Joint Circular No. 45/2014/TTLT-BYT-BLDTBXH guiding the examination and appraisal of disabilities for war invalids and persons receiving benefits equivalent to war invalids

JOINT CIRCULAR

HGuidelines for examining and assessing disabilities for war invalids

and persons entitled to benefits equivalent to those of war invalidsh

___________________

Pursuant to the Ordinance amending and supplementing certain articles of the Ordinance on preferential policies for persons with meritorious services in the revolution No. 04/2012/UBTVQH13 dated July 16, 2012 of the Standing Committee of the National Assembly;

Pursuant to 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.

This Circular prescribes procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.

Pursuant to Decree No. 106/2012/NĐ-CP dated December 20, 2012, of the Government, stipulating the functions, tasks, powers, and organizational structure of the Ministry of Labor, Invalids, and Social Affairs;

At the proposal of the Director of the Department of Medical Examination and Treatment under the Ministry of Health and the Director of the Department of Persons with Meritorious Services under the Ministry of Labor, Invalids and Social Affairs;

The Minister of Health and the Minister of Labor, Invalids and Social Affairs promulgate this Circular guiding the examination and assessment of disabilities for war invalids and persons entitled to benefits equivalent to those of war invalids.

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular guides the dossier, procedures, contents of medical examination and assessment (hereinafter referred to as GĐYK), methods for compiling the percentage of bodily impairment (hereinafter referred to as the percentage of TTCT) due to disability for injured persons, war invalids, type B war invalids, and persons entitled to benefits equivalent to those of war invalids (hereinafter collectively referred to as war invalids) as stipulated in the Ordinance amending and supplementing certain articles of the Ordinance on preferential policies for persons with meritorious services in the revolution No. 04/2012/UBTVQH13 dated July 16, 2012 of the Standing Committee of the National Assembly (hereinafter referred to as Ordinance No. 04/2012/UBTVQH13) and Article 27 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 policies for persons with meritorious services in the revolution (hereinafter referred to as Decree No. 31/2013/NĐ-CP).

Article 2. Interpretation of Terms

In this Circular, the following terms are understood as follows:

1. Initial examination and assessment is the examination and assessment to determine the condition of injury and the percentage of TTCT due to disability for subjects who have not undergone initial examination and assessment before;

2. Re-examination and reassessment is the examination and assessment conducted by the Central Medical Examination and Assessment Board when the competent authority or individual does not agree with the conclusion of the Provincial Medical Examination and Assessment Board that previously conducted the examination and assessment or due to exceeding the professional capacity of the Provincial Medical Examination and Assessment Board;

Provincial Medical Examination and Assessment Boards, the Medical Examination and Assessment Board of the Ministry of Transport (hereinafter collectively referred to as Provincial Medical Examination and Assessment Boards);

3. Final re-examination and reassessment is the examination and assessment conducted by the final re-examination and reassessment board. The final re-examination and reassessment board shall be established by the Minister of Health according to the procedures and formalities prescribed in this Circular;

4. Percentage of bodily impairment in this Circular is commonly used for the percentage of reduction in work capacity due to injury or disability.

Article 3. Subjects for examination and assessment

1. An injured person undergoing initial examination and assessment for disability is a person who meets the provisions of Clause 1, Article 27 of Decree No. 31/2013/NĐ-CP and has not undergone initial examination and assessment for disability.

2. A war invalid who is temporarily assessed as disabled may undergo examination and assessment again after three years to determine the permanent percentage of TTCT, hereinafter referred to as a subject temporarily assessed.

3. A war invalid who has been examined and assessed for disability but then suffers another injury may undergo supplementary examination and assessment and compilation of the percentage of TTCT, hereinafter referred to as a subject for supplementary examination and assessment of new injuries.

4. A war invalid who has been examined and assessed for disability but still has residual injuries may undergo examination and assessment of residual injuries and compilation of the percentage of TTCT, hereinafter referred to as a subject for examination and assessment of residual injuries. The determination of a subject with residual injuries shall be in accordance with regulations of the Ministry of Labor, Invalids and Social Affairs.

5. A war invalid who has been examined and assessed for disability and now has a recurrent injury as stipulated in Clause 4, Article 30 of Decree No. 31/2013/NĐ-CP may undergo examination and assessment of the recurrent injury, hereinafter referred to as a subject for examination and assessment of recurrent injuries (this does not apply to type B war invalids).

Article 4. Competence for Medical Examination and Appraisal

1. The Provincial Medical Examination and Appraisal Board under the direct jurisdiction of the Central Government shall conduct medical examination and appraisal for the subjects specified in Article 3 of this Circular, except for cases stipulated in Point a Clause 2 of this Article.

The Ministry of Transport's Medical Examination and Appraisal Board shall conduct medical examination and appraisal for disability for subjects who have been issued a Disability Certificate by the Ministry of Transport, except for cases stipulated in Point a Clause 2 of this Article.

2. The Central Medical Examination and Appraisal Board shall conduct medical examination and appraisal for the following cases:

a) Subjects specified in Clauses 2, 3, 4, and 5 of Article 3 of this Circular who were previously examined and appraised by the Central Medical Examination and Appraisal Board;

b) Subjects referred to the Central Medical Examination and Appraisal Board by the Provincial Medical Examination and Appraisal Board due to exceeding their professional capacity;

c) Re-examination and re-appraisal at the request of the Department of Medical Examination and Treatment, Ministry of Health, or the Department of War Veterans, Ministry of Labor, Invalids and Social Affairs, or upon the request of the subject undergoing examination and appraisal.

3. The final re-examination and re-appraisal board shall conduct medical examination and appraisal for the following cases:

a) Subjects who disagree with the results of the examination and appraisal by the Central Medical Examination and Appraisal Board;

b) At the request of the Department of Medical Examination and Treatment, Ministry of Health, or the Department of War Veterans, Ministry of Labor, Invalids and Social Affairs.

Article 5. General Responsibilities of Organizations and Individuals Involved

1. The Department of Labor, Invalids and Social Affairs shall be responsible for identifying the subjects, completing the files, and referring the subjects to the Provincial Medical Examination and Appraisal Board for examination and appraisal.

The Department of Labor, Invalids and Social Affairs shall not refer a subject to two Medical Examination and Appraisal Boards at the same level on the same Disability Certificate or Extract from the War Veteran's File.

2. Medical Examination and Appraisal Boards at all levels shall check the files and only conduct medical examination and appraisal when the subject's file is valid according to this Circular, and shall be responsible for the results of the examination and appraisal.

3. In cases where the Provincial Medical Examination and Appraisal Board exceeds its professional capacity, the Provincial Medical Examination and Appraisal Board shall be responsible for completing, transferring the file, and referring the subject to the Central Medical Examination and Appraisal Board for examination and appraisal; simultaneously, it shall notify in writing for the Department of Labor, Invalids and Social Affairs to be aware and cooperate in implementation.

4. If the Department of Medical Examination and Treatment, Ministry of Health, or the Department of War Veterans, Ministry of Labor, Invalids and Social Affairs disagrees with the conclusion of the Provincial Medical Examination and Appraisal Board, they shall issue a written request for the Central Medical Examination and Appraisal Board to conduct medical examination and appraisal; if they disagree with the result of the examination and appraisal by the Central Medical Examination and Appraisal Board, they shall propose to the Minister of Health to consider and decide to establish the final re-examination and re-appraisal board. The Central Medical Examination and Appraisal Board shall be responsible for completing the file and transferring it to the final re-examination and re-appraisal board.

Persons conducting medical examination and appraisal shall be responsible for checking and comparing the person undergoing examination and appraisal with one of their documents: Identity Card or Passport or War Veteran Certificate or confirmation from the Police Station of the place of permanent residence, affixed with a recent photograph of the subject taken against a white background measuring 4 cm x 6 cm within six months of the date of filing the file, stamped with the seal of the Police Station.

Persons undergoing examination and appraisal shall present one of the documents specified in Clause 6 of this Article to the person conducting medical examination and appraisal for verification and comparison each time an activity of examination and appraisal is carried out, and comply with the guidance and instructions of the person conducting medical examination and appraisal and the Medical Examination and Appraisal Board during the process of examination and appraisal.

Chapter II

MEDICAL EXAMINATION AND APPRAISAL FILE

Article 6. Documents for the first medical examination and injury assessment

1. The original Introduction Letter issued by the Department of Labor, Invalids and Social Affairs signed by the Director or Deputy Director authorized by the Director, and stamped (hereinafter referred to collectively as the Department of Labor, Invalids and Social Affairs Leadership). The Introduction Letter must clearly state the subject of the first medical examination and injury assessment.

2. A copy of the Certificate of Injury confirmed and stamped by the Department of Labor, Invalids and Social Affairs Leadership.

3. The Application for Medical Examination and Assessment signed by the person seeking examination and confirmed by the People's Committee of the commune, ward, town (hereinafter referred to collectively as the Commune-level People's Committee) where the person has registered their permanent residence or the organization where the person is working.

Article 7. Documents for medical examination and assessment in cases where the temporary percentage has been determined, or for supplementary injuries

1. The original Introduction Letter issued by the Department of Labor, Invalids and Social Affairs signed and stamped by the Department Leadership. The Introduction Letter must clearly state the subject who has been determined with a temporary percentage or the subject for supplementary injury examination and assessment, and specify the injury to be examined.

2. The Application for Medical Examination and Assessment signed by the person seeking examination and confirmed by the Commune-level People's Committee where the person has registered their permanent residence or the organization where the person is working.

3. In cases of medical examination and assessment of the temporary percentage, the following additional documents are required:

a) A copy of the Certificate of Injury confirmed and stamped by the Department of Labor, Invalids and Social Affairs Leadership. If the subject is already an invalid, this should be replaced with the original Extract from the Invalid File.

b) A copy of the Medical Examination Record of the Medical Examination Board that conducted the examination to determine the temporary percentage of injury caused by disability, confirmed and stamped by the Department of Labor, Invalids and Social Affairs Leadership.

4. In cases of supplementary injury examination and assessment, the following additional documents are required:

a) A copy of the Certificate of Injury of the most recent injury (not yet assessed) confirmed and stamped by the Department of Labor, Invalids and Social Affairs Leadership.

b) A copy of the Medical Examination Record of the Medical Examination Board that conducted the examination to determine the percentage of injury caused by the most recent disability, confirmed and stamped by the Department of Labor, Invalids and Social Affairs Leadership.

Article 8. Documents for medical examination and assessment in cases of residual injuries

1. The original Introduction Letter issued by the Department of Labor, Invalids and Social Affairs signed and stamped by the Department Leadership. The Introduction Letter must clearly state the subject of the residual injury examination and assessment, and specify the residual injury and/or the location of metal fragments in the body to be examined.

2. A copy of the Certificate of Injury confirmed and stamped by the Department of Labor, Invalids and Social Affairs Leadership. If the subject is already an invalid, this should be accompanied by the original Extract from the Invalid File.

3. A copy of the Medical Examination Record of the Medical Examination Board that conducted the examination to determine the percentage of injury caused by the most recent disability, confirmed and stamped by the Department of Labor, Invalids and Social Affairs Leadership.

4. One of the following documents: Radiography results; Computerized Tomography results; Surgical Certificate (for cases where surgery or foreign body removal procedures have been performed); Discharge Certificate for treatment of residual injuries (if applicable). These documents must be signed and stamped by the Hospital Director or an authorized representative, using the hospital's official stamp as prescribed by law on the management and use of seals (hereinafter referred to as the hospital's legal stamp).

5. The Application for Medical Examination and Assessment signed by the person seeking examination and confirmed by the Commune-level People's Committee where the person has registered their permanent residence or the organization where the person is working.

Article 9. Documents for examination and appraisal in cases of recurrent injuries

1. The original letter of introduction issued by the Department of Labor, Invalids and Social Affairs, signed by the head of the department and stamped. The letter of introduction must clearly state the subject to be examined and appraised for recurrent injuries and specify the recurrent injury.

2. A document from the Ministry of Labor, Invalids and Social Affairs agreeing to the subject being examined and appraised for recurrent injuries.

3. A copy of the injury certification signed and confirmed by the head of the Department of Labor, Invalids and Social Affairs and stamped, accompanied by the original extract of the war invalid file.

4. A copy of the medical examination record of the Medical Appraisal Board that last determined the percentage of disability due to injury or impairment, signed and confirmed by the head of the Department of Labor, Invalids and Social Affairs and stamped.

5. A summary of the medical record or discharge certificate after treatment for recurrent injury from a district-level hospital or equivalent, signed by the leader or authorized person and legally stamped by the hospital.

6. A request for examination and appraisal signed by the person seeking examination with confirmation from the People's Committee of the commune where they are registered as a resident or from the organization where they work.

Article 10. Documents for examination and appraisal when exceeding the expertise capacity of the provincial Medical Appraisal Board

1. A document requesting examination and appraisal due to exceeding the expertise capacity of the provincial Medical Appraisal Board, signed by the Chairman or Vice-Chairman of the Board and stamped with the Board's seal.

2. Examination and appraisal documents according to one of the provisions in Articles 6, 7, 8, or Article 9 of this Circular, appropriate to each case.

3. In cases where the provincial Medical Appraisal Board has already conducted an examination and appraisal, include a copy of the examination and appraisal medical record, signed and confirmed by the Chairman or Vice-Chairman of the Board and stamped.

4. In cases where no examination and appraisal have been conducted, include the meeting minutes of the provincial Medical Appraisal Board concluding that the case exceeds their expertise capacity.

Article 11. Documents for re-examination and reappraisal

1. Documents for re-examination and reappraisal at the request of the state management agency include:

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

b) Examination and appraisal documents according to one of the provisions in Articles 6, 7, 8, or 9 of this Circular, appropriate to each case, accompanied by a copy of the examination and appraisal medical record, signed and confirmed by the Chairman or Vice-Chairman of the Medical Appraisal Board that previously examined and appraised the subject and stamped.

2. Documents for re-examination and reappraisal at the request of the subject include:

a) A document requesting re-examination and reappraisal from the provincial Medical Appraisal Board that previously examined and appraised the subject, signed and confirmed by the Chairman or Vice-Chairman of the Medical Appraisal Board and stamped. The document clearly states that the subject disagrees with the conclusion of the Board and requests re-examination and reappraisal, accompanied by the subject's request for examination and appraisal.

b) Examination and appraisal documents according to one of the provisions in Articles 6, 7, 8, or 9 of this Circular, appropriate to each case, accompanied by a copy of the examination and appraisal medical record, signed and confirmed by the Chairman or Vice-Chairman of the Medical Appraisal Board that previously examined and appraised the subject and stamped.

Article 12. Documents for final re-examination and reappraisal

1. Decision to establish the final re-examination and reappraisal board by the Minister of Health.

2. Examination and appraisal documents according to one of the provisions in Articles 7, 8, 9, 10, or Article 11 of this Circular, appropriate to each case, accompanied by a copy of the examination and appraisal medical record, signed and confirmed by the Chairman or Vice-Chairman of the Central Medical Appraisal Board that previously examined and appraised the subject and stamped.

3. Minutes of the examination and appraisal of the Central Medical Appraisal Board.

Chapter III

PROCEDURE AND CONTENT OF EXAMINATION AND APPRAISAL

Article 13. Procedure for Medical Examination and Appraisal

1. Receiving and Processing Medical Examination and Appraisal Files

Based on the files transferred from the Department of Labor, Invalids, and Social Affairs or the Provincial Medical Examination and Appraisal Board, the permanent office of the Medical Examination and Appraisal Board shall receive, examine the files, and establish the medical examination file.

2. Time Limit for Resolution

a) In cases where the medical examination and appraisal files comply with the provisions of this Circular: The Medical Examination and Appraisal Boards at all levels must conduct the medical examination and appraisal for the subject and issue the Medical Examination Record within forty days from the date of receipt of the complete files.

In cases of final appellate medical examination and appraisal, the Medical Examination and Appraisal Board must conduct the medical examination and appraisal for the subject and issue the Medical Examination Record within thirty days from the date of receipt of the Decision to establish the final appellate Medical Examination Board issued by the Minister of Health.

b) In cases where the medical examination and appraisal files do not comply with the provisions of this Circular, the permanent office of the Medical Examination and Appraisal Board must return the files to the agency that referred the subject for medical examination and appraisal along with a response letter specifying the reasons within five working days from the date of receipt of the files.

c) In cases exceeding the professional capacity of the Provincial Medical Examination and Appraisal Board:

- Based on the subject's medical examination and appraisal file and the conditions of the Provincial Medical Examination and Appraisal Board, the permanent office reports to the Chairman to convene a meeting to conclude on the matter of exceeding professional capacity (minutes of the meeting). The meeting must include at least the following members: the Chairman and/or the Vice-Chairman in charge of the Medical Examination and Appraisal Board, the Vice-Chairman in charge of professional matters, the Standing Member, and the Professional Member. Within ten working days from the date of receipt of the compliant file according to this Circular, the permanent office must complete, transfer the file, and refer the subject to the Central Medical Examination and Appraisal Board for medical examination and appraisal;

- In cases where the Provincial Medical Examination and Appraisal Board has conducted the medical examination and concluded on exceeding professional capacity, within ten working days from the date of the meeting, the Board must complete, transfer the file, and refer the subject to the Central Medical Examination and Appraisal Board for medical examination and appraisal.

d) In cases where the Department of Medical Examination and Treatment Management under the Ministry of Health or the Department of War Veterans under the Ministry of Labor, Invalids, and Social Affairs disagrees with the conclusion of the Provincial Medical Examination and Appraisal Board, they may request the Central Medical Examination and Appraisal Board to conduct a re-examination and simultaneously require the Provincial Medical Examination and Appraisal Board to transfer the medical examination and appraisal file to the Central Medical Examination and Appraisal Board.

Within ten working days from the date of receipt of the request, the Provincial Medical Examination and Appraisal Board that conducted the initial examination must transfer the subject's medical examination and appraisal file to the Central Medical Examination and Appraisal Board for re-examination.

e) In cases where the subject does not agree with the conclusion of the Provincial or Central Medical Examination and Appraisal Board, within ninety days from the date of issuance of the Medical Examination Record, the subject may submit a request for re-examination to the Medical Examination and Appraisal Board that initially examined them. Beyond this period, the Medical Examination and Appraisal Board will not consider the request.

Within ten working days from the date of receipt of the subject's request, the Provincial Medical Examination and Appraisal Board that initially examined the subject must review, resolve, and respond to the subject. If the subject still disagrees, the Board must complete, transfer the file, and refer the subject to the Central Medical Examination and Appraisal Board for re-examination.

If the subject does not agree with the conclusion of the Central Medical Examination and Appraisal Board, they may submit a request to the Department of Medical Examination and Treatment Management. Within twenty working days from the date of receipt of the subject's request, the Department of Medical Examination and Treatment Management must report to the Minister of Health for consideration of a final re-examination.

3. Procedure for Medical Examination and Appraisal

a) General Examination: A doctor assigned by the permanent office of the Medical Examination and Appraisal Board conducts the general examination and refers the subject for specialized and ancillary examinations.

b) Specialized Examination: Specialized examiners conduct the examination and provide conclusions on the matters designated by the permanent office of the Medical Examination and Appraisal Board.

c) Professional Consultation: The permanent office of the Medical Examination and Appraisal Board conducts this before convening the board. If necessary, the permanent office may invite specialized examiners to attend the consultation with the presence of the subject being examined.

d) Meeting of the Medical Examination and Appraisal Board:

- The Chairman or Vice-Chairman of the Medical Examination and Appraisal Board chairs the meeting as assigned by the Chairman. The number of board members attending the meeting must ensure more than half of the total number of members (listed in the Decision establishing the Board or the Appointment Decision or the dispatch document of the competent authority), including at least two professional members and one member representing the Labor, Invalids, and Social Affairs sector;

- The conclusion of the Medical Examination and Appraisal Board must be agreed upon by more than half of the attendees. In cases where there is no agreement among more than half of the attendees, the chairperson must designate additional examinations or treatments to assist the Board in reaching a conclusion; or if the conditions for concluding are not met, send it to the authorized Medical Examination and Appraisal Board and clearly state that the conclusion exceeds the professional capacity;

- The conclusion of the Medical Examination and Appraisal Board is issued in the form of a Medical Examination Record (three copies) according to Model 1 attached to this Circular. The permanent office of the Medical Examination and Appraisal Board is responsible for issuing the Medical Examination Record.

e) Transfer of the Medical Examination Record: The permanent office of the Medical Examination and Appraisal Board transfers and stores the Medical Examination Record as follows:

- One copy to the Department of Labor, Invalids, and Social Affairs;

- One copy to the subject undergoing medical examination and appraisal;

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

In cases of medical examination and appraisal for subjects specified in Article 10 of this Circular, an additional copy is sent to the Provincial Medical Examination and Appraisal Board that referred the subject for medical examination and appraisal. In cases of medical examination and appraisal for subjects specified in Article 11 of this Circular, an additional copy is sent to the State management agency that requested the medical examination and appraisal and one copy to the Medical Examination and Appraisal Board that initially examined the subject.

f) The medical examination and appraisal files are managed and stored at the permanent office of the Medical Examination and Appraisal Board in accordance with the laws on archiving.

Article 14. Content of Medical Examination and Appraisal

1. For the subjects specified in Clause 1 and Clause 3, Article 3 of this Circular: The Medical Examination and Appraisal Board shall only examine the recorded injuries in the Injury Certificate transferred by the Department of Labor, Invalids and Social Affairs and determine the percentage of permanent disability according to current regulations.

2. For the subjects specified in Clause 2 and Clause 5, Article 3 of this Circular: The Medical Examination and Appraisal Board shall examine all injuries recorded in the Injury Certificate or the Extract of the Disability File transferred by the Department of Labor, Invalids and Social Affairs and determine the percentage of permanent disability according to current regulations.

3. For the subjects specified in Clause 4, Article 3 of this Circular: The Medical Examination and Appraisal Board shall only examine the remaining recorded injuries in the Injury Certificate and the Introduction Letter from the Department of Labor, Invalids and Social Affairs and determine the percentage of permanent disability according to current regulations.

Article 15. Method for Aggregating Percentage of Body Damage

1. The principle for determining the percentage of permanent disability shall be implemented according to the provisions of Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH dated September 27, 2013 issued by the Ministry of Health and the Ministry of Labor, Invalids and Social Affairs on the percentage of body damage due to injury, illness, disability, and occupational disease (hereinafter referred to as Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH).

2. For the subjects specified in Clause 3 and Clause 4, Article 3 of this Circular, when aggregating the percentage of permanent disability, the percentage of permanent disability of supplementary injuries or remaining injuries (taking the lowest percentage within the corresponding range) shall be added to the already determined percentage of permanent disability (according to the method prescribed in Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH).

Article 16. Medical Examination and Appraisal and Resolution of Benefits for War Invalids Suffering from Diseases Related to Chemical Agent Exposure

1. In cases where the subject is already a war invalid and now undergoes medical examination and appraisal for the percentage of body damage due to diseases related to chemical agent exposure, the Introduction Letter from the Department of Labor, Invalids and Social Affairs must clearly state the level of war invalid benefits currently being received (percentage of permanent disability due to disability).

2. If the subject is already a war invalid with a percentage of permanent disability of 80% or higher, and is now concluded by the Medical Examination and Appraisal Board to have contracted one of the diseases listed in the catalog of diseases and disabilities related to chemical agent exposure (in this case, the Medical Examination and Appraisal Board does not determine the percentage of permanent disability due to disease or disability), then they will receive additional monthly allowances for persons engaged in resistance activities affected by chemical agents at a percentage of permanent disability ranging from 41% to 60%.

3. If the subject is a war invalid with a percentage of permanent disability ranging from 21% to 79%, and is now concluded by the Medical Examination and Appraisal Board to have contracted one of the diseases listed in the catalog of diseases and disabilities related to chemical agent exposure, then the subject will receive additional monthly allowances for persons engaged in resistance activities affected by chemical agents corresponding to the percentage of body damage concluded by the Medical Examination and Appraisal Board.

Article 17. Fees for Medical Examination and Appraisal

1. The fees for medical examination and appraisal for the subjects specified in Article 3 of this Circular shall be covered by the State budget according to the provisions of Circular No. 93/2012/TT-BTC dated June 5, 2012 issued by the Ministry of Finance on the levels of collection, payment, management, and use of medical examination and appraisal fees.

2. In cases where the Provincial Medical Examination and Appraisal Board does not conduct the medical examination and appraisal but only receives and transfers the subject's file to the Central Medical Examination and Appraisal Board for examination due to exceeding their professional capacity, the Provincial Medical Examination and Appraisal Board shall not collect the medical examination and appraisal fee.

3. In cases of re-examination and final re-examination upon request of individuals, the payment of medical examination and appraisal fees shall be carried out as follows:

a) If the results of the re-examination and final re-examination are consistent with the individual's request (the percentage of permanent disability is adjusted upward compared to the results of the original examination that the subject questioned), the medical examination and appraisal fee shall be paid by the Department of Labor, Invalids and Social Affairs.

b) If the results of the re-examination and final re-examination are inconsistent with the individual's request (the percentage of permanent disability remains unchanged or is adjusted downward compared to the results of the original examination that the subject questioned), the medical examination and appraisal fee shall be borne by the individual making the request.

Chapter IV

IMPLEMENTATION

Article 18. Responsibility for Implementation

1. The Ministry of Health instructs the Department of Medical Examination and Treatment to direct, guide, and inspect the Departments of Health of provinces and centrally-administered cities, health departments of ministries and sectors, and 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 instructs the Department of Persons with Merit to direct, 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 base on the provisions of this Circular to direct and guide the implementation of medical examinations and appraisals for subjects under their respective jurisdictions.

Article 19. Transitional Provisions

Where referenced documents in this Circular are replaced or amended, implementation shall be in accordance with the replacing or amending documents.

Article 20. Effective Date

1. This Circular takes effect from February 1, 2015.

From the date this Circular takes effect, Point c, Clause 1, Article 31 of Circular No. 05/2013/TT-BLDTBXH dated May 15, 2013 issued by the Ministry of Labor, Invalids and Social Affairs guiding procedures for establishing files, managing files, and implementing preferential policies for persons meritorious to the revolution and their dependents shall be abolished.

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