How to get disability after a heart attack and what benefits you can get

A heart attack imposes certain lifestyle restrictions on the person who has suffered the attack. After treatment, the patient cannot perform physical activity and needs a calm environment and a positive emotional background. In many cases, a special rehabilitation regime and release from work are required. For such situations, it is possible to create a disability group after a heart attack and stenting.

In addition to official exemption from work, special status gives the right to financial support from the state. The pension amount is assigned depending on the severity of the condition. We'll look at this in more detail later.

Do they give special status after a heart attack?

You can get disability after myocardial infarction and stenting if there are complications of the disease. To confirm them, you need to undergo an examination and submit an application to an expert commission, which makes the appropriate decision.

In theory, obtaining status is not difficult, but you need to be prepared to visit doctors and get tested. It can be difficult to do this on your own due to a heart attack. It’s good if there is a friend or relative nearby who is ready to help. It is better to make an appointment in advance to avoid tiring waiting in lines.

To avoid wasting time on paperwork, first consult with your doctor. Let a specialist assess your current condition and prospects for rehabilitation. Be also prepared for the fact that members of the expert commission may require additional examination and include narrow specialists in the list.

Preferential preferences for people with disabilities due to heart attack

The law does not provide any separate benefits for those disabled people who have been assigned a group due to a heart attack. They can enjoy all the privileges that the assigned group gives them.

This usually includes:

1. Registration of a disability pension;
2. EDV payment, which occurs monthly. In addition to the monetary amount, the EDV also includes in-kind services, which, if desired, can also be replaced with payments.
3. Refund of 50% of paid utility costs;
4. The Labor Code establishes a more gentle work schedule for disabled people - shorter working hours, longer vacations, a ban on being hired to work on weekends, on business trips, etc.
5. Benefits for tax payments, and in some situations - complete exemption from them;
6. Travel on city municipal transport is free, or with compensation of part of the expenses;
7. Providing free medications, prostheses, or discounts on their purchase.

What group can you get?

The commission makes a decision on whether disability is due after a heart attack and stenting based on a comprehensive examination of the patient. Depending on the degree of heart damage and consequences, the first, second or third group can be assigned. Each provides its own privileges in terms of work and preferential financing.

First disability group

The ability to independently serve one’s needs has been lost by 80-95%. People with such a percentage of heart attack lesions are considered disabled.

For this form of the disease, the following benefits are prescribed:

• social pension;
• free travel on buses, trams and trains;
• free medicines;
• spa treatment once a year;
• working week no more than 35 hours;
• exemption from payment of transport tax and real estate tax;
• 50% discount when paying for housing and communal services (if there is more than one apartment, then to choose from).

Second disability group

The second degree is assigned to moderate heart attacks. Such people can perform their labor function only if favorable conditions are created, both physical and psycho-emotional.

Almost all the same preferences apply here as for people with group I. The only exception is in terms of providing medications: for some medications you will have to pay 50% of the cost.

Third disability group

Group III disabled people are entitled to:

• 50% discount on the purchase of medicines;
• 50% discount on utility bills;
• social pension;
• free travel on public transport;
• up to 60 days of vacation at your own expense.

Depending on the degree of complications, you can count on a free nurse. But if relatives live in the house with the patient, they will first have to prove that they themselves cannot perform the functions of care. To do this, the social security authority will need to provide proof of employment confirming full-time employment.

What determines the length of a patient’s stay in a group in 2021?

For how long is disability assigned?

• Disability group 3 is established for a period of 1 year. At the end of the required period, the disabled person must undergo a second commission, which can either extend the validity of the group, or, if there is a positive trend, remove the group altogether.
• Group 2 is also established for a period of 1 year. At the end of this period, after passing a re-examination, the group is either extended or downgraded to group 3.
• Group 1 is initially assigned for 2 years. In this group, permanent disability is most often established, since the chances of full recovery are not very high.

Receipt procedure

The maximum period of sick leave for a heart attack is 4 months. If after this period the patient has not improved, he or his relatives can apply for an ITU.

The basis for examination, regardless of the patient’s condition, is also the performance of work in positions that are contraindicated in case of a heart attack. These include work in construction, aviation, security, courier service, etc. A detailed list can be found in the regional social security office.

To obtain disability after a heart attack and stenting, you need to submit a corresponding application to the expert commission. The following documents are attached along with the application:

• passport;
• a referral to ITU from the applicant (you can fill it out yourself or ask one of your relatives);
• referral from the attending physician;
• SNILS;
• medical history or medical record, which reflects the patient’s condition;
• open sick leave (if available);
• a copy of the work book;
• conclusion from the place of work on the nature of the activity performed.

You can submit documents in person or by mail. The commission reviews the package within 30 days, after which it sends an invitation for inspection. The examination takes place at the patient’s place of residence. If the applicant cannot appear for the commission on his own, then she comes to his home.

The assignment of special status takes place according to the principle of voting. The results of the discussion are recorded in the minutes, on the basis of which a decision is made. The corresponding regime is assigned by the act.

Legitimate reasons for refusal

Keep in mind that MSEC may legally refuse to obtain disability. This happens if:

• treatment and rehabilitation of the patient have been carried out to a sufficient extent, which prevents the possibility of relapses or complications;
• the patient is fully able to work and can fully care for himself;
• the specialty of the certified person does not require significant psycho-emotional stress, concentration or change of place of work.

In case of refusal, the patient has the right to re-apply to the examination bureau for examination in the same manner. If even after this the disability group is not assigned, you can submit documents to the Federal MSEC body, and then to the court.

For how long is disability granted?

A heart attack is recognized as a disease in which recovery is possible. Depending on the severity of the disease, status may be issued for one or two years. In severe cases, the status is assigned for 2 years, but in the second and third cases you will have to undergo a new examination a year after the first commission. Exceptions are possible, but they are rare.

If doctors consider that over the past period the patient feels noticeably better and can perform work functions (fully or in a limited mode), then the list of work restrictions, and with them the benefits, may be changed or canceled altogether. This decision is made based on the results of the re-examination.

They can also be allowed to work if the work does not involve serious emotional or physical stress. If the commission considers the likelihood of recovery low, then such patients may be assigned status indefinitely.

What benefits can you expect in case of refusal?

If the commission considers that the patient has fully recovered, does not require outside assistance in performing daily functions and can carry out work activities, then the status will be denied. They may not give a group even if the commission considers the current working conditions favorable. If necessary, sick leave can be extended for up to 120 days. Sometimes it is only possible to shorten the working week or indicate a change in workplace.

Without recognition of disability, the patient cannot enjoy full financial benefits. But since 2021, all people who have had a heart attack have the right to free medicines. They are issued immediately after discharge from the hospital and are subsequently provided for a year after myocardial infarction. This measure is intended to support all patients who find themselves in difficult situations and reduce the financial burden on their families. Detailed information can be found in Order of the Ministry of Health No. 1n dated January 9, 2021.

There should be no problems with the necessary medications; the authorities allowed us to receive medications six months in advance. In total, the list of free medicines contains 23 names of drugs of domestic and foreign production. They promise to expand this list until 2023.

A document to receive medications can be obtained from your attending physician. To do this, you need to bring your compulsory medical insurance policy, SNILS, passport and extract from the hospital to your appointment. With the finished prescription, you can go to the pharmacy.

How to apply for disability

How to apply for disability

1. Obtain a referral to an ITU or a certificate of refusal to be referred to an ITU (from a medical organization, from a pension agency, or from a social security agency);
2. Prepare identification documents: a passport of a citizen of the Russian Federation, a temporary identity card of a citizen of the Russian Federation, issued before issuing a passport, or their certified copies.
3. Prepare a written application for an ITU.
4. Contact the ITU office at your place of residence or place of stay with a package of documents: an identity document, an application for an ITU, a referral to an ITU or a certificate of refusal to refer, medical documents confirming a health impairment.
5. Wait for an invitation to ITU.
6. Go through a medical examination and get a decision.
7. Obtain a certificate confirming the fact of disability.

What to do if referral to ITU is denied?

If you are denied a referral to the ITU, you must be issued a certificate of refusal to refer to the ITU, which gives you the right to submit documents to the ITU yourself without a referral (clause 19 of the Rules for recognizing a person as a disabled person, approved by Decree of the Government of the Russian Federation of February 20, 2006 No. 95)
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What to do if the patient is unable to come for examination to the ITU facility?

If the recipient of a public service cannot come to the bureau and it is necessary to conduct an MSE at home, an appropriate conclusion from a medical organization providing medical and preventive care is additionally submitted (clause 90 of the Regulations for the provision of public services for conducting a medical and social examination)

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How is disability determined?

When establishing disability, a quantitative assessment of the severity of persistent dysfunctions of the human body due to neoplasms is taken into account. It is based primarily on the assessment of local prognostic factors: localization and size of the tumor, anatomical form of growth, growth rate, degree of invasion of the organ wall (degree of invasion), histological structure and degree of differentiation, degree of malignancy, nature of damage to regional lymph nodes, presence or absence of distant metastases , stage of the tumor process (according to the TNMG system). The possibility of adaptation and compensation, and the presence of complications are also taken into account.

(Order of the Ministry of Labor of Russia dated December 17, 2015 N 1024n (as amended on July 5, 2016) “On classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination" (Registered with the Ministry of Justice of Russia on January 20, 2016 N 40650 ) Registered with the Ministry of Justice of Russia on January 20, 2021 N 40650)

What is IPRA for a disabled person?

IPRA for a disabled person is a set of optimal rehabilitation measures for a disabled person, which includes certain types, forms, volumes, terms and procedures for the implementation of medical, professional and other rehabilitation measures aimed at restoration, compensation for impaired body functions, formation, restoration, compensation of the disabled person’s abilities to perform certain types of activities.

How to make changes to the IPRA of a disabled person?

If it is necessary to make additions or changes to the disabled person’s IPRA, a new referral for medical and social examination is issued and a new disabled person’s IPRA is drawn up.

Is an employee obliged, after his disability group has been determined, to inform the employer about this?

The employer is not legally required to provide documents confirming his disability. An employee can submit such documents at his own request, both when applying for a job and during his work activity.

Can an employee refuse the rehabilitation measures specified in the IPRA?

The employee has the right to refuse one or another type, form and volume of rehabilitation measures specified in the IPRA (IPR), as well as the implementation of the program as a whole. In this case, the employer is released from liability for its implementation. (Part 5 of Article 11 of Law No. 181-FZ, Part 7 of Article 11 of Law No. 181-FZ.)

What rights does a disabled person have at work?

1. Duration of working hours of disabled people and payment for their work - no more than 35 hours per week with full pay (for disabled people of groups I and II);
2. Involvement of disabled people in overtime work, work on weekends, holidays, and also at night is allowed only with their written consent and provided that this is not prohibited for them for health reasons in accordance with a medical report;
3. The duration of annual paid leave for disabled people has been increased and must be at least 30 calendar days (Part 5, Article 23 of Law No. 181-FZ)
   ;
4. The employer is obliged to provide a disabled employee, upon his written application, leave without pay for up to 60 calendar days per year (paragraph 5, part 2, article 128 of the Labor Code of the Russian Federation, letter of Rostrud dated 04/16/2014 N PG/3387-6-1)
   ;
5. The employer is obliged to create and equip (equip) special workplaces for the employment of disabled people. (Part 1 of Article 22 of Law No. 181-FZ.)
   ;
6. Establishment of easy labor for disabled people.

If a disabled person, in accordance with the IPRA, can no longer work at his previous job?

An employee who needs to be transferred to another job in accordance with a medical report with his written consent, the employer is obliged to transfer to another available job that is not contraindicated for the employee for health reasons (Article 73 of the Labor Code of the Russian Federation)

, the employee retains the same average earnings for one month from the date of transfer.
Also, according to clause 9 of the Rules for recognizing a person as a disabled person, approved by Decree of the Government of the Russian Federation of February 20, 2006 No. 95
, disability of group I is established for two years, and disability of groups II and III - for one year. Thus, if a disabled employee who needs easier work has provided the employer with documents confirming the establishment of disability for a specified period, a temporary transfer is issued.

If an employee refuses to be transferred to another job in accordance with his medical report?

If, in accordance with a medical report, an employee needs a temporary transfer to another job for a period of more than four months or a permanent transfer, then if he refuses the transfer or the employer does not have a suitable job, the employment contract is terminated in accordance with clause 8 of Part 1 of Art. 77 Labor Code of the Russian Federation. In this case, the dismissed employee is paid severance pay in the amount of two weeks' average earnings (Part 3 of Article 178 of the Labor Code of the Russian Federation).

What is VMP and how much does it cost?

VMP – high-tech medical care.

VMP is provided in accordance with the List of types of VMF included in the basic compulsory medical insurance program and the List of types of VMF not included in the basic compulsory medical insurance program. Regardless of the type of medical care, it is free, since it is included in the Program of State Guarantees for the provision of free medical care to citizens and is financed by the Federal Compulsory Medical Insurance Fund.

How to get high-tech medical care?

Step 1. Contact your doctor.

Step 2. Wait for the VMP coupon to be issued.

Step 3. Wait for the decision of the commission of the medical organization providing medical care and hospitalization in the receiving medical organization.

Step 4. Upon completion of VMP, receive recommendations.

How to find out the status of a VMP coupon?

The status of the coupon can be viewed on the official website of the Russian Ministry of Health:

What to do if a doctor refuses to refer a patient for advanced medical care?

1. Submitting an application or complaint to another authorized person of the referring medical organization;
2. Filing an application or complaint to Roszdravnadzor or the government body of a constituent entity of the Russian Federation in the field of healthcare;
3. Contacting a medical insurance organization or territorial compulsory medical insurance fund;
4. Applying to the court to declare illegal the inaction of medical workers or refusal to refer for the provision of medical treatment.

What is the validity period of the quota and where can I get it?

The quota is issued by the health department at the place of residence in a specific medical institution and is valid from the moment of its issuance until December 31 of the current year.

Will the quota be valid for re-hospitalization?

If you are hospitalized again, you must take a new quota for treatment, even if hospitalization is planned for the current year.

What to do if there is a prescription, but the pharmacy does not have the medicine?

You need to fill out a prescription for deferred care at the pharmacy. There they are required to register it in the register of unsatisfied demand. Such a magazine should be in every pharmacy that dispenses drugs on preferential prescriptions. After registering a prescription, the pharmacy must submit a request for the drug to the pharmaceutical company authorized to supply preferential drugs to the region and provide the drug to the patient within 10-15 days. Deferred care is not a pharmacy's choice—it is the pharmacy's legal responsibility to arrange deferred care.

Prescriptions are issued with a validity of 30 days. Can a prescription be issued for a longer period of validity?

Prescriptions for medications written out on prescription forms Form N 148-1/u-04 (l) and Form N 148-1/u-06 (l), citizens who have reached retirement age, disabled people of the first group, disabled children, and also for citizens suffering from chronic diseases requiring long-term course of treatment, valid for 90 days from the date of issue.

For the treatment of chronic diseases, the specified categories of citizens can be issued prescriptions for medications for a course of treatment of up to 90 days. (Appendix No. 1 to the order of the Ministry of Health of Russia dated December 20, 2012 No. 1175n)

IMPORTANT MEDICATION INFORMATION!

1. Decree of the Government of the Russian Federation of July 30, 1994 N 890 (as amended on February 14, 2002) “On state support for the development of the medical industry and improving the supply of medicines and medical products to the population and healthcare institutions”

2. Order of the Ministry of Health of Russia dated December 20, 2012 N 1175n (as amended on April 21, 2016) “On approval of the procedure for prescribing and prescribing medications, as well as forms of prescription forms for medications, the procedure for processing these forms, their recording and storage”

3. Federal Law of July 17, 1999 N 178-FZ (as amended on December 19, 2016) “On State Social Assistance”

4. Federal Law of November 21, 2011 N 323-FZ (as amended on July 3, 2016) “On the fundamentals of protecting the health of citizens in the Russian Federation”

5. LIST OF VITAL AND IMPORTANT DRUGS FOR MEDICAL USE FOR 2021 (Approved by Decree of the Government of the Russian Federation of December 28, 2016 N 2885-r)

Re-examination procedure

Re-examination for a disability group is a voluntary exercise and can be prescribed by mutual decision of the patient and the attending physician. The referral reflects the treatment procedures prescribed during the rehabilitation period and makes a conclusion about their effectiveness (they helped, helped slightly or did not help).

The rest of the list of documents is the same as for the initial application. It should also be accompanied by a certificate of the current disability group and an individual rehabilitation program developed by the previous commission. The rehabilitation card must indicate that you have completed all stages of treatment, otherwise you will definitely not be given a new group.

If the rehabilitation program specifies requirements for the work regime, you will need to contact the employer for a mark of completion and a signature on compliance with the prescribed conditions.

What to do if you refuse?

The commission's decision is not final. The patient can appeal it and get a re-examination. To do this, you need to write an application requesting a review of the decision and submit it to the institution where the examination was carried out.

After 3 days, the letter is sent to the ITU main office. After reviewing the application, the patient is assigned a new examination. A repeat examination is carried out within a month after receiving the letter.

It is possible to obtain a review of the ITU's conclusions through the courts. It is considered the final authority, whose decision is not subject to appeal.

Assignment of disability after stenting

The procedure of stenting, or revascularization, is designed to improve the patient’s condition and facilitate recovery after an attack. Based on the results of the procedure, the doctor evaluates its effectiveness and records the result in writing. The subsequent decision of the commission depends on how useful stenting turned out to be:

1. Great effect. Good tolerance to physical activity, no or only slight angina.
2. Good effect. Angina pectoris is moderate and practically does not bother me. Light physical activity is possible.
3. Satisfactorily. Angina pectoris only appears after intense exercise.
4. Unsatisfactory. This assessment indicates that the patient's condition has not changed.

When stenting, the principle of submitting documents and undergoing examination is the same. You can find out whether patients are given disability after stenting of cardiac vessels from their attending physician. Typically, a group is assigned if the results of the procedure are insufficient to continue a full life, but for this you will have to undergo a new examination.

Still have questions about disability after a heart attack?

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Author

Salmina Daria Vladimirovna

Geneticist. Graduated from the Chelyabinsk State Medical Academy. She completed an internship at the Northwestern State Medical University named after I.I. Mechnikov.

Contraindicated types of work

People whose work activity was associated with heavy physical activity, stress, and work in difficult conditions will require retraining. The list of professional contraindications includes:

• night/daily work;
• extended shifts (more than 8 hours);
• work that requires constant walking or standing;
• work away from populated areas;
• working with toxic substances;
• physically hard work;
• high-altitude work;
• difficult working conditions: high/low temperature, high humidity;
• work on board an aircraft (airplane, helicopter, rocket).