Is disability granted for epilepsy in 2021?

Causes of disability

As noted above, epilepsy is part of a group of neurological disorders in the functioning of the brain and is accompanied by specific seizures. And although epileptic seizures are not a necessary phenomenon, when they occur the patient is not able to be responsible for his actions, and may not even deliberately cause harm to himself (for example, in the event of an unsuccessful fall, etc.).

It is noteworthy that outside of seizures, the life of an epileptic does not have any restrictions and is quite ordinary. For this reason, many do not seek special status. The need for it arises only in those whose seizures are quite frequent and dangerous, including for others. Then you need to go through the ITU and establish the degree of restrictions with a specific group.

It is relevant to assign preferential status if the patient has to:

- work as a vehicle driver;

— carry weapons, come into contact with radioactive and chemical substances;

- use complex mechanisms, be at heights, under water, etc.

ITU experts prohibit these types of activities if epilepsy manifests itself quite clearly and has led to persistent disorders of body functions.

In particular, disability is established if, during the period between epileptic attacks, it is necessary to:

- regularly undergo medical examination and examination;

- take medications that have side effects.

According to experts, disabled epileptics may experience behavioral disorders, mental disorders, intellectual degradation and visible manifestations of epileptic disease on the face.

Important

! To establish a special status for adults with epilepsy, it is important to document seizures.

Disability groups

If a patient is diagnosed with epilepsy, he may be sent to MSE if certain factors are present:

the patient creates dangerous conditions in the workplace;
the patient develops complications when taking antiepileptic drugs, there are complications of the underlying disease - epilepsy;
a child with developmental delay and epilepsy is referred for expert assessment;
the patient is referred for MSE in the absence of positive dynamics after surgical treatment.

The disability group for epilepsy will depend on the severity of the patient's condition. The first disability group is issued for severe mental disorders, neurological disorders, loss of skills, including self-care, and severe intellectual and mnestic impairments. The frequency and severity of attacks may vary.

The second disability group for epilepsy is issued for the following conditions:

there is a pronounced mental disorder, the inability to control one’s behavior, to fully work, study, and the inability to provide high-quality self-care;
generalized epileptic seizures occur four or more times a month;
psychomotor seizures more than once a month;
partial seizures more than five times a day;
complication of epileptic syndrome (repetition of an attack when the first attack is not completed, consciousness does not recover) is observed more than once every two to three months;
severe motor dysfunction.

The third disability group is assigned for the following conditions:

partial seizures (no loss of consciousness occurs) are observed at least three times a day;
attacks with loss of consciousness occur at least twice a month;
psychomotor seizures occur once every two to three months;
complication of epileptic syndrome once every four to six months;
the patient has moderately severe mental disorders, minimal personality changes;
There is a decrease in muscle strength and a moderate limitation of static-dynamic capabilities.

What laws govern

Now let’s look at the regulations that regulate the procedure for establishing status at the state level, these are:

— Federal Law of November 24, 1995 No. 181-FZ (as amended on October 30, 2017) “On the social protection of disabled people in the Russian Federation”;

— Decree of the Government of the Russian Federation of February 20, 2006 No. 95 (as amended on August 10, 2016) “On the procedure and conditions for recognizing a person as disabled.”

It is also worth highlighting the following Orders of the Ministry of Labor and Social Protection of the Russian Federation:

— dated October 11, 2012 No. 310n (with additions and amendments dated December 29, 2021) “On approval of the Procedure for the organization and activities of ITU federal government institutions”;

— dated January 29, 2014 No. 59n “On approval of the Administrative Regulations for the provision of public services for conducting MSE”;

- dated August 27, 2021 No. 585n “On classifications and criteria used in the implementation of medical and social examination of citizens by federal government agencies of the ITU.”

Disability in epilepsy and criteria for its assignment

If a person lives calmly without seizures and his quality of life does not worsen, then he will not be given the status of a disabled person. An epileptic whose seizures occur suddenly and can cause harm to the people around him may be considered disabled.

To give examples, they include the following categories.

Transport managers. This includes an aircraft dispatcher, a public transport driver, and a railroad switchman. That is, people on whose work the lives of other people depend: passengers on a train, plane, bus, etc.
Heads of various mechanisms. If an epileptic person works with machinery near water, fire, or at heights, his seizures can become a threat to the life of another person.
People handling weapons or valuable documents. In this case, any mistake can cause irreparable damage.

To determine whether to grant disability for epilepsy to an adult, doctors carefully study the duration and characteristics of the patient's seizures. In cases where a person cannot work in his specialty, he is identified as disabled and given the opportunity to retrain.

They can also be recognized as disabled based on the patient’s quality of life between seizures. For example, if he needs to take medications for epilepsy every day (or that have side effects), he should constantly visit the doctor and get regular checkups.

Whether a person is recognized as disabled or not depends on many factors. For example, whether his seizures affect his development, health and intelligence, how often they occur, whether therapy is effective. Additionally, doctors check the patient’s brain activity to see if he has symptoms related to neurological problems.

It turns out that an adult has a disability due to epilepsy if he has problems with mental health, he degrades intellectually, and behaves inappropriately. The appearance of certain features of epilepsy in the character, as well as dysfunction of the motor system, also contribute to the designation of disability.

Another important point is the age when the patient was diagnosed with epilepsy. In children it occurs a little differently than in adults.

The reason for its appearance also plays a big role. If the patient has side effects from the treatment, this also raises suspicions.

Procedure

If a patient has epilepsy and wants to receive disability for this reason, he needs to act according to a certain algorithm. Everything takes place in several stages.

Get a referral to ITU. This document can be issued by a doctor from a clinic (hospital), a representative of social security or the Pension Fund. The main reasons for seeking treatment are progression of the disease, loss of performance, and mental disorders.
Get a medical examination. This stage is taking tests, other studies and obtaining an opinion from a psychologist.
Conclusion of the commission. Members of the commission study changes in the patient’s body, determine the severity of epilepsy and draw a conclusion about his ability to work.
Getting help. If the commission decides in favor of assigning disability to an adult patient, a corresponding certificate will be issued.

Within a month after the certificate is issued, ITU staff will develop a rehabilitation program for a specific patient. This document will then be sent to the local social security authority. And only after this does a person have the opportunity to apply for a disability pension.

Documentation

To apply for disability due to epilepsy for an adult, you need to submit an application along with a package of documents. This package includes:

ID card (passport);
application and referral for ITU. If the examination was refused, a certificate confirming this;
documents from a hospital or clinic. These are all the results of examinations and doctors’ opinions that confirm disorders in the body due to epilepsy;
accident report from the enterprise where it occurred. Required if disability occurs due to an injury at work. You can get it from the company doctor;
a personal physician’s conclusion that MSA should be performed at home (if necessary).

Foreign citizens may also need SNILS and confirmation of the status of a disabled person in their country.

All documents must be submitted to the social security authority no later than 10 days from the date of submission of the application.

Indications for referral to ITU

Not all epileptics are referred for medical and social examination. If they have no complications, attacks rarely occur; in remission, this is normal. If no one gets hurt in the event of a seizure at work, the epileptic will not be transferred to the category of disabled people, although they may be transferred to a calmer position.

Doctors become suspicious when:

attacks occur frequently, are difficult, and ruin the patient’s life;
the profession is not suitable for an epileptic, since in case of a seizure he can harm someone;
epilepsy becomes more complicated.

In such situations, they begin to think about whether to give a disability to this patient for epilepsy. This is how he receives a referral to undergo the ITU.

Passing the ITU

MSE or medical and social examination is a procedure by which you can obtain a certificate of disability. In order for a person to be given the opportunity to undergo such an examination, an appropriate application must be submitted. It is accepted, processed, and then a request is generated to the local organization for the provision of municipal and government services.

Next, the epileptic will receive an invitation to undergo a medical and social examination at the nearest institution (in his city or a neighboring one). As soon as he arrives, an ITU is carried out. After this, employees formalize and hand over the results and their verdict.

List of examinations and analyzes

After taking tests and undergoing various examinations, the patient is given a verdict - whether he will be assigned a disability or not. But for this you need:

take an electroencephalogram;
take an x-ray of the skull;
examine the field of vision and the fundus of the eye;
take urine and blood tests;
undergo an MRI (CT);
take a psychological test.

In some cases, you will have to be examined by other doctors. The results of all surveys are announced at a general meeting of all members of the commission, and a decision is made.

Drawing up an act and issuing certificates

Ultimately, the patient receives a statement that indicates whether the person's epilepsy is recognized as a disability or not. If yes, then the patient is given a special certificate. It contains the status of the patient, as well as the group of disabled people assigned to him. There is also a rehabilitation program developed individually for a given epileptic.

What features may arise

Children will be examined in the same way as adults, only parents are present with minors during the examination. But children with disabilities are given the status of “disabled child” without a group. A certain category is established from the age of 18 based on the results of the adult ITU.

We also note that permanent rehabilitation is recommended for disabled epileptics, regardless of age, since their disease cannot be treated and requires lifelong medication. And therapy helps to suppress the centers in the brain that are active in the disease in question. Plus, psychological rehabilitation is almost always required to overcome complexes and pressures caused by conditions.

To summarize, we note that in Russia, according to statistics, every hundredth person has epilepsy, and men face this problem more often than women. Be that as it may, against the background of the disease, many are given group 3, and only 1% of disabled people with epilepsy have the most severe category 1.

On what basis can a disabled group be assigned?

Epilepsy is a disease that does not immediately reveal itself. Outwardly, a person is no different from others.

But at the moment of attacks, the patient loses self-control, and therefore can become a very serious danger to others.

It is this reason that can serve as the basis for assigning a disability of one group or another to the patient.

The decision regarding the assignment of a disability group for epilepsy in adults is made by the ITU commission.

It is important to know that not all affected adults are given a disability for epilepsy. The assignment of such status depends on many factors.

Disability for epilepsy in adults is issued immediately if this pathology is congenital and not acquired.

If a person develops a disease in the course of his life, then the reason for obtaining such a status is the loss of working capacity due to the onset of frequent seizures.

Disability is assigned to patients who work at heights, or whose work involves fire, water or complex mechanisms.

During a seizure, a person can harm not only himself, but also others.

Complex partial seizure in epilepsy

The basis for assigning disability for epilepsy for adults can also be his work activity, which is directly related to chemicals, bladed weapons or firearms.

It is possible to apply for disability due to epilepsy in adults if the disease requires constant treatment under the supervision of medical professionals.

That is, if a person is treated in a neurology hospital most of his time or is forced to regularly visit an epileptologist, then these situations serve as the basis for recognizing the person as disabled.

Obtaining this status is also possible if the patient experiences severe side effects from taking medications.

What side effects qualify for disability:

Mental disorders.
Lack of ability to self-control the patient's behavior.
Development of paresis or paralysis.
Receiving physical injuries due to seizures.

Group I

Clinical examination is a comprehensive medical examination of the population, designed to identify diseases and risk factors, as well as a general assessment of the health status of citizens of the Russian Federation, including: examination of patients, laboratory tests, promotion of a healthy lifestyle and drawing the attention of citizens to the state of health of their body.

Persons under 18 years of age undergo medical examinations annually, and the majority of the adult population - once every three years, starting at established age periods (21, 24, 27, etc. until 39) and annually after 40 years.

In this article we will look at what health groups are distinguished based on the results of medical examination of adults and children, and how they differ.

Health groups for adults

Clinical examination is the main activity for research and monitoring of the health level of the adult population. Based on the information obtained as a result of the medical examination, the doctor or paramedic assigns each citizen a health group in accordance with the requirements and criteria defined in Order of the Ministry of Health of the Russian Federation dated March 13, 2021 N 124n “On approval of the procedure for conducting preventive medical examination and medical examination of certain groups of adults population"

The normative act distinguishes four health groups of the adult population - 1, 2, 3a and 3b.

I includes persons who do not have any chronic diseases, as well as risk factors for the development of such diseases, or who have the indicated risk factors with low or average absolute cardiovascular risk and who do not need clinical observation for other diseases (conditions). ).

The results of laboratory examinations of this group of people are within normal limits. As you might guess, this category includes citizens with the most favorable level of well-being.

Based on the results of the medical examination, preventive consultations and other therapeutic and health measures are carried out for people in this category, with the main goal of promoting a healthy lifestyle and compliance with sanitary and hygienic standards.

Group II

This category includes people who do not have any chronic diseases, but are at increased risk of acquiring them. In addition, this includes people who are predisposed to developing cardiovascular diseases. This group is the largest in number, which is associated with a large number of factors that negatively affect the human body (bad habits, poor diet, sedentary lifestyle, climate pollution, etc.).

This category of citizens is diagnosed by conducting a generally accepted standard health examination, as well as additional studies of individual risks, if any.

II includes citizens who have not been diagnosed with chronic non-infectious diseases, but have risk factors for the development of such diseases

with high or very high absolute cardiovascular risk,
as well as citizens who have been diagnosed with obesity and (or) hypercholesterolemia with a total cholesterol level of 8 mmol/l or more, and (or) persons
smoking more than 20 cigarettes a day,
and (or) persons with an identified risk of harmful alcohol consumption and (or) a risk of consuming narcotic drugs and psychotropic substances without a doctor’s prescription, and who do not need dispensary observation for other diseases (conditions).

Citizens with health group II with high or very high absolute cardiovascular risk are subject to dispensary observation by a doctor (paramedic) of a department (office) of medical prevention or a health center, as well as a paramedic of a paramedic health center or a paramedic-obstetric station, with the exception of patients with total cholesterol levels 8 mmol/l or more, which are subject to dispensary observation by a general practitioner.

For citizens with health group II, if there are medical indications, the general practitioner prescribes medications for medical use for the purpose of pharmacological correction of identified risk factors.

Group III (a and b)

Group IIIa includes persons suffering from chronic non-communicable diseases (CNCDs), which require dispensary observation and highly qualified medical care. The bulk of citizens in this category are people over 40 years old, whose ailments are directly related to age and aging of the body. Medical examination of such persons is carried out for the purpose of secondary prevention, namely to prevent complications and exacerbations of an existing disease.

Category III b includes persons who have not been diagnosed with chronic non-diseases, but who require the establishment of dispensary observation or the provision of specialized, including high-tech, medical care for other diseases, as well as citizens suspected of having these diseases who require additional examination.

Citizens with III a and III b are subject to dispensary observation by a general practitioner and medical specialists with preventive, therapeutic and rehabilitation measures.

Health groups for children

The health groups identified based on the results of clinical examination of the children's population differ significantly from those of adults. First of all, it is worth saying that there are as many as 5 categories for classifying children (as opposed to 3 for adults).

This amount is associated with the increased vulnerability of the child’s body to various diseases, which is why their clinical examination requires more attention and thoroughness, which ultimately leads to the receipt of a significant amount of information for classification into categories.

1 group

This category includes physically and mentally healthy children who have high body resistance to disease. They can also sometimes get sick, but at the time of examination they do not have any pathologies. In fact, group 1 includes children who are not sick at all, but in practice there are very few such children.

2nd group

This category includes children who do not suffer from chronic diseases, but have reduced immunity. Such babies can suffer acute infections several times a year, but nothing more. They are usually divided into several subgroups according to the type of risk. For example, category “A” includes children with problematic heredity, and “B” includes children at risk of developing chronic diseases.

3 group

Category 3 includes children with any chronic disease. However, patients in this category are distinguished by the fact that such a disease occurs in a state of compensation. This means that, despite the presence of pathology, the child does not face severe consequences or exacerbations of the disease and can lead a normal life.

4 group

This health category denotes children with chronic illnesses in the subcompensation stage. In this state, there is already a significant deterioration in well-being, disruption of the functioning of some organs and reduced body resistance. Such children often need constant treatment and rehabilitation, while their diseases are most often expressed in some kind of physical disability, and their neuropsychic development is normal.

5 group

This category includes children with serious chronic diseases in a state of decompensation. These are disabled children with severe developmental problems or reduced functionality. It is worth noting that diseases of this group are not always congenital. An absolutely healthy child after an illness, surgery or injury can receive group 5. Such children almost always require constant supervision and assistance.

Conclusion

Thus, health groups represent a scale by which the condition of the body, both an adult and a child, is determined.

Taking into account examinations by specialized specialists, the health group is determined by a pediatrician or therapist, who, in turn, carries out a comprehensive assessment of the condition of the human body.

Disability in children

To assign disability for epilepsy in children, you need to repeat the same thing as for an adult. The child is assigned to a legal representative (parent or guardian), and together with him he undergoes medical examination.

The difference is that in cases of childhood epilepsy, a disability group is not assigned. There is only a general concept of “disabled child”, which applies to all minor epileptics.

And yet, whether epilepsy is a disability or not is decided strictly individually. For some it does not pose a threat, but for others it ruins the life. A person can be recognized as disabled only in cases where, due to seizures, he exposes himself or other people to danger.

How to get disability?

When it comes to applying for disability, you should make an appointment with a neurologist. It is he who will issue a referral to visit all the required doctors and undergo the relevant tests.

Thus, the mandatory conditions should be considered:

complete analysis of both blood and urea;
X-ray of the skull in several projections (preferably in at least two);
examination of the fundus and visual functions;
echo-EG;
electroencephalography (EEG);
if seizures and deterioration of the condition began less than six months ago, then it is necessary to conduct a computed tomography (CT) or magnetic resonance imaging (MRI);
psychotherapist's decision.

After visiting all the doctors and passing the listed tests, the neurologist is obliged to:

issue a referral for medical and social examination (MSE) in accordance with form number 088/a-06;
refer the epileptic to a special commission, where the presence of the disease will be checked, as well as the correctness of filling out all documentation.

After this, the package of documents will be certified by the signature and seal of the head physician of the medical institution. This concludes the first stage. At the next stage, the person must come to the ITU office, where the exact timing of the examination will be indicated.

If a person is recognized as disabled, he will be given a certificate of receipt of one or another disability group. In addition, the medical committee must develop an individual rehabilitation plan (IRP) within 30 days from the date of the decision. Only after approval of the created program, within three days it should be sent to the department of social protection at the place of residence of the epileptic, or it should be handed over to him at the regional ITU office.

After all the required documents have been received, it is necessary to contact the social protection authorities and the pension fund in order for the appropriate benefits, allowances and pension payments to be issued.

What is permanent disability?

There is also the concept of permanent disability, which is assigned to those patients who were previously included in the first or second group. At the same time, the epileptic is faced with a permanent loss of ability to work, and all therapeutic and preventive measures for five years turned out to be ineffective.

Thus, receiving a disability group for epilepsy gives a person more than just social protection. This is an opportunity to work without any problems, receive legal payments and compensation, as well as adequate medical care.

Author of the article:

Sokov Andrey Vladimirovich |
Neurologist Education: In 2005, she completed an internship at the First Moscow State Medical University named after I.M. Sechenov and received a diploma in the specialty “Neurology”. In 2009, she completed her postgraduate studies in the specialty “Nervous Diseases”. Our authors