In some cases, a preliminary medical examination is a prerequisite for employment. The conditions for its implementation are dictated by the established legislation. The purpose of the survey is to protect the health of the employee and the people who are in contact in a work environment.
There are cases of ignoring the rules and procedures for conducting inspections. This can happen both on the part of the employer and on the part of the employee. You should understand in what cases and who needs a medical examination.
Types of medical examination
Preventive examinations of employees - a set of medical and preventive measures carried out to detect deviations in the state of health, prevention of the development and spread of diseases. Depending on how often preventive medical examinations are carried out, they are classified as follows:
- periodic;
- preliminary;
- extraordinary.
Each of the species has a specific purpose, dates, indications, order, required documentation.
Periodic medical examination
Applicants must undergo examinations throughout the entire period of work in accordance with the position held. This is done in order to confirm the professional suitability of the employee and to prevent or detect a developing preventive disease in time.
Health is a state of complete mental, physical, social and mental well-being, and not just the absence of disease. Its level varies depending on many internal and external factors. Periodic medical examination reveals the dynamics in changes in health that occur under the influence of labor factors. Identification of problems allows you to take the necessary measures in the early period of the development of pathology.
Passing a physical examination has the following features:
- It is carried out within the time limits established by law.
- The frequency of carrying out depends on working conditions and factors of production.
- Persons under 21 are screened annually.
- It is carried out on the basis of a list of names formed by the administration of the enterprise, which is sent to the territorial medical institution.
- The employee receives a referral for a physical examination from the employer.
- The employee is examined by all necessary specialists, laboratory and clinical tests are carried out in full.
- Based on the results, a final conclusion is made, which determines the suitability and ability of the employee to take his position.
Inspection frequency by type of labor activity
The list of works for which preventive examinations are mandatory, as well as the frequency of the examination:
- high-altitude and climbing work, labor associated with cranes and elevators - every 2 years;
- maintenance of electrical installations, commissioning and installation work - every 2 years;
- forest protection, work with the forest - every 2 years;
- oil and gas industry, offshore drilling - every 2 years;
- underground work - annually;
- hydrometeorological facilities - annually;
- labor in the field of geology, topography and construction - every 2 years;
- pressure vessel maintenance work - every 3 years;
- machinists, workers of boiler houses, gas supervision - every 2 years;
- work with explosive and flammable substances - annually;
- work in the banking and collection structure, security, and other types of work related to the use of firearms - annually;
- work with mechanized installations - every 2 years;
- work in school-preschool, medical and preventive institutions, pharmaceutical organizations, the medical industry - annually.
Extraordinary examinations
According to the law, each person holding a position in an enterprise has the right to an extraordinary examination in accordance with medical recommendations, during which he retains his position and salary.
This type of medical examination does not have a fixed periodicity. They are carried out in two cases:
- employee initiative - he has complaints about his state of health associated with occupational hazards or other reasons;
- employer initiative - it is suspected that the employee’s health level has deteriorated due to the negative impact of working conditions or other reasons.
On the basis of the employee’s application or a letter to the medical facility of the enterprise’s administration, an order is issued for referral for an extraordinary examination. The document indicates the time period during which the examination will take place, data on the medical institution (name, address, location of the enterprise) and the amount of salary saved for the period of absence of the employee.
In addition, all the costs of conducting an extraordinary inspection are borne by the employer, regardless of who initiated the appeal to the health care facility.
What is a preliminary examination done for?
A preliminary medical examination is carried out in order to assess the health status of the applicant for the purpose of employment, its compliance with the future occupying position, as well as to identify the presence of diseases at the time of employment.
The following groups are subject to mandatory examination:
- Minors
- Workers whose preliminary medical examination is provided for by regulatory legal acts:
- persons employed in hard and hazardous work;
- positions related to the transport industry;
- food production employees;
- persons working in terms of trade;
- employees of children's and medical institutions.
- Persons whose preventive medical examinations are provided for by other legislative documents.
On the basis of state orders, lists and regulations have been approved, which are the basis for the examination of employees: on harmful and hazardous substances, work and specialties, general and highly specialized medical contraindications, the procedure and rules for examinations.
Direction and procedure for its compilation
The person entering the work, the administration of the enterprise issues a referral for a physical examination. It indicates the following data:
- company name, form of ownership and economic status;
- data of a medical health care facility, indicating its address and code for the PSRN;
- what kind of inspection will be carried out;
- FULL NAME. and date of birth of the applicant;
- the unit to which the future place of work belongs, what position will occupy;
- factors of production.
The document is confirmed by the signature of the authorized person, indicating his surname, name, patronymic and position. An employee is issued under signature, and an authorized person keeps a record of issued directions.
Inspection Procedure
After receiving a referral, the employee turns to the specified medical institution. Preliminary and periodic medical examinations are supervised by a general practitioner, who independently summarizes the results of a comprehensive examination.
Other specialized specialists involved in the examination:
- oculist;
- ENT specialist;
- neuropathologist;
- surgeon;
- dermatovenerologist;
- dentist;
- infectious disease specialist (according to indications).
From laboratory and functional examination methods, an X-ray of the lungs, electrocardiography, blood tests for syphilis, a bacteriological smear for gonorrhea, studies on the carriage of intestinal diseases and helminth infections are performed annually.
A woman is examined by a gynecologist, takes smears for a cytological and bacteriological examination, and after 40 years, an ultrasound of the mammary glands, mammography and consultation of a mammologist are mandatory. Men undergo a cancer examination with a urologist with a digital examination of the rectum.
It is mandatory to take a general blood test, specifying the level of the formed elements, hemoglobin, color indicator, detailed leukocyte formula, ESR. Clinical analysis of urine determines the presence of sugar and protein, specific gravity, microscopy of sediment. A biochemical blood test is performed.
For all categories of people undergoing a preliminary medical examination, a health examination by a psychiatrist and narcologist is mandatory.
Based on the results of examinations of narrow specialists and clinical examinations, the therapist decides on the suitability, presence or absence of systemic diseases.
Psychiatric examination
Some working conditions require a psychiatric examination, not just a physical examination by a psychiatrist during a routine medical examination. Survey is carried out to the following persons:
- minors;
- the future position is associated with high-risk conditions (chemical production, activities related to weapons, high-altitude or underground work, employees of the transport industry);
- teachers
- catering workers;
- medical workers.
The examination process takes place in specialized institutions licensed for such activities. The commission consists of 3 specialists. The legislation says that a medical examination of workers by a psychiatrist is voluntary, but in case of refusal to undergo an examination, the administration of the enterprise has the right to refuse a person a job.
For the purpose of examination, the specialists included in the commission may request additional information from the administration of the enterprise, about which the employee is notified. The decision shall be made by voting and issued in writing within three days.
Based on the results of the survey, the commission has the right to declare the employee unsuitable for a certain type of activity (up to 5 years), but with the possibility of further re-examination.
Examination by a narcologist
A preliminary medical examination by a narcologist consists of three stages: direct examination, psychological testing, laboratory examination of blood. Narcological examinations allow you to identify possible signs of the disease, and if they are found, then the employee is sent to the hospital for further examination.
In the absence of problems, a certificate is issued confirming the passage of a routine inspection. The document complies with the established model.
The examination by a narcologist is carried out at the place of registration or in regional centers (for villagers). The company that sent the employee for examination pays for the costs.
Documentation Features
The person who will undergo a preliminary medical examination at the health facility provides the referral received from the employer, an identity document (birth certificate, passport), a health document (if any), a decision on a psychiatric examination (in cases established by law).
Medical examination of employees requires the execution of certain documents. It:
- Medical outpatient card - it records the data of the examination by doctors, test results, and the conclusion of the examination.
- A sanitary book is issued if the employee does not already have it. It clarifies the data on the organization of the employer, personal data of the employee, brief conclusions of the doctors during the examination. A sanitary book is assigned once, even if a person changes jobs.
Fitness Conclusion
Obligatory medical examination of employees requires fixing the final decision, according to the results of which the employer will be able to hire a specialist to work. In conclusion, the following data shall be indicated:
- date of registration of the result;
- Name, gender, date of birth of the employee;
- data about the employer;
- the working conditions of the person, indicating the structural unit, future position, harmful factors;
- final result (identified or not identified medical contraindications for holding a future position).
The conclusion is signed by the therapist, indicating personal data and certifying with the personal seal and the seal of the medical institution. The document is executed in several copies, one of which is entered on the outpatient card of the employee, and the other is handed to him.
Employer costs
According to the law, all expenses for mandatory preliminary and periodic medical examinations are borne by the employer. Costs are classified as those that ensure normal working conditions and safety measures and are documented.
A budget or private enterprise, whose employees will participate in medical examinations, concludes an agreement with a medical institution that has an appropriate license. Payment goes through stages. 30% of the cost of services is paid in advance, and the final calculation is based on the results of the examination.
Conclusion
The administration of the enterprise not only has the right, but is also obliged to prevent an employee who did not undergo a medical examination on time without a good reason from working or being employed. In the case of evading a preventive examination, the employee is removed from the labor process without saving wages. Timely inspection allows not only to preserve the health of the employee, but to prevent the development of possible diseases.