Why apply for disability?
Often patients, after undergoing chemotherapy or undergoing surgery, are in a hurry to return to work and do not want to receive disability so as not to feel sick and thrown out of normal life. This is an understandable desire, but from a practical point of view, given the long recovery process and possible complications, filing for disability may make sense - especially since it is not forever. A person with a disability receives a monthly cash payment (MCA) and, most importantly, a social package. The most important component of this package is subsidized medications, which patients with oncology often have to take for a long time even after discharge from the hospital. Without the benefit, these medications are usually very expensive. In addition to subsidized medications, a person who has become disabled has the right to discounted travel to and from the place of treatment, to benefits when paying for housing and communal services, to vouchers to a sanatorium, to free technical means of rehabilitation (for example, prostheses, including breast prosthetics after a mastectomy), to labor benefits (increased vacation, shortened working hours, etc.).
What does disability provide?
First of all, this is an opportunity to receive free treatment. Cancer patients can receive medications indicated in the federal list of benefits intended for the treatment of tumors. The second is the possibility of receiving a disability pension if the patient is unable to work, or issuing a certificate about the need for special working conditions and further employment.
Creating special conditions is one of the key components in treatment. According to statistics, in the first five years after treatment the risk of relapse is highest. It is compliance with the work and rest schedule, as well as taking medications that can help avoid illness.
Well, the third thing that registration of disability provides is registration of a disability benefit or pension, as well as receiving a number of benefits.
Is any cancer diagnosis a disability?
Often, doctors in a clinic or oncology center tell a patient that he is not entitled to disability - but, firstly, this is not always true, and secondly, making a decision about disability is not within the competence of the attending physician. At the same time, he is obliged to refer the patient for a medical and social examination in the following cases: - if he has lost the ability to work after the operation; - if he receives chemotherapy or hormone therapy; - if the treatment prognosis is unclear or doubtful; - if metastases have appeared or a relapse has begun. In practice, disability is established, as a rule, three to four months after the start of treatment, if it is clear that it will need to be continued. The law formulates three conditions that must be met to recognize a person as disabled: 1) there is a disease - a health disorder with a persistent disorder of body functions; 2) as a result of the disease, the patient’s life activity is limited (the person is completely or partially unable to care for himself, move, work, and so on); 3) there is a need for social protection measures (we need rehabilitation, benefits when purchasing medicines, and so on). If the doctor persists and does not give a referral, you need to request a certificate of refusal to refer for an examination with the seal of the clinic and, with it, independently submit an application to the bureau of medical and social examination.
Video: Is a patient diagnosed with cancer entitled to disability?
You can learn a little more about who can count on registration of disability, what is the procedure and what are the advantages of obtaining the status of a disabled person from a short video:
Obtaining disability in the presence of cancer is a vital necessity. Having received the status of a disabled person, the patient can count on state support - both material and medical, that is, receiving the necessary medications. In addition, the formation of a group can significantly normalize the patient’s working conditions, which is a key point in his recovery.
What documents will be needed?
The attending physician of the clinic, cancer clinic or other hospital where the patient is being treated can refer you for a medical and social examination (MSE). The doctor gives the patient a message sheet for medical examination and a referral for tests and medical specialists. In addition to receiving medical documents, you will need to write an application for an examination, provide copies of your passport and SNILS, and for those who work, a copy of your work record book certified by the employer. It is necessary to make sure that all medical documents bear not only the seal of the attending physician, but also the clinic. After all the doctors have passed through, the clinic sends the delivery note and other documents to the ITU bureau, and the patient waits to be called for an examination. The date must be set within 5 days from the date of submission of the application, and the examination itself must take place no later than within 30 days from the date of submission of the application.
Legislative acts
The concept of “disability” and its key aspects are presented in Law No. 181-FZ of November 24, 1995. And the process of obtaining the status is prescribed in Government Decree No. 95. As for the criteria by which a specific group is given, they are set out in Order of the Ministry of Labor of the Russian Federation No. 1024 dated December 17, 2015
In addition, the procedure for conducting MSE (medical and social examination, within the framework of which experts determine the status) is established by the Resolutions of the Ministry of Labor and the Ministry of Health. Finally, in oncology, the norms of Government Decree No. 247 of April 7, 2008 should also be taken into account.
Important
! According to experts, it is quite difficult to predict the future condition of a cancer patient, so the decision to assign a disability group is made after surgery or during treatment.
Who makes the decision and how?
The ITU bureau, which conducts the examination, has at least three specialists, at least one of them must be a medical and social examination doctor. The rest may be, for example, psychologists and rehabilitation specialists; the bureau may also include a social work specialist. In addition, the patient has the right, at his own choice, to invite to the meeting any specialist (not only a doctor, but also, for example, a lawyer) who will participate in the decision-making process. During the examination, the patient is asked questions and his documents are studied. Medical specialists can examine him. Also, the ITU Bureau may refer the patient for additional examination, which he, however, has the right to refuse.
Conditions of receipt
To obtain disability due to oncology, a mandatory condition is to be on sick leave for 4 months or more.
During this sick leave, primary treatment is carried out, which consists of diagnosing the tumor, deciding on the need for surgery and other treatments. Please note that while on sick leave for oncology, a person has the right to work. After three months of treatment and the opening of sick leave, you can slowly begin preparing for registration of disability due to oncology.
Is it possible to appeal a refusal?
If the decision of the ITU bureau does not suit the patient, he can appeal it to the main ITU bureau for the region within 30 days. The decision of the main bureau, also within a month, can be appealed to the ITU Federal Bureau in Moscow. In addition, at any stage, a decision of the ITU at any level can be appealed in court (within three months from the date of its adoption). To write a reasoned complaint, the patient has the right to request examination reports for review by writing an application addressed to the head of the bureau.
What does the disability group depend on?
The criteria for assigning disability groups I, II or III are determined in accordance with the order of the Ministry of Labor and Social Protection. It lists four degrees of impairment of body functions, expressed as a percentage, and also identifies seven categories of life activity and the degree of their limitation. By comparing all these indicators for each category (ability for self-care, ability to work, ability to move independently, etc.), experts assign a group to the disabled person. — The most “heavy” is group I. It is assigned to a disabled person if he cannot care for himself and needs constant outside help: for example, with complete blindness, amputation of legs, amputation of both legs, paralysis. — Group II is assigned to those whose lives have been significantly affected by the disease and who may require outside help, but not constantly; they need prostheses and special technical means. Examples of such diseases: partial deafness or blindness, some mental disorders, speech disorders. — Disability group III is assigned if a chronic disease or the consequences of surgery have reduced the patient’s performance, he needs special working conditions or a reduction in workload. With the same diagnosis, patients can be assigned different disability groups - this depends on how the disease in each specific case affected the person’s quality of life and condition.
When is permanent disability granted?
According to the law, a group is given on a permanent basis, that is, without the need to undergo examination, in accordance with certain criteria. In particular, it is required that:
— the commission was passed by a retired citizen;
— over 15 years, the patient’s condition has not changed or worsened;
— the disability was the result of injuries received during participation in hostilities;
- the disease was included in the list of the Ministry of Health, which lists health problems that allow one to receive a special status indefinitely (for example, a person has no limbs, a brain abnormality has been identified, etc.);
— the beneficiary was near retirement age and his health had not improved over the past 5 years.
Will I be fired after receiving disability?
If an employee has been assigned disability group III, the employer does not have the right to fire him. But in reality, especially if the employee now requires special working conditions or a reduced workload, he may be persuaded to resign of his own free will or to reduce the position he occupies. The employer must notify a disabled employee of the dismissal two months before the dismissal, and for six months after the reduction of the position, he has no right to introduce it again. When laid off, an employee receives two months' severance pay, and if he goes to the labor exchange within two weeks and is not hired there, he is entitled to another salary for the third month. Also, the employer may try to dismiss a disabled person of groups III and II under Article 83 of the Labor Code - due to the fact that he can no longer perform his job duties, and the enterprise does not have positions that a person with such limitations due to health status can hold. Moreover, in addition to the unpaid wages and vacation pay at the time of dismissal, the disabled person is entitled to compensation in the amount of two weeks’ earnings. Group I disability is considered “non-working”, but in practice this does not mean that a person does not have the right to get a job. For example, he may have access to home work or work in special conditions. He can appeal an employer’s decision, which a disabled employee considers illegal, in court. He can receive free consultation on the issue of violation of labor rights at the regional labor inspectorate.
Disability due to tumors of various locations
It is no secret that neoplasms and metastases develop in different organs. Next, we will consider the most common types of diseases and conditions for which the patient is referred for medical examination.
Brain cancer
This lesion in itself is severe and proceeds through the following phases:
- clinical compensation, when the disease has begun to develop, and the person can still communicate, work, live normally;
— clinical subcompensation, characterized by a satisfactory condition with manifestations of limitations in life activities;
— moderate clinical decompensation is of average severity, and sometimes requires hospital treatment;
- severe clinical decompensation indicates a serious condition, the inability to care for oneself without outside help;
- terminal - the functions of the body are completely disrupted, reaching a comatose state, which after a short period of time is replaced by the death of the patient.
In general, for cancer of the type considered, you can immediately receive a referral for examination. Early stages of the disease imply the establishment of group 3, and advanced stages - 1 or 2 groups.
Mammary cancer
The disease is progressive and in many cases entails negative consequences. We can talk about establishing status if:
- difficult to make a forecast;
- the disease often relapses;
— metastases in organs were detected;
- the tumor continues to grow;
— Chemotherapy was chosen as the treatment method.
Thyroid cancer
In this case, the group should be given after the thyroid gland is removed. This method of healing is considered radical. Plus, doctors pay attention to postoperative complications, whether hypothyroidism has appeared. The likelihood of receiving status is greater if, in addition to everything else, the shoulder joint is damaged and the patient has lost his voice.
For example, group 3 is often prescribed to people with speech problems, joint disorders and hormonal decline. As for group 2, it is not excluded if there are abnormalities in respiratory function, problems with hearing and the ability to speak, including a sharp deterioration in health and the manifestation of hypothyroidism against the background of thyroid cancer.
Important
! Group 1 is assigned to patients with cardiovascular problems, cancer recurrence and complications of hypothyroidism.
Lungs' cancer
For this disease, a group is given quite often. The fact is that here you cannot do without radical treatment, which lasts 70-110 days, but even after that, complete recovery is impossible. In addition to the fact that a person with lung cancer is immediately sent to medical examination, he automatically faces work restrictions (in order not to strain the lungs, heavy and moderately heavy work is excluded)
According to experts, category 3 is relevant after a radical impact on the affected area with further partial restoration of the circulatory and respiratory systems. You can apply for group 2 in the event of the development of complications and serious accompanying diseases, including against the background of a lack of good results from treatment. And group 1 is indicated for relapses, metastases, food fistula, exhaustion and other serious consequences of cancer.
Prostate cancer
You can apply for status by:
— ineffectiveness of hormonal therapy;
- if resection of the prostate gland has been performed;
- after radical treatment;
- stage 4 prostate cancer.
As for the categories of disability, they are established as follows:
— group 3 is prescribed for several years after surgery if urination is restored, or within a five-year period for relapse of the disease, complications and hormonal treatment;
— Group 2 can be given for 5 years against the background of stage 3 cancer and non-radical treatment, or after surgery in the presence of complications and recurrence of the disease;
— Group 1 is for patients who have stage 4, or metastases have appeared and the tumor is progressing.
Tumor of the tongue
This condition is not diagnosed as often as those described above, but the citizen is prohibited from performing work related to speech, being in unfavorable working conditions and overloading himself. There are several possible groups that can be assigned:
— we can talk about group 3 after surgical intervention at stages 2 and 1 of the disease, and work activity requires revision (perhaps you will have to change place, move to a new position, etc.);
— Group 2 includes patients with stage 1 cancer, if there are ulcers on the tongue, or with stage 3 and who refused surgical treatment, faced with complications and metastases.
Why is disability removed and how to maintain it?
Disability is assigned indefinitely in very rare cases; they are listed in Russian Government Decree No. 247, adopted in 2008: for example, in case of relapses and metastases and ineffective treatment of malignant tumors, some types of amputations, muscular dystrophies, total blindness and deaf-blindness. In other cases, disability must be confirmed by undergoing MSA once every two years in the case of group I and once a year in the case of groups II and III. Patients with oncology should remember that they can have their disability removed by approaching the issue formally: if there are no relapses and metastases and antitumor treatment is completed. But in practice, during treatment, concomitant diseases may arise that reduce the quality of life no less than a course of chemotherapy. To extend disability based on concomitant oncological diseases, you need to confirm their presence with medical documents. The patient needs to go to the clinic with these complaints, take sick leave, and, if necessary, be treated in a hospital. The total period of documented treatment of concomitant diseases must be at least 6 months.
Benefits for disabled people due to oncology
There are no special preferences for people with cancer. That is, they are provided with the same benefits as other citizens with disabilities, depending on the group. In general, beneficiaries are provided with:
— pension accruals according to disability group (1, 2 or 3);
— the opportunity to compensate 50% when paying for the utility bill;
— tax benefits or exemptions from them;
— Monthly payment of EDV and NSU (services included in the social package can be monetized);
- privileges in the world of work - more vacation than ordinary citizens, and a shorter working week, plus, you can refuse overtime tasks, business trips, etc.;
— free or discounted medications and special equipment;
— reduction in the cost of railway tickets and free trips on public transport.
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