Unofficial translation
In accordance with Article 9, subparagraph 3) of the Code of the Republic of Kazakhstan dated July 7, 2020 "On public health and healthcare system," I hereby ORDER:
1. To approve the attached rules of expertise for establishing the connection of occupational disease with the performance of labor (official) duties.
2. The Committee on sanitary and epidemiological control of the Ministry of Healthcare of the Republic of Kazakhstan, in accordance with the procedure established by law of the Republic of Kazakhstan, shall:
1) ensure the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan;
2) place this order on the Internet resource of the Ministry of Healthcare of the Republic of Kazakhstan after official publication;
3) within ten working days after the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan, submit to the Legal Department of the Ministry of Health of the Republic of Kazakhstan information on the implementation of the measures provided for in subparagraphs 1) and 2) of this paragraph.
3. Control over the execution of this order shall be entrusted to the supervising Vice-Minister of Healthcare of the Republic of Kazakhstan.
4. This order shall enter into force upon expiry of ten calendar days after the date of its first official publication.
Minister of Healthcare of the Republic of Kazakhstan |
A. Tsoi |
"AGREED"
Ministry of Labour and Social
Protection of the Population
of the Republic of Kazakhstan
Approved by Order of the Minister of Healthcare of the Republic of Kazakhstan dated December 21, 2020 № RK HM-301/2020 |
Rules of expertise for establishing the connection of occupational disease with the performance of labor (official) duties
Chapter 1. General provisions
1. These rules of expertise for establishing the connection of occupational disease with the performance of labour (official) duties (hereinafter referred to as the Rules) shall be developed in accordance with Article 9, subparagraph 3), of the Code of the Republic of Kazakhstan dated July 7, 2020 “On public health and healthcare system” (hereinafter referred to as the Code) and shall define the procedure for the expertise for establishing the connection of occupational disease with the performance of labour (official) duties.
2. The following concepts and definitions shall be used in these Rules:
1) sanitary and epidemiological characteristics of working conditions - a document drawn up by territorial divisions of the state body in the field of sanitary and epidemiological well-being of the population, taking into account the occupational history of the employee, to establish the connection of the disease with harmful and (or) hazardous working conditions;
2) acute occupational disease - a disease that shall occur after a single (during no more than one shift) exposure to harmful occupational factors;
3) harmful working conditions - working conditions that shall be characterized by the presence of harmful industrial factors;
4) harmful industrial factor - an industrial factor, the impact of which on the employee can lead to illness or reduction of working capacity and (or) negative impact on the health of generation;
5) occupational disease - an acute or chronic disease caused by the exposure of the employee to harmful industrial factors in connection with the performance of labor (official) duties;
6) expertise of the connection of occupational disease with the performance of labor (official) duties - a type of examination in the field of healthcare, determining the presence or absence of causal relations between the clinical manifestations of the disease, the results of the medical examination, the occupational history of the patient and industrial factors based on the analysis of data of sanitary and epidemiological characteristics of working conditions;
7) occupational history - a list of professions acquired by a person in chronological order;
8) chronic occupational disease - a disease that arose after multiple and prolonged exposure to harmful industrial factors.
3. Expertise of the connection of occupational disease with the performance of labor (official) duties shall be carried out according to the list of occupational diseases in accordance with Annex 1 to these Rules.
4. The expertise of establishing the connection of occupational disease with the performance of labor (official) duties shall be divided into:
primary, which shall be carried out in case of suspicion of causal relations between the influence of harmful industrial factors and the development of the disease;
re-examination, which shall be carried out after the injured employee undergoes medical and rehabilitation measures and (or) before re-examination in the state medical and social examination bodies.
5. The examination of the connection of occupational disease with the performance of labor (official) duties shall be carried out in relation to employees performing work under an employment contract.
6. The examination of the establishment the connection of occupational diseases with the performance of work (official) duties shall be carried out by state healthcare organizations providing specialized medical care in the field of professional pathology and expertise as part of the organization of education in the field of healthcare (hereinafter referred to as the professional health clinic), approved by the authorized body in the field of healthcare in accordance with Article 220, paragraph 4 of the Code of the Republic of Kazakhstan.
Chapter 2. Procedure for expertise of establishment of connection of occupational disease with performance of labor (official) duties
7. Occupational diseases (acute, chronic) shall be caused by the exposure of persons specified in paragraph 5 of these Rules to harmful and/or hazardous industrial factors in connection with the employee's performance of work (official) duties, which entailed a temporary or persistent loss of professional ability.
8. The diagnosis of an acute occupational disease as well as the preliminary diagnosis of chronic ccupational disease shall be established by medical organizations providing primary healthcare regardless of forms of ownership (hereinafter referred to as medical organizations), the diagnosis of a chronic occupational disease shall be established by state healthcare organizations providing specialized medical care in the field of professional pathology and expertise in the organization of education in the field of healthcare (hereinafter referred to as the professional health clinic) to employees of enterprises or organizations residing in the Republic of Kazakhstan.
Footnote. Paragraph 8 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 11.03.2022 № ҚР ДСМ-23 (shall be enforced upon expiry of ten calendar days after its first official publication).9. Healthcare organizations on the basis of clinical data of the employee's health condition, the card of epidemiological examination of the focus of infectious and parasitic disease approved by the order of the Minister of Health of the Republic of Kazakhstan from August 20, 2021 №ҚР ДСМ-84 “On approval of forms of accounting and reporting documentation in the field of sanitary and epidemiological well-being of the population” (registered in the Register of state registration of normative legal acts under № 24082) (hereinafter - Order № ҚР ДСМ-84) and (or) act on an accident related to labor activity approved by the order of the Minister of Health and Social Development of the Republic of Kazakhstan from December 28, 2015 № 1055 “On Approval of forms for registration of materials of investigation of accidents related to labor activity” (registered in the Register of state registration of normative legal acts under № 12655) shall establish the final diagnosis of acute occupational disease and prepare a notice in the form approved by the order of the Acting Minister of Health of the Republic of Kazakhstan from October 30, 2020 № ҚР ДСМ--175/2020 “On Approval of forms of record documentation in the field of health care” (registered in the Register of State Registration of Regulatory Legal Acts under № 21579) (hereinafter - Order № ҚР ДСМ-175/2020).
Footnote. Paragraph 9 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 11.03.2022 № ҚР ДСМ-23 (shall be enforced upon expiry of ten calendar days after its first official publication).10. If an employee identifies persistent disorders of body function, due to an acute occupational disease, the patient shall be consulted by a doctor of labor medicine (professional pathology) (hereinafter referred to as a professional pathologist).
11. Citizens with a preliminary diagnosis of chronic occupational disease, as well as in case of persistent impairment of body function due to acute occupational disease for more than three months shall be referred to the clinic of occupational health for expert examination of the establishment of the connection of occupational disease with the performance of labor (job) duties by health care entities, with the submission of documents according to paragraph 15 of these Rules.
Footnote. Paragraph 11 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 11.03.2022 № ҚР ДСМ-23 (shall be enforced upon expiry of ten calendar days after its first official publication).12. To conduct an examination of the establishment of a connection between a chronic occupational disease and the performance of labor (official) duties and the consequences of an acute occupational disease in a professional health clinic, a permanent expert professional pathology commission (hereinafter referred to as EPPC) shall be formed on the disease profile approved by the head of the professional health clinic.
13. The chairman of the EPPC shall be a professional physician with a qualification category (scientific and (or) academic degree), who shall be a specialist in the profile of diseases.
The total number of EPPC members shall be at least 3 people. The members of the commission shall be doctors who have the specialty "Labor Medicine (Professional Pathology)." If necessary, doctors on the profile of the disease (not members of the commission) are involved in the examination.
14. The EPPC shall conduct a primary examination of establishing the connection of an occupational disease with the performance of labor (official) duties by the employee and shall determine functional disorders, re-examination - in cases of progression or regression of the disease with the determination of the degree of functional disorders.
15. Medical organizations serving enterprises, at the place of attachment of the patient, professional pathology offices, regardless of the form of ownership, shall send patients to the professional health clinic for expertise in establishing the connection of a professional disease with the performance of labor (official) duties by the employee with the following documents:
1) referral of a medical organization, in the form approved by Order № RK HM-175/2020;
2) conclusion of the medical consultation commission on the form approved by Order № RK HM -175/2020;
3) an extract from medical records of an ambulatory patient (ambulatory, hospital) with data of mandatory (preliminary and periodic) medical examinations, the results of laboratory and functional studies in the form approved by Order № RK HM 175/2020;
4) the original medical record of the ambulatory patient in the form approved by Order № RK HM -175/2020;
5) sanitary and epidemiological characteristics of working conditions;
6) the certificate on an accident related to work shall be provided by the patient specified in paragraph 11 (hereinafter referred to as the Certificate) in the form approved by the authorized state body on labor, in accordance with Article 190 of the Labor Code of the Republic of Kazakhstan dated November 23, 2015 (hereinafter referred to as the Labor Code of the Republic of Kazakhstan);
7) documents confirming the employee's work activity in accordance with Article 35 of the Labor Code of the Republic of Kazakhstan.
15-1. Sanitary and epidemiological characterization of working conditions (hereinafter - SEC) shall be drawn up by the territorial subdivision of the state body in the sphere of sanitary and epidemiological well-being of the population (hereinafter - territorial subdivision) taking into account the professional route of the employee on the basis of documents and materials provided by the employer and available results of sanitary and epidemiological monitoring, control and supervision according to the form approved by the Order № ҚР ДСМ-84.
The head of the organization (employer), according to the professional route of the employee, after receiving a notification of a preliminary diagnosis of chronic occupational disease and (or) poisoning, in the form approved by the Order № ҚР ДСМ-175/2020, or informing the territorial subdivision, within three working days forms a Commission to collect and prepare information for drawing up a sanitary-epidemiological characterization of working conditions (hereinafter referred to as the Commission) of the employee at this enterprise. The Commission consists of representatives of the employer, a specialist of the occupational safety and health service (or a person appointed by the employer to be responsible for occupational safety and health), a medical employee of the enterprise, a specialist of the medical organization servicing the enterprise, a representative of the trade union, an injured employee and (or) a representative of the employee, with the involvement, by decision of the Commission or in disputable situations, of occupational pathologists with a qualification category (academic and (or) academic degree), who are specialists in the profile of the employee's disease or specialists of scientific activity organizations with scientific and (or) academic degrees in sanitation, hygiene and epidemiology, public health, occupational pathology at the expense of the employer, as well as a specialist of the territorial unit.
Within ten working days, the Commission shall collect the necessary documents and materials for drawing up the SEC, including archive data characterizing working conditions at the employee's workplace (site, workshop) (or at similar workplaces) for the entire professional route at the given enterprise:
1) materials of production control;
2) materials of certification of the production facility for labor conditions;
3) materials and results of inspections of territorial subdivisions and territorial subdivisions of the authorized state labor authority;
4) materials of accident investigations, special investigation;
5) information on medical examinations, outpatient cards;
6) plan of measures to improve the health of patients detected during periodic medical examinations;
7) extracts from the logs of registration of briefings and protocols of verification of employee's knowledge of labor protection;
8) copies of documents confirming the issuance of personal protective equipment to the employee;
9) extracts from instructions, regulations, orders or acts regulating the requirements of safety and labor protection, duties and responsibilities of officials for ensuring healthy and safe working conditions at work;
10) information on the nature and severity of damage to the health of the victim;
11) chemical substances and compounds, in contact with which the employee's labor activity was carried out, in hermetically sealed packaging with indication of the name of substances, date of packaging, certified by the employer's seal (if any) in case of suspected occupational disease of allergic nature.
In the absence or in the presence of incomplete data characterizing the working conditions of an employee, the employer shall, at its own expense, conduct the necessary laboratory-instrumental and hygiene-physiological studies to assess the working conditions at the employee's workplace or similar workplaces, taking into account the data of production control.
The employer shall submit the necessary documents and materials collected by the Commission within 3 (three) working days to the territorial subdivision, which shall, on the basis of the provided information and available data (including acts of investigation of cases of occupational diseases of employees of the given and (or) similar industries or sites (workshops), archival results of sanitary and epidemiological monitoring, control and supervision) within 10 (ten) working days, shall draw up SEC in three copies and shall send one copy to the medical organization that submitted the notice of suspected occupational disease and (or) poisoning in the form approved by Order № ҚР ДСМ-175/2020, the second copy to the employer.
If insufficient information is provided to the SEC, the Area Office shall inform the employer in writing within three (3) working days in an arbitrary form that additional information is required, which the employer shall provide within five (5) working days of receipt of the written information.
If the occurrence of occupational disease and (or) poisoning is caused by work at facilities controlled by different territorial subdivisions, the territorial subdivision at the last place of work of a person with suspected occupational disease and (or) poisoning shall draw up an SEC based on materials received from the relevant territorial subdivisions and other organizations (employers) upon official requests. The organizations that received the request shall provide copies of the requested documents for the SEC within 10 (ten) working days.
Footnote. Chapter 2 was added with paragraph 15-1 in accordance with the order of the Minister of Healthcare of the Republic of Kazakhstan dated 11.03.2022 № ҚР ДСМ-23 (shall be enforced upon expiry of ten calendar days after its first official publication).16. The occupational health clinic shall conduct laboratory and functional examination in accordance with clinical minutes in accordance with Article 7, subparagraph 78), of the Code of the Republic of Kazakhstan.
17. EPPC shall conduct a primary examination of the establishment of occupational disease with the employee's performance of work (official) duties in the presence of documents specified in paragraph 15 and the results of examinations specified in paragraph 16 of these Rules.
18 EPPC shall consider:
1) occupational history:
documents confirming the employment of the patient in accordance with Article 35 of the Labour Code of the Republic of Kazakhstan;
2) service experience:
continuous service in harmful and/or hazardous working conditions for at least eight years;
examination of the connection of occupational disease with performance of labor (official) duties shall not be carried out after termination of work in harmful and/or hazardous working conditions for more than three years, if during the period of work in harmful and/or d hazardous working conditions the beginning of disease formation is not established, except for diseases specified in paragraph 19 of these Rules;
3) sanitary and epidemiological characteristics of working conditions:
sanitary and epidemiological characteristics of working conditions reflect all harmful and (or) hazardous production factors of the employee's work (severity of the labor process, physical, chemical, biological factors) along the entire professional route, according to the work book and data of mandatory periodic certification of production facilities according to working conditions for all years of the employee's work;
In the absence or lack of incomplete data of the working process in the sanitary and epidemiological characteristics of working conditions, the head of the professional health clinic shall issue a request to the territorial divisions of the state body in the field of sanitary and epidemiological well-being of the population (hereinafter referred to as the territorial division) to supplement the sanitary and epidemiological characteristics of working conditions;
If no examinations of the production environment were carried out, this shall not be an obstacle to the diagnosis of occupational disease, since this takes into account data from the scientific literature (if they are available and relevant), modeling, as well as extrapolation of similar production conditions;
4) the act of accident related to employment shall be provided by the patient specified in paragraph 11 (if any) in the form established by the authorized state labour body, in accordance with Article 190 of the Labour Code;
5) history of patient disease:
EPPC shall analyze medical documents (original medical records of an ambulatory patient with a medical organization with data from mandatory preliminary and periodic medical examinations, data from an electronic health passport) in the form approved by Order № RK HM-175/2020:
EPPC shall analyse all employee requests for medical care for each disease profile, including patient complaints, history of disease development, clinical data and results of medical examinations:
In the absence of sufficient information on the medical documentation, the EPPC shall request additional documents necessary for the examination of the connection of a occupational disease with the performance of work (official) duties;
6) clinical data and examination results data;
EPPC shall take into account a set of changes in clinical and paraclinical research methods, shall establish a final clinical diagnosis indicating the main diagnosis, complications and the degree of functional changes in the body's organs and systems.
19 EPPC shall take into account:
1) if there is a multifactorial cause of the disease and there is a professional factor among them, then the disease shall be considered professional;
2) certain occupational diseases: silicosis, berylliosis, bladder papilloma, malignancies develop long after termination of work in contact with harmful, and/or hazardous industrial factors;
3) when establishing a chronic occupational disease of an allergic, infectious nature, contact with active sensitizing substances or a biological factor, especially clinical manifestations, is important. Work experience shall not be taken into account.
20 Based on the results of the examination, the EPPC shall make the following conclusions:
1) disease shall be associated with exposure to occupational factors (occupational disease, primary);
2) the disease shall not be associated with exposure to occupational factors;
3) the occupational disease control group with recommendations for re-referral to the occupational health clinic after one year;
4) additional information (which are specified), additional examination and (or) consultation of specialists with a repeat meeting of the EPPC shall be required;
5) occupational disease progresses or regresses (disease occupational, repeated).
21 EPPC shall decide on the timing of the process and shall determine the consequences of an acute occupational disease, indicating the degree and severity of clinical manifestations.
22 EPPC as a result of the examination shall determine the form of repeated consideration of materials (full-time, correspondence).
23 The EPPC conclusion shall be drawn up in accordance with Annex 2 to these Rules.
The EPPC conclusion shall be issued on paper and electronic media and shall be stored in the medical documentation of the patient in the professional health clinic constantly in accordance with the order of the Acting Minister of Culture and Sports of the Republic of Kazakhstan dated September 29, 2017 № 263 "On approval of the List of standard documents formed in the activities of state and non-state organizations, indicating the shelf life" (registered in the Register of state registration of regulatory legal acts of the Republic of Kazakhstan on November 18, 2017 under № 15997) (hereinafter referred to as Order № 263).
The conclusion of the EPPC shall be included in the medical documentation (extract from the medical record of an inpatient patient, extract from the medical record of an ambulatory patient) in the form approved by the authorized body in the field of healthcare in accordance with Article 7, subparagraph 31) of the Code.
24 In case of difficulty in determining the examination of the connection of occupational disease with the performance of labor (official) duties of the EPPC or in connection with the disagreement of the employee, employer, insurance company with the conclusion of the EPPC, according to the term of consideration of the appeal in accordance with Article 8 of the Law of the Republic of Kazakhstan of January 12, 2007 "On the procedure for the consideration of appeals of individuals and legal entities," the medical documents of the patient by the professional health clinic shall be sent for consideration to the Republican expert conflict professional commission (hereinafter referred to as RECPC).
25 The procedure and the composition of the RECPC shall be approved by the head of organization of education in the field of healthcare, on the basis of which the RECPC is created.
Footnote. Paragraph 25 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 11.03.2022 № ҚР ДСМ-23 (shall be enforced upon expiry of ten calendar days after its first official publication).26 The RECPC shall consider documents within the deadline in accordance with Article 8 of the Law of the Republic of Kazakhstan dated January 12, 2007 "On procedure for consideration of appeals of physical and legal persons." If necessary, invites doctors on the profile of diseases to meetings, requests documents from organizations necessary for examination.
27 The RECPC shall consider the following documents:
1) appeals;
2) EPPC conclusion;
3) patient's documents specified in paragraph 15, results of studies specified in paragraph 16 of these Rules.
4) additional documents received at the request of the EPPC or submitted by the patient (if available).
28 If necessary, the RECPC shall request additional documents from medical organizations serving enterprises, at the place of attachment of the patient, offices of professional pathology, territorial divisions, and the employer for the examination of the connection of a occupational disease with the performance of labor (official) duties specified in paragraph 15, subparagraphs 3-6 of these Rules.
29 Upon receipt of the requested documents, a second meeting of the RECPC shall be held to examine the connection of professional illness with the performance of labor (official) duties, with a decision on full-time or correspondence form:
1) disease shall be associated with exposure to occupational factors (occupational disease, primary);
2) the disease shall not be associated with exposure to occupational factors;
3) removal of chronic occupational disease (poisoning).
30 The conclusion of the RECPC shall be drawn up in accordance with Annex 3 to these Rules.
31 The RECPC conclusion shall be issued on paper in three copies, of which:
1) one copy shall be issued to the applicant or his legal representative (employee, employer, insurance company);
2) the second copy shall be entered into the medical information system;
3) the third copy shall be kept in the medical documentation of the patient in the professional health clinic constantly in accordance with Order № 263.
32 Upon initial establishment of chronic occupational disease, the occupational health clinic shall draw up a notification on the occupational disease in the form according to Annex 4 to these Rules and within 3 (three) working days shall send it to employers according to professional route of the employee, to the territorial subdivision which has issued the SEC, and the healthcare organization, established that has established a suspicion (preliminary diagnosis) of occupational disease.
Footnote. Paragraph 32 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 11.03.2022 № ҚР ДСМ-23 (shall be enforced upon expiry of ten calendar days after its first official publication).Annex 1 to the Rules of expertise for the connection of occupational diseases with performance of labor (official) duties |
List of occupational diseases
Annex 2 to the Rules of expertise for the connection of occupational diseases with performance of labor (official) duties |
Сараптамалық кәсіби патологиялық комиссия қорытындысы
№ _______ dated ___________________ 20 "____"
Conclusion of the expert occupational commission
№ _______ dated ___________________ 20 "____"
1. 1. Науқастың тегі, аты, бар болған кезде әкесінің аты (Last name, first name, patronymic of the patient (if any) _______________________________________________
2. Туған күні (Date of birth) ___________________________________
3. Жұмыс орны мен кәсібі (Place of work and type of employment) ___________________
4 Негізгі мамандығы (Main specilaty) ________________
5. Кәсіби бағдарлар:
(Professional direction) __________________________
__________________________________________________________________________
Санитариялық-эпидемиологиялық сипаттаманы сараптау- бірінші рет келген ауруларға.
(Examination of sanitary and epidemiological characteristics of working conditions - for primary patients)
№ _______________ dated ____________________
__________________________________________________________________________
_________________________________________________________________________
6. Ауру анамнезі (History of disease) _________________
7.Әлеуметтік – клиникалық қорытынды (Social and clinical conclusion):
Негізгі диагноз (Main diagnosis)
_________________________________________________________________________
__________________________________________________________________________
Қосымша диагноз (Concomitant diagnosis) ___________________
Еңбек ұсыныстары (Labour recommendations) _________________________________
Ұсыныстар (Recommendations) ____________________________
Келесі қаралу мерзімі (Term of repeated examination) __________
Комиссия төрағасы (Chairman of the commission) _____________
_______________________________________________________
Комиссия мүшелері (Members of the commission) _____________
_______________________________________________________
Annex 3 to the Rules of expertise for the connection of occupational diseases with performance of labor (official) duties |
Республикалық сараптамалық жанжал кәсіби патологиялық комиссия қорытындысы
№________________"____"___________________20 ж.
Conclusion of the republican expert conflict commission
№ _________ 20________from "______" _________________
1. 1. Науқастың тегі, аты, бар болған кезде әкесінің аты (Last name, first name, patronymic of the patient (if any) _____
2. Туған күні (Date of birth) ____________________________
3. Мекен-жайы (Home Address) _________________________
4. Жұмыс орны мен кәсібі (Place of work and specialty) ___________________________
5. Өтінім берілген күн (Date of application): ________
а) кімнен (from whom) _________________________
б) өтінімнің себебі (reason) ______________
6. Пациентың негізгі мамандығы (The main profession of the patient) ____________
7. Kәsіbi baғdarlar:
- Кәсіби маршрут (occupational history) ________________
__________________________________________________________________________
-Санитариялық-эпидемиологиялық сипаттаманы сараптау- бірінші рет келген ауруларға..
(Examination of sanitary and epidemiological characteristics of working conditions - for primary patients)
№ __________________ from _______________________________________________
__________________________________________________________________________
__________________________________________________________________________
8. Сараптамалық кәсіби патологиялық комиссия қорытындысы (Conclusion of the expert
professional pathological commission) ____________
9. Өмірлік анамнезі (History of life) ________________
10. Ауру анамнезі (History of disease) _______________
11. Науқастың шағымдары (Patient complaints) ________
12. Объективті мәліметтер (Objective data) ____________
13. Тексеру (examination)
__________________________________________________________________________
14. Кеңестер (consultations) _____________________
________________________________________________
15. Әлеуметтік – клиникалық қорытынды (Social and clinical opinion)__________________________________
Негізгі диагноз (Main diagnosis)
__________________________________________________________________________
__________________________________________________________________________
Қосымша диагноз (Concomitant diagnosis) __________
Еңбек ұсыныстары (Labour recommendations) ______
______________________________________________
__________________________________________________________________________
Ұсыныстар (Recommendations) _________________
___________________________________________
Комиссия төрағасы (Chairman of the Commission) ________________________________
Комиссия мүшелері (Members of the Commission) ________________________________
Annex 4 to the Rules of expertise for the connection of occupational diseases with performance of labor (official) duties |
Кәсіптік ауру туралы хабарлама
Occupational Disease Notification
1.Тегі, аты, әкесінің аты (Last name, first name, patronymic (if any)) ____________________________
2. Жынысы (Gender) _____________________________
3. Жасы (Age) _________________________ толық жасы (full years)
4. Ұйымның атауы, оның меншіктік түрі (name of the organization, its form of ownersip)___________________________________________
_____________________________________________
5. Цехтің, бөлімшенің, учаскенің атауы (Name of the workshop, department, site) ___________________________________________________
6. Жалпы еңбек өтілі (Total work experience). __________________________________________________
7. Еңбек өтілі (Length of Service experience). Кәсіптік ауруды туғызған өндірістік зиянды факторлармен
жанасуда болған.. (In contact with harmful production factors causing occupational disease) ________________________________________________________
_________________________________________________
8. Негізгі диагнозы (The main diagnosis) _______________
_______________________________________________-
Қосымша (Accompanying) ___________________________________________________
9. Ауруды тудырған зиянды өндірістік фактор (Harmful production factor,
causing the disease) ____________________________
______________________________________________
10. Қорытынды диагноз қойылған күн (Date of final diagnosis)
__________________________________________________________________________
11. Диагнозды қойған ұйымның атауы (Name of the organization that established the diagnosis)
__________________________________________________________________________
12. Хабарламаның тіркеу нөмірі (Notification registration number
№ __) 20__________________ "____" ___________________
Ұйымның Хабарлама жіберілген күн (Sending date of the notice)
мөрінің орны
(Seal) 20_______"____" _________________
Хабарламаны жіберген адамның қолы__________________
(Signature of the person who sent the notice)
тегі, аты, әкесінің аты
(last name, first name, patronymic (if any))