Mandatory preliminary and periodic medical examinations in the 1st quarter of 2022 were carried out in the manner established by order of the Ministry of Health and Social Development on medical examinations No. 302n. On April 1, 2021, a new order of the Ministry of Health dated January 28, 2021 No. 29n came into force, regulating the procedure for conducting them, as well as the list of persons subject to medical examination. Employers are required to strictly follow the provisions of these documents in their work on conducting medical examinations. In this article we explain order No. 29n dated January 28, 2021 on the procedure for referral for medical examinations and what has changed in medical examinations.
The purpose of a referral for a medical examination when applying for a job
In accordance with Art. 212 of the Labor Code of the Russian Federation, the employer has the right not to allow employees to work if they have not passed a mandatory medical examination. Art. 213 of the Labor Code of the Russian Federation establishes the obligation to undergo a preliminary medical examination (before employment) for employees who, in the course of their activities, will be associated with:
- hazardous production;
- harmful working conditions;
- traffic movement.
Important! From 04/01/2021, a new list of production factors and work is in effect, during which preliminary and periodic medical examinations are carried out, as well as the procedure for conducting such medical examinations. Find out what changes to take into account in your work in ConsultantPlus. Trial access to the legal system is free.
Periodic medical examinations (usually annual) are carried out by persons under 21 years of age, as well as other employees in order to prevent the development of occupational diseases. There are also categories of employees who must undergo periodic medical examinations before each time they go to work, for example, drivers.
See also “Constant work at the computer is not a reason to send employees for medical examinations .
Each employee who must undergo a preliminary (regular) examination by a doctor (doctors) receives a referral for a medical examination. With this referral, he comes to a medical institution with which the employer has an agreement to provide this type of medical services.
Who is being examined by a doctor?
In accordance with Art. 213 of the Labor Code of the Russian Federation, the employer is obliged to send the following categories of employees for preliminary and preventive examinations:
- transport workers;
- workers in the food industry, trade and public catering organizations, water works;
- all employees of medical, children's, and educational organizations;
- other employees whose workplaces contain harmful or dangerous factors and working conditions.
A complete list of factors that require a medical examination and the procedure for conducting it are determined by the Ministry of Health. Order No. 302n is currently in force, but from April 1, 2022 it will no longer be in force. The following documents have been accepted to replace it:
- Order of the Ministry of Health No. 29n on approval of the Procedure for conducting medical examinations;
- Order of the Ministry of Health and the Ministry of Labor No. 988n/1420n dated December 31, 2020 on approval of the List of harmful and dangerous factors.
Read more: Order to undergo periodic medical examination
How is a referral for a preliminary medical examination issued?
A referral for a medical examination on the employer’s letterhead is given to the specialist applying for a job in person against signature. Refusal to receive a referral or undergo a medical examination means the applicant’s failure to fulfill his obligations, as a result of which the employment contract (if it was signed) is canceled.
The medical examination is considered completed if the specialist has visited all doctors, and all planned laboratory and diagnostic tests have been carried out. Based on the results of the examination, the person applying for work is given a conclusion.
The second copy of the report remains in the medical institution and is attached to the outpatient medical record, which is created immediately after presentation of the referral for a medical examination.
You will learn more about the nuances of undergoing a medical examination for employees applying for a job in our article “Medical examination upon hiring (nuances)” .
Why is a referral issued?
The employer issues an order on the frequency of medical measures and the order in which they are carried out. Persons sent for medical examination must familiarize themselves with it no later than 10 days before the start of the inspection.
Each person who is required to undergo an inspection is given a referral from the employer against signature. It is drawn up on the basis of a list of persons subject to preliminary and periodic medical examinations. Such a list is compiled by the employer taking into account the specifics of its activities, the work performed by employees and on the basis of the SOUT.
With the referral, the employee comes to the medical institution with which the director of the company has entered into an agreement for the provision of medical services.
The medical examination is considered completed if the citizen has visited all doctors and passed the necessary tests. Based on the results of the inspection, a medical report is drawn up in three copies: one is issued to the employee, the second remains in the medical organization, the third is sent to the employer, including via electronic communication channels.
ConsultantPlus experts examined whether a trip for a mandatory medical examination can be processed as a business trip. Use these instructions for free.
How to apply for a referral for a preliminary or periodic medical examination?
The referral form for a preliminary or periodic medical examination does not have an approved form. However, there is a list of required details (clause 9 of Appendix No. 1 to Order of the Ministry of Health dated January 28, 2021 No. 29n):
- employer's name, email, contact phone number;
- form of ownership and type of economic activity of the employer according to OKVED;
- name of the medical organization, actual address of its location and OGRN code, email, contact phone number; type of medical examination;
- last name, first name, patronymic (if any), date of birth, gender of the employee;
- name of the employer's structural unit (if any);
- name of position (profession) or type of work;
- harmful and (or) hazardous production factors, types of work, in accordance with the list of contingents;
- number of the medical insurance policy of compulsory and (or) voluntary medical insurance.
An authorized employee of the employer fills out the form for a referral for a medical examination.
Find out how to organize a preliminary examination when applying for a job from the Guide to Personnel Issues of the ConsultantPlus system. Follow the link and get free trial access to the K+ system.
Who should undergo a preliminary medical examination under Order 29n?
Order 29n is a relatively new order of the Ministry of Health of the Russian Federation, which entered into force on January 28, 2022. It establishes the frequency of periodic and preliminary medical examinations.
The order is aimed at diagnosing chronic and/or occupational diseases in the early stages, their timely treatment and monitoring the dynamics of improvement.
All employees who will work under the influence of hazardous or harmful production factors associated with:
- chemically active and volatile substances (metals, gases, acids, phenol, etc.);
- fibrous dust (suspended substances having such a small diameter that they can damage the walls of the alveoli and small blood vessels);
- carcinogens of various nature;
- biological factors (fungi, pathogenic microorganisms, biological toxins);
- physical factors (ionizing and non-ionizing radiation, ultra- and infrasound, noise, vibration, poor lighting, cooling or heating microclimate);
- factors of the labor process (severity, tension, the need to continuously be in the process, work with complex optical instruments or high-risk means).
Employees of medical organizations fall into a special category - they work with many harmful factors and at the same time can serve as sources of secondary infection with infectious diseases, therefore they must undergo a full medical examination.
You need to undergo periodic and preliminary commissions from an occupational pathologist.
The list of persons who are required to undergo a preliminary medical examination is compiled by the employer.
The procedures themselves are carried out at the expense of the employer or the Social Insurance Fund. The list of survey items is given taking into account the harmful factor, work experience and age of the employee.
To undergo a preliminary medical examination upon hiring, the employer fills out and issues a referral to the employee, which must be presented at the medical institution with which the organization has an agreement.
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How to fill out a referral for a medical examination of an employee?
The list of persons is approved based on the hiring of new employees and the frequency of medical examinations previously completed by employees.
The procedure for completing a referral is prescribed in clause 9 of Appendix No. 1 to Order 29n, which specifies the information that must be included in the contents of the document.
The following information should be included in the referral for a preliminary medical examination:
- information about the employer (name, telephone, fax, e-mail, form of ownership, type of activity according to OKVED);
- name of the medical organization and type of medical examination to which the employee is sent (in this case, preliminary);
- Full name, gender and date of birth of the employee, position and type of activity, department where he works;
- harmful and dangerous factors that the employee has to face;
- Compulsory medical insurance number.
Referrals are issued to employees against signature; the fact of issue is recorded in the log book.
The directions should be drawn up by a responsible person at the enterprise, most often an occupational safety specialist or one of the occupational safety officers.
With a referral and a list of documents, the employee is sent for inspection. Electronic document flow is possible between the employer and the medical organization.
Based on the results of the examination, the medical institution issues a conclusion. The conclusion determines the suitability or unsuitability of the employee to perform job duties. The medical report is prepared in three copies: one is kept by the employee, the second is attached to the medical record, and the third is sent to the employer.
Order of the Ministry of Health 29n also determines the frequency of medical examinations. The table in the Appendix to the full form of the order indicates the frequency of periodic inspections, which ranges from once every two years to once every six months, depending on the harmfulness of the production factor.
After the examination (based on its results), the employing company is obliged to summarize the results of medical examinations of employees within 30 days and draw up a final report with the support of the federal executive body.
The act helps control the epidemiological situation and improve the socio-economic well-being of workers by preventing occupational diseases.
To undergo a periodic medical examination, the employer draws up a referral according to this sample.
and sample filling 2021
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Where are the directions for a medical examination?
Due to the fact that there is no specific form for sending employees to undergo a medical examination, each employer can approve its own form on the condition that it contains all the required details. In order to save time and avoid mistakes when developing their own form, many people prefer to use ready-made forms.
On our website you can download a completed sample referral for a medical examination using the link below:
Timing and procedure for preliminary medical examinations
Until 04/01/2021, preliminary medical examinations of workers should have been carried out according to Order No. 302n; from April 2022, an updated procedure for their implementation was introduced - in accordance with Order of the Ministry of Health No. 29n.
There are few differences between them and each of them breaks this procedure into a number of stages. Preliminary medical examinations are carried out when an employee enters work. As a rule, before concluding an employment contract with him and starting to perform duties.
In order to organize medical examinations under Order No. 302n or under the new Order No. 29n from April 2022, the company must enter into an agreement with a medical organization that has the appropriate license.
To send an applicant to a medical institution, he is given a referral drawn up by the employer in any form with the obligatory indication of a certain list of details (see table above). Below is a sample referral for a medical examination for practical use.
DIRECTION FOR PRELIMINARY MEDICAL EXAMINATION
Information about medical examinations is reflected in the personal medical record (clause 5, article 34 of the Federal Law of March 30, 1999 No. 52-FZ)
Results
The obligatory medical examination for employees is established in Art. 213 Labor Code of the Russian Federation. If an employee does not undergo a medical examination (or refuses to undergo it), the employer has the right not to allow him to work.
There are mandatory preliminary and periodic medical examinations. The list of harmful production factors, the presence of which requires a medical examination, is contained in Order No. 29n.
To undergo a medical examination, an employee (including those just starting a job) is given a referral. With this referral, the employee applies to the medical institution indicated by the employer. Based on the results of the examination, he is given a medical report.
Sources: Labor Code of the Russian Federation
You can find more complete information on the topic in ConsultantPlus. Free trial access to the system for 2 days.
Which doctors should I go to?
The list of specialists who must conduct the examination is indicated in the form. So, you need to undergo examination by the following doctors:
- therapist;
- surgeon;
- neurologist;
- otorhinolaryngologist;
- ophthalmologist.
Fluorography data is also required, no later than a year ago. Laboratory data is also needed. If you undergo these studies at the direction of your attending physician (therapist at a local clinic), you will not have to pay for them. This will significantly reduce the cost of document preparation.
In some cases, not only form 086/y is required, but also additional medical documents for it. For example, certificate 086/у with additional form 025/yu is required for male applicants undergoing outpatient treatment. The specific composition of the required documents should be clarified in advance at the place of future work or study.
