Order 302n on medical examinations: how to organize a medical examination

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 the preliminary medical examination upon hiring 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.

What is required to undergo a medical examination?

To undergo a medical examination, you will need a passport or other identification document, a referral, a certificate from a narcologist and a psychiatrist, unless otherwise provided by law. All food industry workers must present a health certificate for a doctor's report. This document must first contain information about the completion of the relevant tests.

When re-medical examination of employees occurs, all expenses are borne by the employer. Often, newly hired employees can count on such assistance.

If you get a new job, the receptionist will fill out an outpatient card for you, in which all the results of your examination will be entered. A 3x4 photograph is glued onto this card. You will also need a receipt confirming payment for a medical examination, a compulsory health insurance policy, and a pension insurance certificate.

In connection with the new law, a doctor does not have the right to give permission to work if an employee or applicant has a serious illness, the treatment of which cannot be postponed. The frequency of medical examinations has not changed. Food production employees undergo a medical examination 2 times a year, all others - once a year.

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 ill 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.

Who is required to undergo a medical examination at work and at whose expense?

After the order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 N302n, on January 1, 2012, principles came into force that oblige all employers to carry out regular medical examinations and pay for them at their own expense.

But this only affects those situations in which the organization’s employees actually have problems, for example, with hazardous production, or other difficult working conditions that affect the health of employees.

In accordance with Order N302н, mandatory inspections apply to employees employed in the educational sectors, healthcare sectors, medical industry, social sector, construction sector, motor transport sector, home service sector and other areas in which employees may be exposed to harmful conditions.

A routine medical examination in an organization is carried out for occupational diseases, and therefore pregnancy is not a subject for controversy in this case - pregnant employees undergo a routine examination in the same way as all other employees.

What medical examinations do workers undergo?

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

a preliminary medical examination when hiring .

Only workers who are included in the department’s current list of professions for undergoing a medical examination undergo repeated medical examinations . 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 a mandatory preliminary medical examination is carried out upon hiring and periodic medical examinations (examinations) are specified 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 the 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.

Inspection frequency

Not long ago, the frequency of medical examinations changed. Up to 01/01/12 there was a provision according to which inspections had to be repeated at intervals no less than once every 2 years .

But today, how often mandatory medical examinations should be carried out is reflected in Order N302н - various production conditions harmful to health, for various types of work for which these measures are carried out - annually or up to once every 2 years (Appendices N1, N2 to Order N302n).

Employees of the enterprise working in production who have not reached 21 years of age are required to undergo such medical examinations every year, in accordance with paragraph 17 of Part III of Addendum N3 to Order N302n.

However, the individual frequency of inspections for each individual enterprise depends on the harmfulness of the working conditions. Periodic inspections are carried out during the development of personalized lists, which indicate hazard factors, labor characteristics, etc. All this reflects the real state of affairs in the organization.

Article 219 of the Labor Code regulates legal relations in the field of extraordinary medical examinations.

An unscheduled medical examination is a type of medical examination that is not documented and not included in the relevant lists by regulatory authorities.

An extraordinary medical examination can be carried out both at the request of an employee of the enterprise, and at the initiative of the employer, if it has suspicions of the employee’s professional incompetence.

One of the options for a periodic medical examination is a pre-shift/pre-trip examination , carried out before the working day/shift/trip of an employee-driver, to reveal the possible influence of harmful and unsafe production conditions for the work of the enterprise, conditions or diseases that interfere with the fulfillment of labor obligations.

Including the establishment of intoxication, if any, from alcohol-containing drinks, drug intoxication, as well as other toxic types of intoxication (Article 46 of the Law of the Russian Federation of November 21, 2011 N323-FZ).

Inspection is carried out at the beginning of each working day by a responsible employee. A periodic medical examination for drivers is carried out once every 2 years. The procedure for undergoing a medical examination of drivers is regulated by Order of the Ministry of Health of Russia dated June 15, 2015 N 344n.

Who is responsible for medical examinations?

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 to undergo 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:

Key issues

·What is the difference between part-time, part-time and temporary transfer?

·Which part-time worker must undergo a medical examination?

·Do employees who hold multiple positions need to be sent for a medical examination?

· How to organize a medical examination of part-time workers and employees who combine work; is it possible not to send these employees for a medical examination?

Part-time, part-time and temporary transfer: what's the difference

Many employers are faced with the problem of conducting preliminary and periodic medical examinations. If everything is more or less clear with permanent full-time employees, then part-time workers and temporarily transferred workers are perplexed. First, let's figure out what part-time work, combination work and temporary transfer are.

Part-time workers are employees who, in their free time from their main job, perform work in another position. You can combine work within one organization - internal part-time work, and in different organizations - external part-time work. In this case, employment relations with a part-time worker are formalized in the same way as with other employees, that is, a separate employment contract .

Part-time work is often confused with combination, but these are different concepts. When combined, an employee performs additional work in parallel with the main one during one working day or shift. Combination is possible only within the same organization and is formalized by an additional agreement to the employment contract.

An employer can assign an employee to perform certain work by issuing a temporary transfer to another position. Then the employee is completely relieved of normal duties . The period of temporary transfer is no more than one year, and in the case of replacing an absent employee - until he returns to work (Part 1 of Article 72.2 of the Labor Code of the Russian Federation). For a temporary transfer, it is enough to issue an appropriate order and draw up an additional agreement to the employment contract.

Who undergoes medical examinations

Let us remind you that medical examinations must take place :

·employees engaged in hard work and hazardous working conditions;

·workers associated with traffic (Part 1 of Article 213 of the Labor Code of the Russian Federation);

workers in the food industry, public catering and trade;

employees of water supply facilities;

employees of medical and children's institutions (part 2 of article 213 of the Labor Code of the Russian Federation);

·employees recruited to work in the Far North from other

localities (Article 324 of the Labor Code of the Russian Federation);

· young people under 18 years of age (Article 69 of the Labor Code of the Russian Federation).

Part-time workers or temporarily transferred workers who are on this list must also undergo a medical examination. The procedure for conducting medical examinations1 does not make exceptions for these categories of employees. But there are still some nuances; let’s look at them in more detail.

Medical examinations for part-time workers

There are some work restrictions for part-time workers. For example, you cannot work part-time in harmful conditions if the main work is also associated with harmful conditions (Part 5 of Article 282 of the Labor Code of the Russian Federation). Therefore, when hiring a part-time worker for hazardous work, the employer has the right to require a certificate about the nature of the activity at the main place of work (Article 283 of the Labor Code of the Russian Federation).

It becomes clear that if you hire a part-time worker for a harmful position, organizing a medical examination is your responsibility. But what about professions that are not classified as harmful, but require a medical examination: teacher, waiter, kindergarten teacher and others?

The answer is simple: if the employee’s main position and part-time position are the same, a repeat medical examination can be avoided . Ask the employee to provide a copy of the report from the previous medical examination, which will confirm that the part-time worker is suitable for this job. If there are other harmful factors, you will have to undergo a medical examination again.

Medical institutions that conduct preliminary and periodic medical examinations are subject to certain requirements. For example, doctors who are members of the medical commission must have training in occupational pathology. Therefore, it is better to send new employees to a trusted medical institution with which you have entered into an agreement, rather than leaving the choice of a clinic to the conscience of the employee.

Medical examinations for employees holding multiple positions

Typically, employees combine similar positions : an electric welder also performs the work of a gas welder, a history teacher also performs the work of a social studies teacher. In this case, there is no need to undergo a medical examination again .

Do not confuse combination with increasing the volume of work and expanding service areas . In this case, the employee performs additional work in the same position or profession. And there is no need .

If an employee wants to combine different positions , it is necessary to determine whether new harmful factors will affect him. Depending on this, you will determine which specialists to send the employee to. That is, it is also not necessary to undergo the entire medical examination again.

Medical examination of temporarily transferred workers

The procedure for medical examination of temporarily transferred employees is similar to the procedure for medical examination for employees who work part-time. Using the workplace certification card, they determine what harmful factors will affect the employee and whether an additional medical examination is needed. Remember that it is prohibited (Part 4 of Article 72.1 of the Labor Code of the Russian Federation).

There are situations when a temporary transfer is necessary for an employee for health reasons. Then the employer must offer the employee another, non-contraindicated position. If there is none, the employee is temporarily suspended from work or the employment contract with him is terminated (Article 73 of the Labor Code of the Russian Federation).

How to organize a preliminary medical examination

To conduct a preliminary medical examination, first of all, decide who needs it: make a list of the contingent of workers .

At the same time, choose the medical institution where the workers will go. It must be licensed and have the right to conduct preliminary and periodic medical examinations.

The employer issues a referral to the employee for a medical examination . It can be drawn up, for example, on letterhead. The direction must indicate:

· data of the employing organization;

·data from the medical institution;

·type of medical examination (preliminary or periodic);

·personal data of the employee, place of work and position;

harmful and dangerous production factors, as well as the type of work in accordance with

a contingent of employees approved by the employer who are subject to medical examinations.

· The employer must keep records of issued referrals . For example, register them in the Outgoing Documents Log.

· Upon completion of the medical examination, the medical organization issues a conclusion . It is drawn up in two copies: one is given to the employee, the second is attached to the employee’s outpatient card.

Is it possible not to send “temporary” employees for a medical examination?

It often seems illogical for employers to send an employee for a medical examination if he is transferred to another job for a short time. However, the timing of the transfer does not matter, and violation of labor laws is punishable by a fine :

· for officials – from 15,000 to 25,000 rubles;

·for individual entrepreneurs – from 15,000 to 25,000 rubles or

suspension of activities for up to 90 days ;

·for organizations – from 110,000 to 130,000 rubles

In case of repeated violation of labor and labor protection legislation, the official responsible for the violation may be disqualified for a period of one to three years , and the fine may be 200,000 rubles (Part 3 of Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation).

If an employee himself refuses to undergo a medical examination, the employer must not allow him to work (Article 212 of the Labor Code of the Russian Federation).

Answers to your questions

Is it possible to transfer an employee to another job without a medical examination?

We have the following situation: an employee asks to be transferred to another job (it is classified as dangerous), but does not want to undergo a medical examination, since he has already undergone it in his main position. Is it possible to make a transfer without a medical examination?

If an employee works with the same harmful factors as before, then he can be transferred without a medical examination. A change in working conditions is a reason to send an employee for a medical examination. You cannot guarantee that the new position is not contraindicated for the employee due to health reasons.

When to enter into an employment contract with a part-time worker?

When do you need to conclude an employment contract with a part-time worker: before his medical examination or after?

The medical examination is preliminary in nature, that is, it must be carried out before concluding an employment contract. If an employee does not want to undergo a medical examination, you have the right to refuse to hire him.

Is it necessary to enter into an agreement with several medical organizations?

We have entered into an agreement with a medical organization so that employees have the opportunity to undergo medical examinations. But the organization does not have a narcologist on its staff. Do I need to conclude another agreement with another institution where there is a narcologist?

No, you do not need to enter into an agreement with another medical institution. The clinic must attract a narcologist from another organization, for example, from a local drug treatment clinic, for a medical examination.

Should harmful factors be included in the list for a medical examination?

Based on the results of workplace certification, the industrial training foreman (electric and gas welder) is entitled to compensation for non-ionizing radiation. In the certification card, line 50 indicates Appendix No. 2, paragraph 18. Should non-ionizing radiation be included in the list for periodic medical examination?

The list of employees sent for medical examination is compiled on the basis of the List of harmful and dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out, and the List of works, during the performance of which mandatory preliminary and periodic medical examinations are carried out (hereinafter referred to as the List of Works).

In your case, the certification card provides a link only to the List of Works as a basis for conducting a medical examination. It can be assumed that this is a shortcoming of the organization that conducted the certification of workplaces. Therefore, be sure to indicate in the list of names for the medical examination all the harmful factors that affect the employee, including non-ionizing radiation.

At what address is the list of employees for medical examination provided?

At what address of the enterprise - actual or legal - is it necessary to provide a list of the contingent of employees of the organization subject to a medical examination in 2014 to the territorial department of Rospotrebnadzor, if the addresses do not match?

The list of contingents approved by the employer for a medical examination is sent to the Rospotrebnadzor office at the actual address of the organization.

The most necessary regulations

Remember the main thing

1. Part-time and combination are different concepts. A part-time employee works in his free time from his main job, and a part-time employee works in parallel with his main job.

2. You cannot hire a part-time worker for a harmful position who is already working in harmful conditions at his main job.

3. Part-time workers who are not related to harm can present a copy of the current medical examination report so as not to have to go through all the doctors again.

4. Medical examinations for temporarily transferred workers are carried out by analogy with workers who combine professions. If the temporary transfer is related to health, an additional medical examination is not required.

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 conducting 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 who must undergo 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 act, 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 consult 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 personnel composition of the organization 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 when hiring. 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:

General concepts

The definition of a medical examination entered the legal field after the similar concept of “medical examination” in 2006 (these amendments to the Federal Labor Code were legislatively introduced on June thirtieth, 2006 (N90-FZ)), but its essence after these revisions did not lose its original meaning.

The currently functioning federal law does not provide definitions for a medical examination, but the origin of this combination of words, and in addition the essence of this event, make it possible to reveal its functional meaning.

A medical examination is a professional examination of a patient by a medical professional for diseases.

a conclusion about the patient’s health confirmed as a result of an examination , which includes all the relevant results of the initial examination.

The term “medical examination” is more clearly formulated in Art. 65 Federal Law dated November 21, 2011 N323-FZ and involves a set of medical examination and examination measures aimed at factually confirming that the patient’s health is in any state significant from a legal point of view.

More extensive medical examinations are periodic medical examinations with an expanded list of medical experts participating in them and the methods of examination used.

Periodic medical examinations must be carried out in order to monitor the well-being of the organization’s employees and timely detect infectious diseases in the enterprise.

Read about the initial medical examination when applying for a job in our article.

In addition, promote preventive and rehabilitative actions by employees that contribute to the prevention of diseases, and prevent any episodes associated with illnesses or injuries at work.

Constant medical examinations are carried out during all stages of employees' activities with the employer at certain short-term intervals . The cyclicity of their implementation depends on the harmfulness of production conditions, which have a great impact on the production worker.

There is a fairly clear definition of a medical examination (examination): this is a set of medical and medicinal measures that establish and define pathologies, diseases and the conditions for their occurrence and further development.

Medical examination is divided into several categories: preventive, preliminary, periodic, pre-shift/pre-trip, post-shift/post-trip.

Inspections can be carried out exclusively during regular working hours, i.e. be built into the schedule, and be paid in the amount of the employee’s regular salary (paragraph 11, part 2, article 212 of the Federal Labor Code).

Medical examinations are supervised by the municipal department of Rospotrebnadzor. To this regulatory body, employers send a list of their employees available for medical examination within a ten-day period from the date of its adoption (clause 21, part III, Addendum N3 to Order N302n).

After the completion of the medical examination, the medical organization, together with the regulatory authority, draws up a final document with the results of the examination, after which one sample is sent to the employer, and the others to the regional office of Rospotrebnadzor and the local occupational pathology center.

If during the medical examination an employee was diagnosed with an occupational disease , then it must be confirmed by any licensed medical institution that has permission to carry out examinations and prove the relationship of specific diseases with specialties.