Joint Circular No. 41/2013/TTLT-BYT-BLDTBXH guiding the examination and appraisal of diseases, disabilities, deformities, and congenital defects related to exposure to chemical toxins for veterans and their offspring.

JOINT CIRCULAR

Guidelines for examining and appraising diseases, disabilities, deformities, and congenital defects related to exposure to chemical toxins for persons who participated in the resistance war and their biological children

for persons participating in the resistance war and their biological children

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Pursuant to the OrdinanceNo. Decision No. 26/2005/PL-UBTVQH11 dated June 29, 2005 of the Standing Committee of the National Assembly on preferential treatment for those who have contributed to the revolution and the Ordinance on preferential treatment for those who have contributed to the revolutionNo. Decision No. 04/2012/UBTVQH13 dated July 16, 2012 of the Standing Committee of the National Assembly on amending and supplementing certain provisions of the Ordinance on preferential treatment for those who have contributed to the revolution;No. Article of the Ordinance on preferential treatment for those who have rendered meritorious service to the revolution;

Pursuant to DecreeNo. Decision No. 31/2013/NĐ-CP dated April 9, 2013 of the Government detailing and guiding the implementation of certain provisions of the Ordinance on preferential treatment for those who have contributed to the revolution"b) In addition to the lists of public services issued according to the provisions of Clause 2, Article 4 of this Decree, specialized agencies under provincial People's Committees shall report to the provincial People's Committee for decision-making on amending, supplementing, or issuing the list of public services funded by the state budget within their jurisdiction and consistent with the local budget capacity within the approved budget by the Provincial People's Assembly, and send it to the Ministry of Finance and relevant ministries and sectors for supervision during implementation." July 25, 2017 Government Decree on the functions, tasks, powers, and organizational structure of the Ministry of Planning and Investment;i Detailed guidance oni Pursuant to Decree No. 11/2020/NĐ-CP dated October 15, 2020 of the Government detailing implementation of certain provisions and measures for organizing the implementation of the Law on Petitions;No. Article of the Ordinance on preferential treatment for those who have rendered meritorious service to the revolution;

Pursuant to DecreeNo. 63/2012/NĐ-CP dated 31 August 2012 of the Government on the functions, tasks, powers, and organizational structureuof the Ministry of Labor, Invalids and Social Affairs, amended and supplemented by Decree No. 109/2025/NĐ-CP and Decree No. 193/2025/NĐ-CP transmission within the scope of payment of the health insurance fund.

Based on Decree No. 106/2012/NĐ-CP dated December 20, 2012 of the Government on the functions, tasks, powers, and organizational structure of the Ministry of Labor, Invalids and Social Affairs, the Ministry of Health, and the Director of the Department of Persons Contributing to the Revolution, Ministry of Labor, Invalids and Social Affairs,June 2024;The Minister of Health and the Minister of Labor, Invalids and Social Affairs hereby issue this Joint Circular on Guidelines for examining and appraising diseases, disabilities, deformities, and congenital defects related to exposure to chemical toxinsiPursuant to the request of the Director General of the Department of Vocational Education;

Amending and supplementing Clause 4, Article 4 of Circular No. 06/2011/TT-BYT as follows:intention is railway works, the protected area of railway works, and the railway traffic safety corridor.June 2024;for persons who participated in the resistance war and their biological childreniPursuant to the request of the Director General of the Department of Vocational Education;

The Minister of Health and the Minister of Labor, Invalids and Social Affairs shall jointly issue a Circular guiding the examination and appraisal of diseases, disabilities, congenital deformities, and congenital defects provided for herein. l1. Persons who participated in the resistance war and were exposed to chemical toxins as stipulated in Article 38 of Decree No. 31/2013/NĐ-CP dated April 9, 2013 of the Government detailing and guiding the implementation of certain provisions of the Ordinance on preferential treatment for those who have contributed to the revolution (hereinafter referred to as Decree No. 31/2013/NĐ-CP).No.2. Persons who participated in the resistance war and were exposed to chemical toxins and their biological children recognized and receiving preferential treatment for those who have contributed to the revolution before September 1, 2012.,

Article 1. Scope of application

3. Biological children of persons who participated in the resistance war and were exposed to chemical toxins as stipulated in Article 38 of Decree No. 31/2013/NĐ-CP.

The subjects mentioned in Clause 1, Clause 2, and Clause 3 of this Article shall hereinafter be collectively referred to as the subjects.

Article 2. List of diseases, disabilities, deformities, and congenital defects related to exposure to chemical toxins

1. Soft tissue sarcoma.

2. Non-Hodgkin's lymphoma.

3. Hodgkin's disease.

4. Lung and bronchus cancer.

5. Trachea cancer.

6. Larynx cancer.

7. Prostate cancer.

8. Primary liver cancers.

9. Kahler's disease (malignant multiple myeloma).

10. Acute and subacute peripheral neuropathy.

11. Chloracne.

12. Type 2 diabetes.

13. Porphyria cutanea tarda.

14. Unusual births.

15. Mental disorders.

16. Congenital deformities and defects.

17. Spina bifida.

Article 3. Scope of application of the list of diseases, disabilities, deformities, and congenital defects related to exposure to chemical toxins

1. Diseases and disabilities from Clause 1 to Clause 15 of Article 2 of this Circular shall apply to persons who participated in the resistance war and were exposed to chemical toxins.

2. Diseases, disabilities, congenital deformities, and defects specified in Clauses 14, 15 (slow mental development or called intellectual disability), 16, and 17 of Article 2 of this Circular shall apply to the biological children of persons who participated in the resistance war and were exposed to chemical toxins.

1. Diseases and disabilities specified from Clause 1 to Clause 15 of Article 2 of this Circular shall be applied to persons participating in the resistance war exposed to toxic chemicals.

2. Congenital diseases, disabilities, deformities, and defects stipulated in Clauses 14, 15 (mental retardation or called intellectual disability), 16, and 17 of Article 2 of this Circular shall be applied to the biological children of persons participating in the resistance war exposed to toxic chemicals.

Article 4. Diagnosis of diseases, disabilities, deformities, and defects related to exposure to toxic chemicals

The diagnosis of diseases, disabilities, deformities, and defects related to exposure to toxic chemicals shall be conducted in accordance with the current regulations of the Ministry of Health.

Article 5. Medical examination and appraisal file

1. The medical examination and appraisal file (hereinafter referred to as "GĐYK") for the subjects specified in Clause 1, Article 1 of this Circular includes:

a) An introduction letter from the Department of Labor, Invalids and Social Affairs (hereinafter referred to as "LĐTBXH"), Model 1 issued together with this Circular, signed by the Director or Deputy Director of the Department of LĐTBXH and stamped;

b) A declaration form (Model HH1) issued together with Circular No. 05/2013/TT-BLĐTBXH dated May 15, 2013 of the Ministry of Labor, Invalids and Social Affairs guiding procedures for establishing files, managing files, implementing preferential policies for persons who have rendered meritorious services to the revolution and their dependents (hereinafter referred to as "Circular No. 05/2013/TT-BLĐTBXH");

c) A summary of the medical record of treatment for diseases and disabilities related to exposure to toxic chemicals at state hospitals from district level upwards or discharge certificates from central-level hospitals according to the technical zoning of the Ministry of Health. The summary of the medical record and the discharge certificate must be signed and stamped by the Director or Deputy Director of the hospital.

2. The medical examination GĐYK file for the subjects specified in Clause 2, Article 1 of this Circular includes:

a) An introduction letter from the Department of LĐTBXH (Model 1) issued together with this Circular, signed by the Director or Deputy Director of the Department of LĐTBXH and stamped;

b) A copy of the medical examination GĐYK report of the GĐYK Council that has examined and determined the presence of diseases and disabilities related to exposure to toxic chemicals. In case there is no copy of the medical examination GĐYK report, there must be a copy of the confirmation letter from the District Health Center (district hospital) or a copy of the confirmation letter from the Commune Health Station in the file stored at the Department of LĐTBXH established according to the provisions of relevant legal documents at the time of establishing the file. These copies must be confirmed and stamped by the leadership of the Department of LĐTBXH.

3. The medical examination GĐYK file for the subjects specified in Clause 3, Article 1 of this Circular includes:

a) An introduction letter from the Department of LĐTBXH (Model 1) issued together with this Circular, signed by the Director or Deputy Director of the Department of LĐTBXH and stamped;

b) A declaration form (Model HH1) issued together with Circular No. 05/2013/TT-BLĐTBXH;

c) A summary of the medical record of treatment for diseases, disabilities, deformities, and defects related to exposure to toxic chemicals at state hospitals from district level upwards or discharge certificates from central-level hospitals according to the technical zoning of the Ministry of Health. The summary of the medical record and the discharge certificate must be signed and stamped by the Director or Deputy Director of the hospital.

4. The medical examination GĐYK file due to exceeding professional capacity includes:

a) A document requesting a medical examination and appraisal from the provincial GĐYK Council;

b) A copy of the medical examination GĐYK file as prescribed in Clause 1 or Clause 2 or Clause 3 of this Article, signed and stamped by the Chairman or Vice-Chairman of the GĐYK Council.

5. The request for re-examination and reappraisal file:

a) In cases where the competent state management agency under the Ministry of Health or the Ministry of Labor, Invalids and Social Affairs does not agree with the conclusion of the GĐYK Council, it issues a document requesting the higher-level GĐYK Council to conduct a re-examination and reappraisal; simultaneously, it requests the GĐYK Council that conducted the initial examination and appraisal to transfer a copy of the GĐYK file of the subject to the higher-level GĐYK Council for re-examination and reappraisal. The re-examination and reappraisal request file includes:

- A document requesting a re-examination and reappraisal from the Department of Medical Examination and Treatment, Ministry of Health or the Department of Persons with Meritorious Services, Ministry of Labor, Invalids and Social Affairs;

- A copy of the GĐYK file as prescribed in Clause 1 or Clause 2 or Clause 3 of this Article (depending on the subject requiring re-examination and reappraisal), signed and stamped by the Chairman or Vice-Chairman of the GĐYK Council that conducted the initial examination and appraisal for the subject.

b) In cases where the subject disagrees with the conclusion in the GĐYK report, they submit a petition to the Department of LĐTBXH for consideration and resolution. If the Department of LĐTBXH refers the subject to a higher-level GĐYK Council for re-examination and reappraisal, the Department of LĐTBXH will take the lead and coordinate with the GĐYK Council that conducted the initial examination and appraisal for the subject to complete the re-examination and reappraisal request file. The file includes:

- A document requesting a re-examination and reappraisal from the Department of LĐTBXH, signed and stamped by the Director or Deputy Director of the Department of LĐTBXH;

- A copy of the GĐYK file of the subject as prescribed in Clause 1 or Clause 2 or Clause 3 of this Article, signed and stamped by the Chairman or Vice-Chairman of the GĐYK Council that conducted the initial examination and appraisal for the subject.

Article 6. Authority for Medical Examination and Appraisal

1. The Provincial Medical Examination and Appraisal Council (hereinafter referred to as the Provincial Council) shall accept, review files, and conduct medical examination and appraisal for individuals introduced by the Department of Labor, Invalids, and Social Affairs.

2. The Central Medical Examination and Appraisal Council, the Central Medical Examination and Appraisal Council I, and the Central Medical Examination and Appraisal Council II (hereinafter referred to as the Central Council) shall accept, review files, and conduct medical examination and appraisal in any of the following cases:

a) When it exceeds the professional capacity of the Provincial Council;

b) Re-examination upon request of the General Department of Medical Examination and Treatment under the Ministry of Health or the General Department of War Veterans under the Ministry of Labor, Invalids, and Social Affairs;

c) Re-examination upon proposal of the Department of Labor, Invalids, and Social Affairs.

Article 7. Procedure for Medical Examination and Appraisal

1. General Provisions

a) The Medical Examination and Appraisal Council shall accept and review the medical examination and appraisal file. If the medical examination and appraisal file does not comply with the provisions of this Circular, within five working days from the date of receiving the file, the Medical Examination and Appraisal Council shall return the medical examination and appraisal file to the introducing organization;

b) The Medical Examination and Appraisal Council must conduct medical examination and appraisal for the subject within sixty days from the date of receiving a valid medical examination and appraisal file;

c) During the implementation of medical examination and appraisal, the person who established the medical examination and appraisal file and the appraiser must check and compare the identification card or passport or certified copy of the birth certificate with the subject undergoing medical examination and appraisal;

d) In necessary cases, the Medical Examination and Appraisal Council may designate other clinical or paraclinical examinations or treatment at state health facilities as a basis for determining disease, disability, deformity, or defect;

2. Procedure for Medical Examination and Appraisal

a) Establishing the medical examination and appraisal file and conducting a general examination: Based on the Introduction Letter of the Department of Labor, Invalids, and Social Affairs, the physician of the permanent office of the Medical Examination and Appraisal Council shall establish the medical examination and appraisal file and conduct a general examination;

b) Specialized examination: The specialized appraiser shall conduct the examination and conclude on the contents designated by the permanent office of the Medical Examination and Appraisal Council;

c) Specialized consultation: The permanent office of the Medical Examination and Appraisal Council shall conduct it. In necessary cases, specialized appraisers and relevant parties may be invited to participate;

d) Meeting of the Medical Examination and Appraisal Council: The Chairman of the Medical Examination and Appraisal Council or the authorized person shall chair the meeting. The number of members attending the meeting must ensure more than fifty percent of the total members of the Council, including a representative from the Labor, Invalids, and Social Affairs sector. The decision of the Medical Examination and Appraisal Council must ensure the majority agreement of the members present at the meeting. In case there is no majority agreement among the members present at the meeting, the chairperson of the meeting shall consider and conclude but must clearly record it in the Minutes of the Medical Examination and Appraisal Council meeting;

The conclusion of the Medical Examination and Appraisal Council shall be issued in the form of the Medical Examination and Appraisal Record according to Model 2 attached to this Circular;

Within five working days from the final conclusion of the Medical Examination and Appraisal Council, the permanent office of the Medical Examination and Appraisal Council shall be responsible for completing the Medical Examination and Appraisal Record (four copies);

e) Transfer of the Medical Examination and Appraisal Record: Within three working days from the date of the Medical Examination and Appraisal Record, the permanent office of the Medical Examination and Appraisal Council shall transfer and store the Medical Examination and Appraisal Record as follows:

- One copy to the introducing organization;

- One copy to the Department of Health for issuing the Certificate of Disease, Disability, Deformity, or Defect related to exposure to chemical toxins, except in the case specified in Clause 2, Article 1 of this Circular;

- One copy to the subject;

- One copy stored at the permanent office of the Medical Examination and Appraisal Board.

f) The medical examination and appraisal file shall be managed and stored at the permanent office of the Medical Examination and Appraisal Council in accordance with regulations.

Article 8. Content of Medical Examination and Appraisal

1. For the subjects specified in Clause 1 and Clause 3, Article 1 of this Circular, the Medical Examination and Appraisal Board shall examine diseases, disabilities, deformities, and defects listed in the Catalogue of Diseases, Disabilities, Deformities, and Defects related to exposure to toxic chemicals as stipulated in Article 2 of this Circular, which are recorded in the Introduction Letter issued by the Department of Labor, Invalids, and Social Affairs.

2. For the subjects specified in Clause 2, Article 1 of this Circular, the Medical Examination and Appraisal Board shall only examine diseases, disabilities, deformities, and defects listed in the Catalogue of Diseases, Disabilities, Deformities, and Defects related to exposure to toxic chemicals as stipulated in Article 2 of this Circular, which are recorded in the Introduction Letter issued by the Department of Labor, Invalids, and Social Affairs, the Medical Examination and Appraisal Report, or the Summary of Medical Records for treatment of diseases, disabilities, deformities, and defects at state hospitals from district level upwards, or discharge certificates from central-level hospitals according to the technical stratification of the Ministry of Health.

Article 9. Issuance of Certificate of Disease, Disability, Deformity, and Defect Related to Exposure to Toxic Chemicals

1. The Director of the Department of Health shall issue the Certificate of Disease, Disability, Deformity, and Defect Related to Exposure to Toxic Chemicals according to Model 3 promulgated together with this Circular based on one of the following documents:

a) The Medical Examination and Appraisal Report of the Medical Examination and Appraisal Board;

b) The conclusion that the subject suffers from infertility issued by a provincial general hospital or a provincial specialized obstetrics and gynecology hospital, or a central city-level hospital, or a hospital of Class I or higher. These hospitals must be approved by the competent authority to implement techniques for determining infertility according to the regulations of the Ministry of Health.

2. Within ten working days from the date of receiving all required documents as stipulated in Clause 1 of this Article, the Department of Health shall have the responsibility to issue and transfer the Certificate of Disease, Disability, Deformity, and Defect Related to Exposure to Toxic Chemicals to the Department of Labor, Invalids, and Social Affairs for use as a basis to implement preferential policies for the subjects specified in Clause 1 and Clause 3 of Article 1 of this Circular.

Article 10. Fees for Medical Examination and Appraisal

The fees for Medical Examination and Appraisal shall be implemented in accordance with the provisions of the law.

Article 11. Responsibility for Implementation

1. The Ministry of Health shall instruct, guide, and inspect the Departments of Health of provinces and centrally-administered cities, and the Medical Examination and Appraisal Boards at all levels to implement in accordance with the provisions of this Circular.

2. The Ministry of Labor, Invalids, and Social Affairs shall instruct, guide, and inspect the Departments of Labor, Invalids, and Social Affairs of provinces and centrally-administered cities to implement in accordance with the provisions of this Circular.

3. The Ministry of Public Security and the Ministry of National Defense shall instruct and guide the implementation of medical examination and appraisal for the subjects specified in Clause 1 and Clause 2 of Article 38 of Decree No. 31/2013/NĐ-CP based on the provisions of this Circular.

Article 12. Effective Date

1. This Circular takes effect from January 5, 2014.

2. Decision No. 09/2008/QĐ-BYT dated February 20, 2008 of the Ministry of Health promulgating the Catalogue of Diseases, Disabilities, Deformities, and Defects related to exposure to toxic chemicals/dioxins; Models HH2, HH3, HH5, and HH6 promulgated together with Circular No. 05/2013/TT-BLĐTBXH shall cease to be effective from the date this Circular takes effect.

During the implementation process, if there are difficulties or obstacles, agencies, organizations, and individuals should reflect them to the Ministry of Health and the Ministry of Labor, Invalids, and Social Affairs for consideration and resolution./.