Staphylococcus aureus is not carried out. Examination of medical personnel for the carriage of opportunistic microorganisms is carried out only according to epidemiological indications.

1.7. Personnel of surgical hospitals (departments) are subject to prophylactic immunization against hepatitis B on a mandatory basis upon admission to work in the absence of vaccination data. Once every 10 years, the staff is vaccinated against diphtheria and tetanus. In connection with the task of eliminating measles in the country, additional immunization is being carried out for people under 35 years of age who have not had measles and have not been vaccinated with a live measles vaccine or vaccinated once. Immunization against other infectious diseases is carried out in accordance with the national vaccination schedule, as well as according to epidemiological indications.

1.8. In surgical hospitals (departments), a record of injuries and emergencies (cuts, injections, blood on visible mucous membranes, damaged skin, etc.) associated with the professional activities of personnel should be established, indicating the preventive measures taken (emergency prevention).

1.9. All personnel must undergo annual dispensary observation for the timely detection of diseases and the implementation of appropriate therapeutic measures.

1.10. The results of periodic examinations, treatment, information about preventive vaccinations are recorded in the control card of dispensary observation and brought to the attention of the person responsible for organizing and carrying out measures for the prevention of nosocomial infections.

Requirements for the sanitization of the hands of medical personnel

Hand hygiene of medical personnel is one of the most important infection control measures to break the chain of transmission of nosocomial infections.

At the suggestion of the American scientist P.B. Price, microorganisms are divided into those that are able to live and multiply in the skin - resistant microflora and those that only contaminate the skin - transient microflora.

The frequency of detection of opportunistic and pathogenic microorganisms can be very high. Often, the pathogen released from a patient with a purulent-septic infection is not found anywhere except in the hands of the staff. All this time, microbes that remain on the skin and can be transmitted to patients through contact, as well as contaminate environmental objects. This circumstance makes the hands of personnel the most important factor in the transmission of nosocomial infection.

Transient microorganisms remain on the skin of the hands for a short time (rarely more than 24 hours). They can be easily removed with normal hand washing or destroyed with antiseptics.

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 of the Labor Code of the Russian Federation, are required to undergo a medical examination (both before starting work, 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 with this requirement entails 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

Unlike the initial medical examination that the employee undergoes before entering into an employment agreement 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;
• Name 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.

Don't know your rights?

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 periodic medical examinations 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 an examination of his health 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 to this specialist is replaced by a mandatory mammography procedure, followed by its presentation to a 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: the specified list may be supplemented by other types of surveys 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 hazardous 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 Vehicle carrying 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 institution 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 health status is checked both by general practitioners and narrowly specialized specialists. List of doctors whose examination is prerequisite for the employee to carry out further work activities, 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.

Medical examination of medical workers is performed when these specialists are hired and in the course of work. In order to prevent infections, the employer is obliged to organize medical examinations. More details - in the material of the article.

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Medical examinations of medical workers: general information

The federal law of March 30, 1999 under N 52-FZ "On the sanitary and epidemiological well-being of the population" does not give rise to discrepancies: article 34 "Mandatory medical examinations" reflects that employees are required to undergo preliminary examinations upon admission to the position, as well as periodic preventive health screenings at the time of employment medical workers. At the same time, individual entrepreneurs, as well as legal entities must provide all the necessary conditions for this, issue directions.

Which doctors an employee should visit before starting work is reflected in the Order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 under N 302n “On approval of lists of harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations ”(see). The Order entered into force on January 1, 2012.

In addition, reference should be made to Art. 213 of the Labor Code of the Russian Federation, which establishes cases of mandatory examinations for:

• persons employed in work with harmful, dangerous working conditions;
• all employees of medical organizations, regardless of their position;
• employees engaged in certain types of activities, incl. associated with sources of increased danger.

What is included in medical examinations of medical workers

In general, a medical examination for medical workers includes almost the same list of examinations as for other categories of citizens. The only thing is that it has been expanded with some additional procedures, which must be completed without fail, as this is regulated by law.

Employees go through:

1. chest x-ray;
2. swabs for gonorrhea;
3. blood test for syphilis (RW);
4. studies on the carriage of pathogens of intestinal infections;
5. research on helminthiases;
6. swab from the throat, as well as the nose for the presence of pathogenic staphylococcus aureus;
7. serological examination for typhoid fever;
8. once a year, a visit to a dermatovenereologist, therapist, dentist, otorhinolaryngologist, psychiatrist, narcologist and infectious disease specialist is required.

When conducting preliminary and periodic medical examinations of medical workers, it is required to pass a clinical blood test (hemoglobin, erythrocytes, platelets, color index, leukocytes, ESR, leukocyte formula). Mandatory is a clinical analysis of urine ( specific gravity, sugar, protein, sediment microscopy). An employee undergoes electrocardiography, digital fluorography or radiography in two projections (direct and right lateral) of the lungs. In addition, biochemical screening is shown: determination of the content of cholesterol and glucose in the blood serum.

All physicians must be vaccinated without fail in accordance with the National Immunization Schedule, approved by the Order of the Ministry of Health of Russia of March 21, 2014 under N 125n. At the same time, for employees of other areas of activity this rule does not apply - they may refuse vaccinations for various reasons, including personal beliefs. The employer cannot remove them from work, but this does not mean that workers can be admitted without passing a medical examination at all.

Important! Medical examination of medical workers includes regular examination for the presence of tuberculosis. So, employees of maternity hospitals (departments, perinatal centers) undergo a preventive examination 2 times a year. Employees of medical, including health resort organizations - once a year (Order of the Ministry of Health of Russia dated March 21, 2017 N 124n).

Also, special medical examinations should be carried out by health workers engaged in performing ultrasound examinations - at least once a year. Employees engaged in radiotherapy using sealed sources of ionizing radiation - annually.

Is self-examination possible for healthcare workers?

The very system of medical examinations of medical workers is organized by the head and is confirmed by documents, as stated in the order of the Ministry of Health and Social Development under No. 302n. During employment, when employees are required to undergo preliminary medical examinations, the employer issues a special sheet in which the conclusions of doctors are recorded.

The employer is obliged:

• develop and approve a list of names of employees for whom periodic medical examination of medical workers is mandatory in accordance with the law;
• send the list to Rospotrebnadzor within ten days from the date of its approval;
• coordinate with the hospital the date of the medical examination;
• send a list of workers to the clinic two months before the scheduled date;
• to acquaint employees against signature with the schedule of medical examinations ten days before its start;
• draw up referrals for medical examinations and issue them to employees;
• report to the FSS of the Russian Federation information on the preliminary and periodic inspections carried out by filling out table 10 of form 4-FSS.

The medical organization is obliged:

• draw up a plan for medical examinations of medical workers, coordinate it with the employer and approve it with the head of the medical organization;
• form a permanent medical commission;
• the commission should determine the need for the participation of certain medical specialists, the types and volumes of studies;
• conduct inspections and sampling;
• draw up: an outpatient medical card, a health passport;
• refer an employee to an occupational pathology center, if required;
• based on the results of medical examinations of medical workers, not later than thirty days after their completion, together with the employer and Rospotrebnadzor, summarize the results of the medical examination and draw up the final report;
• send the final act within five days from the date of approval not only to the employer, but also to Rospotrebnadzor, the regional center of occupational pathology.

The employee is obliged:

• arrive at the medical organization on the appointed date with the specified documents: passport, referral for a medical examination, health passport if available, decision of the medical commission that conducted the mandatory psychiatric examination;
• undergo a medical examination of medical workers.

What does the final act on medical examinations of medical workers include?

The act includes the same information that is reflected in the medical book. If a health worker provides only a medical book during employment, it is not a fact that it is not fake. In recent years, cases of buying medical examinations have become more frequent, which was noted even by the country's chief doctor himself.

In the final act drawn up for each physician, indicate:

1. date of issue of the conclusion;
2. Full name, date of birth and gender of the person applying for a job or undergoing an annual examination;
3. the name of the employer;
4. full name of the structural unit, if any, positions or types of work;
5. the name of the harmful production factor or type of work;
6. results of medical examinations of medical workers.

The conclusion is signed by the chairman of the commission indicating the surname and initials. It must be certified by the seal of the organization that conducted the inspection. Without this, the document can be considered invalid.

In general, the institution is compiled general act, which reflects the full information:

• the name of the organization that conducted the inspection, the address of its location and the OGRN code;
• date of drawing up the act;
• full name of the employer;
• the total number of employees, including women, persons under the age of 18, as well as specialists who have a persistent degree of disability;
• the number of all workers engaged in heavy work, in harmful or dangerous conditions;
• the number of persons employed in jobs that require periodic medical examinations of medical workers and examinations for the purpose of protecting health, preventing the spread and occurrence of diseases;
• the number and list of employees who have undergone periodic inspection;
• the percentage of coverage of specialists by periodic inspection;
• a list of persons who have undergone a periodic examination, indicating the date of birth, gender, structural unit, conclusion of the commission;
• the number and list of employees who, for various reasons, did not complete the periodic inspection;
• the number of employees who have no contraindications to work;
• the number of persons with temporary contraindications;
• the number of specialists with permanent contraindications;
• the number of those who need additional examination, including in the center of occupational pathology;
• the number of employees in need of outpatient, inpatient examination and treatment;
• the number of persons in need of sanatorium treatment, dispensary observation;
• the results of the implementation of the previous recommendations reflected in the final act;
• recommendations to the employer on the implementation of recreational activities, including prevention.

The number of points reflected in the final act may be expanded. Only a part of them is given as an example. Pay special attention to the last point - this complex can check Labour Inspectorate, which occurs most often in emergency situations and in a number of other situations.

When checking compliance with the sanitary and epidemiological regime, representatives of Rospotrebnadzor have the right to verify the list of employees according to the final act with the list of the contingent. When compiling a document sent for approval, the employer must pay attention to the correctness of the indication:

• the name of the employer;
• ownership and type economic activity employer according to OKVED;
• the name of the medical organization, the actual address of its location and the code according to the OGRN;
• types of medical examinations of medical workers, which can be both preliminary and periodic;
• FULL NAME. incoming employee;
• date of birth of the person entering the work;
• the name of the structural unit in which the person entering the work will be employed;
• the name of the position (profession) or a specific type of work;
• harmful and (or) dangerous production factors, etc.

If the document is drawn up with obvious violations, during the inspections, problems will arise not only for the organization whose employees underwent medical examinations, but also for the one that conducted them. The employer is obliged to carefully study the final act, check the presence of seals, signatures and other significant information.

Health passport

When conducting medical examinations of medical workers in an institution that has assumed this responsibility, a personal outpatient card is created for each employee. The order of the Ministry of Health and Social Development under No. 302n, which entered into force already in 2012, mentions the Health Passport, but they began to check it not so long ago. There are no exceptions for medical workers of private clinics, as well as beauty parlors.

The Health Passport must have a unique number. It also contains the date of completion. The document is kept by the employee, and it is handed over to the organization that conducts medical examinations only for the duration of their passage.

Penalties for non-compliance with the rules for conducting medical examinations of medical workers

The employer is obliged to organize the passage of a mandatory preliminary medical examination. If he applied for a job without a conclusion or with a certificate that reflects obvious contraindications, then in the event of a check, he may be held administratively liable, and labor contract will have to stop. At the same time, before the termination of the TD, the employer must offer the employee another position that he can perform taking into account the state of health. If a similar violation is committed by a person previously subjected to administrative punishment, he faces severe punishment.

If the employee has not passed the mandatory medical examination of medical workers, the required psychiatric examination, or, in accordance with the conclusion issued in accordance with the procedure established by law, contraindications for current work in this position have been identified, the employer is obliged to remove him. In addition, the employee may be subject to disciplinary liability, if you rely on the paragraphs of Art. 192 TK.

On the basis of the Order of the Ministry of Health and Social Development No. employees of enterprises educational institutions, outlets undergo an annual medical examination. For managers, a personnel survey excludes worries about the risks to the health of others, protects against compensation. According to Art. and TK expenses for passing a medical examination are borne by the employer.

A medical examination is a comprehensive measure for the diagnosis of pathologies and the prevention of occupational diseases. The procedure is periodic. The objectives of the medical examination are:

• monitoring the health of employees;
• reduction in the number of injuries received at work;
• compliance with the terms of medical supervision for representatives of certain professions;
• monitoring the dynamics of diseases of workers;
• detection of the initial stage of pathologies that develop due to harmful factors;
• monitoring of possible obstacles for certain works;
• prevention of infectious diseases;
• elimination of risks of accidents at work.

A person who has passed a periodic medical examination receives the conclusion of a medical commission. Based on it, he can ask the employer to transfer to a less dangerous production site.

Types of Medical Examinations of Employees

Depending on the frequency, there are three types of surveys.

Types of medical examinations

Mandatory preliminary medical examination

Preliminary medical examination of employees is a one-time procedure before being accepted into the staff of the enterprise. The candidate receives a referral from the employer or undergoes an examination as a mandatory step in the preparation labor contract. On the basis of unsatisfactory results, applicants are refused.

You need to pass a preliminary, and upon admission to the state, an annual scheduled medical examination:

• job applicants under the age of 18;
• applicants planning to perform heavy or dangerous work;
• applicants for employment in the regions of the Far North;
• athletes, pilots, drivers, machinists;
• employees of the ranks of the Ministry of Emergency Situations, customs, judges;
• railroad workers.

Organizations that neglect these rules are subject to an administrative fine. For other categories of business, passing a medical examination remains at the discretion of management.

Important! When an applicant is unsuitable for health reasons, the refusal is sent in writing. If you do not agree to undergo an examination to sign an employment contract, the authorities have the right to refuse employment.

Periodic medical examination of employees

According to par. 12 hours 2 tbsp. The TC for the specialists of the enterprise is subject to an annual scheduled medical examination. Diagnostic procedures can be performed in a public hospital or private clinic with a license.

During the medical examination, specialists conduct analyzes and tests that are different for professions, ages, and genders. A number of procedures are required for all employees. These include an examination by a general practitioner, a neurologist, a surgeon, an ophthalmologist, the delivery of general blood tests, urine tests, fluorography, and an ECG. The result of the examination is recorded in the medical book.

The procedure for passing a medical examination every year is required for:

• workers in production associated with harmful or dangerous factors;
• employees of the catering enterprise;
• people working at height;
• physicians, representatives of sanitation stations, pharmaceutical specialists;
• personnel of educational institutions;
• citizens working in the field of poultry, livestock and water utilities.

Employees under 21, drivers, machinists and pilots undergo periodic examinations before starting their shift.

On a note! Organizations whose staff spends more than 50% of their working time at a computer can order an on-site medical examination. Its results are equated to "usual".

Extraordinary medical examination of employees

The legislation of the Russian Federation does not establish a clear procedure for conducting a medical examination out of turn. It can be passed by an employee on his own initiative in case of suspected deterioration in health. Most often, these reasons are related to professional activities.

Representatives of a medical institution can give recommendations when undergoing an unscheduled examination after a periodic one. The reason is an additional examination or medical examination initiated by labor protection specialists who suspect that conditions at work have deteriorated sharply, and the annual analysis revealed suspicious symptoms.

Who should have a medical examination

The legislation of the Russian Federation clearly establishes who exactly undergoes a routine medical examination - they are checked annually:

The frequency of the medical examination

Based on the type of activity of the organization, the timing of the medical examination is established. For whom an annual scheduled medical examination is required for 2019-2020, you can find out from the table.

Crane operators, lifters, electricians, employees of transport and felling companies should be examined once every 2 years.

At the place of work, specialists are examined, the quality of their health and work is affected by noise, light, temperature, physical and sensory loads.

The procedure for conducting medical examinations of employees of the enterprise

Responsibility for the passage of annual scheduled medical examinations by the personnel rests with the employer. The medical center, with which the organization has an agreement, forms a medical commission. Full list doctors are available in Order no. The procedure for conducting a medical examination is established by law.

Step 1. We conclude an agreement

The company's management selects a medical institution and signs an agreement with it. The terms of medical examination are selected and agreed after the contract is drawn up.

Important! The clinic must have a license for the diagnostic examination of workers.

Step 2: Make a List

The employer makes two lists:

• contingent - a list of employees and positions held;
• nominal - list of personnel.

The first document is sent to the territorial Rospotrebnadzor within 10 days. The second one is submitted to the medical center 2 months before the date of the examination.

Step 3. Making a plan

The executing party (medical center) that accepted the list of names must develop a calendar plan within 10 days from the date of receipt and 14 before passing the medical examination. It indicates by day which specialists to undergo and which tests to pass. The employer approves the plan with a signature and seal.

Sample health checkup plan

Step 4. We prepare the order

The employer draws up an order on the need for a medical examination and the order of its priority. Employees get acquainted with the text of the document 10 days before the medical examination. The order reflects:

• grounds for periodic medical examination - this is Art. , and TK;
• the need to approve the list of employees and the inspection schedule;
• medical institution where the staff is sent;
• documents that citizens need to have on hand;
• the obligation to save earnings (based on Art. Labor Code);
• the obligation to provide a medical report;
• a way to familiarize the heads of the subdivision of workers with the order.

Important! The document should indicate the persons who control its execution.

Sample order for medical examination

Step 5. Issue directions

The legislation of the Russian Federation does not establish a unified form of referral. The company compiles it arbitrarily and hands it over to the employee.

Step 6. Workers are inspected

Having a referral for a medical examination from the employer, a passport, company representatives come to the medical center with which the company has an agreement. For the period when diagnostic activities are carried out, the average salary is retained for employees.

Sample referral letter for medical examination

What to do after the inspection

After the annual scheduled medical examination of the organization's personnel is completed, medical center There are 30 days to draw up the act-conclusion. The document is certified by the director of the clinic, and then submitted for approval to the territorial Rospotrebnadzor.

The employer collects medical books from employees with the results of medical examinations, signatures and seals of doctors. According to a medical opinion, a person's belonging to a dispensary group is established. In the medical record, doctors need to indicate recommendations for maintaining health. In the presence of pathologies - provide data on observation, therapy and rehabilitation.

Expenses for passing a medical examination

The company-employer compensates for 100% the costs of personnel for the inspection. For the period of the survey, employees retain their average earnings. At the end of the event, employees must hand over the medical book to the employer.

Depending on the region, the management pays the medical center 1,500-5,000 rubles, but most companies offer a discount. The state compensates part of the funds through the FSS.

The employer also pays for the medical examination when applying for a job. If the employee paid for the services of specialists on his own, he is entitled to a refund. To do this, you need to write an application and attach receipts of payment.

Consequences of not passing a medical examination

Legislation establishes liability measures for management and employees who have not passed a periodic medical examination.

Staff Sanctions

If a citizen refuses to undergo a scheduled inspection, the employer has the right to remove him from work and not pay wages until the violator passes the examination. If a person does not want to undergo a medical examination during employment, he is denied employment. In the presence of good reasons the employee receives a salary for the entire period of unemployment.

Sanctions for the employer

An employer who has ignored the annual scheduled medical examination of his employees is subject to a fine depending on the form of ownership. Individual entrepreneurs pay 15 thousand rubles, legal entities - 110 thousand rubles.

If an employee missed the inspection for reasons independent of him and the management, the head of the company pays a downtime in the amount of 2/3 of the person's salary.

The frequency of the medical examination depends on the professional qualifications of the specialists. For most activities, it is regular - once a year. Adhering to the passage algorithm will save the employer from a fine, and the staff will not be suspended from work.