What is included in the medical board. Features of the medical examination when applying for a job. Who conducts a medical examination before the start of the working day or shift

For employment in some positions (cooks, teachers, employees of the Ministry of Internal Affairs and many others), the applicant must pass a medical examination. It consists of taking tests and examination by several specialists - a therapist, surgeon, ophthalmologist and others. The service can be obtained from the state or private clinic: in the latter case it will be much faster. The procedure for passing a medical examination and compensation for examination is described in detail in the following.

Legislative framework: who and at whose expense undergoes a medical examination when applying for a job

The current legislation obliges to undergo medical examination. Employment screening for the following positions:

1. Teachers, educators, teachers and all other employees working with children.
2. Doctors, nurses, other employees of hospitals, sanatoriums, health centers.
3. Employed in the field of catering or food production.
4. Employees who work in difficult or harmful, dangerous working conditions.
5. Professional athletes.
6. All minors applying for official employment.
7. All applicants planning to work on a rotational basis.
8. All applicants who plan to work for Far North.
9. Employed in works that are carried out underground.
10. Employees of law enforcement agencies, the Ministry of Internal Affairs, the FSB, border services, etc.
11. Judges of all levels.
12. Private security workers.
13. Drivers or employees whose activities are related to traffic Vehicle.
14. Laundry workers.

Expert opinion

Chadova Svetlana

Leading Human Resources Specialist, lawyer consultant on labor law, site expert

Local authorities can supplement this list with other positions. However, employers themselves do not have the right to expand the list of professions, i.e. citizen must pass medical checkup when applying for a job only in cases provided for by local or federal law.

The same article of the Labor Code states that any medical examination necessary for the implementation official duties, traversed only at the expense of the employer. This refers not only to passing a medical examination when applying for a job, but also scheduled examinations, examinations before each shift, etc.

At the same time, the medical examination itself is included in the program of compulsory medical insurance, i.e. the state is guaranteed to pay:

• examinations of all doctors (the list of specialists is presented below);
• primary tests (blood, urine, feces, ECG and some others).

Also, in most cases, a free opinion from a psychiatrist and narcologist is also provided. But in some hospitals (especially in small towns) the employee has to visit specialized centers or go to a larger settlement in order to obtain documents from these specialists. In this case, the service will be provided for a fee, but subsequently the employer will have to compensate for all costs except for travel expenses (however, the company may reimburse them at its discretion).

There are 2 payment schemes:

1. The company enters into an agreement with a specific medical organization (meaning a private hospital), and the job seeker is examined free of charge.
2. Either the applicant himself undergoes a medical examination when applying for a job, collects documents confirming his expenses, and then receives compensation in cash or by transfer to bank card where the salary goes. Specific terms for calculating compensation are not specified - usually this happens within a few months or six months from the date of employment. If during the first weeks / months it turns out that the employee cannot perform his duties for health reasons, he will be fired without compensation for passing the medical examination.

It is also important to understand that when conducting any examinations for already employed workers (scheduled, unscheduled medical commissions), the employer saves not only workplace, but also the average earnings, i.e. actually recognizes this time as working.

On the other hand, there is no direct prohibition in the legislation to send an employee to the hospital on his day off. Practice shows that such cases are quite common, but it is still rather difficult to recognize them as unlawful.

Where is the medical examination

There are 2 options:

1. In the state (municipal) polyclinic at the place of residence or at the address of temporary registration.
2. In a private medical facility.

In the first case, the procedure almost never fits into 1 day - often examinations in city clinics have to be completed throughout the working week due to large queues and, in part, not quite convenient appointment schedules.

In the second case the procedure will take 3-4 hours(usually in the morning), but it is paid separately. At the same time, the cost of the examination is quite affordable - it depends on the number of specialists and on the region where the clinic is located: on average about 1500-3000 rubles.

The applicant has the right to choose any of the options, but it is important to consider 3 points:

1. If the company has entered into an agreement with a commercial clinic, then it is necessary to undergo an examination there. In this case, the applicant will go through the doctors in a few hours, and he will not have to pay anything.
2. If the company does not have such an agreement, but the future employee passed a medical examination in a private clinic when he was hired, he may have difficulty with compensation. The fact is that in itself a medical examination in a state hospital can be done free of charge, although with a significant waste of time.
3. Finally, if we are talking about passing an examination during employment for a civil or military service (employees of the Ministry of Internal Affairs, the Ministry of Emergency Situations, the Ministry of Defense and many others), most often a medical examination is held in special departmental hospitals, i.e. in fact, the employee has no choice. At the same time, along with the standard list of tests and doctors, you may need to go through other specialists. The same is true for athletes.

The procedure for passing a medical examination: a list of doctors and the validity period of the certificate

During the examination, it is necessary to go through all the doctors whose opinions are required to grant admission. At a minimum, the list of specialists looks like this:

1. Therapist (makes a final conclusion based on the conclusions of other doctors).
2. ENT (otorhinolaryngologist).
3. Ophthalmologist.
4. Psychiatrist.
5. Neurologist.
6. Surgeon.
7. Expert in narcology.

Women at any age also undergo a gynecologist, and over 40 years - a mammologist; also at this age you need to do a mammogram.

Among the required tests, it is necessary to pass the following:

• blood;
• urine;
• fluorography.

Additionally, you may need spirography, blood pressure measurement and other types of examinations - complete list depends on the age, profession, as well as the individual condition of the person.

The procedure for passing the medical examination is as follows:

1. The applicant checks with the employer in which clinic he needs to undergo an examination. This is done only in cases where the company has entered into an agreement with a specific private hospital or when applying for a civil or military service (a medical examination is held in departmental hospitals).
2. Also, the future employee receives a referral for examination from the company. There is no single form for this document, so it can be drawn up in any form.
3. Then, together with this referral, as well as a passport and a compulsory medical insurance policy, a citizen comes to the hospital and gets an appointment with a therapist. If necessary, you need to take with you a personal medical book, which is purchased at your own expense (it costs about 300-500 rubles).
4. After that, he goes through all the specialists and takes tests according to the list specified by the therapist.
5. After passing the medical examination, the future employee receives an admission from the therapist, with whom he goes to the employer.

This document is valid for 6 months from the moment of its issuance. However, it is important to understand that if an employee quickly quit his job, and then gets a job in another place where a certificate is also required, he will be required to undergo a medical examination again.

If a person has recently taken any tests, it is not necessary for him to go back for an examination. It is enough to take with you the appropriate medical documents. However, the duration of many tests is short - for example, blood and urine tests are no more than 14 days.

Responsibility for failure to pass the medical examination

First of all, refusing to pass a medical examination will lead to the fact that the employer will not hire the employee, since the company does not want to take risks due to the lack of medical clearance. If the applicant forged the data or hid the fact of non-passing, but at the same time provided false (old) documents with a permit, he faces administrative responsibility and is practically guaranteed to be fired.

Hello! In this article we will talk about conducting medical examinations for employees of the enterprise.

Today you will learn:

1. What types of medical examinations are established labor law;
2. For workers of what professions, medical examinations are mandatory and with what frequency;
3. How to properly prepare for a medical examination of employees of your organization;
4. What are the consequences of failure to pass the primary or periodic medical examination for the enterprise and for specialists.

Why Send Employees for Medical Examinations

The term "medical examination" in the professional field has replaced the concept of "medical examination". In fact, both of them mean a set of measures to study the health of an employee, identify possible pathologies and prevent them.
It will depend on the physical condition of the employee how fit he is to perform certain labor duties. To understand whether the health of a subordinate corresponds to the position and paid activity, the employer sends employees of his company for a mandatory medical examination.

First of all, a periodic medical examination is necessary for workers in professions associated with danger: firefighters, rescuers, miners. The category of hazardous industries also includes enterprises whose activities are associated with chemical mixtures, biological substances, allergens, toxins, ultraviolet radiation.

The health status of employees of such companies must be monitored in order to avoid a sharp deterioration and prevent disability or possible industrial injuries. If at least one of the factors affects production employees, a medical examination should be organized once a year or more often.

Food workers, trade or organizations Catering, teachers in schools and preschool institutions undergo a medical examination in order to preserve their own and the safety of the health of those with whom the employee is in contact. In addition, the goals of medical examinations include monitoring the dynamics of the health of employees, preventing the development of diseases associated with professional activities.

The control of this aspect of labor is legally assigned to the head of the company. It is he who is required to determine how often employees must undergo mandatory medical examinations, whether a medical examination is necessary for a candidate before taking office, and other organizational issues.

Types of Medical Examinations of Employees

There are three main types of medical examinations at the enterprise, depending on the time of their conduct:

• Mandatory primary medical examination;
• Periodic medical examination;
• Extraordinary.

Mandatory preliminary medical examination

Preliminary medical examination- This is a one-time examination conducted for the admission of a new employee to the state. Individually, he is given a referral for examination by specialists. The initiative may come from you as a leader, but sometimes a preliminary medical examination is a mandatory step for a conclusion, which is enshrined in the legislation of the Russian Federation. It concerns certain types labor activity. Unsatisfactory results of medical examinations entail a refusal to conclude an employment contract with potential employees.

An initial medical examination is required for:

• Applicants under the age of 18;
• Applicants for hard or dangerous work;
• Applicants for work in the Far North;
• Athletes;
• Employees working with transport (pilots, machinists, drivers).

Managers who neglect this rule risk receiving administrative punishment and a fine for their company. In addition, there are areas of activity for whose employees a primary medical examination is also required. This category includes employees of the Ministry of Emergency Situations, customs, judges, railway employees.

If during the examination a non-compliance of the applicant for the position on health is revealed, you need to draw up written refusal in hiring. If the applicant refuses to undergo a medical examination, the head has every right to refuse to conclude labor relations with him.

For other types of business, a preliminary medical examination can be arranged at the request of the manager. It is worth remembering that the company will have to pay for visits to specialists. Most often, the entire complex of conclusions about the health status of the applicant takes place in the clinic with which the company has entered into an agreement.

Periodic medical examination of employees

You can choose the organization to which you entrust the conduct of a medical examination. The only criterion is having an appropriate license.

The specialists that employees will need to pass, analyzes and tests will differ for different professions, for men and women, for employees different ages. Nevertheless, the general list of procedures and specialists remains unchanged during any periodic medical examination at the enterprise.

First of all, the employee must be examined by a therapist, then the usual tests are taken: a general blood test and a general urinalysis. It is very important to include fluorography in the medical examination. It will make it possible to draw a conclusion about the standing of the lungs and bronchi and to identify tuberculosis, which in the early stages is actually asymptomatic.

Mandatory tests include an ECG and a visit to a neurologist, surgeon, ophthalmologist. The examination data is recorded in the medical book.

Mandatory medical examination is provided for a certain list of employees:

• Employees of production where there is one or more factors harmful or hazardous to health;
• Employees of public catering establishments;
• involved in high-altitude work;
• Medical workers, employees of sanitary and hygienic enterprises, pharmaceutical companies;
• Employees of educational institutions;
• Employees whose activities are related to animal husbandry, poultry farms and water utilities.

Regardless of the specifics of your business, all employees under the age of 21 must undergo mandatory periodic medical examinations.

There are activities that require inspection before the start of each shift. These include drivers, before each flight they are required to undergo special tests. Pre-shift medical examinations are also necessary for employees whose activities are associated with high physical and emotional costs (pilots, machinists).

Even if the activities of your company's employees are related to standard office work, the labor code provides for mandatory periodic medical examinations.

This applies to those employees who spend more than 50% of their time at a computer monitor. In this case, you can use the on-site medical examination service: many clinics have mobile brigade, which comes to the offices and conducts the necessary tests.

The rules for conducting extraordinary medical examinations are regulated by law least of all. These events do not have a frequency. They can be initiated by the employee himself in case of deterioration in health, if there is a suspicion that it is related to professional activities.

The second case of an unscheduled medical examination is the recommendations of specialists after the conclusion of a periodic examination. Perhaps the planned tests were not enough to determine the compliance of the employee with his activities and additional expertise is required. Also, labor protection specialists can send all or some employees for an unscheduled examination. Such cases can occur with a sharp deterioration in working conditions, the appearance of suspicious symptoms in one or more employees of the company.

Who pays for medical examinations of employees

The company fully bears the cost of the entire range of measures for the examination of employees. In addition, the average salary is kept for the employee of the organization for the period of passing the medical commission. A personal medical book is transferred to you, as an employer, for the entire time that the employee works in the company.

The cost of a medical examination of one specialist can vary from 1,500 to 5,000 rubles, depending on the region and the necessary tests. Most clinics provide a discount proportional to the staff.

The costs of the primary medical examination for the applicant also fall on the employer. Payment for a medical examination for employment is made in the same way as for a periodic examination. If the health of the candidate does not allow to conclude an agreement with him, the honey book remains in his personal use.

If a potential or current employee paid for the passage of specialists, the legislation provides for compensation for the costs of a medical examination by the employer. To do this, it is enough for the employee to write a free-form application and attach documents confirming the payment.

In the event that employees fail to undergo a medical examination due to the fault of the employer and their subsequent removal from duties, the company is obliged to pay them an amount equal to 2/3 of the salary.

A part of the amount for the medical examination is compensated through the compulsory insurance fund.

Step-by-step instructions for preparing for a periodic medical examination

Since all preparation for a medical examination at the enterprise is the responsibility of the employer, you will need to understand the nuances.

There is an algorithm that allows you to quickly and correctly prepare for a medical examination:

Step 1. The choice of a company that will conduct a medical examination, and the conclusion of an agreement with it. Most clinics are licensed to examine employees. After the conclusion of the contract, it is necessary to choose and agree on the terms of medical examination.

Step 2 Compilation of a list of employees who require a medical examination. This document is sent to the department of Rospotrebnadzor of your district. Indicate in the list of all employees by occupations that are affected by the negative factors discussed above.

Step 3 When the list of the contingent is agreed with Rospotrebnadzor, you will need to draw up a second list that lists the names of the company's specialists sent for a medical examination. Indicate their full name and influencing negative factor. This list also needs to be approved.

Step 4 After assurance, send this list to the company with which you have entered into an agreement for a medical examination. This must be done no later than two months in advance.

Step 5 The party providing services under the medical board will draw up an action plan by date. It usually takes about ten days. You, as an employer, only need to approve this plan.

Step 6 After the implementation plan is drawn up and agreed, you will need to familiarize your company staff with it. This step must be completed no later than two working weeks before the medical examination.

Step 7 All specialists who must undergo a medical examination are given a referral. Its receipt is confirmed by painting. The direction contains information about the enterprise, medical organization, full data of the employee, including occupation, according to, availability harmful factors. The document is certified by an authorized person of the employer.

Step 8 After passing the medical examination, supporting documents are issued: a conclusion based on the results of the examination and an act. The conclusion is drawn up in two copies. One is transferred to the employee, the second remains in personal map. Four copies of the acts are drawn up by the commission together with Rospotrebnadzor. One of them is sent to the employer.

Employees are only responsible for coming to the medical organization at the appointed time with a passport and referral.

Consequences of not passing a medical examination

Labor Code regulates not only the frequency and nuances of medical examinations by employees, but also measures for employees and employers if the medical examination has not been passed.

Often the applicant does not agree to the passage preliminary medical examination. In such circumstances, the employer does not have the right to conclude employment contract with an employee.

The employer signs a written refusal to accept a job, and if the applicant's health does not correspond to the intended duties, he cannot be admitted to the proposed activity.

Ignoring these conditions is fraught with a fine for the company. The amount may vary, depending on the form of the company. For individual entrepreneurs minimum fine threshold 15 000 r., for organizations - 110 000 rub.

What to do if a subordinate has not passed a periodic medical examination? The Labor Code obliges to temporarily suspend professional activity worker.

If the medical examination was not passed due to the fault of the employee, then wage not charged. In the event that the medical examination was not passed for reasons valid or beyond the control of the employee, the salary part of the salary is paid to him for the entire period of involuntary unemployment.

The issued act of the medical commission may state that it is impossible to continue working in the position occupied by the employee. If health problems prevent him from performing his duties, you can offer him another position. The Labor Code also provides for transfer to a less paid job within the company in such cases. If this is not possible, cooperation with the employee must be terminated.

Scheduled medical examinations will help you not only avoid sanctions and fines, but also maintain confidence that all employees can perform their direct duties without risk to their health.

Passing a medical examination when applying for a job

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The Labor Code says that there are categories of workers for whom a medical examination is mandatory upon employment. At the same time, only a few examples are indicated in the Code itself, the establishment of all other categories remains the responsibility of separate regulations and federal laws.

Who and why should undergo a preliminary (primary) medical examination when applying for a job?

Employees undergo medical examinations for the following purposes:

1. Identification of health contraindications for the performance of a particular type of work.
2. Reducing the number of cases of occupational diseases and injuries received at work.
3. Suspension from work, employees who, for health reasons, cannot work in this position.

The main document that regulates the mandatory medical examinations is the Labor Code of the Russian Federation, it establishes:

1. A small list of categories that must undergo a medical examination and gives the right to establish extended lists by separate regulations.
2. Obliges the parties to labor relations (employee and employer) to carry out such inspections without fail as part of the fulfillment of labor protection requirements in the organization.
3. Obliges the employer to pay for all medical examinations.

At present, the main document that regulates who must undergo a medical examination before hiring is the Order of the Ministry of Health and Social Development of the Russian Federation “On Approval of Lists of Harmful and (or) Hazardous Production Factors and Work, during which mandatory preliminary and periodic medical examinations (examinations) are carried out. ), and the Procedure for Conducting Mandatory Preliminary and Periodic Medical Examinations (Examinations) of Employees Engaged in Hard Work and Work with Harmful and (or) Dangerous Working Conditions” dated April 12, 2011, No. 302n, it regulates the following aspects:
Identifies the factors and work in the performance of which a medical examination is mandatory.

1. Establishes the procedure for medical examinations.
2. Establishes which documents must be presented by the employee for the inspection, and which should be issued to him based on the results of the inspection.
3. Determines who can conduct inspections.
4. Determines the procedure for the employer when sending for medical examinations.

Factors, the influence of which requires a medical examination, are indicated in Appendix 1 to this order, and the types of work in Appendix 2.
When the employer issues a referral, he must indicate the points of the relevant applications, there may be several of them at once.

What does the survey include?

The employer issues a referral to the future employee, in which he indicates the grounds for the inspection. With this referral, the employee can go either to any clinic that has a license to carry out paid services, or to the institution indicated to him by the employer.
They determine the list of doctors that a person has to go through.

The conclusion of a psychiatrist and a narcologist is obtained in separate institutions.

This should be done at the place of registration. If the registration was changed less than a year ago, or if the person does not live where he is registered, you can contact the appropriate dispensaries at the place of residence and ask to make a request at the place of registration.
After the answer comes, the conclusion can be obtained at the place of residence by passing additional examinations.
As a rule, this is an encephalogram and a urine test for the presence of narcotic substances.

What documents are needed to pass the medical examination for work?

In order to pass a medical examination, a person must have a passport and a referral from the employer, in which there must be a reference to factors and work.


In addition, additional documents may be required. For example, driver's license if a medical examination is passed for admission to driving vehicles.

How long is the certificate valid?

After the inspection, a conclusion should be drawn up and issued to the employee on his suitability (or unsuitability) for the performance of the work indicated in the direction.
The form of the conclusion form in Order 302n is not established, therefore it is issued on the form of a medical institution. Some polyclinics write the results of examinations directly to the direction of the employer. This will not be a violation, provided that the conclusion of the chairman of the medical commission (therapist) is indicated there, the date of the conclusion is clearly stated and all this is certified by the triangular seal of the medical institution.


The period of validity of the certificate, that is, the frequency of the medical examination, depends on what factor, or what work serves as the basis for the medical examination. As a rule, the certificate is valid for 1-2 years. It is counted from the date of the conclusion on the suitability of the employee.

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What is the cost of the procedure

The total cost of the medical examination depends on the place of its passage. It will depend on the number of doctors you need to go through. For example, the average cost of a medical examination for a driver in Moscow is 1,500–2,000 rubles. Here you need to add the passage of a narcologist and a psychiatrist. Depending on the place of passage, the cost of a certificate from these specialists starts from 300-500 rubles and more.

Who pays

According to Article 213 of the Labor Code of the Russian Federation, the costs of paying for the medical examination of employees are borne by the employer. He must pay the employee the entire cost of the procedure upon presentation of the relevant documents on the costs incurred, or send the person to a medical institution with which he has an agreement and pay the cost on his own.

If at your own expense

The employer does not have the right to force the employee to undergo a medical examination when hiring at his own expense, he must reimburse the funds spent, even if the employee was found unfit for the job for which he is employed.

Medical examination depending on the employee

In addition to the factors listed in Order 302n, there are certain categories of workers who need to be sent for a medical examination.

For underage workers

If the employer employs citizens who are under 18 years of age, then he must send them for a medical examination, regardless of what job they are employed.

Minors cannot be hired with harmful and dangerous factors, even if they have passed a medical examination.

For managers

The legislation does not specify that the head must undergo a medical examination. But it can be provided corporate policy organizations. At the same time, it must be remembered that it is impossible to oblige an employee to undergo a medical examination if it is not provided for by law.
The work of a manager does not exclude the presence of factors for a medical examination. For example, all employees who work at a computer for more than half of their working time must undergo a medical examination.
Also, a free medical examination for a manager can be established as a bonus under the system of voluntary medical insurance for employees.

For the driver

All drivers must undergo a medical examination upon employment. Moreover, this category includes not only persons who get a job in this position, but also employees who will work in another position, but drive the organization's car. For example, an electrician itinerant character work, who will independently drive a car owned by the employer.

Passing a medical examination upon admission to work is regulated by the Labor Code of the Russian Federation and is mandatory for several very large groups of workers. The medical examination makes it possible to identify the ability of new employees to carry out labor activities without prejudice to their health, and also creates the necessary basis for carrying out preventive measures to eliminate possible occupational diseases.

Regulatory documents defining the conditions of medical examination

At the legislative level, provisions have been developed that fix the standards for the procedure for a medical examination upon admission to work. These, first of all, include the provisions of the Labor Code on the implementation of medical examinations for selected groups of workers:

• Art. 69 and part 1 of Art. 266 concern persons under the age of 18;
• part 1 art. 213 explains the procedure for issuing a medical examination for workers in industries with harmful or dangerous working conditions, the same article regulates its implementation in motor transport companies;
• Art. 324 applies to persons working in the Far North or equivalent areas;
• Art. 298 concerns restrictions for workers working on a rotational basis;
• part 2 art. 213 is devoted to the conditions for issuing a medical examination in the food industry, trade and public catering, as well as in children's and medical institutions;
• part 1 art. 330.3 regulates the medical examination at underground work.

Several fundamental federal laws and regulations have been issued that prescribe the rules for passing a medical examination in certain industries or clarify them:

• paragraph 8 of the Decree of the Plenum of the Supreme Court No. 1 dated January 28, 2014 on the conditions of a medical examination for persons under 18 years of age;
• Order of the Ministry of Health and Social Development of the Russian Federation No. 302n dated April 12, 2011, which contains a complete list of jobs with working conditions recognized as harmful or dangerous;
• Decree of the Government of the Russian Federation No. 1020 of 09/08/1999 regulating the execution of a medical examination for drivers railway transport and other employees who ensure the movement of trains;
• part 1 art. 6 of Law No. 77-FZ of April 14, 1999 on medical examination for departmental security;
• paragraph 3 of Art. 9 of Law No. 38-FZ of March 30, 1995 on the prevention of the spread of HIV infection;
• paragraph 1 of Art. 23 of Law No. 151-FZ of August 22, 1995 on medical examinations for emergency service workers.

There are numerous industry instructions regarding medical examinations for workers of various professions and fields of activity.

Groups of persons with mandatory medical examination upon admission to work

The following categories of persons are distinguished for whom a medical examination is mandatory upon employment:

1. Minors (less than 18 years of age).
2. Employees working in organizations with difficult, harmful or dangerous working conditions, including transport.
3. Persons working in the Far North or equivalent regions.
4. Shift workers.
5. Employees associated with public catering, the food industry, the food trade, as well as those who carry out their labor activities in organizations that provide the population with water.
6. Employees of medical, treatment-and-prophylactic and children's institutions.
7. Departmental security personnel.
8. HIV-infected.
9. Emergency service workers.

Video: who does not need to undergo a medical examination when applying for a job

Rights and responsibilities of the parties

The procedure for passing a medical examination provides for the responsibility of both the employer and the employee.

An employee, when required by law, is obliged to agree to a medical examination upon admission to work. It is both his right and duty. Of course, before entering a new job, he may refuse to undergo a medical examination, basing his refusal on the fact that he is not an employee of the enterprise and is not obliged to follow the instructions of his potential employer before signing an employment contract. However, then the administration of the company has the full legal right not to hire him (Article 69 of the Labor Code of the Russian Federation).

If the employer violates the law and hires a new employee without a medical examination, then in accordance with Part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, he will incur a certain administrative penalty. The specified article of the Labor Code of the Russian Federation provides for the imposition of a fine:

• in the amount of 15 to 25 thousand rubles per official;
• in the amount of 15 to 25 thousand rubles per individual entrepreneur;
• value from 110 to 130 thousand rubles. to a legal entity.

When hiring without a medical examination is repeated, then in accordance with Part 5 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, the guilty will be punished:

• a fine of 30 to 40 thousand rubles. or disqualification for a period of one to three years for officials;
• a fine of 30 to 40 thousand rubles. for individual entrepreneurs or administrative suspension of activities up to three months;
• from 100 to 200 thousand rubles. or suspension of the enterprise for a period of up to three months.

Video: employer's obligations during a medical examination at the enterprise

Procedure for the medical examination

The procedure for passing a medical examination is regulated by the articles of the Labor Code of the Russian Federation, Order of the Ministry of Health and Social Development No. 302n dated April 12, 2011, Resolutions of the Chief Sanitary Doctor of the Russian Federation, as well as other legislative documents and numerous departmental instructions.

Pass order

The medical examination is divided into the following main stages:

1. Interview with potential employee in order to reach an agreement on the conditions of enrollment for a future job.
2. Preparation and issuance of a referral for a medical examination.
3. Implementation of the medical examination.
4. Obtaining results and presenting them to the employer.

The following items must be submitted in the referral:

1. Company name.
2. The main details of this organization: OKVED, form of ownership, legal address.
3. The name of the medical institution where the worker is sent.
4. Medical institution address.
5. Survey type.
6. Full name of the client sent for examination.
7. The name of the profession or position intended for the employee.
8. Brief description of future work.
9. A complete list of working conditions that adversely affect the health of the worker.

This document is signed by the head of the company or an authorized employee. Then the referral is entered in the register of referrals for a medical examination. And only after registration the document is issued to the employee against receipt.

In the direction for a medical examination must be indicated factors of production that adversely affect health

Legislation regulates the competence of organizations to carry out medical examinations. It is allowed to be carried out in both public and private medical institutions. The main and strictly obligatory criterion for the legality of a medical examination in a medical clinic is that it has a state certificate and license authorizing the conduct of medical and preventive activities.

It is much more convenient for an enterprise sending for a medical examination to draw up an agreement with a medical clinic that has the appropriate permits. The recommendation to conclude contractual agreements with such medical institutions for a period of at least three years is fixed in paragraph 2.3 of the Methodological Framework for conducting preliminary and periodic medical examinations, approved in the Decree of the Ministry of Health and Social Development on 14.12.2005. In the absence of an agreement, the client is sent to any medical institution that has the necessary permits and certificates.

List of doctors

With a referral for a medical examination, an employee usually initially turns to a general practitioner. This doctor can sometimes decide the issue on his own and by his sole decision to recognize the patient as fit for work in a new place. However, in many cases, the therapist is not able to single-handedly determine the degree of health of the patient and the level of his suitability for a particular work activity. For example, it is impossible to consider the suitability of a client for work in a medical or children's institution without analysis and contact with narrow specialists, where health requirements for employment are quite stringent.

Therefore, for the most part, the initial physical examination is not limited to a visit to the therapist. The list of doctors to be visited depends on the direction of the client's future activities. In addition, the age and gender of the patient are taken into account. For example, juveniles receive a more comprehensive examination than adults.

The standard list of doctors participating in the medical examination is as follows:

• therapist;
• ophthalmologist;
• neuropathologist;
• otolaryngologist;
• surgeon.

Medical examination begins with a visit to a therapist

And also, to determine the state of health of the client, blood and urine tests are taken, fluorography is done and a cardiogram is recorded. These are general lists of doctors and tests during medical examinations for most workers. Women are examined by a mammologist and a gynecologist.

For workers in the food industry, employees of dairy and distribution points and a number of other related specialties, it is necessary to undergo the following doctors:

• dentist
• psychiatrist;
• narcologist;
• otolaryngologist;
• dermatologist;
• occupational therapist;
• gynecologist (for women);
• mammologist (for women after they reach 40 years).

Also, workers in this category must do a number of preventive vaccinations to obtain a vaccination certificate and undergo research:

• fluorography;
• blood test for syphilis;
• stool tests for worm eggs and enterobiasis;
• a smear for staphylococcus aureus;
• general urine analysis;
• a clinical blood test and a separate determination of glucose and cholesterol levels.

Mandatory periodic medical examinations and preventive vaccinations are provided for food industry workers.

Adolescents are prohibited from entering any job without a medical examination (Article 266 of the Labor Code of the Russian Federation). This applies to absolutely all professions. In addition to doctors on the standard list, adolescents are required to be examined by a pediatrician or family medicine specialist, as well as by a dentist. Holding general analysis blood and urine, as well as fluorography for adolescents is a mandatory procedure.

A psychiatric examination may also be part of the medical examination. Mental disorders are a contraindication for certain activities. These include:

• work in extreme conditions(for example, at a height, underground, in a harsh climate);
• work related to the circulation of psychotropic substances, drugs and chemicals;
• teaching and social work;
• work in power structures;
• activities related to transport (drivers, pilots, dispatchers, etc.).

An examination by a psychiatrist takes place in the form of a conversation: the doctor asks questions that the visitor must answer. Some of them may seem strange, and some are directly related to work. For example, a candidate for the position of a miner should be excluded from claustrophobia. The content of the answer, the peculiarities of thinking and the speed of reaction are evaluated.

Registration of inspection results

The form of the conclusion on passing a medical examination depends on the group to which the applicant belongs.

As a form of document, in the general case, old-style forms are still used, approved by the Order of the USSR Ministry of Health No. 1030 dated 10/04/1980, despite the fact that the order itself has become invalid. This is form No. 086 / y, it is used for citizens who have reached the age of 18. Today, due to the lack of new forms, it is allowed to use the old forms (letter of the Ministry of Health and Social Development of the Russian Federation No. 14–6 / 242888 dated 11/30/2009).

The certificate must contain the stamps of doctors and the seal of the medical institution

For professional examination of workers employed in work with harmful or dangerous species working conditions, form No. 302n is applied. It was approved by Order of the Ministry of Health and Social Development No. 302n dated April 12, 2011 (Appendix No. 5).

A medical examination certificate is usually valid for three days. If the conclusion is positive, then it is issued only to the applicant and he himself presents it to the management of the enterprise. In the case when the medical board makes a negative decision, it is also issued personally to the patient, but in addition to this, a copy is sent to the enterprise within three days.

For the implementation of both preliminary and periodic medical examinations in medical institution a permanent commission is being created, headed by a general practitioner with a certificate in the specialty "occupational pathology". Based on the medical examination, the head of the commission draws up a conclusion, which is then signed by the head physician of the clinic and certified by a seal.

The medical report is handed to the applicant, in case of a negative result of the medical examination, a copy of the report is sent to the enterprise

For applicants applying for work in the food industry, public catering, trade, medical, medical and preventive and children's institutions, as well as in companies related to water supply facilities, a personal medical book or a medical book of a catering worker is used. These books are issued in accordance with the instructions approved in the Order of Rospotrebnadzor No. 402 of 05/20/2005 and the Order of the Ministry of Health No. 330 of 08/05/2003.

There are different types of medical books for the following professions and industries:

• food industry and trade;
• Catering;
• students;
• medicine;
• education;
• staff of children's camps;
• preschool institutions;
• consumer service organizations;
• employees of sports pools;
• employees of hotel complexes;
• pharmacy workers;
• drivers of vehicles delivering food;
• sellers.

To obtain such books, the applicant must pass a commission consisting of doctors of various specialties, the composition of which depends on the specific profession, as well as a certain set of laboratory tests.

Personal medical book - an officially approved document in a standard format

Medical examination conclusions for persons under 18 years of age are made in accordance with the requirements of Section 3 of the Sanitary and Epidemiological Rules and Regulations, which are drawn up in accordance with the Decree of the Chief State Sanitary Doctor of the Russian Federation No. 58 of 09/30/2009.

Medical examination payment

According to part 2 of Art. 212 and part 8 of Art. 213 of the Labor Code, all costs are borne by the enterprise sending the employee for a medical examination. If the company has an agreement with medical institution and the medical examination is carried out there, then payment is made quickly and without difficulty. Another thing is when such an agreement does not exist and the applicant undergoes a medical examination at his own expense. Then the company is obliged to compensate the employee for the costs of conducting it. The same provision applies to a medical examination to obtain a medical (sanitary) book.

Of course, the potential employer is obliged to fully reimburse the cost of a medical examination carried out for obtaining a job, including all tests and examinations. Moreover, even if a situation arises when a person underwent a medical examination at the direction of the company, but nevertheless, for some reason, was not hired, the employer does not have the right to demand compensation for the expenses incurred. The laws of the Russian Federation also do not provide for the employee to work off the expenses of the employer for the implementation of a medical examination.

What to do when the physical examination shows negative results

Often there is a conflict when, following the results of a medical examination, a conclusion is made, according to which the employee, due to the level of health, is not able to fulfill the tasks assigned to him. professional duties. There are two main options here:

1. The applicant did not pass the initial medical examination.
2. The employee did not pass the periodic medical examination.

In the first case, when an employment contract has not yet been drawn up, on the basis of a negative conclusion, the employer does not have the right to accept the employee for a position that was agreed before the result was obtained. Of course, the manager can offer the employee a place corresponding to the level of his health, and he can accept or reject this offer.

The issue of failure to pass a periodic medical examination has several solutions. The employer, according to paragraph 5 of part 1 of Art. 76 of the Labor Code of the Russian Federation, does not have the right to allow an employee to engage in activities that are contraindicated for him on a medical report. By allowing such an employee to perform their previous labor duties, the employer commits an illegal act and, on the basis of labor legislation, must be punished.

Therefore, the algorithm of actions of the employer, who received negative results of the medical examination of his employee, is as follows:

1. Issuance of an order for removal from office. The order is given to the employee for review, which is certified by a signature.

   The suspension order is issued on the basis of a medical report.

2. Notification of the absence of work suitable for the employee for health reasons.

   The notification is handed over under the signature of the employee about his familiarization with the contents of the document

3. If, according to the medical report, the period during which the employee cannot work in the previous position is less than four months, then at the end of this period a second order is issued to allow the employee to perform his old duties, and as a result, he continues to work in the old job.
4. If the unfitness of the employee for a period of more than four months is recorded in the medical report, then, in accordance with paragraph 8 of part 1 of Art. 77 of the Labor Code of the Russian Federation, the employee must be fired. In this case, a dismissal order is issued and an entry is made in the work book.

   IN work book date, record of dismissal and its basis are put

Another thing is when the enterprise has vacancies that correspond to the level of health of the employee and give him the opportunity to carry out activities in another place. The employer is obliged to offer the employee these vacancies. In this case, there are three most common options:

1. The employee agrees, and by order they transfer him to a new place of work.
2. The employee does not agree and asks to be fired own will or as agreed by the parties. In this case, he writes explanatory note of his disagreement and a letter of resignation. A dismissal order is issued.
3. The employee does not agree to move to another place of work. In this case, it is necessary that he fix his refusal on the administration's written proposal for a possible transfer to another job, and also write an explanatory note in any form about the reasons for his disagreement. If the employee refuses to write any explanations, then an appropriate act is drawn up, which is signed by the immediate supervisor of the employee and two witnesses. On the basis of a medical report and an act, a dismissal order is issued.

If the employee, for health reasons, did not fit another job at the enterprise, he can be fired under paragraph 8 of Art. 77 TC

Expiry date of medical examination certificate

In general, a certificate in form 086 / y on passing the initial medical examination is valid for six months. After six months, you need to repeat everything all over again.

For drivers, a certificate was previously issued for three years. In 2018, the medical certificate for drivers is valid for two years. At the same time, for some categories of drivers, a certificate is issued only for a year. These include:

• citizens under 21;
• drivers over 50;
• persons with certain medical conditions or physical disabilities, such as those who wear eye lenses;
• professional drivers.

It should be noted that the validity of certificates from a narcologist and a psychiatrist is also one year.

Diseases for which a medical examination certificate is not issued

There are a number of diseases or physical defects, the existence of which leads to a negative conclusion of a medical examination on the professional suitability of an employee. Different professions have their own list of such diseases or defects. One of the toughest professions in relation to health requirements is the profession of a vehicle driver. According to Decree of the Government of the Russian Federation No. 1604 of December 29, 2014, diseases or medical contraindications are defined, in which it is generally forbidden to drive a vehicle. In particular, these diseases include:

• mental disorders, including schizophrenia, mental retardation, affective disorders;
• mental disorders associated with the use of psychotropic substances;
• epilepsy;
• eye diseases - achromatopsia and blindness in both eyes.

In this industry, there are restrictions under which you can drive a vehicle, but subject to certain rules and regulations. For example, persons with a missing hand or entire arm or with a shin stump are allowed to drive, but only in cars with an automatic transmission.

For the food industry, there is also a list of occupational diseases that exclude the possibility of working in this industry. To them, according to Art. 23 of Law No. 29-FZ, as amended on July 19, 2011, includes infectious diseases, including HIV infection.

The issue of passing a medical examination when applying for a job is relevant for the vast majority of professions. The procedure for passing and documentary support of this necessary and important procedure is quite fully regulated by the legislation of the Russian Federation. Nevertheless, there are some insufficiently developed nuances that should be paid attention to both by the employer and the employee sent for a medical examination.

In accordance with part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, the admission of an employee to the performance of labor duties without passing, including periodic medical examinations, entails the imposition of administrative responsibility for from 110 to 130 thousand rubles. More than 40 people work in the organization without a medical examination. The organization was carried out according to working conditions. How is the list of employees who must undergo preliminary and periodic medical examinations determined? Should all employees of the organization (including lawyers, accountants) undergo such inspections?

According to the second part of Art. 212 of the Labor Code of the Russian Federation (hereinafter referred to as the Labor Code of the Russian Federation), the employer is obliged in cases provided for by labor legislation and other regulatory legal acts containing norms labor law organize, at their own expense, mandatory preliminary (upon employment) and periodic (during employment) medical examinations, other mandatory medical examinations, mandatory psychiatric examinations of employees, extraordinary medical examinations, mandatory psychiatric examinations of employees at their request in accordance with medical recommendations with the preservation of their place of work (position) and average earnings for the time of passing the specified medical examinations, mandatory psychiatric examinations.

In turn, the employee is obliged to undergo mandatory preliminary (upon employment) and periodic (during employment) medical examinations, other mandatory medical examinations, as well as to undergo extraordinary medical examinations at the direction of the employer in cases provided for by the Labor Code of the Russian Federation and other federal laws. (Article 214 of the Labor Code of the Russian Federation).

Thus, the passage of medical examinations, including preliminary and periodic ones, is mandatory only in cases provided for by law.

The obligation to conduct medical examinations of certain categories of employees is provided for by the norms of Art. 213 of the Labor Code of the Russian Federation. In accordance with this article, mandatory preliminary and periodic medical examinations must be carried out by employees engaged in work with harmful and (or) dangerous working conditions (including underground work), employees engaged in work related to traffic, employees of food organizations industry, public catering and trade, waterworks, medical organizations and children's institutions, as well as some other employers.

According to the fourth part of Art. 213 of the Labor Code of the Russian Federation harmful and (or) dangerous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations are carried out, the procedure for conducting such examinations is determined by the federal executive body authorized by the Government of the Russian Federation.

To date, such normative act establishing the List of harmful and (or) hazardous production factors (hereinafter referred to as the List of Factors), the List of works during the performance of which mandatory preliminary and periodic medical examinations (examinations) of employees are carried out (hereinafter referred to as the List of Works) and the Procedure for conducting mandatory preliminary (upon admission to work) and periodic medical examinations (examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions (hereinafter referred to as the Procedure) is the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 N 302n.

At the same time, there is a position that the presence in the workplace of employees of harmful and dangerous production factors (performing the relevant work) specified in the List of factors (for example, working with a PC for more than 50% of the working time, which may apply, in particular, to lawyers and accountants), is an independent basis for sending such workers for a mandatory medical examination, regardless of whether the working conditions at their workplaces are classified as harmful or dangerous according to the results of certification or a special assessment of working conditions (see, for example, letter of the Ministry of Labor of Russia dated 03/21/2014 N 15 -2 / OOG-242, letter of Rostrud dated 09.10.2015 N TZ / 20422-3-3). A similar point of view is presented in the explanations of Rostrud specialists posted on information portal this office on the Internet (see answer 1, answer 2, answer 3). The legitimacy of such an interpretation of the provisions of the List of factors is also confirmed by the Supreme Court of the Russian Federation (determination of September 24, 2015 N 302-KG15-11278).

At the same time, in law enforcement practice, there is another approach to resolving the issue of the need for medical examinations in the situation under consideration, based on the following logic. Within the meaning of Art. 213 of the Labor Code of the Russian Federation, part four of this article is aimed at implementing the requirements of its first part. In other words, it is precisely the fact of the presence of harmful and hazardous conditions labor at the workplace is the basis provided for by the Labor Code of the Russian Federation for conducting mandatory medical examinations of employees.

About justice this conclusion, in our opinion, is also evidenced by note No. 2 to the List of factors, according to which this list lists factors that, according to the level of their impact, are classified as harmful and (or) dangerous classes in accordance with regulatory legal acts.

It should be noted that harmful and dangerous factors in themselves are such, regardless of the level of their impact and are not divided into classes (see Article 209 of the Labor Code of the Russian Federation, Classifier of harmful and (or) hazardous production factors (Appendix N 2 to the order of the Ministry of Labor of Russia dated 24.01. 2014 N 33n), GOST 12.0.003-74 "System of labor safety standards. Hazardous and harmful production factors. Classification", approved by the Decree of the State Standard of the USSR of 13.11.1974 N 2551).

It is the working conditions, depending on the level of impact on the employee of harmful and (or) hazardous production factors, that are divided according to the degree of harmfulness and (or) danger into four classes - optimal (class 1), permissible (class 2), harmful (class 3; subclasses 3.1 -3.4) and dangerous (grade 4) (see art. 14 federal law dated December 28, 2013 N 426-FZ "On a special assessment of working conditions", hereinafter - Law N 426-FZ). Considering the above, we believe it is possible to conclude that note N 2 to the List of factors refers precisely to the fact that the presence of the factors named in this List is taken into account when determining the need for medical examinations only if the level of impact of the relevant factors indicates the presence harmful or dangerous working conditions at the employee's workplace (class 3.1 and above). In support of this thesis, we can cite the letter of the Federal Medical and Biological Agency dated April 13, 2012 N 1-08/894. A similar point of view was expressed in the letter of Rospotrebnadzor dated June 19, 2015 N 01 / 7015-15-31.

At the same time, we note that some of the factors named in the List of Factors contain a special note "when attributing working conditions for this factor, based on the results of certification of workplaces for working conditions, to harmful conditions" (see paragraphs 3.8, 3.9, 3.12, 4.1, 4.4.1-4.4.3 of the Factor List). On this basis, some experts conclude that since such a clause was required for certain items of the List of factors, then other factors listed in it are the basis for a medical examination, regardless of whether working conditions are classified as harmful or dangerous according to the results of a special assessment. In support of this thesis, clause 19 of the Procedure is also cited, according to which the lists of the contingent and the lists of names of workers subject to mandatory medical examinations include, among other things, workers exposed to harmful production factors specified in the List of factors, as well as harmful production factors , the presence of which is established by the results of attestation of workplaces in terms of working conditions (currently - a special assessment of working conditions), carried out in the prescribed manner. As a source of information about the presence of harmful production factors at workplaces, in addition to the results of attestation of workplaces for working conditions, the results of laboratory research and testing obtained as part of control and supervision activities, industrial laboratory control, as well as operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in the implementation of production activities.

However, as already mentioned above, the list of factors itself does not refer to any factors, but only to those that, by the level of their impact, may indicate the presence of harmful conditions labor. At the same time, in our opinion, the employer, in the absence of the results of a special assessment of working conditions, can indeed resort to other sources of information on harmful factors named in paragraph 19 of the Procedure, and if, on the basis of these sources, he can conclude that the impact of these factors, according to their level, may lead to the assignment of the working conditions of the employee to harmful or dangerous, he decides on the need for a medical examination of such an employee. Without violating the requirements of the law, the need for such a procedure for the employer's actions may arise in the event of the creation of new jobs. In accordance with parts 1 and 2 of Art. 17 Law N 426-FZ special assessment working conditions at newly created workplaces should be carried out within 6 months from the date of their commissioning. At the same time, as the Ministry of Labor of Russia explained in a letter dated April 16, 2015 N 15-1 / OOG-2242, the commissioning of newly organized workplaces should be understood as the start date of the regular production process at these workplaces.

Accordingly, workers for work in these places will in any case be accepted earlier than a special assessment of working conditions is carried out for them. In this case, the employer really should independently assess the presence of harmful or hazardous factors at such workplaces and the level of their impact in order to determine the need to send employees for medical examinations (except for the cases referred to in clauses 3.8, 3.9, 3.12, 4.1, 4.4.1-4.4.3 of the List of factors under which the employer has the right to focus only on the results of a special assessment).

At the same time, in our opinion, in the event that the employer has the current results of certification of workplaces for working conditions or a special assessment of working conditions, he needs to use them. Obligations to use other sources of information in the presence of the results of a special assessment The procedure has not been established, as evidenced by the phrase “can be used” used in clause 19 of the Procedure in relation to such sources.

The letter of the FMBA of Russia already mentioned above also states that the employer should use other sources of information about the harmful factors affecting the employee in order to determine the need for medical examinations precisely in the absence of certification results. Supreme Court of the Udmurt Republic, in its decision dated April 15, 2015 in case N 7-124 / 2015, also came to the conclusion that there was no corpus delicti in the actions of the employer who did not ensure that the employees undergo a medical examination, including due to the fact that he had attestation cards for the workplaces of these employees, did not containing indications of the presence of harmful production factors at the relevant workplaces.

Thus, we believe that the employer is obliged, in pursuance of the requirements of parts one and four of Art. 213 of the Labor Code of the Russian Federation to conduct a medical examination of workers in the presence of harmful production factors at their workplaces only if the level of their exposure indicates the presence of harmful or dangerous working conditions at such workplaces. When establishing the fact of the presence of harmful factors at workplaces and determining the level of their impact, the employer should first of all be guided by the results of attestation of workplaces for working conditions or a special assessment of working conditions, and only in their absence should he resort to other sources of information (except for cases named in the Order).

Given the above, we believe that if there are results of certification of workplaces for working conditions that have not expired (part 4 of article 27 of Law N 426-FZ), or a special assessment of working conditions confirming the absence of harmful or dangerous working conditions, the employer does not have an obligation to organize mandatory medical examinations of employees who work at workplaces in respect of which the absence of harmful or dangerous working conditions has been established.

At the same time, if employees are employed in jobs that are included in the List of Works, the employer is obliged to arrange for them to conduct preliminary and periodic medical examinations. Rostrud specialists give similar explanations (see answer 4).

Thus, in our opinion, the employer is obliged to include in the lists of contingents of employees undergoing preliminary and periodic medical examinations the following categories of employees:

Employees who work at workplaces in respect of which, based on the results of attestation of workplaces for working conditions (or a special assessment of working conditions), the presence of harmful and dangerous working conditions has been established;

Employees who work at newly created workplaces for which a special assessment of working conditions has not yet been carried out, while at such workplaces there are harmful and (or) dangerous production factors diagnosed by the employer in accordance with clause 19 of the Procedure;

Employees employed in jobs included in the List of Jobs;

Other employees for whom labor legislation and other regulatory legal acts containing labor law norms provide for the obligation to organize preliminary and (or) periodic medical examinations (for example, persons under the age of eighteen years - Article 69 of the Labor Code of the Russian Federation) * ( 1).

However, please note that this position is our expert opinion. As can be seen from the answer, the regulatory and judicial authorities may take a different point of view on a given issue.

Prepared answer:
Legal Consulting Service Expert GARANT
Erin Pavel

Response quality control:
Reviewer of the Legal Consulting Service GARANT
Voronova Elena

The material was prepared on the basis of an individual written consultation provided as part of the Legal Consulting service.

*(1) See also Encyclopedia of Solutions. Preliminary medical examination.