Circular No. 18/2000/TT-BYT guiding the medical examination dossier and procedure for workers participating in social insurance

CIRCULAR

Guidelines on medical examination files and procedures for workers participating in social insurance.

Pursuant to Article 33 Chapter 4 of the Law on Health Care for the People regarding medical examinations dated June 30, 1989,

Pursuant to Chapter II Regulations on Social Insurance promulgated together with Decree No. 12/ dated October 20, 2015 of January 26, 1995 and Decree No. 45/ dated October 20, 2015 of July 15, 1995 of the Government promulgating the Regulations on Social Insurance for workers participating in social insurance; officers, professional military personnel, non-commissioned officers, soldiers of the Vietnam People's Army and police officers;

Pursuant to the standards for disability and loss of labor capacity due to illness issued together with Circular No. 12/TT-LB dated January 26, 1995 of the Ministry of Health - Ministry of Labor, Invalids and Social Affairs;

To unify the implementation of medical examinations for civil servants, public officials, state employees, armed forces and workers participating in social insurance (hereinafter referred to collectively as workers); following the consensus expressed in Document No. 2700/LDTBXH-BHXH dated August 15, 2000 of the Ministry of Labor, Invalids and Social Affairs and Document No. 1921/BHXH-CDCS dated September 20, 2000 of the Vietnam Social Security, the Ministry of Health guides the establishment of files and procedures for medical examinations to implement social insurance benefits for workers as follows: The Ministry of Health has issued guidelines on the establishment of files and procedures for medical examinations to implement social insurance benefits for workers based on the provisions of Article 3 Regulations on Social Insurance promulgated together with Decree No. 12/CP dated January 26, 1995; Article 3 of the Regulations on Social Insurance for military personnel and police officers promulgated together with Decree No. 45/CP dated July 15, 1995 of the Government.

I. APPLICABLE OBJECTS

1. Workers and Vietnamese experts going to work abroad for a limited period according to Decree No. 152/1998/NĐ-CP dated September 20, 1999, after completing their term of service abroad and returning to Vietnam.Workers participating in social insurance under Decision No. 49/1998/QĐ-TTg dated February 28, 1998 of the Prime Minister concerning athletes and coaches.

Workers who have suffered workplace accidents, occupational diseases that have not been examined or have already received one-time compensation or monthly compensation upon recurrence. Workers who have stopped working and are waiting to reach the age to receive monthly pension when their ability to work is reduced. Workers currently receiving monthly compensation for loss of labor capacity who need to be re-examined for their ability to work.

II. MEDICAL EXAMINATION FILES AND PROCEDURES

Files and procedures for examining disabilities caused by workplace accidents.

Workers injured in cases determined to be workplace accidents, or those who have suffered workplace accidents and received one-time compensation (including those still working and those who have stopped working), and workers who suffer workplace accidents and receive monthly compensation when old injuries recur.

1.2. Initial examination files include:

- Accident investigation report (according to the model) stipulated in Joint Circular No. 03/1998/TTLT-BLDTBXH-BYT-TLĐLĐVN dated March 26, 1998 of the Ministry

1. Application documents for examination of commendation titles include: of Labor, Invalids and Social Affairs - Ministry of Health - General Confederation of Trade Unions of Vietnam. In cases where traffic accidents are considered workplace accidents, an additional traffic accident report (copy) must be included. If the accident site does not have the conditions to prepare an accident report, it must have a confirmation from the local authority at the accident site or a confirmation from the traffic police.

1.1. Recipients:

- Certificate of injury due to workplace accident issued by the hospital that provided emergency treatment (signed by the Director or Deputy Director of the hospital) according to the regulations of the Ministry of Health.

- Discharge certificate. 1.3. Initial examination procedure:

When a worker is considered to have suffered a workplace accident, the employer has the responsibility to report it promptly to relevant authorities and prepare an accident report on-site or an accident investigation report according to Joint Circular No. 08/1998/TTLT-BLDTBXH-BYT-TLĐLĐVN dated March 26, 1998 after the worker has stabilized from treatment. The employer then has the responsibility to complete and transfer the worker's workplace accident file, including the accident investigation report, certificate of injury due to workplace accident, and discharge certificate to the Provincial Social Security (hereinafter referred to collectively as Provincial Social Security). The Provincial Social Security has the responsibility to review all types of files. If they are complete and comply with regulations, it will introduce and transfer the worker's workplace accident file to the Provincial Medical Examination Board (hereinafter referred to collectively as Provincial Medical Examination Board) or the Central Medical Examination Board for examination. 4. Re-examination of workplace accidents.

1.4.1. Cases for re-examination: Health.

- Recurrence of old injuries.

- The worker, employer, or social security agency disagrees with the conclusion of the Medical Examination Board (hereinafter referred to as the applicant).

1.4.2. Re-examination files include:

- Application for labor capacity examination due to workplace accident.

1. - Introduction letter from the Provincial Social Security. Treatment documents for recurrent injuries (if the re-examination is requested by the applicant, treatment documents for recurrent injuries are not required).

- Copy of the previous examination file including: Examination record, decision of the Provincial Social Security Director on monthly or one-time workplace accident compensation. If the re-examination is requested by the applicant, the re-examination file is the initial examination file as prescribed.

1.4.3. Re-examination procedure:

- When old injuries recur, after stabilizing from treatment, the worker submits an application to the employer if still employed or to the Provincial Social Security if retired, along with treatment documents for recurrent injuries.

- The employer has the responsibility to accept treatment documents for recurrent injuries, transfer the file, and introduce the worker to the Provincial Social Security (if the worker is still employed). - The Provincial Social Security has the responsibility to copy the file including: Previous examination record, decision of the Provincial Social Security Director on monthly or one-time workplace accident compensation, along with treatment documents for recurrent injuries transferred by the unit, and transfer the file with the introduction letter of the worker to the Medical Examination Board for re-examination of workplace accident disabilities (according to the classification of the Medical Examination sector).

||| Application for labor capacity assessment due to workplace accident.

||| Introduction letter from the Provincial Social Insurance. Medical records of recurrent injury treatment (if the assessment is requested by the individual, these treatment records are not required).

||| Copy of previous file including: Assessment report, decision of the Provincial Social Insurance Director on monthly or one-time work injury allowance. If the assessment is requested by the individual, the re-examination file is the initial examination file.

||| 1.4.3. Procedure for re-examination:

||| When a recurrent injury occurs, after stable treatment, the worker submits an application to the employer if still employed, or to the Provincial Social Insurance if retired, along with medical records of recurrent injury treatment.

||| The employer is responsible for receiving the medical records of recurrent injury treatment, transferring the file, and introducing the worker to the Provincial Social Insurance (if the worker is still employed).

||| The Provincial Social Insurance is responsible for copying the file including: Previous assessment record, decision of the Provincial Social Insurance Director on monthly or one-time work injury allowance, together with medical records of recurrent injury treatment provided by the unit, transferring the file along with the introduction letter of the worker to the Medical Examination Council for reassessment of work-related injury disability (according to the分级诊疗行业的分级标准).

- Persons who suffered work-related accidents before January 1, 1995 and have not been referred for disability assessment according to Consolidated Document No. 843/LĐ-TBXH on July 25, 1996 of the Ministry of Labor, Invalids and Social Affairs; based on Consolidated Document No. 908/TLĐ dated July 25, 1996 of the Vietnam General Confederation of Labor, the Social Insurance Provincial Branch shall be responsible for requesting the Trade Union and Industry Union (previously managing social insurance) to hand over complete files as prescribed and refer them for assessment. day25/7/1996 of the Ministry of Labor, Invalids andSocial Affairs; based on Consolidated Document No. 908/TLĐ dated July 25, 1996 ofthe Vietnam General Confederation of Labor, the Social Insurance ProvincialBranch shall be responsible for requesting the Trade Union and Industry Union(previously managing social insurance) to hand over complete files as prescribedand refer them for assessment.

a) Achievement certificates of individuals or groups proposed for reward; file and procedure for assessingwork capacity to implement retirement benefits:
2.1. Object:

Workers whose health hasdeclined.

Workers who have stoppedworking and are waiting to reach the age to receive monthly pension benefits.

2.2. File for initial work capacityassessment includes:

Application from the workerfor work capacity assessment.

Summary of the worker'sfile.

Detailed medical record.

2.3. Procedure for initialwork capacity assessment:

2.3.1. For workers stillworking: When workers fall ill or their work capacity declines, they submit anapplication to the employer requesting work capacity assessment.

The employer is responsiblefor receiving the application from the worker, completing the file as prescribedabove, referring and transferring the worker's file to the Provincial MedicalAssessment Board or the Central Medical Assessment Board for work capacityassessment.

2.3.2. For those awaitingretirement:

- Retirees awaiting toreach the age to receive monthly pension benefits, when they fall ill or sufferfrom accidental risks leading to a decline in work capacity, submit anapplication together with the certificate of entitlement to retirement benefits tothe Social Insurance Provincial Branch where they are managed, requesting workcapacity assessment.

The Social InsuranceProvincial Branch is responsible for receiving the application, making a copy ofthe certificate of entitlement to retirement benefits transferred by the retireeawaiting, guiding the retiree awaiting to establish a detailed medical record tocomplete the file including:

+ Application for workcapacity assessment;

+ Certificate of entitlementto retirement benefits (copy) (replacing the summary of the worker's file);

+ Detailed medical record.

Detailed medical recordfor retirees awaiting established by state healthcare facilities as stipulated inGovernment Decree No. 01/1998/NĐ-CP dated January 3, 1998, including centrallevel, provincial level, hospitals under ministries and sectors, military regionhospitals, corps hospitals, district and county health centers, multi-specialtyclinics in regions, infirmaries of armed forces units, and grassroots healthstations. After completing the file as prescribed above, the Social InsuranceProvincial Branch refers and transfers the file of the retiree awaiting to theMedical Assessment Board for work capacity assessment.

3. Documents file and procedure foroccupational disease assessment:

3.1. Recipients:

Workers suffering fromoccupational diseases.

3.2. File and procedure for initialoccupational disease assessment include:

3.2.1. File for initial occupationaldisease assessment:

Application for workcapacity assessment.

- Measurement results of thework environment (or certified copies issued by preventive healthcare centers atcentral and provincial levels) where the worker has worked in the last 12months. If these results are insufficient, previous measurement results shouldbe attached.

- File of workers suffering fromoccupational diseases according to Circular Jointly Issued by the Ministry ofHealth, Ministry of Labor, Invalids and Social Affairs No. 08/1998/TT-LT datedApril 20, 1998 and related documents concerning occupational diseases (copies). Y3.2.2. Procedure forinitial occupational disease assessment:

The employer is responsiblefor completing the file as prescribed above, transferring the file of theworker suffering from occupational diseases to the Social Insurance ProvincialBranch where the unit has registered for social insurance:

- The Social InsuranceProvincial Branch is responsible for rechecking the file if it is complete andcompliant with regulations, then referring and transferring the file of theworker suffering from occupational diseases to the Medical Assessment Board forwork capacity assessment according to the分级分类体系

- When the above filesare complete, the Medical Assessment Board will accept and conduct the assessmentaccording to the regulations of the Medical Assessment Department.

3.3. File

and procedure forsubsequent occupational disease assessments: 3.3.1. Files forsubsequent occupational disease assessments include:

- Application for reassessmentof work capacity.

- Minutes of the previousMedical Assessment Board (original).

- Measurement results of thework environment, if the worker has stopped working, only the measurement resultsof the work environment during employment are required.

- File of workers sufferingfrom occupational diseases according to Circular Jointly Issued by the Ministryof Health, Ministry of Labor, Invalids and Social Affairs No. 08/1998/TT-LT datedApril 20, 1998 and related documents (copies).

- File of workers suffering fromoccupational diseases according to Circular Jointly Issued by the Ministry ofHealth, Ministry of Labor, Invalids and Social Affairs No. 08/1998/TT-LT datedApril 20, 1998 and related documents concerning occupational diseases (copies). Y3.3.2. Procedure forsubsequent occupational disease assessments:

Workers submit anapplication for work capacity assessment, and are responsible for submittingrelated documents to the employer if they are still employed, or to the SocialInsurance Provincial Branch if they have stopped working.

- The employer isresponsible for accepting the file submitted by the worker, completing the fileas prescribed above, and transferring it to the Social Insurance ProvincialBranch where the unit participates in social insurance.

- The Social InsuranceProvincial Branch is responsible for accepting and checking the file transferredby the employer or directly accepting and completing the file as prescribed forworkers who have stopped working, referring and transferring the file of theworker suffering from occupational diseases to the Medical Assessment Board(according to the classification of the Medical Assessment Department) forreassessment of work capacity.

4. File

for reassessing workcapacity for persons currently receiving disability benefits. Persons currentlyreceiving monthly disability benefits who need to be reassessed due to illnessrequiring hospitalization or accidental risks leading to a decline in healthshall submit an application to the Social Insurance Provincial Branch along withmedical records, treatment documents, and discharge certificates.

The application forreassessment includes: 4.1. Application forreassessment of work capacity.

5. Certificate of archival business inspection results 4.2. Minutes of theprevious Medical Assessment Board (original).

Medical records, treatmentdocuments, discharge certificates.

After completing the fileas prescribed, the Social Insurance Provincial Branch will refer and transferthe reassessment application to the Provincial Medical Assessment Board or theCentral Medical Assessment Board for reassessment.

4.3. ||| Medical record book, treatment documents, discharge papers.

||| After completing the file in accordance with regulations, the Provincial Social Insurance introduces and transfers the application for reassessment of labor capacity to the Provincial Medical Examination Council or the Central Medical Examination Council for assessment.

As for individuals receiving disability benefits under the provisions of Resolution No. 16/HĐBT dated February 8, 1982 of the Council of Ministers (now the Government), the Provincial Social Insurance shall copy the "summary of illness status" prepared by the medical department to replace the original labor capacity assessment record. In cases where the disability benefit application lacks the "summary of illness status," the Provincial Social Insurance shall guide the preparation of detailed medical records as prescribed for those retiring and awaiting their first labor capacity assessment under Point 2.3.2, Section 2 of the aforementioned Part. The time limit for re-assessing labor capacity from the initial assessment to the re-assessment must be at least one year (12 months or more). II In addition to the regulations on injury assessment files due to workplace accidents or labor capacity assessment files to implement social insurance benefits, the parties involved must present their national identity cards when attending the medical examination board. An Inspector is a person assigned to perform inspection duties at theeducation inspection organization, appointed in accordance with the InspectorRegulation issued pursuant to Decree No. 191/HĐBT dated June 18, 1991 of theCouncil of Ministers

The transfer of files to the Medical Examination Board must be guaranteed through postal service; if delivered directly, the files must be sealed in envelopes with sealing stamps.

III. ORGANIZATION

||| The transfer of files to the Medical Examination Council must be guaranteed through postal service; if sent directly, the file must be sealed in an envelope with a sealing stamp.

Employers are responsible for requesting employees to submit relevant documents, completing, and transferring the employee's file to the Medical Examination Board or the Provincial Social Insurance as stipulated above. SIGNATURE2. The Medical Examination Board includes: The Central Medical Examination Board.C -

1. - The Southern Branch of the Central Medical Examination Board.

located in Ho Chi Minh City.

located in Da Nang City. I- The Medical Examination Boards of provinces and centrally administered cities.

located in Da Nang City. II- The Medical Examination Boards of sectors: National Defense, Public Security, and Transportation.

They are responsible for implementing the inter-ministerial regulations strictly, and must base their determination of the percentage of lost work capacity on the national standards already issued.

If the employer, employee, and social insurance agency disagree with the Medical Examination Board's conclusion, they have the right to request a higher-level Medical Examination Board for a re-assessment.

2.1. The Medical Examination Board will only proceed with the assessment when all legal procedures are complete based on the documents submitted by the employer or the Provincial Social Insurance.

2.2. The Medical Examination Board is responsible for organizing and conducting the assessment according to the assessment procedure from the receipt of the file until the issuance of the conclusion record, within the shortest possible time but not exceeding 60 days.

2.3. When the Medical Examination Board convenes to conclude, the parties cannot be absent.

The conclusion record of the Medical Examination Board is established in five copies of equal value:

- One copy retained by the Medical Examination Board.

- Four copies returned to the recommending authority (one copy for the employer, one copy for the employee, two copies for the social insurance agency) to implement social insurance benefits.

2.4. The Medical Examination Board will only examine injuries and illnesses recorded in the received files transferred by the employer or the Provincial Social Insurance. 3. The Provincial Social Insurance of centrally administered cities is responsible for receiving, preparing, checking, and transferring the employee's file to the Medical Examination Board as prescribed, and implementing social insurance benefits for the employee based on the Medical Examination Board's conclusion.

IV. EFFECTIVE PROVISIONS

1. This Circular takes effect 15 days from the date of issuance, replacing the documents and procedures specified in the Appendix accompanying the Inter-Ministerial Circular

No. 12/TT-LB dated July 26, 1995 of the Ministry of Health

- Labor, Invalids, and Social Affairs for individuals undergoing injury assessment due to workplace accidents, labor capacity assessment, to receive social insurance benefits.

2. Provincial health departments, sectoral health departments, and provincial social insurances are responsible for disseminating, guiding, and directing subordinate units to implement the provisions of this Circular. 3. The Institute of Medical Examination has the responsibility to direct the Medical Examination Boards at all levels to implement in accordance with the provisions of this Circular: During implementation, if there are difficulties or obstacles, units and localities need to promptly reflect to the Ministry of Health (Treatment Department, Institute of Medical Examination) for research and timely resolution./.

2. The Provincial Health Department ||| Health services of provinces and centrally-administered cities, health sectors, and provincial social insurances are responsible for disseminating, guiding, and directing subordinate units to implement the provisions of this Circular.

||| 3. The Institute of Medical Examination has the responsibility to direct all levels of Medical Examination Councils to implement in accordance with the provisions of this Circular: During implementation, if there are difficulties or obstacles, units and localities need to promptly reflect to the Ministry of Health. ||| . ||| (Treatment Department, Institute of Medical Examination) for research and prompt resolution./.