Medical commission according to order 302. List of harmful and dangerous production factors by profession - order on medical examinations. What medical examinations do workers undergo?

Order 302n dated 04/12/11 of the Ministry of Health and Social Development on medical examinations and commissions was given. A referral form from the employer for a mandatory medical examination or medical examination upon hiring is provided. This sample form for the 2018 - 2019 form can be downloaded for free. A list of harmful production factors of Order 302n by profession for mandatory medical examination is provided.

Procedure for medical examinations

The procedure for conducting mandatory medical examinations of workers is given in Appendix 3 to the order of the Ministry of Health and Social Development dated April 12, 2011 No. 302n. The procedure for conducting pre-shift, pre-trip and post-shift, post-trip medical examinations of people. Who manage transport, approved by order of the Ministry of Health dated December 15, 2014 No. 835n. These documents can also be applied to all other categories of employees.

Types of medical examinations

Mandatory medical examinations are divided into three types:

• preliminary;
• periodic;
• extraordinary.

This classification of medical examinations is provided for by the provisions of Part 1.

Mandatory medical examinations (examinations) may be provided for certain categories of employees. They are carried out at the beginning of the working day (shift). And also during and (or) at the end of the working day (shift). The time spent undergoing such medical examinations (examinations) is included in working hours. This procedure is provided for in Part 3 of Article 213 of the Labor Code. Employees engaged in underground work are required to undergo such medical examinations (Article 330.3 of the Labor Code).

Medical examination at work, when is an employee required to undergo an examination in accordance with Order 302n?

List of harmful or dangerous production factors and work. During which a periodic medical examination is carried out. Both mandatory preliminary and periodic medical examinations at a doctor’s appointment are approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n. Medical examinations are required if the work involves harmful or dangerous factors. Among such factors, the electromagnetic field of the broadband frequency spectrum from the PC is mentioned. Work on reading and entering information. Work in dialogue mode for a total of at least 50% of working time. It is not stipulated that the need for a medical commission depends on working conditions.

An employee who uses a computer more than 50% of the time must undergo a medical examination. Between medical examinations, not only periodic (once every two years), but also a preliminary medical examination. That is, before applying for a job (letters dated 03/21/14 No. 15-2/OOG-242, dated 08/18/15 No. 15-1/OOG-4397).

Who conducts the medical examinations

The employer is obliged to organize medical examinations of employees. To do this, the organization enters into an appropriate agreement with a medical institution. Who has a license for medical activities (clause 6 of the Procedure, approved by order of the Ministry of Health and Social Development dated April 12, 2011 No. 302n, clause 46 part 1 article 12 of the Law dated May 4, 2011 No. 99-FZ).

The employer can also conduct medical examinations (for example, pre-trip) in its own medical center. Who has a license to practice medicine. The right to conduct preliminary and periodic medical examinations (clause 46, part 1, article 12 of the Law dated 05/04/2011 No. 99-FZ, clause 4 of the Procedure, approved by order of the Ministry of Health and Social Development dated 04/12/2011 No. 302n).

Should an organization, when conducting medical examinations (including pre-trip) in its own medical center, obtain a license for this type of activity? Conducting medical examinations is not the main activity of the organization

Yes, I should. Medical activities are licensed. Medical examinations (including pre-trip) are considered medical services. They are subject to licensing (clause 46, part 1, article 12 of Law dated 05/04/2011 No. 99-FZ. List of Regulations, approved by Government Decree dated 04/16/2012 No. 291). No exceptions for medical activities. The legislation does not provide for licensing for its own needs. Therefore, when conducting medical examinations (including pre-trip) in your own medical center, you must obtain a license for this type of activity.

The need to obtain a license to conduct medical examinations is also indicated in paragraph 8 of the Procedure approved by Order of the Ministry of Health dated December 15, 2014 No. 835n.

Does an employee of an organization (for example, an accountant) with a medical education diploma have the right to conduct pre-trip medical examinations of drivers. The organization does not have its own medical center

No, you have no right. Organizations of all forms of ownership and entrepreneurs are required to organize mandatory pre-trip medical examinations of drivers. For those who have motor transport (clause 1 of article 20, article 23 of the Law of December 10, 1995 No. 196-FZ).

An organization can organize a mandatory medical examination either at its own medical center. Or under an agreement with a medical institution. A medical institution with which an agreement has been concluded to conduct medical examinations. It must have a license for this type of activity (clause 46, part 1, article 12 of Law No. 99-FZ dated May 4, 2011).

If the organization independently conducts a pre-trip medical examination. It is necessary that only medical professionals do this. In this case, the organization itself must obtain a license. This is provided for in paragraph 8 of the Procedure, approved by Order of the Ministry of Health dated December 15, 2014 No. 835n.

Thus, if an employee of an organization has only a diploma of medical education, but does not have the appropriate certificate, then he does not have the right to conduct mandatory medical examinations.

The requirement for employee qualifications is not the only one when conducting a medical examination independently.

Medical examinations are mandatory even when selling manufactured goods, the Supreme Court believes

Preliminary and periodic medical examinations All employees of trade organizations must pass. Including those who are not directly involved in the sale of products. It does not matter what exactly the company sells - food products or cars. The Supreme Court came to this conclusion in its ruling dated December 6, 2017 No. 34-AD 17-5.

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For example, mandatory medical examinations are provided for those who are employed:

• in public utility organizations. Providing hairdressing and cosmetic services (clause 9.29 of SanPiN 2.1.2.2631-10, approved by resolution of the chief sanitary doctor dated May 18, 2010 No. 59);
• construction industry (clause 13.1 of SanPiN 2.2.3.1384-03. approved by the resolution of the chief sanitary doctor dated June 11, 2003 No. 141);
• in public catering organizations (clause 13.1 of SanPin 2.3.6.1079-01. approved by the resolution of the chief sanitary doctor dated November 8, 2001 No. 31);
• on work related to the maintenance of electric power facilities (Procedure, approved by order of the Ministry of Energy dated August 31, 2011 No. 390);
• on public railway transport (Procedure approved by order of the Ministry of Transport dated July 16, 2010 No. 154).

Also, employees under 18 years of age and professional athletes undergo mandatory medical examinations (Articles 69, 266, 348.3 of the Labor Code).

An entrepreneur-driver must undergo mandatory pre-trip medical examinations. And post-trip medical examinations too. If he is engaged in transportation and manages the transport himself. This is provided for in paragraph 4 of Article 23 of the Law of December 10, 1995 No. 196-FZ. Clause 3 of the Procedure approved by Order of the Ministry of Health dated December 15, 2014 No. 835n.

When hiring an employee who has no contact with patients, does the administration of a medical institution have the right to require a medical examination and a medical record?

Yes, you have the right. Employees of medical institutions, including children's. Must undergo preliminary medical examinations upon entry to work. No exceptions for employees. All employees pass. Even those who are not in direct contact with children (sick people).

Data on medical examinations are entered into the employee’s personal medical record. When hiring, the administration may require an employee to undergo a medical examination. Or a medical book with data on its completion. An employee who refuses to undergo a medical examination shall not be allowed to work. (Article 69, Part 2 of Article 213 of the Labor Code, Article 34 of the Law of March 30, 1999 No. 52-FZ, clause 15.1 of SanPiN 2.1.3.2630-10, approved by the Decree of the Chief State Sanitary Doctor of May 18, 2010 No. 58) .

Who should pay for the registration of a personal medical record for an employee - the organization or the employee

The organization must pay such expenses. A personal medical record indicates that an employee is fit for health reasons to perform a certain job. To receive the appropriate marks, the employee takes tests, undergoes an examination, etc. All these activities must be financed by the employer (Articles 213, 266 and 348.3 of the Labor Code).

What responsibility is provided for an employee if he, having received a medical book at the expense of the employer, quit or did not start work at all?

The employee does not bear any responsibility for such actions. Firstly, the law obliges the employer to pay for all medical examinations (examinations) (Articles 213, 266 and 348.3 of the Labor Code). And secondly, termination of an employment contract at one’s own request is a voluntary expression of the will of the employee. Therefore, it is impossible to oblige an employee to pay the costs of obtaining a personal medical record. Labor legislation does not provide for the possibility of recovering damages from an employee. If caused as a result of refusal to conclude an employment contract.

Medical examinations and special medical conditions can be carried out at the expense of the Social Insurance Fund. Please submit your application before August 1st

The following activities can be financed by the Social Insurance Fund:

• training on labor protection for established categories of workers;
• spa treatment;
• purchasing personal protective equipment;
• mandatory periodic medical examinations;
• purchase of first aid kits, tachographs, breathalyzers.

All documents must be completed properly. Contain reliable information. On the day of submitting documents, the applicant should not have any debt in payment of insurance premiums. Unpaid penalties and fines.

Note: Download the application form for the allocation of financial support. Format.doc 41 Kb, Ministry of Labor of the Russian Federation: Order 598n dated 09/02/14 (as amended on 04/04/2017)

Documents are submitted by the insurer of public services through the MFC. During a personal visit to the FSS or by mail.

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When employees who work at a computer should not undergo medical examinations

When employees work at a computer more than half of their working time. But at the same time, their working conditions are recognized as optimal or acceptable. The employer may not send them to preliminary and periodic medical examinations. Rostrud reported this in a letter dated 02.28.17 No. TZ/942-03-3.

In relation to a number of factors listed in the List, it is indicated. What passing medical examinations necessary when classifying working conditions as hazardous. For example, for the factor “Reduced air temperature in production premises”. But for the factor “electromagnetic field of a broadband frequency spectrum from a PC, there is no such clause. The presence of hazardous radiation and the classification of work based on this factor as “harmful” is possible only according to working conditions. In this part, Order No. 302n contradicts the provisions. This article directly states: workers are sent to undergo mandatory preliminary and periodic medical examinations. Those who are employed in jobs with harmful or dangerous working conditions.

Rostrud officials draw the following conclusion. If the current results confirm that the employee's working conditions. Who works at the computer, optimal or acceptable. Then the employer is not obliged to send him for a medical examination.

Kontur.Accounting: Keep personnel records and calculate salaries in a web service for free

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Preliminary medical examinations

Preliminary mandatory medical examinations are carried out upon hiring. Their goal is to determine before concluding an employment contract. Can a candidate apply for a particular position due to health reasons?

If the preliminary medical examination is carried out in a medical institution. To obtain a medical certificate, the candidate must be given a referral. In the referral for a medical examination issued to an applicant for a position in harmful (hazardous) work, indicate harmful (dangerous) production factors. Which an employee will encounter after being hired for a vacant position. In addition, in the direction indicate:

• employer's name;
• form of ownership and organization according to OKVED;
• name of the medical organization, actual address of its location and OGRN code;
• type of medical examination (preliminary);
• last name, first name, patronymic, date of birth of the applicant;
• name of the structural unit of the organization (if any) in which the candidate will be employed;
• the name of the position (profession) of the applicant or the types of work that he will perform.

A referral for medical examinations is issued to the person against signature. The employer must organize a record of issued referrals.

Note: See paragraphs 7, 8 of the Procedure approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

Currently, there is no unified form for referral for medical examinations. The organization has the right to develop it independently.

Is it necessary to undergo a medical examination for an employee who was fired and then rehired for the same job?

If an employee who was employed in “harmful” work quit. And then he was hired again for the same job. Then he must undergo a preliminary medical examination again. That is, if the employee was fired (with termination of the employment contract). And then he is hired for the same job, he is subject to all the requirements of labor legislation. Including in terms of undergoing a mandatory preliminary medical examination. This conclusion follows from the letter of the Ministry of Labor of Russia dated April 28, 2017 No. 15-2/OOG-1224.

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Periodic medical examination

Periodic mandatory medical examinations are carried out throughout the employee’s entire tenure in the organization. Their goal is to monitor the health of employees. Timely detection of occupational diseases. To conduct periodic medical examinations, create a list of employees who:

• are exposed to harmful production factors specified in the list. Approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n. Also, harmful factors are determined based on the results of a special assessment of working conditions (workplace certification) and during laboratory research and testing;
• carry out work according to the list approved by order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

Note: Clause 19 of Order No. 302n, clause 5 of Article 7 and subclause 1 of clause 3 of Article 10 of Law No. 426-FZ.

Send the approved list to the territorial body of Rospotrebnadzor within 10 days (clause 21 of Order No. 302n).

Based on this list, create a list of employees by name. Which need to undergo periodic inspection. If a medical examination is carried out on employees. Those employed in hazardous (hazardous) work. It must indicate harmful (hazardous) production factors. Which have an impact on employees.

Send the name list of employees to the medical organization. No later than two months before the start date of the periodic medical examination agreed with this organization

Note: a (clause 23 of the Procedure)

.

Having received the list of names, the medical institution draws up a calendar plan for conducting medical examinations. Coordinates it with the organization. The employer must make employees aware of this plan. But no later than 10 days before the start of the medical examination.

Before conducting a periodic medical examination, give the employee a referral. It is completed in the same manner as during preliminary medical examinations. (Clause 24 of Order No. 302n). The direction is issued to the person against his signature. The employer must organize a record of issued referrals.

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Form 302n Referral for a medical examination of the driver, sample, example excel format, guarantor

There is no unified form for referral to a preliminary periodic medical examination. The organization has the right to develop it independently. A form for a medical examination, a referral for a medical examination from the employer is issued to the person against signature. Specify the type of medical examination (preliminary or periodic). Indicate in it the harmful (dangerous) production factors that the employee will encounter after being hired for a vacant position. The employer must organize a record of issued directions

Below is an example of a referral for a medical examination. Suitable for driver, seller. It can be downloaded for free.

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Reporting

Report information about preliminary and periodic mandatory medical examinations to the Social Insurance Fund. Fill out table 5 in the calculation using Form 4-FSS. Taking this data into account, the Social Insurance Fund will set a discount for the organization. Or an increase in the contribution rate. For compulsory insurance against industrial accidents and occupational diseases (subclause 18, clause 2, article 17 of Law No. 125-FZ of July 24, 1998).

Responsibility for failure to conduct a medical examination

An employee who has not passed the mandatory medical examination should not be allowed to work. By virtue of paragraph 12 of part 2 of Article 212 of the Labor Code. For violation of this requirement, the labor inspectorate may fine:

• organization in the amount of 110,000 to 130,000 rubles;
• officials of the organization (for example, a manager) in the amount of 15,000 to 25,000 rubles;
• entrepreneur in the amount of 15,000 to 25,000 rubles.

Inspectors may learn about a violation from an employee complaint or during an inspection.

Administrative liability is provided for violation of the procedure for conducting mandatory medical examinations of drivers. If the waybills do not contain a record of the driver undergoing a medical examination. Or the driver’s examination note on the waybills was not made by a qualified doctor. And someone else.

The amount of the fine under Article 11.32 of the Code of Administrative Offenses:

• for citizens – from 1000 to 1500 rubles;
• for officials of the organization (for example, a manager) - from 2000 to 3000 rubles;
• for organizations – from 30,000 to 50,000 rubles.

For the absence of a mark on the waybill indicating that the driver has undergone a pre-trip medical examination, the traffic police inspector may fine:

• manager - 5,000 rubles;
• 
  The article will help in a dispute with an employer regarding the classification of an injury at work. To do this, you need to contact the labor inspectorate with a complaint. It will set out in detail all the circumstances of his injury.

Since January 2012, the Order of the Ministry of Health and Social Development of the Russian Federation of April 12, 2011 No. 302N “On approval of lists of harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations), and the procedure for conducting mandatory preliminary and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions.”

Order No. 302N approved and put into effect three complementary regulations

• Order 302n Appendix No. 1“List of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out”;
• Order 302n Appendix No. 2“List of works during the performance of which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out”;
• Order 302n Appendix No. 3“The procedure for conducting mandatory preliminary (upon entry to work) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions.

At the same time, the following regulatory documents were declared invalid and cancelled:

1. Order of the Ministry of Health and Medical Industry of the Russian Federation dated March 14, 1996 N 90 “On the procedure for conducting preliminary and periodic medical examinations of workers and medical regulations for admission to the profession” (according to the conclusion of the Ministry of Justice of Russia, the document does not require state registration, letter dated December 30, 1996 N 07-02-1376-96).
2. Order of the Ministry of Health and Social Development of the Russian Federation dated August 16, 2004 N 83 “On approval of lists of harmful and (or) hazardous production factors and work, during which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations ( surveys)" (registered by the Ministry of Justice of the Russian Federation on September 10, 2004 N 6015).
3. Order of the Ministry of Health and Social Development of the Russian Federation dated May 16, 2005 N 338 "On amendments to Appendix No. 2 to the Order of the Ministry of Health and Social Development of Russia dated August 16, 2004 N 83 "On approval of lists of harmful and (or) hazardous production factors and work , during which preliminary and periodic medical examinations (examinations) are carried out, and the procedure for conducting these examinations (examinations)" (registered by the Ministry of Justice of the Russian Federation on June 3, 2005 N 6677).
4. Subparagraphs 11, 12 (with the exception of subparagraphs 12.2, 12.11, 12.12), 13 of Appendix No. 2 to the order of the USSR Ministry of Health of September 29, 1989 No. 555 “On improving the system of medical examinations of workers and drivers of individual vehicles.”

Appendix No. 1 To the order of the Ministry of Health and Social Development of the Russian Federation No. 302N

Appendix No. 1 to Order 302n of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 is presented in the form of a table and has the following content:

1. A direct list of harmful and (or) dangerous production factors in the following sections: chemical factors, biological factors, physical factors, labor process factors.
2. Frequency of medical examinations.
3. Participation in medical examinations of doctors of certain specialties (in addition to the mandatory list of medical specialists).
4. Scope of laboratory and functional studies (in addition to the mandatory scope of studies).
5. Additional medical contraindications to work, which are in addition to medical contraindications (Appendix No. 3, section IV, clause 48)

Mandatory scope of examination for all categories of workers

The mandatory scope of examination of an employee undergoing a preliminary or periodic medical examination includes:

1. Examination by an occupational pathologist, general practitioner, psychiatrist, psychiatrist-narcologist, obstetrician-gynecologist (for women).
2. When conducting preliminary and periodic medical examinations, all subjects are required to undergo: a clinical blood test (hemoglobin, color index, red blood cells, platelets, leukocytes, leukocyte formula, ESR); clinical urine analysis (specific gravity, protein, sugar, sediment microscopy); electrocardiography; digital fluorography or radiography in 2 projections (direct and right lateral) of the lungs; biochemical screening: blood serum levels of glucose, cholesterol.
3. All women 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.

Appendix No. 2 to the order of the Ministry of Health and Social Development of the Russian Federation No. 302N

Appendix No. 2 to Order 302n of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 is presented in table form and includes:

That. if the task of a medical examination is to identify conditions and diseases that in the process of work can lead to negative consequences for the employee himself (protecting the health of the citizen), then during the examination for registration of medical insurance, the task of identifying conditions and diseases dangerous both for the employee and for others is added citizens (sanitary and epidemiological well-being of the population).

Appendix 2 consists of 27 points, which we will conditionally divide into 3 groups and consider in more detail.

Clause 27 consists of 16 subclauses depending on the category of ground vehicles. It must be borne in mind that the classification of vehicles used in the order, adopted by the State Duma of the Russian Federation on October 19, 2011, has not yet been put into effect. According to the new classification, Russia will now have 9 categories and 6 subcategories of vehicles (previously there were 5 categories).

Arranging medical examinations is the prerogative of the employer. The company’s personnel or an employee just being hired does not need to look for a medical institution to undergo a medical examination and find money for it. The HR department of any company is responsible for the timely execution of this event and must correctly draw up the relevant documents and monitor compliance with legal requirements. Let's figure out according to which order of the Russian Federation mandatory medical examinations are carried out , and what documents they must be supported by.

302 order on medical examinations: for whom they are mandatory

According to Art. 76 of the Labor Code of the Russian Federation, an employee who has not passed the mandatory medical examination is suspended from work. However, this does not mean that all employees must be examined, because we are talking about mandatory examination. Order No. 302 of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 approved a list of hazardous and harmful work and production factors, the implementation of which is accompanied by mandatory periodic medical examinations. The same act defines the procedure for conducting medical examinations.

• age group up to 21 years;
• those employed in hazardous industries, heavy and dangerous work;
• related to traffic, incl. railway;
• working in the energy and construction industries;
• departmental security;
• food industry, trade and catering enterprises;
• medical and children's institutions;
• employees of water pipelines and water supply facilities;
• professional athletes.

The medical examination under order 302-n can be preliminary (i.e. upon entry to work), periodic or extraordinary. Any type of inspection is organized at the expense of the employer. Examinations are carried out on a reimbursable basis by medical institutions, with which companies enter into appropriate agreements. We should remember that medical examinations of workers (Order 302-n speaks directly about this) are carried out by medical organizations of any form of ownership that have a license to conduct them, as well as examinations of professional suitability. Mandatory details of such agreements are:

• item;
• information about the availability of a license to conduct medical activities;
• list of paid medical services;
• conditions, cost and timing of their implementation;
• calculation procedure.

Stages of personnel work to implement the requirements of Order 302-

Personnel officers are guided by Appendix No. 3, which determines the conduct of a medical examination by order 302-n. Having concluded an agreement with a medical institution, the personnel service is obliged to establish an internal procedure for sending employees for medical examinations:

• issue a corresponding order (sample) and familiarize employees with it against signature;

Order 302n on passing medical examinations

In this article we will talk about medical examinations. Passing medical examinations is regulated by Order of the Ministry of Health and Social Development of the Russian Federation N 302n dated April 12, 2011. It presents a list of professions, harmful and dangerous factors for undergoing a medical examination. Here you can download a sample of documents on passing a medical examination at an enterprise (sample order and list of professions), etc.

Brief video about medical examinations

How to organize a medical examination?

The need for workers to undergo medical examinations, and for employers to organize them, is spelled out in Art. 212, 213 Labor Code. And as we have already said, medical examinations are regulated by Order 302n.

It lists in detail:

• production factors for which workers need to undergo a medical examination;
• jobs for which they also need to undergo a medical examination.

For each item in the list of factors or works, the following is given:

• frequency of inspections for this factor or work;
• a list of specialists who must assess the worker’s health status;
• list of laboratory and functional tests (blood test, ultrasound, ECG, etc.);
• additional requirements or contraindications (for example, the absence of a hand may be an obstacle to working as a security guard, an employee of the Ministry of Emergency Situations, a turner, a driver, etc.).

Usually this information is enough to compile a list of professions to undergo a medical examination at a specific enterprise. If it is difficult for an occupational safety engineer or other authorized person to do this on their own, employees of the clinic where the medical examination is planned to take place, or employees of sanitary and epidemiological authorities will always come to the rescue.

Based on this list, an order for undergoing a medical examination at the enterprise is drawn up annually, a sample of which can be asked from the labor inspector (a sample order is posted in this article with the ability to download it).

Typically, the list of doctors and tests for a specific place of work is the same for preliminary and periodic medical examinations. If working conditions have changed or the employee has acquired an additional profession, then the number of doctors and tests required to undergo a medical examination will increase.

The need to undergo a medical examination upon hiring and during work

Workers need to undergo a medical examination in order to:

• preserve your health, and in some cases, your life;
• women - to bear and give birth to healthy children;
• obtain permission to perform work;
• newly hired persons - find out whether their health condition will allow them to perform the desired job.

Employers need to organize a medical examination in order to:

• prevent accidents and diseases related to working conditions of workers;
• ensure maximum production efficiency (no need to look for replacements for constantly sick workers, pay sick leave, train new workers hired to replace sick workers);
• ensure sanitary and epidemiological safety in their organizations (relevant for hospitals, pharmacies, kindergartens, schools, canteens, cafes, restaurants, hairdressers, beauty salons, hotels, sports complexes and other public service institutions);
• avoid penalties.

What medical examinations do workers undergo?

Medical examinations can be preliminary, periodic, preventive, unscheduled, pre-shift and post-shift.

Preliminary medical examination When hiring, all workers who have hazardous working conditions, have a risk of getting occupational diseases, as well as persons specified in Article 213 of the Labor Code of the Russian Federation (trade, education, food industry, etc.) must undergo testing.

Repeated medical examinations Only workers who are included in the current department’s list of professions are required to undergo a medical examination. In different organizations, medical examinations for representatives of the same profession differ. This happens because, in addition to the name of the profession or position, when sending for a medical examination, the harmful and dangerous factors that affect the worker and the categories of work that he performs are taken into account. For example, in one building materials warehouse, the night cleaner simply washes the floor, so every year she only undergoes a fluorogram and a gynecologist. And in another, she also washes high-lying windows and chandeliers, so she still needs to see a neurologist, ophthalmologist and surgeon. If she does not use a rag and a mop to clean the floor, but a special machine, then the research and inspections necessary for admission to servicing machines and mechanisms are added to the list.

Please note: workers under 21 years of age must undergo a medical examination annually, regardless of the category of work they perform.

The list of works, as well as harmful and dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out, is indicated in Appendices 1 and 2 of Order 302n “On Medical Examinations”.

There are also unscheduled medical examinations that are carried out upon request:

• employer. The employer has the right to send a worker for an unscheduled medical examination if he has been ill for a long time or with a certain disease (for example, a disease of the cardiovascular system has manifested itself for the first time), or there are suspicions that his health condition does not allow him to perform his work duties;
• worker. He has the right to demand that he be sent to undergo an unscheduled medical examination if he believes that his health condition has worsened due to the influence of any production factors;
• medical institutions. Based on the results of the next medical examination, doctors may recommend undergoing the next examination earlier, for example, not after 1 year, but after 6 months.

The employer pays for all medical examinations of its employees, even potential ones. If a worker (most often a job applicant) paid for the medical examination himself, the money spent must be reimbursed.

In general, the employer is responsible for organizing and conducting medical examinations. Therefore, from among his employees he selects those responsible for:

• compiling a list of professions to undergo a medical examination. Typically these are OT employees;
• preparation and issuance of an order about passing a medical examination at the enterprise, a sample of which is kept by the clerk, the health care service or other persons involved in the process;
• organizing the medical examination itself– preparing documentation for the hospital, sending employees for a medical examination, monitoring its completion;
• prohibition from work of persons who have not passed the examination. Most often, these are the immediate supervisors of the work (site managers, foremen).

The day or days on which workers undergo a medical examination are paid “on average”. If a worker refuses to undergo a medical examination, he is not allowed to work, and the days during which he did not work for this reason are not paid.

Sample order for undergoing a medical examination at an enterprise:

How to organize periodic medical examinations at your enterprise?

To organize a medical examination, you need:

1. Study the provisions of Order 302 on passing medical examinations.
2. Conclude an agreement with a medical institution for medical examinations, agree with it on the start date for medical examinations of employees of your organization.
3. Based on the provisions of Order 302, compile a list of professions of the organization’s workers for undergoing a medical examination upon hiring and for periodic medical examinations. When compiling a list, you also need to take into account vacant positions.
4. Approve this list with the sanitary and epidemiological inspection body that controls your organization.
5. Calculate the number of workers in the professions included in the list. Make a list of their names indicating their full name, profession (including part-time work), age, gender, harmful and dangerous factors and special work, the name of the structural unit and approve it with the employer.
6. Send this approved list to the medical institution no later than 2 months before the date appointed in paragraph 2.
7. Within 10 days after sending the list, receive from the medical institution a calendar plan for the medical examination of its employees. It must be drawn up at least 2 weeks before the start of the medical examination. The employer agrees on this calendar plan, and the medical institution approves it.
8. Organize the arrival of the organization’s employees at the medical facility on the days allocated for their medical examination.
9. Pick up medical reports, the final report, and other documentation that the medical institution will provide, for example, certificates of work performed under the contract.
10. Organize control over the implementation of recommendations issued by the medical institution for each employee, if this concerns the employer. For example, if a loader of raw materials and materials is recommended to be transferred to another job due to unsatisfactory lung condition, the employer should take care of this. And if he is recommended to see a nephrologist due to congenital characteristics of the body, then he should do this himself.
11. Ensure that employees who have not passed a medical examination are not allowed to perform work.

When drawing up an estimate under a contract, keep in mind that the cost of examining a specific employee is determined as the sum of examinations for “his” factors and types of work that are included in the list. Therefore, the cost of examining a man and a woman of the same profession (for example, conveyor operators) will differ due to different examinations.

Since the organization’s personnel composition is constantly changing, it is convenient to conduct medical examinations under 2 contracts concluded with the hospital: one for periodic medical examinations, the other for preliminary medical examinations. Under a “periodic” agreement, payment can be made as a one-time payment; under a “preliminary” agreement, payment can be made monthly, depending on the number of people examined by order of the enterprise.

Sample list of employees to undergo a medical examination at the enterprise:

How to organize a medical examination when applying for a job?

To organize such a medical examination, you need:

• conclude an appropriate agreement with a medical institution;
• issue a referral approved by the employer to the candidate for employment in accordance with Order 302 no on undergoing medical examinations;
• notify the candidate that at the medical institution he will need to present this referral, a passport, if necessary, the results of a psychocertification, a health passport, if he has one;
• obtain from him a conclusion from a medical commission based on the results of the medical examination;
• draw up accounting documents for the medical examination - certificate of completion of work, etc.

Samples or procedures for filling out basic papers are contained in Order 302 n on passing medical examinations.

The medical examination system is aimed at preventing the development of occupational diseases among enterprise employees, the spread of infectious diseases, as well as assessing a person’s suitability for health reasons to perform the assigned work.

Who must undergo a medical examination at the enterprise?

According to the order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 No. 302n, a list of harmful and (or) hazardous production factors is established, in the presence of which mandatory preliminary (upon hiring) and periodic medical examinations(examinations).

The costs of conducting a health examination of its employees, according to the Labor Code of the Russian Federation, are borne by the employer.

Preliminary medical examinations for employment are required in the following cases.

• Hiring employees under 18 years of age;
• If employees are engaged in heavy work and work with harmful and (or) dangerous working conditions (including underground work), as well as in work related to traffic (pilots, machinists, drivers);
• If work is carried out in the Far North;
• Athletes;
• If employees go to work in organizations in the food industry, public catering and trade, water supply facilities, medical and preventive care and children's institutions, as well as some other employers (see Article 213 of the Labor Code of the Russian Federation);
• Additional conditions put forward by local governments to the management of the enterprise (Part 4 of Article 213 of the Labor Code of the Russian Federation).

In addition, there are areas of activity for which employees also require a primary medical examination. This category includes employees of the Ministry of Emergency Situations, customs, judges, and railway employees.

The following groups of people undergo periodic medical examinations:

• workers who perform work in harmful and dangerous conditions;
• workers performing work related to traffic, including subway workers;
• workers employed in the food industry;
• employees of trade and public catering organizations;
• water supply workers;
• employees of medical organizations;
• workers in child care institutions;
• workers involved in the production and distribution of food products;
• workers providing hairdressing and cosmetic services in public utility organizations;
• medical workers, rescuers, and other water park personnel located in the water area;
• Workers under the age of 21.

The frequency with which periodic medical examinations are carried out is determined by the conditions of the working environment or the type of work. Employees under 21 years of age undergo a medical examination every year; other employees are subject to a medical examination once every 1-2 years.

Medical examination by order 302n: which doctors to undergo.

To conduct periodic medical examinations, the medical institution creates a medical commission of doctors acting on a permanent basis, who have undergone specialization in occupational pathology.

Employees subject to a medical examination must undergo a therapist, narcologist and psychiatrist. Depending on the type of activity of the organization, working conditions and recommendations of medical specialists, doctors from other specializations are involved in the medical commission, in particular otolaryngologist, dermatovenerologist, neurologist, ophthalmologist, allergist, gynecologist, endocrinologist.

Mandatory diagnostic examinations.

The list of mandatory diagnostic procedures for workers undergoing periodic examinations includes laboratory and functional tests in the form of:

• clinical urine and blood tests;
• fluorography or radiography of the chest organs;
• biochemical screening.

A female medical examination involves an annual appointment with an obstetrician-gynecologist with mandatory bacteriological and cytological examination.

Women over the age of 40 should undergo breast examination through mammography or ultrasound once every 2 years. Depending on working conditions, ultrasound, spirometry, blood tests, including hormonal tests, and other specific medical studies may be additionally performed.

What are the consequences of refusing medical examinations?

Requirements for an enterprise to provide regular scheduled medical examinations based on Order 302n are mandatory. The amount of the fine in case of non-compliance ranges from 15,000 rubles. for individual entrepreneurs and from 110,000 for other forms of ownership. If, due to the lack of a medical examination, the employee’s health is seriously harmed or his death occurs, the officials will bear criminal liability (Article 143 of the Criminal Code of the Russian Federation).

Where to undergo mandatory medical examinations in Bor.