History of Medicine

History

An Open Access Journal

From the history of public service of medical-social expertise in Russia

Sergey N. Puzin1, 2, Nina V. Dmitrieva1, Marina A. Shurgaya1, Natalya N. Solovyova3, Natalya V. Filatkina4
1FSBEI FPE RMACPE MOH Russia (2/1 Barrikadnaya St., Moscow 123995, Russia);
2FSAEI HE I.M. Sechenov First MSMU MOH Russia (Sechenov University) (8 Trubetskaya St., building 2,
Moscow 119991, Russia);
3The Main Bureau of Medical and Social Expertise for the Ulyanovsk Region (Gaya Avenue 69A, Ulyanovsk 432035, Russia);
4SBIH Psychiatric hospital 13 of the Department of Health of Moscow (27 Stavropolskaya St., Moscow 109559, Russia)

In this article we are looking at the stages of reorganisation of medical expert commissions into workplace health expert committees (WHEC). Classification of disability, according to which a disabled person could be assigned to one of three groups, is proposed. This classification regulated the criteria for the establishment of each group in accordance with the indications for employment. The Regulation on the WHEC, approved in 1942, practically became fundamental for all subsequent regulatory documents on the activities of the WHEC. According to this Regulation, the WHEC was able to grant certificates stating that the disability is related to being at the front. A new category of people with disabilities was created – the veterans of the Eastern Front of World War II. The Regulation on the WHEC, introduced in 1948, expanded the functions and powers of these services. The categories of people who had to be assessed by the WHEC were determined. Since 1955, the inpatient examination and the work of specialised (tubercular and psychiatric) WHEC have been organised. During 1956–1984 WHEC received the authority to set the time of the onset of disability to address the issue of pension benefits for people previously recognised as being disabled. The dates for re-examination of people with disabilities were established. In 1956, a new Regulation on the WHEC was introduced. According to this document, as recommended by the WHEC, it was possible, in the absence of medical contraindications, for people with disabilities of all three groups to continue working, but under different conditions. During 1940–1960s, a new directive appeared – medical rehabilitation, the basic principle of which was specialised assistance to people with amputations, severe injuries of the skull, brain, spinal cord, and vertebral column. A foundation for the specialisation and improvement of expert doctors was created. The development of the state service of medical and social expertise was carried out in accordance with the new approaches of the World Health Organisation to the definition of disability, based upon the clinical and expert diagnosis of functional disorders and activity limitations.

Keywords: history of health care, workplace health expert committees, disability groups, development

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