Mandatory medical examinations during the COVID-19 epidemic: recommendations for an occupational safety specialist

Officials of the Russian Ministry of Health have again changed the rules for undergoing medical examinations in 2021 for those who work (or get a job) in difficult, harmful or dangerous working conditions. Almost by tradition, innovations are associated with coronavirus. What has changed for workers and employers in terms of mandatory periodic medical examinations?

Also see:

• What does periodic medical examination of employees include starting from 2020?
• What changes in medical examinations of workers from 2021

Order of the Ministry of Health dated May 18, 2020 No. 455n

Clarifications to the previously valid version of the Procedure for Conducting Mandatory Medical Examinations were made by a separate order of the Ministry of Health, which was issued on May 18, 2021 under No. 455n.

Let us recall that the unified Procedure for conducting mandatory preliminary (upon entry to work) and periodic medical examinations and examinations of workers engaged in heavy work and work with harmful and (or) dangerous working conditions was approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n (hereinafter referred to as - Order).

The procedure
obligated employers to conduct medical examinations and examinations in specified cases:

• when hiring new employees;
• periodically inspect those already working.

If for any reason an employee did not undergo a regular medical examination, the employer had to remove him from work. Until the moment when the medical examination is passed with a result that allows the continuation of work.

We described in detail the procedure for removal from work in the article “How and on what grounds does removal from work occur.”

In 2021, starting from June 2 (10 days from the date of registration of Order No. 455n with the Ministry of Justice of the Russian Federation), the rules have been changed : employers are allowed to:

• shift schedules for mandatory medical examinations;
• do not suspend from work employees who have not completed pre-assigned inspections and examinations.

When and who to refer to the occupational pathology center

Changes to Order No. 302n significantly change the rules for sending workers to the occupational pathology center. These rules, unlike other changes, will take effect not from the beginning of 2020, but from July 1, 2021.

According to the new rules, it was clarified that workers who have five years of work experience in hazardous working conditions (subclasses 3.1–3.4, class 4) must be sent to the occupational pathology center for the first periodic examination, and then once every five years.

Example:

When to refer an employee who works in hazardous working conditions to the occupational pathology center

Lineman Ivanov began working in hazardous working conditions in 2015. In 2021, his work experience in hazardous conditions was 5 years. He is due to undergo another periodic examination in 2021. Since this is the first periodic medical examination for Ivanov after his work experience in hazardous working conditions was 5 years, he must be sent to the occupational pathology center as part of this medical examination. Next time he should be sent to the occupational pathology center no earlier than 2026.

Workers with persistent consequences of industrial accidents need to be referred to the occupational pathology center simply once every five years.

Workers who have received conclusions on a preliminary diagnosis of an occupational disease must be sent to occupational pathology centers within one month from the moment of suspicion of a connection between the disease and the profession.

If an employee undergoes a periodic medical examination at an occupational pathology center, then the employee will need to present to the medical specialists an extract from his medical record with the conclusions of medical specialists, the results of laboratory and other tests, conclusions based on the results of a preliminary or periodic examination for previous years of work in harmful and dangerous working conditions .

Attention:

during the year of examination at the occupational pathology center, the employee does not need to be sent for a periodic medical examination to another medical organization.

In addition, according to the new rules, employees with five years or more of work experience will be allowed to undergo periodic medical examinations in mobile medical teams of specialist doctors at occupational pathology centers, including using mobile medical complexes.

Is it possible:

• in the regions of the Far North and equivalent areas;
• in the absence of an occupational pathology center in the locality in which the production facility is located.

Before a medical examination in a mobile medical team, workers will need to undergo diagnostic tests at medical organizations.

What has changed regarding mandatory medical examinations?

The amendments made by order of the Ministry of Health dated May 18, 2020 No. 455n were required due to changes in the work of medical organizations in connection with the coronavirus. The massive reorientation of medical institutions to combat the pandemic and the limitation (or even termination) of the services they provide in other areas has led to the practical impossibility of organizing regular mass medical examinations of workers on time.

Health Ministry officials allowed employers to postpone periodic medical examinations of employees for up to 6 months . This period is called the maximum. Within its limits, an employee without a medical examination may be allowed to work as usual and without the application of penalties to the employer.

The decision to change the schedule of mandatory medical examinations, according to Order No. 455n, falls entirely within the competence of the employer .

A prerequisite for exercising the employer’s right to postpone a medical examination is the introduction of a high alert or emergency situation.

Where to get a medical certificate for a driver's license

A new driver’s license is issued after passing the following medical specialists and procedures:

Psychiatrist and narcologist

Pay attention to points number 3, 4, 8 and 9 in the table above. Upon receipt of a medical certificate, you will in any case have to visit a drug treatment and psychoneurological clinic. The legislation directly states that the institution must be municipal or state:

An examination by a psychiatrist is carried out in specialized medical organizations of the state or municipal health care system at the place of residence or place of stay of the driver of the vehicle (candidate driver of the vehicle) undergoing a medical examination (hereinafter referred to as the examinee), who have a license to carry out medical activities to provide services ( performance of work) on “psychiatry” and “psychiatric examination”.

An examination by a psychiatrist-narcologist, including determination of the presence of psychoactive substances in the urine, as well as qualitative and quantitative determination of carbohydrate-deficient transferrin (CDT) in blood serum, is carried out in specialized medical organizations of the state or municipal health care system at the place of residence or place of stay of the person being examined, having a license to carry out medical activities to provide services (perform work) in “psychiatry-narcology” and “laboratory diagnostics” or “clinical laboratory diagnostics”.

Moreover, you should contact dispensaries only at the place of permanent registration (registration) or temporary registration. It is impossible to see a psychiatrist and narcologist without registration.

Note. Some private medical centers offer to see specified doctors, but such offers do not comply with legal requirements. Those. we are talking about fraud.

Other doctors and examinations

You will also have to undergo the remaining mandatory medical specialists and procedures included in the list. In addition, some points are completed only with the direction of the relevant doctors. Points 1, 2, 5, 6, 7 from the table can be completed at any medical center in the country.

Who still needs to be examined?

exceptions to the new rules for medical examinations during the coronavirus period . Thus, it is still not possible to cancel or reschedule medical examinations for the following categories of workers:

• whose responsibilities include working with food products (including repair and sanitary processing of equipment and equipment for such work and food trade);
• working with children (including in organizations not related to compulsory education: sports sections, clubs, creative workshops, etc.);
• workers in the field of consumer services, if the work involves close contact between employee and client (hairdressers, beauty salons, bathhouses, etc.);
• employees of medical institutions and retail outlets (pharmacies);
• workers in medical production (including those involved in packaging, packing and selling medicines);
• working in swimming pools and spas;
• workers in hotels, boarding houses, hostels, etc.;
• conductors in transport, incl. flight attendants of aircraft.

The specified occupations are listed in paragraph - List of works, during the performance of which mandatory preliminary and periodic medical examinations are carried out (approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n). For such employees, medical examinations must continue according to the rules provided for by Order No. 302n and the specified List of Works.

Differences of the new form

Starting in 2021, Russia began issuing certificates for the traffic police for driving licenses on new forms. Now the form is called 003-B/U. How is it different from the old statements?

For example, new fields. From now on, in the mentioned documentation you can see:

• field “Place of registration of citizen”;
• information about the doctor who confirmed the commission’s conclusion;
• all possible categories of vehicles.

Some sections have been removed from the form. For example, the following are now missing:

• fields with the conclusion of each specialist;
• validity period of the paper;
• space for a personal photograph of the driver.

Despite this, the above-mentioned extract remains very informative. And therefore, every citizen will be able to use the V/U-003 certificate when applying for a “driver’s card”.

Let's sum it up

In connection with the situation that has arisen during the fight against coronavirus, the Ministry of Health has clarified the procedure for employers to organize mandatory medical examinations.

For many “pests”, from June 2, 2021, it is permissible to postpone the mandatory medical examination during the period of high alert or emergency regime.

But there is also a list of those categories of workers to whom this innovation does not apply. Periodic medical examinations should still be organized for them at the required time and at the expense of the employer.

Read also

17.01.2020

Which doctors to visit

The list of examinations during a medical examination and which specialists health workers should undergo is determined in Order of the Ministry of Health and Social Development dated April 12, 2011 No. 302n.

Examinations that doctors must undergo:

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

Medical examination of medical workers includes regular examination for the presence of tuberculosis (Order of the Ministry of Health of the Russian Federation dated March 21, 2017 No. 124n).

All medical workers are required to be vaccinated in accordance with the National Vaccination Calendar, approved by Order of the Ministry of Health of Russia dated March 21, 2014 No. 125n.

Is it possible to avoid fines if office workers do not undergo the required medical examination?

Rostrud officials themselves tried to answer this question. Here are their main recommendations:

1. To finalize local acts related to the organization of employee activities:

• Specify in job descriptions a limited duration of time spent at the computer, and provide for mandatory technical breaks for employees. According to the instructions, the total time of contact with the computer during an 8-hour working day should not exceed 3.5 hours.
• Rewrite the list of employee responsibilities in the job description so that half of the responsibilities indicated in it are not related to being at the computer.

According to Rostrud, in this case the likelihood of fines will be minimal.

1. Have a conclusion on the environmental safety standards, which will indicate that electromagnetic radiation in the workplace is within normal limits. There are judicial precedents where the presence of such a conclusion helped to cancel a fine imposed by the State Tax Inspectorate through the court.

Grounds for dismissal of an employee who has not passed a medical examination

Company management may suspend an employee from work if he does not pass a medical examination.

When he continues to refuse this examination, it is possible to formalize the termination of the employment contract on the basis of clause 5 of part 1 of Art. 81 of the Labor Code of the Russian Federation, which presupposes this punishment for repeated failure by this person to fulfill his labor duties.

However, when the commission recognizes an employee as unsuitable for a given job, and the employer is unable to transfer him to an easier job, the company can also terminate the employment contract on the basis of clause 8 of part 1 of Art. 77 of the Labor Code of the Russian Federation, which implies dismissal for refusal to transfer to another job for medical reasons.

Mandatory medical examination for office workers: Legal Regulations

According to the norms of Art.
213 of the Labor Code of the Russian Federation and clause 13.1 of SanPiN 2.2.2/2.4.1340-03, all employees who work in conditions that include factors harmful to human health must undergo regular medical examinations. The employer is obliged to send such employees for preventive examinations by doctors and not allow those who have not passed the medical examination to work. All costs for these activities are borne by the employer. The list of harmful factors is also known - it was approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n (hereinafter referred to as order No. 302n). This list also includes such a phenomenon as “electromagnetic field of a broadband frequency spectrum from a PC.” Simply put, radiation from office equipment, primarily from computers.

At the same time, in the chain of the Labor Code of the Russian Federation - SanPiN - order of the Ministry of Health and Social Development, there is no direct connection between the need for medical examinations and the results of SOUT. That is, even if, according to the results of the SOUTH assessment, the workplace of an office worker is recognized, for example, as not containing factors hazardous to health, but there is a computer on it, on which the employee spends more than half of his working time, periodic medical examinations of such an employee are still necessary.

Is it necessary to conduct medical examinations for employees who work at computers for more than half the working day if, based on the results of a special assessment, the workplace is found to be safe? The answer to this question is in ConsultantPlus. Study the material by getting trial access to the K+ system for free.

How to register for a medical examination (medical record)

Based on the results of the medical examination, the medical institution that conducted it draws up a final report within 30 days.

The final report is information about each employee who passed the inspection. This information is also reflected in the medical record.

The act states:

• 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 of the structural unit, if any, position or type of work;
• name of the harmful production factor or type of work;
• results of medical examinations of medical workers.

The act is endorsed by the chairman of the commission indicating the surname and initials and certified by the seal of the organization that conducted the inspection.

In general, a general act is drawn up for the organization, which includes all employees who have undergone a medical examination for health workers, a list of recommendations to the employer for the implementation of a set of health measures, including preventive ones.

When checking compliance with sanitary and epidemiological regulations, representatives of Rospotrebnadzor have the right to check the list of employees according to the act with the list of working employees.

When undergoing an examination, marks are made on the appropriate page of the medical book. The medical book is issued in accordance with Order of Rospotrebnadzor No. 402 of May 20, 2005. It reflects the results of the examination, which are certified by the doctor’s signature, seal and stamp of the medical institution.