What does the medical board for work include. Medical examinations of employees - the procedure for conducting mandatory, periodic and extraordinary medical examinations. Where to get direction

Before starting work in a new place, an employee must provide a sanitary book or a certificate of the established form. They contain information about the health status of the employee.

According to the law, the employer monitors the regularity of medical examinations. There is a mandatory one - when applying for a job, then they pass periodic and, if necessary, extraordinary. The regularity of periodic in most cases - once every two years, and under difficult working conditions - annually.

Mandatory medical examination

The direction for inspection is issued by the management of the enterprise and has an arbitrary form. The hospital issues a conclusion of a special form. It contains information about a potential employee: the position for which the applicant is counting, profession, work experience and insurance. It is determined what kind of medical examination should be when applying for a job, which doctors sign it.

Order of the Ministry of Health and Social Development of the Russian Federation No. 302-n dated April 12, 2011 provides for the procedure for passing doctors and approved the list of narrow specialists who should be passed. It lists the types of work. Sends for a medical examination and is paid by the employer.

The choice of doctors is provided by the specialty of the applicant for work. It is possible that the composition of specialists is approved by the ministry or department in which the employee is going to work.

The approved list of narrow specialists includes an oculist, a surgeon; neuropathologist, otolaryngologist. It is according to the results of their examination that the therapist writes his conclusion.

Both those working at the enterprise and those who are employed are required to undergo a medical examination, in accordance with Article 214 of the Labor Code of the Russian Federation. The employer must explain to the applicant for the position which doctors need to go through and which tests to pass, since each of the industries has its own health requirements. A form for passing a medical examination can also be obtained directly from the enterprise.

An employee has the right not to undergo a medical examination during employment if his position does not fall into the list specified in Art. 213 of the Labor Code of the Russian Federation. But if available internal document on the mandatory provision of a certificate, he will have to do this. If the employee refuses to pass the commission, the employer may refuse to employ him with a written justification.

Analyzes and research

On the preliminary stage potential employees are given fluorography and a cardiogram. The mandatory list also includes a number of tests (blood, urine). The blood test indicates platelets, leukocytes, erythrocytes and ESR. In the urine, protein, sugar and sediment microscopy are determined. The result of biochemical analysis is the determination of the content of glucose and cholesterol in the blood serum.

Fluoroscopy is required annually. This is due to the danger of tuberculosis. More often it is not recommended to do it because of the irradiation of the body. If a year has not passed, the fluorography is considered valid.

According to the law, the district therapist must begin and end the examination. At the beginning of the examination, he will coordinate the passage of the necessary narrow specialists. At the end, they will certify the documents and issue a final permit. Each of the doctors must put his seal on the form. The patient must watch carefully so that no one misses.

When undergoing a medical examination by a gynecologist, when applying for a job, attention is paid to bacteriology (study of flora) and cytology (identification of atypical cells).

If a woman is over 40, then every two years she is given an ultrasound of the mammary glands.

In addition to the therapist, an examination by a psychiatrist and a narcologist is mandatory.

Minors are subject to the same requirements as regular employees. True, they do not need to undergo a cardiologist.
For some categories of employees, a short course of lectures and a test for knowledge of the sanitary minimum are provided. This may take several days. At this time, it is necessary to visit special centers for hygiene and epidemiology.

Medical examination allows you to identify the presence of occupational diseases. Their statistics are kept. Morbidity analysis allows you to determine measures to improve working conditions.

Depending on the conditions of the future work of the employee during the medical examination, various factors are determined that can affect the body. For example, in persons whose production activity is accompanied by thermal stress, thermal stability is determined (clause 3.3 of MP 2.2.8.0017-101).

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Private and public clinics

The conclusion on the passage of a medical examination is provided by both private and public clinics.

The visit to the state clinic is longer due to the queues. The advantage is that you don't have to pay.

Preference private clinic– without waiting in line, and the results will be ready on the same day. But you have to pay for the comfort. However, not all clinics have the right to issue medical examination certificates. A mental health certificate can only be obtained from a public hospital.

Important information

It should be noted that according to the law, the passage of scheduled medical examinations for working citizens is mandatory once a year, and for employees Food Industry- twice a year

Blood tests are accepted by almost all clinics that have official registration. Their conclusions are certified with a signature and a seal. At the same time, some state medical institutions take tests for description in the same private laboratories with more modern equipment.

You need to take accurate information from the employer: whether a certificate from a particular private clinic is suitable. Following the labor code, the employer pays for the inspection. The employee retains the right to refuse to visit those doctors whose visits are not provided for by law and are not regulated at the enterprise.

Features for different categories of workers

The Labor Code among the categories undergoing a medical examination distinguishes people performing heavy and dangerous work, transport workers, trade and food industry workers, employees of children's and medical institutions. Under special control are those who stay on long (several months) business trips and work in the Far North.

For those who work with children and food, a more thorough examination is carried out. It must be passed by all staff of child care facilities, since children are at risk for various respiratory diseases.

A thorough medical examination is also carried out in the transport sector, since those involved in the transportation of people are responsible not only for their lives, but also for the health and safety of passengers.

Catering workers can infect people with various viruses that enter the body with food. In addition to standard examinations, catering workers require the conclusion of a bacteriological laboratory about the absence of Escherichia coli and other viruses. The same requirements apply to employees working in trade.

The table shows the categories of employees for whom mandatory preliminary medical examinations are also established.

Consequences of not having a medical examination certificate

The absence of a health book or other documents on a medical examination by an employee entails liability. The employer has no right to conclude with him labor contract. The punishment awaits the employer if the medical examination is overdue. For a repeated violation, an official may be suspended from work for up to three years.

The fine is up to 25,000 rubles for individuals and up to 130,000 for legal entities.

Refusing to undergo medical examination new employee must be aware that the refusal of employment by the employer will be legal.

Watch a video that will tell you in detail about passing a medical examination

Payment for services

The company pays for all types of medical examinations necessary for employees. For optimal work, management can choose a medical institution and conclude a service agreement with it. Then on a certain day, all employees quickly pass the necessary doctors.

There is an option to pay bills to employees who have passed the inspection. Their cost must be agreed with the employer. An employee writes an application for reimbursement of expenses for a medical examination and receives payment in the first salary.

When concluding a contract with a medical institution, it is necessary to check its license and eligibility to provide such services.
It must be remembered that certificates are valid only for a certain time, so do not delay presenting them at work.

If you have any questions about passing a medical examination when applying for a job, write in the comments

"On the sanitary and epidemiological well-being of the population" does not give rise to discrepancies: Article 34 "Compulsory medical examinations" states that employees ... are required to undergo preliminary and periodic preventive medical examinations upon admission to work. Individual entrepreneurs and legal entities are obliged to provide the conditions necessary for the timely passage of medical examinations by employees.

Which specialists should a medical worker visit before starting work (because without undergoing medical examinations on the basis of the same Federal Law-52, he cannot be allowed to perform official duties) is stated in the Order of the Ministry of Health and social development RF dated April 12, 2011 "On approval of the lists of harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations are carried out ..."

The order came into force on January 1, 2012. However, until now it has not yet been read by the heads of cosmetology clinics to the end. According to the old tradition, they looked into the list, found an item that concerns health workers (in order No. 302n this is item 17 of Appendix 2) and decided that this was enough.

Those who had the patience to scroll through Appendix 2 to the end found that no, not enough. Indeed, other types of inspections are indicated in the note to the appendix.

Medical examinations of medical workers

Medical workers undergo:

When applying for a job:

• chest x-ray;
• blood test for syphilis;
• swabs for gonorrhea;
• a study on the carriage of pathogens of intestinal infections and a serological examination for typhoid fever (hereinafter - according to epidemiological indications);
• research on helminthiases (in the future - at least once a year or according to epidemiological indications);
• a swab from the throat and nose for the presence of pathogenic staphylococcus (hereinafter - once every 6 months);
• 1 time per year examination by a dermatovenerologist, otorhinolaryngologist, dentist and infectious disease specialist (on recommendation).

During both preliminary (before starting work) and periodic (that is, annual) medical examinations, the health worker takes a clinical blood test (hemoglobin, color index, erythrocytes, platelets, leukocytes, leukocyte formula, ESR), a clinical urinalysis (specific gravity, protein , sugar, sediment microscopy), undergoes electrocardiography, digital fluorography or radiography in 2 projections (direct and right lateral) of the lungs, biochemical screening: determination of glucose and cholesterol in blood serum.

All women are examined by an obstetrician-gynecologist with bacteriological (for flora) and cytological (for atypical cells) studies at least once a year; women over the age of 40 undergo mammography or ultrasound of the mammary glands once every 2 years.

All medical workers must be vaccinated according to the National Immunization Schedule, approved by Order of the Ministry of Health of Russia dated March 21, 2014.

Can an employee undergo a medical examination on their own and is it enough just to have a medical book at the workplace?

No. The system of medical examinations itself must be organized by the head and confirmed by certain documents.

This is stated in the order of the Ministry of Health and Social Development No. 302n, but in more detail - in the territorial department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the city of Moscow "On the application of the order of the Ministry of Health and Social Development of Russia No. 302n dated April 12, 2011."

Conducting a medical examination program in a clinic or beauty salon with a medical license begins with the head compiling a list of the contingent of employees available in his institution and sending it to the territorial body of Rospotrebnadzor.

This list is approved by Rospotrebnadzor, and on its basis it is possible to conclude an agreement with an organization that has a license for the type of activity.

In fact, it contains in a structured form everything that is in the medical book itself, only in the act it can be read, while in the medical book the seals are usually sloppy and the signatures of doctors are illegible. That is why there are so many fake, counterfeit books - the temptation is great, anyway, no one understands anything in them ...

The former chief sanitary doctor, widely known in medical (and not only!) circles, G. Onishchenko assured that the medical book is the most forged document in Russia.

So, the final act is all the information about each of the workers who passed the inspection.

It states:

• date of issue of the conclusion;
• surname, name, patronymic, date of birth, gender of the person entering the work (employee);
• the name of the employer;
• Name structural unit employer (if any), position (profession) or type of work;
• name of the harmful production factor(s) and (or) type of work;
• the result of a medical examination (medical contraindications identified, not identified);
• the conclusion is signed by the chairman of the medical commission indicating the surname and initials and certified by the seal of the medical organization that conducted the medical examination.

Such an act is drawn up for each employee who was sent for a medical examination. In general, a general act is drawn up for the organization, and now it contains all the information in full:

• the name of the medical organization that conducted the preliminary examination, the address of its location and the OGRN code;
• date of drawing up the act;
• the name of the employer;
• the total number of employees, including women, employees under the age of 18, employees who have a persistent degree of disability;
• the number of employees employed in hard work and at work with harmful and (or) dangerous working conditions;
• the number of employees employed in jobs that require periodic medical examinations (examinations) to protect public health, prevent the occurrence and spread of diseases, including women, workers under the age of 18, workers who have been diagnosed with a persistent degree of disability ;
• the number of employees subject to periodic medical examination, including women, employees under the age of 18, employees who have a persistent degree of disability;
• the number of employees who have undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
• the percentage of coverage of employees with periodic medical examinations;
• a list of persons who have undergone a periodic medical examination, indicating gender, date of birth, structural unit (if any), conclusion of the medical commission;
• the number of employees who have not completed a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
• a list of employees who have not completed a periodic medical examination;
• the number of employees who have not undergone a periodic medical examination, including women, employees under the age of 18, employees who have been diagnosed with a persistent degree of disability;
• a list of employees who have not undergone a periodic medical examination;
• the number of employees who do not have medical contraindications to work;
• the number of employees with temporary medical contraindications to work;
• the number of employees with permanent medical contraindications to work;
• the number of employees in need of an additional examination (conclusion not given);
• the number of employees who need to be examined in the center of occupational pathology;
• the number of employees requiring outpatient examination and treatment;
• the number of employees in need of inpatient examination and treatment;
• the number of employees in need of sanatorium treatment;
• the number of employees in need of dispensary observation;
• a list of persons with a preliminary diagnosis of an occupational disease, indicating gender, date of birth, structural unit (if any), profession (position), harmful and (or) dangerous production factors and work;
• a list of newly established chronic somatic diseases indicating the class of diseases according to the International Classification of Diseases - 10 (hereinafter - ICD-10);
• a list of newly established occupational diseases with an indication of the class of diseases according to ICD-10;
• the results of the implementation of the recommendations of the previous final act;
• recommendations to the employer on the implementation of a complex of health-improving measures, including preventive and other measures.

Pay attention to the last - this very complex can be checked by the labor inspectorate!

When checking compliance with the sanitary and epidemiological regime in a clinic or beauty salon, representatives of Rospotrebnadzor also have the right to verify the list of employees according to the final act with the list of the contingent.

Yes, you and I have not yet specified what should be indicated in the list of the contingent, which is compiled by the employer in order to be approved by Rospotrebnadzor:

• the name of the employer;
• form of ownership and type economic activity employer according to OKVED;
• the name of the medical organization, the actual address of its location and the OGRN code;
• type of medical examination (preliminary or periodic);
• surname, name, patronymic of the person entering the work (employee);
• date of birth of the person entering the work (employee);
• the name of the structural unit of the employer (if any), in which the person entering the work will be employed (the employee is employed);
• the name of the position (profession) or type of work;
• harmful and (or) dangerous production factors, as well as the type of work in accordance with the contingent of employees approved by the employer, subject to preliminary (periodic) inspections.

Health passport

Important! When conducting a medical examination in an organization that has assumed this responsibility, an outpatient card is issued for an employee undergoing a medical examination. Since May 2015, this is form N 025 / y "Medical record of a patient receiving medical care on an outpatient basis", approved by the Order of the Ministry of Health of Russia dated December 15, 2014.

The order of the Ministry of Health and Social Development No. 302n, which entered into force in 2012, already mentions the Health Passport, but the regulatory authorities (in particular, Rospotrebnadzor) began to check it recently. There are no exceptions for medical workers in private clinics, including cosmetologists: A health passport is not issued only to those who are attached to the FMBA of Russia for medical care.

The Health Passport must have a number, the date of its completion. And this document is constantly kept by the employee, to the organization that conducts medical examinations, it is handed over only for the duration of their passage.

Penalties for non-compliance with the rules of medical examinations

And another question - who pays for everything? The answer is unequivocal - a legal entity that concludes an agreement with the organization for preventive and periodic medical examinations. This is where it comes into play Civil Code A: The Contractor undertakes to do, the Customer undertakes to pay. Who is the customer of the medical examination? Clinic or beauty salon with a medical license.

And now about whether they can impose a fine for non-compliance with the rules for conducting medical examinations.

The Code of Administrative Offenses, article 5.27.1 "Violation of state regulatory requirements for labor protection contained in federal laws and other regulatory legal acts of the Russian Federation" will tell us about fines for medical examinations in 2015:

Allowing an employee to perform job duties without ... mandatory preliminary (when applying for a job) and periodic (during labor activity) medical examinations... shall entail the imposition of an administrative fine on officials in the amount of fifteen thousand to twenty-five thousand rubles; for persons engaged in entrepreneurial activities without forming a legal entity - from fifteen thousand to twenty-five thousand rubles; on the legal entities- from one hundred ten thousand to one hundred thirty thousand rubles.

During employment, not everyone thinks about how to pass a medical examination when applying for a job. In some enterprises, a preliminary inspection by specialists is not a necessary requirement.

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Other employers inform the person about this after he has passed the preliminary interview.

What you need to know

Medical examinations are of several types:

Preliminary	Helps determine whether an employee's health will allow them to work. If the result is negative, the candidate is denied employment. Even after signing, the employer is obliged to familiarize himself with the conclusion of specialists. Only then the employee is allowed to perform his duties. When hiring, the medical board primarily concerns underage candidates and applicants for public office. For example, judges
Periodic	It is passed by those who work in special areas. Medical examination helps to identify occupational diseases at an early stage
Before shift	In specialized enterprises where the life of an employee or other people is endangered, a health check is carried out at the beginning of each shift. This is usually practiced in heavy and underground work. In the event of a sudden change in the health of a worker, doctors are required to examine the person, even after the shift. Such inspections are regulated by the order of the head of the enterprise. To prevent serious and dangerous diseases, visits to doctors occur at regular intervals. It might be once, twice a year
Extraordinary	The initiative can come from the employee himself or from the employer

Obtaining a medical examination always requires labor and time.

Basic concepts

A medical examination is a visit to specialists and the delivery of the necessary clinical tests. Which specialists to pass for some cases is stipulated in the legislation of the Russian Federation.

At other enterprises, this issue is being coordinated by the head with the medical staff of the clinic.

Specialists of a medical institution give birth to each person who applied. It contains all the results of the survey.

A duplicate is issued to the worker. A health passport is similar to a medical card. For its safety, unlike the card of a medical institution, the person himself is responsible.

All information about the tests passed, the inspection passed must be entered in this document. There are times when a passport can be lost. It will be restored by the specialists of the medical institution, where all the examinations were carried out.

Why is it needed

Passing a medical examination before the device on vacant position allows the employer to be aware of the mental and physical condition of the candidate.

This is important for the performance of a specific amount of work in certain conditions labor. Managers of enterprises are interested in finding workers who are in good health and who do not have any contraindications.

Preliminary medical examination helps prevent the spread of many diseases.

This is one of the factors that reduces the likelihood of accidents that may be the result of inadequate actions of the working personnel. Thanks to this, the lives of customers and staff members are not endangered.

If, in the performance of duties, responsibility for the lives of others is assigned, there are sources of increased danger, risk, then a psychiatrist's conclusion is required.

A special examination reveals the applicant's reaction to various influencing factors of future work conditions.

The reaction of his body is determined. For work involving thermal stress, it is necessary to determine the thermal stability of the candidate's body.

If, after passing a medical examination, a person was not given a positive one, then he is not suitable for a vacant position. Such persons are not allowed to work.

Mandatory visits to doctors' offices before employment benefits both the employer and the individual himself:

The legislative framework

In Russia, medical examination is regulated by a number of legislative documents that supplement or clarify the Labor Code of the Russian Federation. Establishment of conflicting norms and rules is not allowed.

The Labor Code is the main law. He lists the categories of workers who are required to undergo inspection. Article 213 covers the main provisions.

Minor citizens turn to specialists, regardless of where they want to work ().

The Labor Code of the Russian Federation requires all employees to visit doctors at the set time, to notify management in a timely manner of all changes related to their health, which may adversely affect the quality and safety of the work performed.

If a candidate for a certain position provides deliberately false results preliminary inspection, the employer owes him ().

Candidates for employment must take into account the requirements.

There are listed:

• harmful factors that indicate that work falls under the category of dangerous professions;
• diseases resulting from this work;
• medical professionals who are able to identify the relevant diseases.

Additionally, regulations may be issued:

1. Ministry of Labor and Social Protection.
2. Government of the Russian Federation.

Municipal authorities representing the authorities have every right to introduce additional requirements regarding inspection at certain enterprises.

Features of passing a medical examination when applying for a job

After the examination, each medical specialist decides on the suitability of a person for this work.

A general conclusion is drawn up regarding his professional suitability. All information is entered into the outpatient card of the candidate for the relevant position.

If the worker is recognized as meeting the necessary requirements, the conclusion is signed by the attending physician or the head of the clinic.

He can be admitted to work in this enterprise only subject to certain conditions. For example, if you have poor eyesight, be sure to wear glasses.

Those with hearing loss should wear a hearing aid. A note on individual needs is made in the issued document.

If the result of the medical examination is negative, the applicant cannot hold the specified position. The clinical expert commission notifies him of this by issuing a conclusion.

The employer also receives a copy of this document within three days. The employee is denied employment ().

Where to get direction

According to the legislation of the Russian Federation, visiting the necessary medical professionals when hiring, organized by the employer. From the enterprise, the applicant receives a referral to the clinic.

The document contains a list of harmful production factors that will affect the employee when performing the required task.

All companies are required to make prior arrangements with a specialized clinic.

When hiring new employees, the manager generates lists of candidates who are sent for inspection. A copy of the document is sent to regional management SES.

The original is sent to medical institution where the inspection is to be carried out. The employer and the medical representative agree on the deadlines for completing the task.

A commission is formed from medical specialists. If a person has already undergone an examination and has a medical book on hand, this will be enough for.

The document gives some insight into his physical and emotional state. Perhaps the employer will not have any doubts, and the applicant will be hired.

When there is no book, the company will issue a referral form for a medical examination to find out the health status of the employee.

The document must contain the following information:

• the name of the medical institution;
• applicant's personal data;
• candidate's profession;
• experience;
• proposed position;
• the nature of the medical examination;
• information about the insurance company;
• signature of the chief physician;
• clinic stamp;
• photograph of the specified dimensions.

Having received a referral under the signature, the applicant is obliged to the shortest time visit the specified clinic, pay for the services of specialists and start a mandatory round of doctors.

Sometimes the question arises: “First, do I need to write a job application or pass a medical examination?”

If the internal rules of the company allow you to initially issue an application, then they do so. After receiving a referral for a medical examination.

Who must pass

In Russia, the Labor Code defines all relationships related to employment issues (, 213 of the Labor Code of the Russian Federation). specific list there are no persons who are required to undergo a medical examination.

• under the age of majority (pass an annual examination until they reach the age of 18);
• applicants for places with harmful and life-threatening, health working conditions;
• future trade workers, Catering, food industry (cafes, canteens, restaurants);
• child caregivers in educational institutions (summer camps, orphanages, kindergartens, libraries);
• employees of medical institutions, water supply facilities;
• persons with on a rotational basis work();
• those who are sent on long business trips;
• planning to move to the Far North ();
• workers public transport, paramilitary guards;
• gas and oil companies who work under dangerous climatic conditions;
• athletes ();
• dealing with optical instruments;
• civil servants (determine the acts of the relevant departments);
• persons who work most of the time underground;
• employees of companies such as travel companies, nightclubs, beauty salons;
• pregnant women;
• those who spend a lot of time at the computer;
• specialists of hairdressing salons;
• workers of communal organizations;
• builders.

All those who fall under this list are required to submit a health book with the following data when applying for a job:

1. Date of examination.
2. Details of a medical institution.
3. Clinic stamp.

A complete list of works that require a medical examination is given in Order No. 302n (Appendix 1 and 2). It is available in Rossiyskaya Gazeta.

Legal systems are also aware of it. For some professions, mandatory inspection is prescribed by industry rules and laws:

Where can I get tested

The decisions of medical specialists from clinics that have been issued a license to provide such services (issued by the health department of a particular region) have legal force.

Most often, this is a central (city, district, regional) medical facility. Paid clinics may also be licensed.

Having made a choice where to go to the doctors, you must contact the registry of this institution with the following documentation:

• identification;
• direction;
• health certificate, if any.

The receptionist will give you a list of doctors to visit and their office numbers.

List of doctors on the bypass list

The list of specialists determines a lot. Which doctors and tests are needed is decided taking into account the profession for which the applicant is employed.

Mandatory visit for all types of work:

1. surgeon.
2. Otolaryngologist.
3. Therapist.
4. Neurologist.
5. Ophthalmologist.

This list is updated depending on the gender of the worker and the place of work:

1. Women need an examination by a gynecologist, mammologist.
2. Men visit a urologist.
3. Food industry workers, educators, teachers go through a dermatologist and venereologist.
4. Persons involved in activities that are associated with harmful substances, increased danger to health, must have a psychiatric examination.

In addition to visiting specialists, you will need to pass some tests and undergo an additional examination. What is included:

1. Analysis of urine and blood.
2. Biochemical blood test for cholesterol and sugar.
3. Electrocardiogram.
4. Fluorography.
5. Mammography (women over 40).
6. Measurement of blood pressure.
7. Chemical-toxic tests for the presence of narcotic drugs, psychotropic substances (not for all professions).
8. Chest X-ray.
9. Analysis of smears (performed by a gynecologist).

Passage of the gynecologist

A visit to a mammologist and gynecologist is mandatory for almost all professions where women are employed.

This is a great opportunity to detect the development of dangerous diseases in advance, to prevent the spread of viral infections. This shows concern for the health of the population as a whole.

What is the cost of the procedures

The list of specialists for medical examinations can be quite extensive. Therefore, you have to stand in the hospital queues for a long time. This is a big time investment.

Contacting a paid clinic helps save precious minutes. But, there is also a negative point - it is expensive. The price ranges from 800 to 3 thousand rubles. Therefore, a reasonable question arises: "Who pays all the bills?"

Does the employer have to pay for the medical examination (reimbursement)

Article 212 and oblige the employer to pay all bills for the medical examination of the candidate for the position.

If a person is invited to carry out this procedure at his own expense, this is a clear violation of the law.

To compensate for the funds spent related to the medical examination, an application from the employee to the management will be required.

Attached to the document:

1. Direction.

This amount will be reimbursed by the accounting department with the first advance payment or salary. Deadline - payment date wages for the first month of work.

Is it necessary to go through the process?

Taking into account the laws of the Russian Federation, it is safe to say that passing a medical examination by specialists is a necessary requirement for a number of professions.

If this is not done:

1. The employer will pay an administrative fine.
2. The employee will not be allowed to work.

It is worth noting that in some cases the employer will decide whether a medical examination is needed. This applies to labor that does not require special health, does not fall under the list given in the legislation.

Last modified: January 2020

When a person's health is directly related to the work duties performed, the employer organizes an initial medical examination upon employment. Its conduct is strictly regulated by the provisions of the Labor Code of the Russian Federation, which determine who is not required to undergo a medical examination, and in which cases a medical certificate of fitness for the profession is mandatory.

There are several categories of citizens, representatives of various ages and specialties, for whom employment without a medical examination is impossible. Doctors of certain specializations must examine the employee before he starts work, and give an opinion on the ability to perform a certain range of duties.

Basic provisions for the procedure

A medical examination upon employment is mandatory only in certain cases established by the provisions of the law. First of all, it is recommended to study articles 69,213,266, 324, 348.3. Article 212 of the Labor Code of the Russian Federation obliges an enterprise to refuse employment to citizens if the requirement for an initial medical examination is ignored by employees, or employees responsible for registering a person allow a person to leave without being examined by doctors.

The main article regulating the mandatory medical examination is Article 213 of the Labor Code of the Russian Federation. So, one cannot do without an examination by doctors when applying for a job related to transport management. They will not be hired without a health check and with frequent contact with adults and children.

A medical examination is necessary when registering in organizations where the specifics of work require the adoption of important decisions on which the lives of other citizens depend, or when working conditions are dangerous and harmful.

Sometimes during the check-up process, a person unexpectedly learns about the presence of serious problems associated with heredity or chronic diseases. When the presence of infectious diseases is detected, the employer will be able to prevent the spread of dangerous diseases by prohibiting access to work for carriers of infections.

What includes

When hiring, it is important to correctly determine the list of doctors that each new employee must pass. In addition to the mandatory list, additional narrow specialists or laboratory tests may be required. When determining which doctors will be required, the employer first of all indicates the therapist with whom the examination begins and ends.

The therapist determines most of the general questions regarding the state of human health on his own, however, when hiring in a particular specialty, expert opinion from other doctors will certainly be required, especially if a minor is employed.

The medical commission, in addition to the therapist, includes the following representatives of medicine:

• ophthalmologist;
• neuropathologist;
• lore;
• surgeon.

However, this list is often supplemented:

1. For the fair sex, an examination by gynecologists will be required, and after the 40th anniversary, by mammologists.
2. In the food industry, a mandatory examination includes an additional psychiatrist, narcologist, dentist, dermatologist. These doctors are also citizens involved in the distribution and production of baby milk food.
3. When working with psychotropic substances, extreme conditions, in the law enforcement agency, teaching activities, an examination by a psychiatrist will be required. Professions related to transport (dispatchers, drivers, etc.) fall into the same category. The examination takes place in the form of answers to the doctor's questions, and their subsequent assessment of the features of mental work, response, etc.

Laboratory studies may include not only a general analysis of urine, blood and fluorography. Additionally, for workers in the food industry, blood donation for syphilis, glucose, cholesterol, testing for staphylococcus aureus, enterobiasis is organized.

If the profession requires, when applying for a job, they get a vaccination certificate and update preventive vaccinations.

The procedure for conducting a medical examination at the enterprise

The procedure for passing a medical examination is regulated by federal legislation and orders of the Ministry of Health and the Chief Sanitary Doctor, and other norms of regional legislation.

When applying for a job, the company does not have the right to require a medical examination in a particular clinic. A person can independently decide where to pass the test, or provide the organization of the medical examination to the enterprise, since both parties are interested in this procedure. If an enterprise enters into an agreement for a medical examination of employees, the examination process will be simple and fast at all, eliminating tedious queues and obtaining coupons.

The law does not require the obligatory choice of a state medical institution, therefore, paid clinics that have the appropriate certificate and licenses are often preferred for medical examinations.

After the employer reports a positive decision to hire a person, they will agree on the details of subsequent employment. As a rule, each company knows very well who must undergo medical examinations, and in which cases they are not necessary.

1. Obtaining a referral from the employer, signed by the head or person who should be engaged in a medical examination in the organization. Previously, the form is subject to registration in a separate journal. In the direction indicate what the employee will encounter in the process of doing the work.
2. Visiting a pre-selected medical facility, and consult a therapist. As a rule, the medical examination begins and ends with it. The therapist is also responsible for issuing referrals for tests.
3. Laboratory studies are carried out immediately, or the next day in the morning.
4. Over the following days, the worker visits specialists who will be identified by the therapist at the first visit.
5. When all the conclusions and signatures of specialists are affixed on the form, the therapist checks the results of the tests and enters them into the document. The finished document is handed over to the employee, and the second copy is left at the clinic for storage.
6. On the eve of going to work, a new employee presents the received document, which is then filed into a personal file.

Is the procedure required?

Often, workers who go to work for the first time have doubts about whether or not a medical examination is mandatory or not. And sometimes doubts are justified. The fact is that for a number of employees the law does not require examinations, and the employer insists on them on his own initiative. When opening a new rate in a new direction, the question of whether it is necessary to undergo an examination also arises with the employer, because cooperation with a medical institution is paid.

It should be based on the validity of the requirement for a medical examination, based on the provisions of the Labor Code of the Russian Federation and individual specialized acts.
So, the rules for passing a medical examination approve employment checks:

• employees under the age of 18;
• persons employed in dangerous, hazardous, heavy industries requiring special endurance and good health;
• transport workers (all types);
• citizens who work in the Far North;
• workers in the food industry, food trade;
• employees involved in providing the population with water;
• health workers and teachers, employees of healthcare facilities;
• in departmental security;
• citizens with HIV infection;
• persons involved in rescue operations.

Sometimes a medical examination is not required by law, but the employer requires it, referring to internal regulations. It should be understood that, when applying for a specific company, an employee either accepts the conditions of employment and further work, or not.

Validity and payment

When applying for a job, often employers are required to present a special certificate. It is issued on a special form in the form 086 / y. If a civil servant is hired, use a different form 001-GS / y. Since the issuance of a certificate often requires additional costs, even at the stage of discussing the conditions of admission, it is worth discussing who pays for the procedure.

If a person paid full cost, then the employer agrees to reimburse the expenses incurred by the employee in connection with employment.

If employment is only planned, and the person decided to undergo a medical examination in advance, it should be remembered that the validity period does not exceed:

• for a civil servant - 12 months;
• for other employees - 6 months.

Despite the fact that the deadline has not yet expired, new employer have the right to ask to update the results of the examination, or to supplement the list with new specialists, if the nature employment requires the adoption of increased security measures, which the person did not suspect until the moment of employment.

In addition to primary examinations, the enterprise may conduct annual medical examinations. This often happens when work involves a high responsibility for the fate of other people, or working conditions can seriously undermine a person’s health. In such cases, the enterprise, in order not to tear employees away from production process agrees to conduct a medical examination on its own territory by inviting the right specialists. Naturally, such an event incurs additional costs, however, given how much time will be spent when employees are separated from production activities, it is more profitable for the organization to undertake the medical examination.

Each profession has its own characteristics in terms of validity. For example, drivers have a mandatory medical examination on the eve of each exit to work. However, a pre-trip inspection does not imply a large-scale inspection and testing, and is carried out as part of the preparation at the beginning of each shift.

The issue of payment is one of the most discussed when, when agreeing on the conditions for hiring, management announces the obligation to undergo a medical examination. Of course, the enterprise itself, when hiring a new person, does not want to bear the costs, not being sure that the employee will not leave after working 1 day after the funds for the medical examination are spent in full. For this reason, managers often force them to undergo an examination at their own expense, promising to compensate for the costs later.

You should know that it can be difficult to receive compensation later, when the money has already been paid and the person has gone to work. Other norms begin to operate when subordinates depend on their leader. In theory, every employee has the right to complain to Labor Inspectorate However, in practice, such cases are very rare, even though the employer violates the basic principles of labor law. Attempts to bring violators to justice through the prosecutor's office are even less rare.

In order to avoid problems after employment, it is recommended to negotiate with the management on the shore who pays and where to undergo the inspection. Then the examination procedure will not cause difficulties and will not cause disputes among the parties. labor relations.

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In accordance with part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, the admission of an employee to the performance of labor duties without passing, including periodic medical examinations, entails the imposition of administrative responsibility for from 110 to 130 thousand rubles. More than 40 people work in the organization without a medical examination. The organization was carried out according to working conditions. How is the list of employees who must undergo preliminary and periodic medical examinations determined? Should all employees of the organization (including lawyers, accountants) undergo such inspections?

According to the second part of Art. 212 Labor Code Russian Federation (hereinafter - the Labor Code of the Russian Federation), the employer is obliged in cases provided for labor law and other normative legal acts containing norms labor law, organize the holding at the expense of own funds mandatory preliminary (upon employment) and periodic (during employment) medical examinations, other mandatory medical examinations, mandatory psychiatric examinations of employees, extraordinary medical examinations, mandatory psychiatric examinations of employees at their request in accordance with medical recommendations with retention of their place work (position) and average earnings for the period of passage of the specified medical examinations, mandatory psychiatric examinations.

In turn, the employee is obliged to undergo mandatory preliminary (when applying for a job) and periodic (during employment) medical examinations, other mandatory medical examinations, as well as to undergo extraordinary medical examinations at the direction of the employer in cases provided for by the Labor Code of the Russian Federation and other federal laws (Article 214 of the Labor Code of the Russian Federation).

Thus, the passage of medical examinations, including preliminary and periodic ones, is mandatory only in cases provided for by law.

The obligation to conduct medical examinations of certain categories of employees is provided for by the norms of Art. 213 of the Labor Code of the Russian Federation. In accordance with this article, mandatory preliminary and periodic medical examinations must be carried out by employees engaged in work with harmful and (or) dangerous working conditions (including underground work), employees engaged in work related to traffic, employees of food organizations industry, public catering and trade, waterworks, medical organizations and children's institutions, as well as some other employers.

According to the fourth part of Art. 213 of the Labor Code of the Russian Federation harmful and (or) dangerous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations are carried out, the procedure for conducting such examinations is determined by the federal executive body authorized by the Government of the Russian Federation.

To date, such normative act establishing the List of harmful and (or) hazardous production factors (hereinafter referred to as the List of Factors), the List of works during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out (hereinafter referred to as the List of Works) and the Procedure for conducting mandatory preliminary (upon admission to work) and periodic medical examinations (examinations) of workers employed in heavy work and in work with harmful and (or) dangerous working conditions (hereinafter referred to as the Procedure) is the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 N 302n.

At the same time, there is a position that the presence in the workplace of employees of harmful and dangerous production factors (performing the relevant work) specified in the List of factors (for example, working with a PC for more than 50% of the working time, which may apply, in particular, to lawyers and accountants), is an independent basis for sending such workers for a mandatory medical examination, regardless of whether the working conditions at their workplaces are classified as harmful or dangerous according to the results of certification or a special assessment of working conditions (see, for example, letter of the Ministry of Labor of Russia dated 03/21/2014 N 15 -2 / OOG-242, letter of Rostrud dated 09.10.2015 N TZ / 20422-3-3). A similar point of view is presented in the explanations of Rostrud specialists posted on information portal this office on the Internet (see answer 1, answer 2, answer 3). The legitimacy of such an interpretation of the provisions of the List of factors is also confirmed by the Supreme Court of the Russian Federation (determination of September 24, 2015 N 302-KG15-11278).

However, in law enforcement practice There is another approach to resolving the issue of the need for medical examinations in the situation under consideration, based on the following logic. Within the meaning of Art. 213 of the Labor Code of the Russian Federation, part four of this article is aimed at implementing the requirements of its first part. In other words, it is precisely the fact of the presence of harmful and hazardous conditions labor at the workplace is the basis provided for by the Labor Code of the Russian Federation for conducting mandatory medical examinations of employees.

About justice this conclusion, in our opinion, is also evidenced by note No. 2 to the List of factors, according to which this list lists factors that, according to the level of their impact, are classified as harmful and (or) dangerous classes in accordance with regulatory legal acts.

Note that the harmful and dangerous factors themselves are such, regardless of the level of their impact and are not divided into classes (see Article 209 of the Labor Code of the Russian Federation, Classifier of harmful and (or) hazardous production factors (Appendix N 2 to the order of the Ministry of Labor of Russia dated January 24. 2014 N 33n), GOST 12.0.003-74 "System of labor safety standards. Hazardous and harmful production factors. Classification", approved by the Decree of the State Standard of the USSR of November 13, 1974 N 2551).

It is the working conditions, depending on the level of impact on the employee of harmful and (or) hazardous production factors, that are divided according to the degree of harmfulness and (or) danger into four classes - optimal (class 1), permissible (class 2), harmful (class 3; subclasses 3.1 -3.4) and dangerous (grade 4) (see art. 14 federal law dated December 28, 2013 N 426-FZ "On a special assessment of working conditions", hereinafter - Law N 426-FZ). Considering the above, we believe it is possible to conclude that note N 2 to the List of factors refers precisely to the fact that the presence of the factors named in this List is taken into account when determining the need for medical examinations only if the level of impact of the relevant factors indicates the presence harmful or dangerous working conditions at the employee's workplace (class 3.1 and above). In support of this thesis, we can cite the letter of the Federal Medical and Biological Agency dated April 13, 2012 N 1-08/894. A similar point of view was expressed in the letter of Rospotrebnadzor dated June 19, 2015 N 01 / 7015-15-31.

At the same time, we note that some factors named in the List of Factors contain a special note "when attributing working conditions for this factor, based on the results of certification of workplaces for working conditions, to harmful conditions" (see paragraphs 3.8, 3.9, 3.12, 4.1, 4.4.1-4.4.3 of the Factor List). On this basis, some experts conclude that since such a clause was required for certain items of the List of factors, then other factors listed in it are the basis for a medical examination, regardless of whether working conditions are classified as harmful or dangerous according to the results of a special assessment. In support of this thesis, paragraph 19 of the Procedure is also cited, according to which the lists of the contingent and the lists of employees subject to mandatory medical examinations include, among other things, workers exposed to harmful production factors specified in the List of factors, as well as harmful production factors , the presence of which is established by the results of attestation of workplaces in terms of working conditions (currently - a special assessment of working conditions), carried out in the prescribed manner. As a source of information on the presence of harmful production factors in the workplace, in addition to the results of attestation of workplaces for working conditions, the results of laboratory research and tests obtained in the framework of control and supervision activities, production laboratory control, as well as the use of operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in the implementation of production activities.

However, as already mentioned above, the list of factors itself does not refer to any factors, but only to those that, by the level of their impact, may indicate the presence of harmful conditions labor. At the same time, in our opinion, the employer, in the absence of the results of a special assessment of working conditions, can indeed resort to other sources of information on harmful factors named in paragraph 19 of the Procedure, and if, on the basis of these sources, he can conclude that the impact of these factors, according to their level, may lead to the assignment of the working conditions of the employee to harmful or dangerous, he decides on the need for a medical examination of such an employee. Without violating the requirements of the law, the need for such a procedure for the employer's actions may arise in the event of the creation of new jobs. In accordance with parts 1 and 2 of Art. 17 Law N 426-FZ special assessment working conditions at newly created workplaces should be carried out within 6 months from the date of their commissioning. At the same time, as the Ministry of Labor of Russia explained in a letter dated April 16, 2015 N 15-1 / OOG-2242, the commissioning of newly organized workplaces should be understood as the start date of the regular production process at these workplaces.

Accordingly, workers for work in these places will in any case be accepted earlier than a special assessment of working conditions is carried out for them. In this case, the employer really should independently assess the presence of harmful or dangerous factors and the level of their impact in order to determine the need to send employees for medical examinations (except for the cases listed in clauses 3.8, 3.9, 3.12, 4.1, 4.4.1-4.4.3 of the List of factors in which the employer has the right to focus only on results of a special evaluation).

At the same time, in our opinion, in the event that the employer has the current results of certification of workplaces for working conditions or a special assessment of working conditions, he needs to use them. Obligations to use other sources of information in the presence of the results of a special assessment The procedure has not been established, as evidenced by the phrase “can be used” used in clause 19 of the Procedure in relation to such sources.

The letter of the FMBA of Russia already mentioned above also states that the employer should use other sources of information about the harmful factors affecting the employee in order to determine the need for medical examinations precisely in the absence of certification results. The Supreme Court of the Udmurt Republic in its decision dated April 15, 2015 in case N 7-124 / 2015 also concluded that there was no offense in the actions of the employer who did not ensure that the employees undergo a medical examination, including due to the fact that he had attestation cards for the workplaces of these employees , which do not contain indications of the presence of harmful production factors at the relevant workplaces.

Thus, we believe that the employer is obliged, in pursuance of the requirements of parts one and four of Art. 213 of the Labor Code of the Russian Federation to conduct a medical examination of workers in the presence of harmful production factors at their workplaces only if the level of their exposure indicates the presence of harmful or dangerous working conditions at such workplaces. When establishing the fact of the presence of harmful factors at workplaces and determining the level of their impact, the employer should first of all be guided by the results of attestation of workplaces for working conditions or a special assessment of working conditions, and only in their absence should he resort to other sources of information (except for cases named in the Order).

Given the above, we believe that if there are results of certification of workplaces for working conditions that have not expired (part 4 of article 27 of Law N 426-FZ), or a special assessment of working conditions confirming the absence of harmful or dangerous working conditions, the employer does not have an obligation to organize mandatory medical examinations of employees who work at workplaces in respect of which the absence of harmful or dangerous working conditions has been established.

At the same time, if employees are employed in jobs that are included in the List of Works, the employer is obliged to arrange for them to conduct preliminary and periodic medical examinations. Rostrud specialists give similar explanations (see answer 4).

Thus, in our opinion, the employer is obliged to include in the lists of contingents of employees undergoing preliminary and periodic medical examinations the following categories of employees:

Employees who work at workplaces in respect of which, based on the results of attestation of workplaces for working conditions (or a special assessment of working conditions), the presence of harmful and dangerous working conditions has been established;

Employees who work at newly created workplaces for which a special assessment of working conditions has not yet been carried out, while at such workplaces there are harmful and (or) dangerous production factors diagnosed by the employer in accordance with clause 19 of the Procedure;

Employees employed in jobs included in the List of Jobs;

Other employees for whom labor legislation and other regulatory legal acts containing labor law norms provide for the obligation to organize preliminary and (or) periodic medical examinations (for example, persons under the age of eighteen years - Article 69 of the Labor Code of the Russian Federation) * ( one).

However, please note that this position is our expert opinion. As can be seen from the answer, the regulatory and judicial authorities may take a different point of view on a given issue.

Prepared answer:
Legal Consulting Service Expert GARANT
Erin Pavel

Response quality control:
Reviewer of the Legal Consulting Service GARANT
Voronova Elena

The material was prepared on the basis of an individual written consultation provided as part of the Legal Consulting service.

*(1) See also Encyclopedia of Solutions. Preliminary medical examination.