Medical report kek. Clinical Expert Commission (CEC) and its functions. How can I obtain this certificate?

In government clinics and a clinical expert commission is being created in the health authorities of the Russian Federation. This commission consists of 15 doctors and various representatives of medical institutes.

Chapter commissions- most often the chief physician or the head of a department. Meetings of the commission can be held either every week or as necessary. It all depends on what basis the commission is based on.

KEC Help- this is a documented conclusion of the KEK commission. The most important medical certificate. From a legal point of view, it has the greatest weight in relation to other certificates. The CEC can be challenged only in a commission at a higher level or in court and the prosecutor's office. But it is necessary to have specific reasons. Disagreement alone will not be enough.

In addition, this conclusion is the final decision in all medical disputes. It happens that patients do not agree with the diagnosis and are determined to challenge it. It is the KEC that makes the final decision on the objectivity of the diagnosis and the effectiveness of the prescribed treatment.

What can KEC certificates be used for?

It makes it possible to continue treatment for one year. In this case, the patient is not assigned a disability and cannot be fired from work/expelled from school.

For reference only KEC makes it possible to extend temporary disability without assigning a disability group for a maximum period of 12 months.

In what cases is a KEC certificate issued?

The commission meets when the doctor does not have the right to make a decision himself:

1. The patient needs sick leave for more than a month.

2. It is necessary to provide living space to incapacitated persons (disabled persons)

3. It is necessary to confirm the right to social services. payments to disabled people

4. CEC for academic leave is given to students of educational institutions in three cases:

1) for health reasons (severe injuries, pregnancy, loss of legal capacity, etc.);

2) caring for children and seriously ill relatives. Due to the difficult financial condition of the family, etc.;

3) for other reasons that require completion or suspension of training. For example, natural disasters

5. The need to approve the decision to terminate the pregnancy

6. Permission is required for a seriously ill child to switch to home schooling (CEC for home schooling)

7. KEC for exemption from physical education (the student needs exemption from physical activity)

Commission is responsible for the accuracy, validity and objectivity of the examination. Accordingly, decisions of the EEC can be appealed legally.

The health care facility has a card in which data on all decisions without exception is entered.

DECOR

According to the form, the KEK certificate must indicate:

FULL NAME. patient;

The name of the organization to which the document will be provided;

The decision made by the commission;

Date of issue of the document.

To indicate the diagnosis in the EEC, the patient’s consent is required.

KEC medical certificates must be certified by the signature of the chairman and members of the commission. It is mandatory to have the personal seals of doctors and the seal of the medical institution.

HOW TO OBTAIN A KEC CERTIFICATE?

You must contact the clinic to which you are assigned. Be prepared for a long wait. First, wait for the commission, then issue the EEC’s conclusion. This is all long work. This certificate takes much longer to complete than other types of medical documents. It may take from 1 to 7 days to collect all the necessary information and various documents.

If you decide to apply for a certificate from a public clinic, you should do this in advance. When deadlines are still “tolerated.”

Budget accounting KOSGU

KOSGU (classification of operations of the general government sector) and its use in accounting

KOSGU is a special complex of grouped operations in the field of public administration. All operations are combined depending on their content in economic terms. KOSGU codes are used for planning and implementing the budgets of organizations that are in any way connected with the budget system of the Russian Federation, as well as in the operations they carry out.

All aspects of the application of KOSGU in practice are determined by the regulations of the Ministry of Finance of the Russian Federation, which establish the rules for maintaining budget accounting.

The entire complex of KOSGU consists of 8 general groups, united under a common economic content, which are divided into many sub-articles.

KOSGU groups

Each operation according to the KOSGU system can be defined in one of eight groups, each of which contains articles whose content corresponds to the name of the group. Each group is internally grouped and has its own sub-items.

Sub-items of group 100 – “Income”:

1. Code 110 – budget profit related to the tax legislation of the Russian Federation.
2. Code 120 – profit received from the operation of property that is permanently or temporarily owned by a budget organization.
3. Code 130 – profit received by a budget organization from providing clients with various paid services.
4. Code 140 – profit received by the organization as a result of fines, sanctions and mandatory payments.
5. Code 150 – finances received by the organization from other parts of the budget system of the Russian Federation, international financial organizations or from organizations and governments of other countries.
6. Code 160 – income from insurance deposits and penalties on these deposits.
7. Code 170 is the exchange rate difference between national and foreign currencies, the value of which can be positive or negative.
8. Code 180 – sources of profit that could not be attributed to the previous subparagraphs.

Sub-items of group 200 – “Expenses”:

1. Code 210 – funds to pay employees.
2. Code 220 – funds spent on services of third parties
3. Code 230 – funds spent on servicing the public debt.
4. Code 240 – payments to organizations free of charge.
5. Code 250 – payments to budgets free of charge.
6. Code 260 – funds transferred by the organization to social security funds.
7. Code 290 – expenses of the organization that could not be attributed to the previous paragraphs.

Sub-items of group 300 – “Receipt of non-financial assets”:

1. Code 310 – increase in the price of fixed assets.
2. Code 320 – funds spent by the organization to increase intangible assets.
3. Code 330 – increase in the value of non-produced assets and costs of increasing property prices.
4. Code 340 – increase in the value of the material reserve.

Sub-items of group 400 – “Disposal of non-financial assets”:

1. Code 410 – reduction in the price of fixed assets.
2. Code 420 – profit from the sale of an organization’s intangible assets, such as fixed assets, intangible assets, inventories and the like.
3. Code 430 – reduction in the value of non-produced assets.
4. Code 440 – reduction in the price of the material reserve.

Sub-items of group 500 – “Receipt of financial assets”:

1. Code 510 – growth of financial balances of members of the budget system.
2. Code 520 – increase in the value of securities, except for participation in capital.
3. Code 530 – increase in prices for forms of participation in capital.
4. Code 540 – funds spent on issuing budget loans to other participants in budget interaction, with the exception of foreign ones.
5. Code 550 – funds spent from the organization’s budget on other financial assets.

Sub-items of group 600 – “Disposals of financial assets”:

1. Code 610 – decreasing the balance in the budget account.
2. Code 620 – fall in the value of securities, without forms of participation in capital.
3. Code 630 – reduction in price for forms of participation in capital.
4. Code 640 – reduction of debt on budget loans and credits.
5. Code 650 – decrease in the value of other financial assets.

Subparagraphs of group 700 – “Increase in liabilities”:

1. Code 710 – increase in the internal debt of the organization.
2. Code 720 – increase in the organization’s external debt.

Subparagraphs of group 800 – “Reduction of liabilities”:

1. Code 810 – reduction of the organization’s internal debt.
2. Code 820 – reduction of the organization’s external debt.

KEC budget accounting

With the evolution of the market economy at this point in time, the taxation system is changing significantly in all sectors of the national economy.

Lease, joint stock and joint ventures arise. In the process of work, accountants need to apply new techniques that reflect the property in a special form and the relationships of the participants. Conducting accounting in organizations on a budgetary basis has its own specifics. This specificity is determined by the legislation of the Russian Federation on the budgetary mechanism and procedure, as well as the directive on accounting in organizations that are funded by the budget.

Accounting is a regulated system for collecting, registering and generalizing information in financial terms about property, the responsibility of the company for all business transactions and their movement through continuous and documentary accounting.

Accounting Features:

1. education of accounting according to sections of budget classification articles;
2. verification of execution of cost estimates;
3. cash and actual expenses are distinguished in accounting;
4. sectoral characteristics of accounting in public sector organizations

Economic definitions

To save the list of articles and subarticles, use the reference book “Economic Classification Codes (ECC)”. The directory is used to create accounts in the organization’s Working Chart of Accounts, as well as to register settlement and payment documents. The directory includes the code and name of sections and subsections of the classification of operations of the public administration sector (KOSGU). In addition, in addition to the articles specified by the Instructions on the procedure for using the classification of the budget of the Russian Federation, the reference book also contains the code “000”. This code is used to compile transactions that do not need to be assigned a classification code for the operations of the public administration sector. For example, the formation of transactions for an autonomous institution for non-monetary liabilities and assets. Chart of accounts for budgetary and accounting of budgetary organizations, the code for the classification of operations of the public administration sector corresponds to the type of accounting transaction “disposal” or “receipt”. Depending on whether the posting is in debit or steal, the account is selected.

KOSGU: what is it and how to use it correctly

The classification code for the operations of the government sector is automatically indicated for similar accounts in all accounting entries. The list of items of economic classification of expenses or income is a limited choice for other accounts. It is also worth paying attention when selecting a specific entry in a document from the directory “Economic Classification Codes.” So that you can subsequently create the necessary reporting with the required detail. A budget classification is created in the subsystems, and a unified classification of the budget system is introduced.

KEC or VKK? The umbrella term VKK (medical advisory commission) and KEK (clinical expert commission) is used to designate the expert structure for conducting a medical examination of temporary disability, with an emphasis on the need to extend treatment for a longer period.

CEC (clinical expert commission) is a collegial body that is organized in state (municipal) medical institutions, as well as in regional (territorial) health authorities of the Russian Federation if they have at least 15 working doctors on their staff. The CEC includes the chairman - the chief physician or (in large medical institutions) his deputy for clinical expert work (CER), the head of the relevant department and the attending physician. If necessary, heads of specialized offices and medical specialists (doctors of narrow specialties) from research institutes and other medical institutions and organizations may be involved.

The composition of the clinical expert commission (CEC) may change periodically depending on the specifics of the issue being considered by the medical commission (MC). The KEC is headed by the chairman of the medical commission (MC), who is also the chairman of the KEC - the chief physician of a medical institution or the head of a certain department, or another practicing physician. The Chairman of the KEC is a permanent member of the commission.

As a rule, if the KEC is created on the basis of a medical institution, meetings of the commission are held weekly; if the EEC operates under the health authorities, then the commission members meet as needed.

The KEC is a medical body that makes collective decisions on complex medical issues by voting, guided by the professionalism of its members, common sense and in the interests of the patient's health. All decisions made by the CEC (clinical expert commission) are legally valid and subject to execution by those to whom they are addressed.

The powers and functions of the KEC are quite diverse. In accordance with the main legislative acts of the Russian Federation, norms and rules of clinical expert work (CER), the commission (CEC) is authorized to consider the most difficult, from a medical point of view, questions and draw conclusions, which are documented and issued in the form of a CEC conclusion (CEC certificates) .

However, the powers of the clinical expert commission extend not only to decision-making in difficult situations. Such commissions are authorized to monitor the quality of medical services, provide assistance in the form of counseling to those patients who have been incorrectly diagnosed, if the patient believes that the treatment prescribed to him is not effective, and the drugs he is using are inappropriate. In such cases, you can contact the clinical expert commission with a request to review the appointments of the treating staff.

The powers of the clinical expert commission may include the functions of removing medical personnel from work if the commission has identified serious violations in the course of its activities. The work of the clinical expert commission is intended not only to resolve social and medical situations, but also to improve the quality level of service to citizens, the responsibility of treating physicians, as well as the effectiveness of the treatment methods used.

The Clinical Expert Commission (CEC) can consider conflict situations and controversial issues that often arise in clinics and other medical institutions. The decision-making basis of the EEC is always based on the interests of the patient (patient) and the state, that is, to promptly release sick people from work, remember that release from work is often decisive in the treatment and outcome of the disease. At the same time, the doctor should not allow unreasonable dismissal from work. He must constantly be concerned about reducing the incidence of temporary disability and remember that reducing, for example, the average duration of a case of disability by just one day saves millions of workers.

All decisions of the EEC can also be challenged in the courts if the patient believes that the actions of its members were not justified and the decision was made incorrectly.
The powers of the clinical expert commission include analysis, consideration and making decisions in the following areas:

— in the case when it is necessary to extend sick leave for a period of more than a month;
— when a student or student needs to be granted academic leave due to psychological or physical health conditions;
- if it is necessary to exempt students of secondary schools from entrance or transfer exams, as well as physical activity, due to a serious illness or rehabilitation period after an illness;
- if the patient needs a conclusion on premature termination of pregnancy due to medical indications, an existing disease of the woman in labor that poses a threat to her life;
- in cases where it is necessary to provide separate or additional living space to persons who have lost their ability to work or disabled people;
- a request for the right to benefits for disabled people from childhood and up to the age of 16, as well as for financial support of persons exercising their guardianship;
— pupils and students who need long-term release from physical education classes;
— when a child, for health reasons, is unable to attend a general education school, the issue of transferring him to home schooling is considered.

When a consensus is reached, in confirmation of the decision made by the commission, a completed KEK certificate form is issued (also known as the KEK conclusion protocol), certified by the seal of the medical institution and the signatures and seals of all medical specialists included in the KEK.
The KEK certificate has the following mandatory items:

• FULL NAME. and date of birth of the patient;
• clinical diagnosis and its complications;
• decision of the commission.

In addition, the KEK certificate must contain the following data:
— the reason and subject of the meeting of the clinical expert commission;
— list and signatures of the commission members and the chairman;
— the exact date of the meeting;
— seal of the medical institution where the meeting of the clinical expert commission was held.

It is important to know that the CEC (clinical expert commission) and the VKK (medical advisory commission or medical control commission) are medical commissions (MCs) created in medical institutions, primarily to conduct the II stage of the examination of temporary disability (EVN) , with an emphasis on the need to extend treatment for a longer period.

Officials of the Ministry of Health and Social Development of the Russian Federation decided to remove the term “clinical expert commission” (CEC) from all regulations and replace it with the term “medical commission” (MC), which “should be used in current practice” (quote). But the corresponding letter contains many inaccuracies, primarily related to incorrect references to regulatory legal acts that did not allow this letter to enter into legal force.

Thus, the terms “TEC” and “VKK” currently used in practical organizational work on the examination of temporary disability (TEI) mean the same thing! Those. both KEK and VKK are the names of essentially the same medical council (body).

The abbreviations "KEK" and "VKK" do not contradict current legislation and can be considered equivalent for use in medical institutions until new documents regulating expert work are adopted.

To enter into the use of a number of special rights or to obtain specific medical certificates and medical opinions, it is often necessary to obtain a KEK conclusion - a medical certificate issued as part of the work of a clinical expert commission and based on the results of this work.

The KEK certificate (the documented conclusion of the KEK) is officially considered as the most significant and most important medical certificate. The KEK conclusion cannot be ignored - the KEK certificate is of greater importance from a medical and legal point of view than any other medical documents, medical certificates, forms, reports, etc.

However, this is not the only thing that makes the medical report of the EEC a certificate of paramount importance. Such a medical certificate provides the patient with a number of other rights. Actually, the CEC conclusion itself can be used simultaneously to implement several or even all of them. At the same time, few people need this in practice. Most often, obtaining a KEC medical certificate is dictated by only one, maximum, two tasks related to the very specific life circumstances of the patient.

Let us indicate specifically what the medical conclusion of the EEC can be used for.

First of all, this document provides its owner with the right to continue treatment for one year, starting from the moment the KEK medical certificate is issued, without assigning a disability group, without dismissal from work or expulsion from the place of study. Those. only a KEK certificate gives the exclusive right to extend the period of temporary disability of a student or worker and the corresponding continuation of treatment without assigning disability for the maximum permitted duration - twelve calendar months (one year).

In addition, the CEC conclusion is a document necessary for the subsequent execution of other documents. In particular, this applies to the process of registering the right to a student’s academic leave, to obtain a long-term exemption from physical education in an educational institution, to receive a referral for treatment to a specialized sanatorium, etc. Conclusion KEC ensures transfer to home schooling, official recognition of disability and inability to study according to a standard traditional program, fundamental inability to perform certain labor and professional duties. A KEK medical certificate is needed by citizens preparing for the process of prosthetics, who wish or are forced to undergo MSTEC in the near future (this is the officially recognized abbreviation of medical, social and labor examination). The conclusion of the CEC is also the primary result of the disability examination; without reviewing the medical case by a clinical expert commission, the disability recognition commission cannot meet.

Finally, it is the conclusion of the clinical expert commission that appears to be the document that can and even should put an end to medical disputes and uncertainties. So, in particular, often the patient or his relatives, close people, official representatives, etc. Sometimes they disagree with the diagnosis given to the patient and are even ready to actively challenge it. It is the clinical expert commission that must make the final decision on the objectivity and correctness of the diagnosis. The EEC also makes decisions regarding controversial and inaccurate diagnoses. The point is that an individual specialist doctor or even a group of such doctors is not always able to make an accurate final diagnosis. Moreover, if it is necessary to continue or prescribe treatment, to refer the patient to any procedure, etc., then a clinical expert commission is convened, which must make a decision. This decision will be reflected directly in the medical certificate - the conclusion of the EEC.

Let us note that the clinical expert commission is a collegial medical body that may be non-permanent and work exclusively in cases where it is necessary to make a decision and issue conclusions from the CEC. Accordingly, there must first be a request for the convening of the CEC and its consideration of the circumstances of a particular medical case. Typically, KEC are the most qualified doctors and medical experts of a given medical institution, as well as invited specialists. The CEC is traditionally chaired by the chief physician of a medical institution or medical structure. The quantitative composition of the commission can be varied, it depends on what kind of case is being considered, as well as on which medical institution, in which locality the clinical expert commission works.

Previously, the clinical expert commission was called the medical advisory commission (MCC). In accordance with this, the conclusion of the KEK, according to the old tradition, is often called the conclusion of the VKK or the VKK certificate. Everyone should keep in mind that this is the same document. Another thing is that the CEC is the modern name of a collegial medical body, and if we are talking about official documents, then it is necessary to use the official terminology - a clinical expert commission, and not a medical advisory commission. Plus, the same commission is often referred to simply as a medical commission, which is also, by and large, true, but does not correspond to the official terminology. Thus, KEC is both VKK and VK.

Many people, trying to obtain an EEC conclusion, encounter certain problems stemming from a basic misunderstanding of the decoding of this abbreviation. Consequently, in accordance with this, instead of an abbreviation in modern Russian medicine, the full name is increasingly beginning to be used - clinical expert commission. Of course, receiving the conclusion of a clinical expert commission or receiving the conclusion of the CEC is not a fundamental difference, or more precisely, it is the absence of a difference.

Let's consider how to act for a person who is faced with the need to urgently obtain a KEK medical certificate.

First of all, you need to clearly define why this particular medical certificate is needed. This is necessary, first of all, for its correct filling and design. After this, you need to go to a medical institution authorized to issue medical certificates of the appropriate type. It must be said that clinical expert commissions are created on the basis of any medical institution. This means that you can equally well go to a clinic, a hospital, a student medical center, or another medical structure. Another thing is that the most preferable place to obtain a KEK medical certificate is the local clinic. In this case, the EEC conclusion is guaranteed to be of an official nature and will be filled out correctly, and all deadlines will be met.

Registration of a KEK medical certificate in any case requires passing a medical examination. Each member of the commission must independently examine the patient, study the results of his tests and examinations. To do this, the therapist, having learned about the patient’s intention to issue a CEC certificate, directs him to the appropriate procedures. Their passage is free if the document is needed by the patient at the request of a certain structure (educational institution, place of work, medical institution, etc.).

Please note that specific medical procedures, tests, examinations, etc. may change. It all depends on why you need to issue a KEC certificate and what the patient’s goals are. Thus, when challenging a diagnosis, measures are carried out according to one scheme, for obtaining academic leave by the patient - according to another, and for the initial determination of disability - according to a third. Moreover, much also depends on the health status of the individual patient.

However, in any case, you can issue a KEK certificate only on an official form approved for use throughout the Russian Federation. This form must be equipped not only with watermarks and a hologram, but also with the stamp of the medical institution and the seals of all doctors who are members of the KEC. Each of these doctors writes down his conclusion in the KEK certificate. Collectively, the commission makes the final decision, which ultimately is the conclusion of the EEC. Incorrect execution of the KEC medical certificate automatically casts doubt on the commission’s conclusion. To avoid problems associated with this, along with the KEK medical certificate, a protocol of the meeting of the clinical expert commission is also drawn up with a detailed description of all medical opinions and a reflection of the final conclusion of the commission, formed on a collegial basis.

Challenging the conclusion of the EEC is possible in a higher-level commission, as well as in the judicial authorities and prosecutors. However, for this there must be really serious and really compelling reasons, and not just disagreement with the opinion of the members of the clinical expert commission or the desire to get the opportunity that the CEC certificate provides.

Chairman of the KEC is provided for in medical institutions with a staff of 25 or more doctors who provide outpatient care and have the right to issue certificates of incapacity for work. The chairman of the CEC for the examination of temporary disability must be a highly qualified specialist and have training in medical labor examination.

The Chairman of the KEC organizes events to improve the qualifications of doctors on issues of temporary disability, ensures timely study by all doctors of the medical institution of current regulations, instructions, orders and instructions on the issues of examination of work capacity and issuance of certificates of incapacity for work (certificates). His responsibilities include instructing newly admitted doctors to the medical institution on the issues of examining temporary disability and personally monitoring their work.

According to the head department or the attending physician, the KEC advises patients with a difficult situation regarding the determination of work ability, and extends the certificate of incapacity for work. He controls the correctness of the examination by systematically selectively checking the validity of issuing and extending certificates of incapacity for work (certificates), as well as the correctness of their execution, studies individual outpatient records, and, if necessary, personally examines the patient.

Special attention he should pay attention to systematic monitoring of the initial issuance of a certificate of incapacity for work, monitoring the state of disability of patients who have a certificate of incapacity for work for more than 1 month. The group of long-term and frequently ill patients, as well as those patients for whom MSEC recommends follow-up treatment, is subject to special control. And in the case of a personal examination of the patient and a CEC examination, a corresponding entry is made in the medical history.

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The Clinical Expert Commission (CEC), consisting of a board of doctors, makes decisions on private medical cases. These decisions are formalized in the form of a protocol for concluding the CEC. Such a conclusion allows you to extend treatment for a longer period, take an academic course at a university, or leave the academy, go to home schooling, etc.

The Clinical Expert Commission (CEC) and the Medical Advisory Commission (MAC) are a board of medical specialists that exists in almost every medical institution, created to periodically conduct an independent medical examination. Clinical expert commission (CEC), medical advisory commission, medical control commission (MCC) or simply medical commission (MC) - all this is the essence of the name of the same medical body, collectively making decisions based on the results of consideration of a particular medical case.

The commissions of the EEC and the VKK include issues related to decision-making in the field of diagnosis, treatment, rehabilitation of patients, as well as establishing a person’s working capacity. Among other things, its jurisdiction includes situations related to the resolution of conflicts between patients and medical organizations, if they arise during or after completion of treatment.

VKK and KEK can be summarized by the term VK, which stands for medical commission. In turn, the medical commission is a board of medical specialists who are engaged in the second stage of the examination of temporary disability (TD). Those. examination of temporary disability (TDW) with an emphasis on extending treatment for a longer period. According to the regulations of the USSR period, the abbreviation “VKK” was used as a medical advisory commission or a medical control commission.

The leadership of the Ministry of Health and Social Development of the Russian Federation decided to replace the term “Clinical Expert Commission” with the term “Medical Commission”. In accordance with the letter of the Federal Service for Surveillance in Healthcare and Social Development dated June 2, 2005 N 01i-242/05, the term “medical commission” is used in current practice on the basis of Art. 39 "Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens." According to Section IV “On the Medical Commission of Health Care Institutions” of Letter No. 26-M of the Ministry of Health and Social Development of Russia dated January 25, 2005, the term “clinical expert commission” is currently being removed from all regulations of the Ministry of Health and Social Development of Russia. This document was sent to the health authorities, but due to the fact that many inaccuracies and inconsistencies were identified in the document, in particular, the document incorrectly referred to regulations, it was never approved. From all of the above, we can conclude that the abbreviations “VKK” and “KEK” are the designation of the same structure of the medical body, which is engaged in conducting the second stage of the examination of temporary disability (EVN). The second stage of the examination of temporary disability (TDW), as a rule, involves making decisions on the need to extend treatment for a longer period.

Since the concepts of “KEC” and “VKK” do not contradict the current legislation and are essentially the name of the same medical body, the use of these two names when preparing medical documentation is equivalent and interchangeable until new rules for maintaining medical records are adopted.

In any medical institution, a weekly schedule of meetings of the CEC (WCC) has been approved. Accordingly, on strictly defined days of the week, according to the approved schedule, a medical commission (MC) is convened, which includes medical specialists with the greatest amount of professional knowledge and work experience. At the CEC meeting, the most complex issues from a medical point of view are considered and the most significant decisions are made. To make urgent decisions, a medical commission (MC) may be convened unscheduled.

Typically, the KEC (VKK) is headed by the chief physician of a medical institution or the head of the department, but it happens that the KEC (VKK) is headed by another specialist with sufficient experience in clinical expert work. The number of members of the medical commission (MC) can range from five to fifteen members. It is not excluded that, in addition to doctors working in a given medical institution, the commission may include specialists invited from other medical institutions and organizations. These may include, for example, employees of research institutes (RIs) and other specialized healthcare organizations.

In terms of the personal composition of the KEK commission and the VKK commission, it is worth noting some formal differences in the concepts of KEK and VKK. The Clinical Expert Commission (CEC) assumes the presence in the commission of experts invited from other medical institutions (research institutes, clinics, etc.). The medical advisory commission (MCC) most often consists only of practicing doctors. The medical control commission in this case differs from the medical consultation commission in its purpose. It is created to control the issuance of certain medical certificates and permits. The concept of “medical commission” acts as a kind of generalizing term in relation to all the previous ones. However, this division is quite arbitrary, so the concepts “KEC” and “VKK” are usually used as synonyms.

The composition of the KEC (VKK) is, by and large, constant. However, it may vary depending on the specific case. Periodic rotation of commission members is also expected.

Based on the results of consideration of a specific issue, the commission makes an official conclusion (conclusion of the EEC or resolution of the High Quality Committee), which reflects the collective opinion of the commission members about the patient’s health status, develops further treatment tactics or resolves issues of transferring the patient to other medical institutions. All decisions of the medical commission (MC) are formalized in the form of a protocol - “Conclusion of the Medical Commission” or “Certificate of the Medical Commission” in form 035/u-02.

The final conclusion of the ECC (resolution of the VKK) is made on the basis of a decision that the commission makes collectively, provided that the majority of its members have expressed a similar opinion on the issue under consideration.

The conclusion of the KEK (decision of the VKK) is drawn up in the form of a certificate-conclusion of the KEK, form 035/u-02.

Thus, the certificate “Conclusion of the EEC” or “Certificate of the VKK” is the most important medical document that has the greatest weight from a medical and legal point of view.

The KEK certificate (VKK certificate) is filled out briefly according to the established form 035/u-02 and includes the following data:

1. Full name and date of birth of the person to whom the KEK certificate is issued (form 035/у-02);

2. Name of the place where the certificate was presented (place of study, work, name of the judicial authority);

3. Clinical diagnosis;

4. Commission decision;

5. Terms of treatment, release, transfer;

6. Date of issue of the certificate.

The certificate-conclusion of the KEK (form 035/u-02) is certified by the signatures of the chairman of the commission, the head of the department, the attending physician and the signatures of all members of the KEK (VKK) with their personal seals. Also, the KEK (VKK) certificate is certified by the seal and stamp of the medical institution.

Typical cases in which it is necessary to make decisions by the High Commission are:

1. Granting academic leave or leaving it;

2. Transition to homeschooling;

3. Full or partial exemption from physical education for a long period;

4. Decision on the citizen’s incapacity for work;

5. Decision on the suitability of a citizen for a certain work activity;

6. The decision to transfer the patient to disability status.

Documentary confirmation of the conclusions of the medical commission (MC) is the KEK certificate (form 035/u-02), which is issued to the patient or his legal representative. All data on the diagnosis, the patient’s health status, the means and methods used to treat the disease, the possible prognosis of the disease, as well as other information obtained during the examination and treatment of the patient, are protected by the “medical confidentiality law” and cannot be disclosed to third parties without the official consent of the patient.

The time frame for the ECC to make a decision when considering one issue is not limited, but rarely takes more than one week. At the same time, meetings of the KEK (VKK) are also held once a week. Thus, the time frame for making a decision by the ECC will depend on the specifics of a particular case and on the issues that will be considered.

It is also worth noting that the KEK certificate (form 035/u-02) has legal force regardless of which medical institution issued it. The only thing that is taken into account is whether the medical institution has accreditation to issue such certificates.

Thus, the KEC (VKK) is authorized to make final decisions on special cases related to medicine. To receive a KEK (VKK) certificate means to receive the most influential medical opinion, which will be quite difficult to challenge.

FORMS OF MEDICAL CERTIFICATES: