Annual medical examination of employees. This is a medical examination

Yulia Egorova talks about the new rules for medical examinations

The law obliges

IN lately In connection with the active social policy of our state, such a form of health care as a preventive medical examination is becoming increasingly relevant.

The Labor Code defines groups of people for whom medical examination is mandatory.

Labor Code of the Russian Federation Art. 213 (extract):

Workers engaged in heavy work and work with hazardous working conditions<…>undergo mandatory preliminary (upon entry to work) and periodic medical examinations to determine the suitability of these workers to perform the assigned work and prevent occupational diseases.

Workers<…>medical and preventive care and children's institutions<…>undergo the specified medical examinations (examinations) in order to protect public health and prevent the occurrence and spread of diseases.

An important point reflected in Article 213 of the Labor Code is that carrying out preventive examinations of these groups of workers is the responsibility of the employer and is carried out at his expense, including working hours and maintaining wages. The state supports this using the “carrot and stick” method. Gingerbread is a preferential taxation of amounts spent by the employer on conducting medical examinations. Whip is an administrative liability under Article 5.27 of the Code of Administrative Offenses of the Russian Federation for officials guilty of violating labor laws.

What to do with the mandatory medical examination if, according to the law, medical examinations and interventions cannot be carried out without consent, and even more so against the will of the patient?

Preventive examination is mandatory only for certain groups of workers in order to protect public health. Employment in such responsible work can only be voluntary, and consent to preliminary and periodic medical examinations is assumed to be automatic upon signing an employment contract, which most often includes a clause on undergoing examinations as an essential condition.

What has changed in the medical examination?

Until 2012, medical examinations were regulated by several orders, some of which were issued back in Soviet times. Since January 2012, Order of the Ministry of Health and Social Development of Russia No. 302n dated April 12, 2011 “On approval of lists of harmful and (or) hazardous production factors and work...” came into force. On at the moment This order and its annexes are the main regulatory framework for carrying out preventive examinations, and previously existing orders have been canceled since 2012.

Compared to the old procedure for conducting medical examinations Several fundamental differences emerged.

1. Now only an occupational pathologist should head the medical commission, and the commission’s medical specialists need advanced training in the field of occupational pathology.

2. The principles for compiling lists of workers sent for medical examinations have changed. If previously employees were included in the list depending on their position, now an employee can be added to this list only on the basis of certification of the workplace, which must be carried out in accordance with another order of the Ministry of Health and Social Development of Russia (No. 342n dated April 26, 2011 “On approval of the Procedure for certification jobs according to working conditions"). That is, even if a person works at a uranium mine, but the employment contract does not indicate a workplace certification card, then he does not need to undergo a medical examination, and he has no medical contraindications to work.

3. A psychiatrist and a narcologist are included in the medical commission; their examination is now mandatory for everyone undergoing a medical examination, and not just for those who are hired or have access to drugs, as was previously the case.

These innovations can generally be considered positive, especially if medical examinations of employees are not reduced to a formality, as, unfortunately, sometimes happens. The emphasis on occupational pathology increases the preventive value of medical examination, and preventing persons with alcohol or drug addiction from dangerous work will certainly reduce the level of injuries in the workplace.

Health passport

The so-called “health passport” is also gradually being introduced into practice - a document of the established form, a sample of which can be found at the link medexx.ru. The passport contains information about employees undergoing medical examinations; during the examination, it is kept in the medical organization, and after it is given to the employee.

The introduction of health passports does not cancel personal medical records. The procedure for issuing a medical book is regulated by Rospotrebnadzor Order No. 402 of May 20, 2002 “On a personal medical book and sanitary passport,” which continues to be in effect. In addition, the lists of workers required to have a health passport and a medical book are somewhat inconsistent, and employees of children's health care institutions are required to have both. Of course, in this case, you can undergo an annual medical examination, recording the examination results in both documents. You can learn more about medical books and who needs them on the website of the Moscow Center for Hygiene and Epidemiology http://www.mossanexpert.ru

Organization of medical examination of employees

According to the order, now only a medical institution that has received the appropriate license can provide medical examination services. At the same time, the institution must have a permanent medical commission under the leadership of an occupational pathologist. Therefore, the natural desire for every health worker to undergo a medical examination directly at the place of work, unfortunately, is not feasible if the establishment does not have the appropriate license.

The same is true with analyses. For the organization performing the medical examination, no normative document prohibiting the use of the results of tests and examinations performed in other medical institutions. But, given that this is a paid service, it is unprofitable and quite risky for medical institutions to accept third-party results, since they can be falsified. Unfortunately, it is also impossible to undergo a medical examination privately - where you prefer - because the employer must organize a centralized medical examination and provide the medical organization with a list of employees, data on the certification of workplaces and harmful factors of production. Moreover, the medical organization must summarize the results no later than a month after the completion of the periodic medical examination. Then, together with the territorial bodies of the federal executive body authorized to exercise state control and supervision in the field of ensuring the sanitary and epidemiological well-being of the population, and representatives of the employer, the medical institution draws up a final act.

Our medical examination or medical examination of doctors

Let's talk about the features of medical examinations for health workers. According to paragraph 17 of Appendix No. 2 to Order No. 302n, medical personnel of all medical institutions must undergo a preventive medical examination annually. The “program” of the medical examination is presented in Table 1.

Consultations and examinations	Who passes	How often to go
therapist, psychiatrist, narcologist, dentist, dermatovenerologist, otorhinolaryngologist	All	1 time per year
clinical blood test (hemoglobin, color index, red blood cells, platelets, leukocytes, leukocyte formula, ESR)	All	1 time per year
Clinical urine analysis (specific gravity, protein, sugar, sediment microscopy)	All	1 time per year
biochemical screening (content of blood serum glucose, cholesterol)	All	1 time per year
blood test for syphilis	All	1 time per year
smears for gonorrhea	All	1 time per year
neurologist, ophthalmologist, allergist, endocrinologist, oncologist	health workers whose work involves exposure to chemical, physical and biological unfavorable factors	Once a year or once every 2 years - according to Appendix No. 1 to Order No. 302n**
blood test for hepatitis B and C, as well as HIV	only workers who have professional contact with infected material or blood products, and only with the consent of the worker	1 time per year
studies for carriage of intestinal pathogens and serological examination for typhoid fever	All	upon admission to work and in the future - according to epidemiological indications
helminthiasis tests	All	upon entry to work and in the future - at least once a year or according to epidemiological indications
swab from the throat and nose for the presence of pathogenic staphylococcus	All	upon starting a job and thereafter - once every 6 months

* The inclusion of a dermatovenerologist and an otorhinolaryngologist in the medical examination commission for medical workers is based on frequent professional contact with various types of allergens. On the recommendation of these specialists, further examination may be prescribed in the form of specific allergy diagnostics, examination of external respiration function and consultation with an allergist. ** Appendix No. 1 to Order No. 302n also indicates additional medical contraindications for work associated with unfavorable factors, such as hypochromic anemia, benign neoplasms, microcirculation disorders of any nature.

The result of the medical examination

If the examinee does not have any health problems, the occupational pathologist makes a conclusion about suitability for the work performed. But what if a medical examination reveals any diseases? Full list contraindications are quite extensive and are contained in paragraph 48 of Appendix No. 3 to Order No. 302n.

It must be said that many of the points when applied to medical workers are controversial. For example, how stable angina pectoris, post-infarction cardiosclerosis, drug-compensated epilepsy, widespread ichthyosis, or even early stage cancer can interfere with the performance of a therapist’s duties is personally unclear to me.

Of course, for emergency work in the ambulance, operating room, emergency department and similar areas, good health is necessary, but for routine appointments and consultative work, such requirements seem to me to be excessive. If all the contraindications listed in this list are observed in detail, medicine risks losing a large number of older specialists, whose knowledge and experience are of great value, despite the imperfect state of their health.

Mandatory participation in a medical examination by an occupational pathologist involves identifying the connection between detected diseases and professional activities. If an occupational disease is suspected, the medical organization issues the employee a referral to an occupational pathology center or a specialized medical institution that has the right to conduct research regarding the connection of the disease with the profession. Such a medical institution also draws up and sends, in the approved manner, a notice of establishing a preliminary diagnosis of an occupational disease to the territorial body of the federal executive authorities authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being.

The employer, if medical contraindications are discovered, is obliged to remove the employee from the work he is performing or provide him with another one that is not contraindicated for him due to health reasons. At the same time, at the first stage, the employer is obliged to offer the employee available vacant positions, and then, by the decision of the employee himself, an additional agreement to the employment contract on the transfer is drawn up or, in case of refusal, the removal procedure provided for in Article 76 of the Labor Code of the Russian Federation is applied. At the same time wages for the period of exemption from work duties is not accrued, but the place of work and position are retained. If the period for which the employer is forced to suspend an employee for medical reasons exceeds four months, then the employee is subject to dismissal under Art. 77 Labor Code of the Russian Federation.

Some difficulties when undergoing a medical examination may arise for employees who have a disability for any reason. Along with the referral for a medical examination, it is better for them to provide the conclusion of the next medical and sanitary examination, so that the commission can make a decision on admission to work.

There is something to strive for

The legal regulation of preventive medical examinations is given great attention: clear rules for their implementation have been defined, a list of works has been given that require a medical examination, outdated orders have been cancelled, and centralized control over the inspections has been introduced. However, perfection has not yet been achieved. The most reasonable thing would probably be to issue a separate order on preventive examinations of medical personnel and somewhat soften the list of contraindications for working in medicine.

A medical examination of medical workers is carried out when hiring these specialists and in the process of work. In order to prevent infections, the employer is obliged to organize medical examinations. More details can be found in the article.

Download documents on the topic:

Medical examinations for healthcare workers: general information

The Federal Law of March thirtieth, 1999 under N 52-FZ “On the sanitary and epidemiological welfare of the population” does not give rise to discrepancies: Article 34 “Compulsory medical examinations” reflects that employees are required to undergo preliminary examinations when applying for a position, as well as periodic preventive pre-employment medical examinations medical workers. At the same time individual entrepreneurs, as well as legal entities must ensure all necessary conditions To do this, write out directions.

Which doctors should an employee 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 came into force on January 1, 2012.

In addition, one must rely on Art. 213 of the Labor Code of the Russian Federation, which establishes cases of mandatory inspection for:

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

What does medical examination of medical workers include?

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, since this is regulated by law.

Workers undergo:

chest x-ray;
smears for gonorrhea;
blood test for syphilis (RW);
studies on carriage of pathogens of intestinal infections;
studies for helminthiasis;
a swab from the throat and nose for the presence of pathogenic staphylococcus;
serological examination for typhoid fever;
once a year you are required to visit a dermatovenerologist, therapist, dentist, otolaryngologist, psychiatrist, narcologist and infectious disease specialist.

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

All doctors must be vaccinated according to the National Vaccination Calendar, approved by Order of the Ministry of Health of Russia dated March 21, 2014 under N 125n. However, this rule does not apply to employees in other areas of activity - they may refuse vaccinations for various reasons, including personal beliefs. The employer cannot remove them from work, but this does not mean that employees can be admitted without undergoing a medical examination at all.

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

Also, medical workers involved in performing ultrasound examinations must undergo special medical examinations - at least once a year. Employees engaged in radiation therapy using sealed sources of ionizing radiation - annually.

Is a self-examination possible for healthcare workers?

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

The employer is obliged:

develop and approve a list 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;
agree with the hospital on the date of the medical examination;
send a list of employees to the clinic two months before the scheduled date;
familiarize employees with the medical examination schedule, against signature, ten days before it begins;
prepare referrals for medical examinations and issue them to employees;
report to the FSS of the Russian Federation information about preliminary and periodic inspections carried out by filling out table 10 of form 4-FSS.

A 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 must determine the need for the participation of certain medical specialists, the types and volumes of research;
conduct inspections and take samples;
draw up: an outpatient medical card, a health passport;
refer the employee to the occupational pathology center, if required;
based on the results of medical examinations of medical workers, no later than thirty days after their completion, together with the employer and Rospotrebnadzor, summarize the results of the medical examination and draw up a 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 facility on the appointed date from specified documents: a passport, a referral for a medical examination, a health passport if available, a decision of the medical commission that conducted a mandatory psychiatric examination;
undergo a medical examination by medical workers.

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

The act includes the same information that is reflected in the medical record. If a health worker provides only a medical record during employment, it is not a fact that it is not fake. IN recent years Cases of purchasing 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, the following is indicated:

date of issue of the conclusion;
Full name, date of birth and gender of the person entering work or undergoing an annual examination;
employer's name;
full name structural unit if available, positions or types of work;
name of the harmful production factor or type of work;
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, a general act is drawn up for the institution, which reflects complete information:

name of the organization that conducted the inspection, address of its location and 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 been diagnosed with a permanent degree of disability;
the number of all workers engaged in heavy work, located in harmful or dangerous conditions;
the number of persons employed in work that requires periodic medical examinations of medical workers and examinations in order to protect health, prevent the spread and occurrence of diseases;
number and list of employees who have undergone periodic inspection;
percentage of specialists covered by periodic examination;
a list of persons who have undergone periodic examination, indicating the date of birth, gender, structural unit, and the 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 people with temporary contraindications;
number of specialists with permanent contraindications;
the number of those who need additional examination, including at the occupational pathology center;
the number of workers in need of outpatient, inpatient examination and treatment;
the number of people in need of sanatorium-resort treatment and dispensary observation;
results of implementation of previous recommendations reflected in the final act;
recommendations to the employer on the implementation of health-improving measures, including prevention.

The number of points reflected in the final act may expand. Only some of them are given as an example. Pay special attention to the last point - this complex can check labor inspection, which happens most often during emergencies and in a number of other situations.

When checking compliance with sanitary and epidemiological regulations, representatives of Rospotrebnadzor have the right to check the list of employees according to the final act with the list of contingent. When drawing up a document sent for approval, the employer must pay attention to the correctness of the following:

employer's name;
forms of ownership and type economic activity employer according to OKVED;
name of the medical organization, actual address of its location and OGRN code;
types of medical examinations of medical workers, which can be either preliminary or periodic;
Full name incoming employee;
date of birth of the person applying for work;
the name of the structural unit in which the person applying for work will be employed;
name of the position (profession) or specific type of work;
harmful and (or) hazardous 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 for the presence of seals, signatures and other relevant 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 worker. The order of the Ministry of Health and Social Development No. 302n, which came into force in 2012, mentions the Health Passport, but they began to check it not so long ago. There are no exceptions for health workers in private clinics and beauty salons.

The Health Passport must have unique number. It also indicates 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 the examination.

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

The employer is obliged to organize the 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 an inspection he may be subject to administrative liability, and the employment contract will have to be terminated. In this case, before the termination of the TD, the employer must offer the employee another position that he can perform taking into account his state of health. If a person who has previously been subject to administrative punishment commits a similar violation, he or she 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 the manner prescribed 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 based on the paragraphs of Art. 192 TK.

Particular attention is paid to health checks for employees whose work involves risk to life: rescue workers, police officers, military personnel (from submariners to the honor guard company) and others. Mandatory and periodic medical examinations of workers necessary in chemical, engineering, light and many other types of industry.

The physical condition and general health indicators at such enterprises must be monitored, firstly, for the safety of the workers themselves (it is known that many diseases are much easier to prevent or identify in the early stages than to treat advanced cases). Secondly, to exclude all kinds of industrial injuries. When a person works in a hazardous industry (say, going down a mine every day), a medical examination is carried out at least once a year.

Those whose profession is not harmful or dangerous, but is somehow connected with food (employees of restaurants, canteens, bakeries, factories producing various semi-finished products, etc.) are also required to undergo examinations by doctors.

Employees undergo mandatory medical examinations:

schools,
kindergartens,
medical institutions.

Regular medical examinations, in addition to disease control, allow you to see the overall picture of the health status of employees over a certain period of time. It becomes possible to monitor changes in the well-being of workers, to determine the exact factors, in addition to production factors, that negatively affect well-being. Thus, the development of occupational diseases is controlled and the spread of infectious diseases is prevented.

The director of the company directly monitors how employees undergo medical examinations. He also determines the frequency of medical examinations, naturally, based on the requirements of the law. Guided by labor safety standards, the manager determines the need for a candidate for a certain position to undergo a medical examination and obtain a medical record.

What medical examinations should an employee undergo?

1. Preliminary. The essence is in the name: they are carried out before taking office to check whether the candidate can cope with the workload assigned to him, whether his health will allow him to perform professional responsibilities.

Categories of employees for whom preliminary medical examinations are mandatory - minors; citizens working in heavy industries; workers in the food industry and trade, as well as everyone whose profession is related to teaching children and treating people.

2. Periodic. They are carried out once every six months or once a year in order to identify diseases, as well as to prevent the development of dangerous diseases that can lead to disability.

Periodic medical examinations of workers (Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n) allow you to monitor their general health. Monitor any changes in health over time, including those leading to the development of occupational diseases. Laboratory studies show how much working conditions affect the well-being of an employee. Let's say the readings were better a year ago, which means something has changed in twelve months. Therefore, it is necessary to identify the cause of the changes and, possibly, refer the person for treatment.

3. Extraordinary. There are no plans for extraordinary medical examinations. For the manager to order an extraordinary medical examination, something serious must happen. For example, after an inspection by supervisory authorities (Rospotrebnadzor, prosecutor's office). The employee has the right to ask to schedule an extraordinary examination. The worst thing is when there is an outbreak of an infectious disease at the enterprise.

The fine that threatens the manager for the lack of a medical examination

The Labor Code of the Russian Federation (in particular, Articles 214 and 212), Order of the Ministry of Health and Social Development of the Russian Federation No. 302n and other acts oblige annual medical examinations of workers and clarify which employees must undergo periodic medical examinations.

The Labor Code of the Russian Federation prohibits the admission to work of those who have not been examined by doctors in a timely manner and have not checked their mental and physical health.

Article electronic journal « General manager» will help you avoid possible mistakes: it is better to prevent fines than to later challenge them in court.

Mandatory medical examinations of workers: types and procedure

Of the three main types of medical examinations, only two, preliminary and periodic, are mandatory.

Preliminary medical examinations

In accordance with Order No. 302n, employees must undergo preliminary medical examinations only at the time of direct registration for work. And only in the case where the proposed position involves working in difficult and dangerous conditions. Until the spring of 2011, that is, before the signing of the Order, the task of preliminary medical examinations was to establish the fact that the candidate had no medical contraindications to this species works Now, in addition to this, a person gets tested and goes to doctors to rule out possible diseases.

Medical examinations of employees are carried out only after the head of the enterprise signs the relevant document - a referral. What exactly should the manager write in it:

full name of the legal entity or private entrepreneur, in accordance with the requirements of OKVED;
the name and actual (not legal) address of the medical organization where the medical examination will take place, in addition the OGRN code is written;
the type of medical examination is indicated (in this case, that is, when registering an employee, preliminary);
Full name and date of birth of the person who will be examined. The exact name of the employee’s position for which he is being hired is also indicated here;
the harmful and dangerous circumstances that a person will encounter during his professional activities are indicated;
the type of activity of the employee is prescribed (what exactly he will do in production).

The direction is signed either by the immediate supervisor or by the person responsible for labor protection at the enterprise (deputy for personnel, for example). The full name of the person who issued the referral and his position must be indicated. The employee receives the document and must put his signature on it, since the company keeps strict records of issued directions.

Do not think that the employee is only required to come to the designated place and go around the doctors on the list. The law requires that you provide the medical organization, firstly, with a passport and a referral from the employer. A health passport (if available) is also required. The medical institution is required to create an outpatient card for the person who comes.

A health passport, in case of its absence, is issued during a preliminary medical examination. This document is done once and is in the citizen’s hands. It indicates the date the passport was filled out, and the document is assigned an identification number (it is impossible and illegal to have multiple passports). The health document includes the name of the organization that issued the referral for a medical examination, the name and address of the medical organization itself (the citizen will be assigned to it in the future for observation), data of the passport holder: full name, compulsory medical insurance policy number. The document indicates the results of examinations and the conclusions of all specialists examined.

During the entire period while the examination is being carried out, the health passport is kept in the medical institution. Upon completion of the inspection, the document is returned to the owner. The only place where people don’t ask for a health passport is the Federal Medical and Biological Agency of Russia.

The health passport is issued once and in a single copy. In case of loss, a duplicate is made. To restore a lost document, a citizen must contact a medical organization with a corresponding application.

In addition to the above documents, the citizen is required to provide certificates of mental health. Psychiatrists and narcologists are required to visit everyone who works at high-risk facilities or in hazardous industries. Conclusions on the mental state must be obtained every five years (this is stated in Part 5 of Article 213 of the Labor Code of the Russian Federation).

The medical examination is considered completed after the results of all laboratory tests are entered into the health passport. As a result, the medical organization issues a conclusion in which the medical institution, based on the research conducted, prescribes contraindications or their absence for the type of work for which the person is sent.

The conclusion is drawn up in two copies: the first remains in the medical institution and is stored in the personal outpatient card, the second is given to the patient.

Periodic medical examinations

Periodic medical examinations are not a one-time event. Medical examination is carried out throughout the entire period of work where the employees’ activities involve a risk to life or where there are difficult working conditions. Who exactly should be examined by doctors periodically, usually once a year, explains new Order No. 302n. This document clearly defined the objectives of periodic medical examinations, summarizing data from the old Regulations for 1996 and 2004.

Let us consider in more detail those tasks for the purpose of solving which periodic medical examinations are carried out at enterprises:

ensuring timely disease prevention;
identifying infectious diseases to prevent their spread among the population.

The frequency of medical examinations, contrary to public opinion, is not determined by management decisions. The most important factor here is the type of activity of the enterprise, that is, how dangerous the work is and what kind of harm to health it can cause. The information about which employees are required to undergo periodic examinations is clearly and in detail set out in Order No. 302n, and there is also a complete list of hazardous industries in which workers are required to be examined by doctors.

If during a routine medical examination an employee is diagnosed with any chronic diseases, then, based on the doctors’ conclusions, he (the employee) is assigned an extraordinary medical examination. Previously, the enterprise compiles lists of such employees who, for one reason or another, needed to undergo a medical examination outside of the plan.

Important: the lists of those who are subject to an extraordinary medical examination also include employees whose workplaces have been certified to reveal harmful factors affecting their health. Moreover, it is not at all necessary that production be considered dangerous.

It is logical that not only employees employed in hazardous and hazardous industries, but also employees of other professions should undergo mandatory periodic and preliminary medical examinations. The list of such specialties is given in Order No. 302n.

Name of work and professions	Inspection frequency
1. High-altitude professions, as well as places associated with work on lifting structures, including:	annually
1.1. Crane operator	once every two years
1.2. Lifter	once every two years
2. Ensuring the operation of functioning electrical installations with voltages of 42 V and above alternating current, 110 V and above direct current. All installation work, commissioning, all kinds of testing and measurements are here.	once every two years
3. Logging: shaft, rafting, transportation, primary processing. Also activities related to forest protection and restoration.	once every two years
4. Work in remote areas.	annually
5. Activities related to pressure vessels.	once every two years
6. Professions where it is necessary to come into contact with flammable and explosive substances.	annually
7. Persons who, due to their duty of service, are allowed to carry military weapons.	annually
8. Specialties whose activities are related to gas. Including fire protection, services and departments for rescuing people in the mountains.	annually
9. Rescuers (work in emergency situations resulting from a natural or man-made disaster).	annually
10. Work with mechanical equipment, with open, moving or rotating parts (turners, milling machines, stampers and others).	once every two years
11. Divers working in a gas environment with normal pressure.	once every two years
12. Underground work.	annually
13. Work performed using insulating personal protective equipment and filtering gas masks with a full face part.	once every two years
14. Any activity somehow related to food: storage, transportation by all types of transport, production and sales. This list includes employees of vegetable warehouses and warehouses, grocery stores, factories producing semi-finished products, etc.	annually
15. Employees of public catering establishments: restaurants, bars, catering units in production, canteens, etc.	annually
16. Higher or secondary students educational institutions who undergo practical training at enterprises whose employees are required to undergo medical examinations.	annually
17. Everyone without exception medical workers and doctors in all clinics, hospitals, sanatoriums, maternity hospitals and other medical institutions.	annually
18. Employees of children's educational institutions, as well as employees of institutions additional education.	annually
19. Employees of children's health institutions (camps, dispensaries, etc.).	annually
20. Teachers and nannies in preschool institutions, employees of orphanages, boarding schools (including educational ones), orphanages, children's sanatoriums and year-round camps. Workers of social institutions: shelters, nursing homes.	annually
21. Employees public baths, hairdressing salons, beauty salons - everyone associated with consumer services for the population.	annually
22. Specialists of hydrotherapy enterprises and swimming pools (including fitness clubs).	annually
23. Russian Railways employees - conductors, on airplanes - flight attendants and stewards, hotel workers.	annually
24. Pharmacists, specialists from medical and pharmaceutical enterprises - everyone who, by occupation, is in any way connected with the manufacture and sale of medicines.	annually
25. Employees of enterprises involved in the provision of drinking water (waterworks, treatment plants), as well as with the maintenance of water supply networks.	annually
26. Workers at dairies.	annually
27. Ground transport drivers.	once every two years

According to Order No. 302n, when compiling a list of those in need of an extraordinary medical examination, the director of the organization is obliged to indicate the position next to each name (according to staffing table) and identify those factors that can negatively affect health. In addition, the type of activity of the employee should be specified.

The list of people certified and signed by the top management of the enterprise must be sent to the territorial executive authority that oversees this area (carries out sanitary and epidemiological supervision). The list can be sent by mail within ten days.

Next, the list of names is sent to the medical organization, where employees will be examined. It is this medical institution that, within ten days of receiving the list of people, writes a plan by numbers: when and who undergoes a medical examination. This plan is checked with management (after all, when an employee goes to doctors and gets tested, no one will perform his functions for him, and the director is obliged to ensure the uninterrupted operation of his enterprise). At the end, the plan is returned to the medical organization, where its management finally approves the schedule of extraordinary medical examinations for employees of a particular enterprise.

Ten days before the examination date, the manager notifies employees that they will soon have to visit doctors. Already immediately the day before the examination or right before its start, employees are given a referral for an examination, similar to the one issued for undergoing a preliminary medical examination. During the periodic examination, the medical institution does the same documents: an outpatient card and a health passport, of course, if it has not been issued earlier.

After completing the periodic medical examination, in addition to the conclusion, which is issued to the employee immediately after the examination, a final report is additionally drawn up. This is a special document. It is done within a month and must be agreed upon with the employer and with the regional Office of the Federal State Institution “Center for Hygiene and Epidemiology of the Russian Federation”. Order No. 302n provides an expanded list of the data that is indicated in the final act (see paragraph 43 of the Order). The chairman of the commission that conducted the medical examination certifies the final act in its latest edition, after all agreements with interested parties, certifying the document with the seal of the medical institution. A total of four copies of the act are made, which are intended:

directly for this medical institution where the surveys were carried out. Here the deed is kept for fifty years;
for the employer so that he can file the document in his archives and, if necessary, have written evidence of a periodic medical examination (in the case of an inspection by supervisory authorities);
for the regional center of occupational pathology;
for the territorial Administration of the Federal State Health Institution “Center for Hygiene and Epidemiology of the Russian Federation”.

Since the final act is drawn up and undergoes the final stages of signing within the walls of the medical institution, it is the institution that is obliged to send copies of the document by mail to everyone to whom they are entitled by law within five days.

Accident at work: director's responsibility

Why are pre-shift and post-shift medical examinations of workers needed?

There are categories of company employees who are required to undergo a medical examination not once a year or six months, but every day. The Labor Code of the Russian Federation (Article 213) states that for certain types of specialties, medical examinations are established, which are carried out at the beginning and at the end of the work shift (day). The law does not give a clear name to such examinations, but in the professional environment they are referred to as post-shift and pre-shift. These names begin to appear in the order of the Ministry of Health dated December 15, 2014 No. 835n. In addition to post-shift and pre-shift medical examinations, the Order introduces the concepts of pre-trip and post-trip medical examinations, thereby designating such examinations as separate species medical examinations of workers.

Pre-trip medical examinations appear in Federal law No. 196 of December 10, 1995 “On safety traffic" This act obliges employers to conduct a medical examination of all drivers who go on a trip.

The Labor Code of the Russian Federation does not fully explain which categories of workers should be checked by doctors at the beginning and end of the working day, the law does not provide clear guidelines on the procedure for conducting such medical examinations, but the fact of mandatory daily medical examination remains. The law reserves the employer the right to regulate this procedure by internal regulations.

Categories of employees whose activities are related to management terrestrial view Transport, guided by the Labor Code of the Russian Federation, Federal Law No. 196 and Order of the Ministry of Transport of the Russian Federation dated March 28, 2007 No. 36, must undergo medical examination before going on a flight or starting a work shift. These categories include:

everyone who works underground;
drivers whose professional duties include driving a vehicle;
entrepreneurs who are not professional drivers, but get behind the wheel as part of their activities;
persons operating various types of railway transport, including assistant drivers;
specialists in the chemical, nuclear industries and others whose activities are related to hazardous industries.

Heads of organizations that do not have the above-mentioned jobs also have the legal right to conduct pre-shift and post-shift medical examinations to ensure the safety of the life and health of their own employees and those who will come into contact with them. Everything depends only on the will of each individual employer.

The organization's responsibility to conduct daily medical examinations falls entirely on the shoulders of the company's management. But if the company does not belong to the above list, then such medical examinations are not mandatory.

Order No. 832n established certain standards for conducting daily medical examinations:

unlike other examinations, for example, periodic examinations when an employee is sent to a medical facility, examinations before the start of a work shift are organized directly at the workplace;
Absolutely all material costs associated with conducting a pre-shift medical examination are borne by the employer (nothing is deducted from the employees’ wages);
the examination is carried out exclusively by professional doctors who have the appropriate license;
The doctor is obliged to examine the employee, measure his pulse, blood pressure, body temperature, and find out if there are any complaints about his health. It is also necessary to test the person for alcohol and drugs;
Based on the results of the medical examination, a conclusion is made. It is this document that determines whether the employee is allowed to work or not.

All medical examinations are recorded in a special journal. The results of the examinations are also recorded there. After each procedure, the employee and the specialist who conducted the examination are required to sign in the journal to confirm the fact of the procedure and its results.

Article No. 213 of the Labor Code states: the employer must include the time spent on a medical examination in the working day. However, despite this, bosses and subordinates often argue regarding the regulation of the time of examination: the former, of course, want the medical examination to begin and end before and after working hours. However, it is illegal to extend a shift at the expense of an examination. It is also illegal to deduct from an employee’s salary the cost of the time spent on conducting the inspection procedure.

Unfortunately, according to research in this area, many employers, taking advantage of the low labor literacy of their staff, force employees to come to work actually before their shift so that they have time to see a doctor. Not all subordinates meekly put up with violations of the law and go to court with claims. As shown judicial practice, Themis often takes the side of the employee rather than the employer.

Criminal liability for violation of labor protection: strict from two to seven

How to organize mandatory preliminary and periodic medical examinations of workers: a step-by-step algorithm

1. We conclude an agreement with a medical organization to conduct preliminary and (or) periodic examinations of employees. Next, we select a date suitable for everyone for the first periodic medical examination.

2. We are developing a list of employees

This list must necessarily include workers who are exposed to hazardous production circumstances indicated in:

Appendix No. 1 of the Order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n;
data from the certification of workplaces at the enterprise for working conditions (certification is carried out in accordance with Order No. 342n of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2011);
accompanying documents on production equipment and raw materials used in the enterprise;
production control and laboratory scientific research.

As well as employees whose type of activity is listed in Order No. 302n.

Order No. 302n clearly defines what data is indicated in the list of employees:

employee position according to the staff schedule;
a description of which factor among those listed in the paragraphs just above negatively affects the worker’s health.

3. We approve the list of employees who are subject to preliminary and periodic medical examinations.

4. Within 10 days, we send the list to the territorial body of Rospotrebnadzor, not at the legal location, but at the actual location.

5. We draw up a list of names based on the approved list of contingents, which should include:

Full name of the person being sent for examination and the exact wording of his position;
identification of reasons that negatively affect the employee’s health.

6. We approve the list of names.

7. We send a list of names to the medical organization. This must be done at least two months before the scheduled date of the examination.

8. We agree on a calendar plan for conducting periodic inspections.

It is the responsibility of the medical organization to schedule the timing of medical examinations, who comes and on what day. The management of the enterprise only adjusts the calendar plan drawn up by the doctors, making minor changes. The employer has two weeks allotted by law for this.

9. We notify employees. It is necessary to warn employees about the upcoming medical examination at least ten days before the scheduled calendar plan dates.

10. We provide the employee with a referral for periodic inspection.

The employee must sign for receipt.

The document states the following:

the exact name of the employing company, including the organizational and legal status of the company and the type of activity in which it is engaged;
code of the medical institution according to OGRN and location of the medical organization;
what kind of medical examination is to be performed - preliminary or periodic;
Full name, date of birth and job position of the person being sent for examination;
circumstances that occur at the enterprise and which may negatively affect health.

The direction is signed either by the head of the enterprise or by the person responsible for occupational safety in the company (for example, a human resources manager). The same employee keeps strict records of issued referrals. Let us remind you that all referrals to a medical institution are issued strictly according to a previously compiled list of those who are subject to a medical examination.

How to take care of employee health, increasing productivity and sales

In what cases and how are extraordinary medical examinations of employees carried out?

The need for extraordinary medical examinations is prescribed in the final examination report, which is drawn up by the medical institution. Not all employees should be examined by doctors, unscheduled, so to speak. The law clearly stipulates which employees are subject to an extraordinary medical examination (see Labor Code of the Russian Federation, Articles 213 and 348):

persons whose working conditions are recognized as dangerous or harmful;
persons whose professional activities are directly related to transport;
employees food production, catering establishments, food trade and transportation. Also employees of all preschool, school and additional education institutions. Medical workers.

An extraordinary examination can be organized at the initiative of the employer, but only in certain cases:

when the employee himself asked for an unscheduled medical examination;
when there are appropriate medical indications or previous medical examinations revealed the need for an extraordinary examination;
recommendations from the territorial Office of Rospotrebnadzor;
in a situation where an infectious disease is detected (in order to prevent its spread).

When none of the signs indicated above are observed, the employer, without the appropriate consent of the subordinate, does not have the right to order an extraordinary medical examination.

The employer has the right to order an employee for a medical examination even when there is a clear deterioration in the employee’s well-being, and labor efficiency decreases. In turn, the employee is required by law to notify his superiors about any health problems that have arisen. For example, remission of a chronic disease.

In order for the examination to take place, the employer draws up a letter addressed to the chief physician of the medical institution, which sets out the circumstances that prompted the employee to be referred to the doctors. As a rule, medical reports on the employee’s health status and certificates (of course, if available) are attached to the letter. The enterprise issues an order to conduct an extraordinary medical examination, and the employee is given a referral.

At whose expense are medical examinations of employees carried out and how much will it cost?

The law here is clear: all costs associated with conducting periodic, extraordinary or preliminary medical examinations must be borne by the employer. Anyone who hires a person may offer to pay for doctors’ services after passing the examination. This is possible, but only by agreement of the parties. To recover his expenses, the employee subsequently writes a free-form application addressed to the boss, attaching receipts or other documents confirming the fact of payment for the examination. It is worth remembering that the state, from the compulsory health insurance fund, partially compensates enterprises for the costs of medical examinations of employees.

The cost of a medical examination depends on the region. Many medical institutions provide a discount to businesses when medical examinations are carried out on a large scale.

During the entire period while the employee undergoes a medical examination, his salary is retained. Days spent in a medical institution will be counted as working days, that is, this is not any kind of vacation or sick leave.

The personal medical record is kept by the employer. Naturally, until the moment of dismissal. After completing cooperation with a person, they are obliged to return it to him.

The article contains the procedure for conducting a medical examination, taking into account recent changes, the algorithm for conducting a periodic medical examination, an explanation of when it is necessary to conduct an unscheduled one, and what fines may be imposed for failure to conduct a medical examination.

Read our article:

New medical examinations for enterprise employees in 2019

A medical examination (MO) is a comprehensive examination of an employee in order to identify negative changes in his health and determine his suitability to perform work duties. First of all, a medical examination is necessary for personnel who are exposed to harmful and hazardous production factors (HAPF) in the workplace. The list of such factors and the procedure for undergoing medical examinations by employees are established by Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

In March 2018, the approved changes came into force. It was expanded (clause 20 of Appendix No. 2): instead of employees of social shelters and nursing homes, employees of organizations must now be sent to the Ministry of Defense social services providing social services:

in stationary form of social services;
semi-stationary form of social services;
in the form of social services at home.

The procedure for conducting a medical examination in Appendix No. 3, as well as the requirements for documents confirming its completion, have not changed.

The service was created to simplify routine tasks, including those related to organizing a medical examination. The service will automatically generate completed lists of contingents, referrals for medical examinations and draw up a schedule of medical examinations; in addition, in the service you can view paragraph of order 302n and the frequency of medical examinations simply by typing the name of a specific position.

Article 213 of the Labor Code of the Russian Federation - medical examinations

For what purposes are mandatory periodic medical examinations carried out?

The following employees must undergo periodic preventive medical examinations.

Those exposed to harmful or dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out.
Performing work specified in the list, during the performance of which mandatory preliminary and periodic medical examinations of workers are carried out.
. If these jobs involve persons under 21 years of age, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).
Involved in underground work. Such employees undergo periodic medical examinations annually (clause 12 of Appendix 2 to Order No. 302n).
Employed in organizations of the food industry, public catering and trade, water supply facilities, medical organizations and child care institutions (Article 213 of the Labor Code of the Russian Federation). The frequency of medical examinations for specific professions is given in Appendix No. 2 to Order No. 302n.
Athletes. They undergo medical examinations annually (Article 348.3 of the Labor Code of the Russian Federation).
Persons under 18 years of age. They undergo medical examinations annually (Article 266 of the Labor Code of the Russian Federation).

The List specifies the jobs and professions during which workers must undergo mandatory preliminary and periodic medical examinations, regardless of what is established at these workplaces and the availability of vocational training.

Name of work and professions	Inspection frequency
	1 time per year
10. Performed directly on mechanical equipment that has open moving (rotating) structural elements (lathes, milling and other machines, stamping presses, etc.)	1 time every 2 years
11. Under water, performed by workers in a gas environment under normal pressure conditions	1 time every 2 years
12. Underground	1 time per year
13. Performed using insulating and filtering gas masks with a full face part	1 time every 2 years
14. In food industry organizations, dairy and distribution points, bases and warehouses food products, where there is contact with food products in the process of their production, storage, sale, including work on sanitary processing and repair of inventory, equipment, as well as work where there is contact with food products during their transportation by all types of transport	1 time per year
15. In catering organizations, trade, buffets, catering units, including in transport	1 time per year
16. Performed by students of educational organizations of general and vocational education before and during internship in organizations whose employees are subject to medical examinations	1 time per year
17. Medical personnel of medical institutions, as well as maternity hospitals (departments), children's hospitals (departments), children's clinics, departments of pathology of newborns, premature babies	1 time per year
18.V educational organizations all types and types, as well as children's organizations that do not carry out educational activities(sports sections, creative, leisure children's organizations, etc.)	1 time per year
19. In children's and adolescent seasonal health organizations	1 time per year
20. In preschool educational organizations, children's homes, organizations for orphans and children left without parental care (persons in their place), boarding educational organizations, recreational educational organizations, including sanatorium type, children's sanatoriums, year-round recreation camps , as well as social shelters and nursing homes	1 time per year
21. In consumer service organizations (bathhouse attendants, shower workers, hairdressers)	1 time per year
22. In swimming pools and spas	1 time per year
23. In hotels, hostels, passenger carriages (conductors), as a flight attendant	1 time per year
24. In organizations of the medical industry and pharmacy chains related to the manufacture, packaging and sale of medicines	1 time per year
25. At water supply facilities related to water treatment and maintenance of water supply networks	1 time per year
26. Related to milk processing and production of dairy products	1 time per year
27. On driving land vehicles	1 time every 2 years

*If the listed jobs involve persons under 21 years of age, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).

Medical examinations should be carried out already in the presence of harmful or dangerous production factors specified in the list at the workplace, and their level does not matter.

The following factors are exceptions:

3.5. – ;
3.8., 3.9. – air temperature;
3.12. – light environment;
4.1. – physical overload;
4.4.1., 4.4.2., 4.4.3. – sensory loads.

For these factors, medical examinations are carried out only if the working conditions are classified as harmful or dangerous based on the results of the assessment and safety assessment.

How to organize a preliminary medical examination

When hiring, for example, accountants, programmers, management personnel and other office employees who work at a computer more than 50 percent of the working time, the employer is obliged to send them for a medical examination (clause 3.2.2.4 of the List of harmful and (or) hazardous production factors, approved by Order No. 302n). The frequency of MO is once every two years.

Passing a periodic medical examination

The procedure for conducting periodic medical examinations is regulated by Order No. 302n. The algorithm is as follows:

The medical organization, within 30 days after the completion of periodic medical examinations, summarizes their results. Then, together with the territorial bodies of Rospotrebnadzor and representatives of the employer, it compiles in four copies, which are sent within five working days from the date of approval:

employer;
to the center of occupational pathology of a constituent entity of the Russian Federation;
to the territorial body of Rospotrebnadzor.

One copy of the final act is kept in the medical organization for 50 years.

When are extraordinary medical examinations of employees carried out?

Extraordinary medical examinations are carried out on the basis medical recommendations specified in the final report of the medical examination.

at work with harmful or dangerous working conditions, including underground;
at work related to traffic;
athletes();
working in food industry organizations, public catering and trade, water supply facilities, medical organizations and child care institutions, etc.

The employer has the right to send an employee to an extraordinary medical examination in the following cases:

at the request of the workers themselves (Article 219 of the Labor Code of the Russian Federation);
in accordance with the recommendations of specialists who participated in preliminary or periodic examinations, as well as for epidemiological indications;
in accordance with ;
according to the conclusion of the territorial bodies of Rospotrebnadzor with mandatory justification in the direction of the reasons;
when a case of nosocomial infection is detected, by decision of specialists from Rospotrebnadzor authorities and institutions.

In the absence of the grounds listed above, the employer does not have the right to send the employee for an extraordinary medical examination without his consent.

An employee is obliged to immediately notify his immediate or superior manager about a deterioration in his health, including the manifestation of signs of an acute occupational disease (Article 214 of the Labor Code of the Russian Federation). The employer, if there are clear signs indicating a decrease in the employee’s ability to work, may send him for an extraordinary medical examination.

Who to refer for a medical examination

Responsibility for failure to undergo a medical examination in the organization

The employer is responsible not only for the timely organization of medical education for employees at its own expense, but also for the admission to work of persons who have not undergone a preliminary or periodic examination, or who are not allowed to work for medical reasons. If inspectors of regulatory authorities establish such a fact, the employer may incur administrative liability.

According to Part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, the fine will be as follows:

for officials – from 15,000 to 25,000 rubles;
for persons carrying out entrepreneurial activities without forming a legal entity - from 15,000 to 25,000 rubles;
For legal entities– from 110,000 to 130,000 rubles.

The amount of the fine is calculated based on the number of employees who have not completed the mandatory training. If, due to the lack of a medical examination, the employee’s health is seriously harmed or his death occurs, the officials will bear the consequences (Article 143 of the Criminal Code of the Russian Federation).

Medical examination is procedure for identifying occupational diseases at the enterprise, which is controlled by law and is of particular importance for both the employer and the employee. A medical examination reveals pathologies and diseases that the employees themselves may simply not have noticed.

Regular prevention allows you to timely avoid the spread of infectious diseases in the enterprise, occupational diseases of 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 thirtieth, 2006 (N90-FZ)), however, its essence after these revisions did not lose its original meaning.

The currently functioning federal law does not provide definitions for 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 meaning.

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

“Inspection” means confirmed as a result of an examination patient health report, which includes all relevant results of the primary survey.

The term “medical examination” is more clearly formulated in Art. 65 Federal Law dated November 21, 2011 N323-FZ and involves a set of medical examination and examination measures aimed at factually confirming that the patient’s health is in any state significant from a legal point of view.

More extensive medical examinations are periodic medical examinations with an expanded list of medical experts participating in them and the methods of examination used.

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

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

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

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

There is a fairly clear definition of a medical examination (examination): this is a set of medical and medicinal measures, establishing and defining pathologies, diseases and the conditions for their occurrence and further development.

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

Inspections can be carried out exclusively during regular working hours, 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. To this regulatory body, employers send a list of their employees available for medical examination, within ten days from the date of its adoption(clause 21, part III, Addendum N3 to Order N302n).

After the completion 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 others to the regional office of Rospotrebnadzor and the local occupational pathology center.

If during the medical examination the employee had an occupational illness was discovered, then it must be confirmed by any 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 dated April 12, 2011 N302n, on January 1, 2012, principles came into force that oblige all employers to implement regular medical examinations and pay for them at your own expense.

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

According to with Order N302н mandatory inspections concern employees employed in the educational industries, healthcare industries, medical industries, social sphere, in the construction industry, in the automotive industry, in the home service industry and other areas in which employees may be exposed to harmful conditions.

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

Regulations on medical examinations in the organization

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

Download a sample of the Regulations on primary and periodic medical examinations for free.

Inspection frequency

Not long ago, the frequency of medical examinations changed. Up to 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 shown in Order N302н– various production conditions harmful to health, for various types labor 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 21 years of age are required to undergo such medical examinations every year, in accordance with paragraph 17 of Part III of Addendum N3 to Order N302n.

However, the individual frequency of inspections for each individual enterprise depends from harmful working conditions. Periodic inspections are carried out during the development of personalized 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 extraordinary medical examinations.

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

One of the options for periodic medical examination is pre-shift/pre-trip inspection, carried out before the working day/shift/trip of an employee-driver, to reveal the possible impact of harmful and unsafe production conditions, conditions or diseases that interfere with the fulfillment of labor obligations for the work of the enterprise.

Including the establishment of intoxication, if any, from alcohol-containing drinks, 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 examinations for drivers are carried out once every 2 years. The procedure for undergoing a medical examination of drivers is regulated by Order of the Ministry of Health of Russia dated June 15, 2015 N 344n.

Algorithm

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

The examination is carried out in a medical institution and is considered fully completed only after a complete visit to all doctors and the completion of all general laboratory tests.

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

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

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

The employer is obliged to offer alternative place of work, work in 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 medical commission must include specialist doctors-occupational pathologists who have undergone the appropriate advanced training processes in their immediate specialty (clause 5, part I of Addendum N3 to Order N302n).

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

Who should be responsible for late medical examination?

For conducting regular medical examinations the employer is responsible. This affects the types of workers 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 go through routine examinations– this provision is fixed in Article 214 of the Federal Labor Code, according to which employees are required to undergo mandatory periodic medical examinations by order of their immediate management.

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

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

During the period of time when an 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 work experience, providing the opportunity for annual paid leave (Article 121 of the Labor Code).

If, under specific conditions, the employer is the initiator and culprit of the conflict, then the period of dismissal of the employee is determined as simple (under Article 157 of the Labor Code).

Fine for failure to undergo periodic medical examination

The size 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 significantly in recent years.

Currently, the amount of 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 count all employees of the organization who did not visit doctors, which will ultimately result in fines with multi-digit figures. This fine is imposed on the entire company and try there is no point in challenging it in court.

For example, in one such case, an employee argued for skipping medical examinations by arguing that an assessment of working conditions at the workplace (i.e., certification) did not show any problems, and this relieved company management from the need for constant medical examinations.

The court did not accept this argument, because the company belonged to the category of catering enterprises, and employees of such enterprises were subject to regular inspections in accordance with Part 2 of Article 203 of the Federal Labor Code of January 2, 2000, Art. 23 Fed. Law No. 29-FZ and clause 15.1 SP 2.3.6. 1079–01.

As a result, the court decision the activities of the enterprise were suspended.

Find out whether a psychiatrist is needed for a medical examination from the video: