Management of temporal disabilities and responsibilities of the attending doctor

The principle person in expert examination of temporal disability is the attending doctor who is allotted adequate rights and responsibilities. Along with diagnosing, surgery and pharmacotherapy, administering regimen and rehabilitation treatment, the attending doctor makes a decision on the necessity of complete or partial relief for the injured with respect to work, and prepares medical documents.

The first medical document of an expert examination of the dental patient are the medical records of the dental patient (from № 043u) or medical records of an inpatient (from № 310) which provides the doctor with data about the disease or injury on the grounds of which they make a conclusion regarding a type, characteristics of the disease or injury, degree of severity, dysfunctions of systems and organs, period and treatment modality.

Data in medical records must be confirmed by records by the patient’s visits to the doctor in an everyday registration sheet of a dentist (from № 037u) and an inpatient’s case history - in an inpatients register of the department and in the register of admitting office.

  A document which confirms temporal disability of the patient during his in- or outpatient treatment and which is made on the grounds of hospital records or case history is called a sick leave.

The procedure of granting medical certificates used to be regulated by the Act of Trade Union Organization and the USSA Health Care Commiittee № 1382 of 14.08.1937 with additions and amendments of 13.11.1984.

The regulation currently in use is Law № 455 of 13.11.2001 “On approval of the regulation on granting medical certificates which confirm a citizen’s temporal disability”.

Major clauses of the Regulation

1. Temporal disability of working citizens is confirmed by a sick leave.

A sick leave is granted to:

– Citizens of Ukraine and foreigners who reside in Ukraine and work on the basis of a labour contract at enterprises, institutions, companies and organizations irrespective of the form of ownership.

– persons elected to the state authority bodies, local self-governing bodies etc.

3. The right to grant a sick leave have:

– attending doctors who are responsible for case of work at state-owned and municipal medical facilities;

– attending doctors who work in inpatient hospitals of prosthetic-and-orthopedic institutions of the Ministry of Labour and Social Policy of Ukraine;

– doctor's assistant in areas where doctors are not available, on ships at sea.

4. The right to grant a sick leave do not have:

– doctors who work on an ambulances, at blood transfusion banks, facilities for medical and legal expert examination, recreational hospitals and resort outpatients clinics, holiday homes, tourist centres, prosthodontic departments.

– sanitary facilities;

– Attending doctors in sanitary institutions of all forms of ownership who provide cosmetic surgery without medical indications.

5. Granting and extension of documents which confirm the patient’s temporal disability occurs only after the attending doctor have personally examined the patient and made a proper record, which substantiates the temporal disability.

6. A sick leave in case of the disease or injury is granted on the day of ascertaining the disability for the whole period of temporal disability till it is over or a group of disability is granted by the Medical community commission of experts, except for inpatient treatment. In case of inpatient treatment, a sick leave is issued by the attending doctor and the head of the department for the whole period of treatment. If it is necessary to continue treatment on an outpatient basis, a sick leave may be extended for the period up to 3 calendar days provided it is substantiated in the case history and the abstract of record.

In case of disability caused by a disease or injury the attending doctor in outpatient and polyclinic institutions can personally issue a sick leave for the period of up to 5 consecutivecalendar days and its further prolongation depending on the severity of disease up to 10 consecutivecalendar days. If the disability lasts more than 10 consecutivecalendar days, the prolongation is performed by the attending doctor together with the head of the department for up to 30 consecutivecalendar days. Then – the Medical revising commission which follows examination by a commission of experts, periodical examining done at least once in ten days, but no exceeding the period fixed for referring the patient to the Medical community commission of experts.

7. People who are refused disability are issued a medical certificate in a free form with indication of date and time of his visit to the medical facility.

8. In case of temporal disability of the patient caused by a disease or injury as the result of alcohol or drug intoxication which is determined in accordance with regulation of Ministry of Health and Ministry of Internal Affairs of Ukraine, the patient is granted a sick leave in which the fact of intoxication is noted. The same record is made in the case history and hospital records. 

9. Temporal disability of university students and students of vocational schools is confirmed by a medical certificate for a student (form № 095/0), approved by the Act of the Ministry of Health of Ukraine № 369 of 29.12.2000.

10. A free-format medical certificate is granted by a doctor and is to be signed and stamped by the head doctor of the medical facility if the examination is done to determine whether the injury is caused by working conditions or if the individual has a referral by investigating bodies, prosecutor’s office or court: to sick people, unemployed and to individuals referred to be examined by military commissariat, or to an individual on his own initiative.

11. The violation of the procedure of granting and completing documents of temporal disability is the attending doctor’s responsibility. In case of repeated violations the doctor can be deprived the right to grant certificates of temporal disability.

In the of case an unfavourable labour prognosis, long duration of the disease (more than 4 months), stable or irreversible character, the decision on the necessity of referring the newly-admitted patient to the Medical community commission of experts is made only afterconsultation with the Medical revising commission or the head doctor to whom an attending doctor together with the head of the department present the patient who in their opinion needs to be sent to an expert commission. At the same time they complete a document "Referral to the Medical community commission of experts" -

form № 088/u - and represent the patient in front of the Medical revising commission.

Activities of the Medical community commission of experts are regulated by the Cabinet of Ministers’ Act № 221 of 04.04.1994 "On approval of the mentioned procedure of organizing and performingmedical and community expert examination for disability". The Medical community commission of experts diagnoses disability and gives labour recommendations. The attending doctor in accordance with the decision of the Medical community commission of experts perform regular medical check-up and appoints restorative procedures. This patient’s medical certificate of disability is closed on the day of submission of his documents to the Medical community commission of experts. The date of establishing disability is written on the medical certificate of disability. In the case the patient is not recognized as disabled and is recognized as being capable to work, his medical certificate of disability is closed on the day his examination.

If the patient is recognized as disabled, his medical certificate of disability is extended till his recovery or re-referral to the Medical community commission of experts.

6. MATERIALS FOR SELF-CONTROL: