CIRCULAR

PROVIDING GUIDANCE ON DOSSIERS AND PROCEDURES FOR MEDICAL EVALUATION FOR LABORERS PARTICIPATING IN SOCIAL INSURANCE

Pursuant to Article 33, Chapter 4 of the June 30, 1989 Law on Protection of People’s Health on medical evaluation;
Pursuant to Chapter II of the Regulation on Social Insurance, issued together with the Government’s Decree No. 12/CP of January 26, 1995 and Decree No. 45/CP of July 15, 1995 promulgating the Regulation on Social Insurance applicable to laborers participating in social insurance; officers, career armymen, non-commissioned officers and soldiers of the People’s Army and the People’s Police;
Pursuant to the criteria prescribed for disability and labor capacity loss due to ailments, issued together with Joint-Circular No. 12/TT-LB of July 26, 1995 of the Ministry of Health and the Ministry of Labor, War Invalids and Social Affairs;
In order to uniformly carry out medical evaluation for State officials and employees, army men, and laborers participating in social insurance (hereafter referred collectively to as laborers); after consulting with the Ministry of Labor, War Invalids and Social Affairs in Official Dispatch No. 2700/LDTBXH-BHXH of August 15, 2000; and Vietnam Social Insurance in Official Dispatch No. 1921/BHXH-CDCS of September 20, 2000, the Ministry of Health hereby provides guidance on the elaboration of dossiers and the procedures for medial evaluation for the implementation of social insurance regimes for the laborers, as follows:

I. SUBJECTS OF APPLICATION:

1. Subjects prescribed in Article 3 of the Regulation on Social Insurance, issued together with the Government’s Decree No. 12/CP of January 26, 1995; and Article 3 of the Regulation on Social Insurance applicable to people’s army and police personnel, issued together with the Government’s Decree No. 45/CP of July 15, 1995.

2. Vietnamese laborers and specialists sent to work abroad for a definite period of time under the provisions of Decree No. 152/1999/ND-CP of September 20, 1999, who have returned to the country after the expiry of their working periods.

3. Laborers participating in social insurance under Decision No. 49/1998/QD-TTg of February 28, 1998 on a number of regimes applicable to sport athletes and trainers.

4. Those who have suffered from labor accidents or occupational diseases, but not yet been medically evaluated, or have enjoyed lump-sum or monthly allowances when they relapse into illness.

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6. Those who are enjoying monthly allowances for working capacity and wish to have their working capacity re-evaluated.

II. DOSSIERS AND PROCEDURES FOR MEDICAL EVALUATION

1. Dossiers and procedures for evaluation of injuries caused by labor accidents

1.1. Subjects:

The laborers who have got accidents determined as labor accidents, or labor accident victims who have enjoyed lump-sum allowances (including those who are still at work and those who have ceased working), and labor accident victims who have enjoyed monthly allowances when their old injuries recur.

1.2. The dossiers for first-time evaluation shall include:

- Record on investigation of labor accidents (according to set form) as prescribed in Joint-Circular No. 03/1998/TT-LT/BLDTBXH-BYT-TLDLDVN of March 26, 1998 of the Ministry of Labor, War Invalids and Social Affairs, the Ministry of Health and the Vietnam Labor Confederation. For cases of traffic accidents which are considered labor accidents, the traffic accident record (the copy thereof) is required. If at the places where traffic accidents occur, exist no conditions to make records thereon, the certification by authorities of the localities where such accidents occur, or by traffic police must be obtained.

- Certificate of casualty caused by labor accidents (according to set form), granted by the hospital providing emergency treatment of the injuries (signed and sealed by the director or deputy director of the hospital), according to the Ministry of Health’s regulations.

- Paper on discharge from the hospital.

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- When laborers have got accidents considered labor accidents, their employers shall have to report such to the concerned agencies as soon as possible, make the on-spot labor accident records or labor accidents investigation reports according to the provisions of Joint-Circular No. 03/1998/TTLT/BLD-BYT-TLDLDVN of March 26, 1998. After the laborers have been hospitalized, the employers shall have to compile, finalize and transfer the labor accident dossiers of the laborers, which include: a record on investigation of labor accident, a certificate of casualty caused by the labor accident, and hospital-discharge paper, to the Social Insurance of the provinces and centrally-run cities (hereafter referred collectively to as provincial Social Insurance).

- The provincial Social Insurance shall have to check the dossiers; if such dossiers are complete and proper, they shall make recommendation (according to set form) and transfer the labor accident dossiers of the laborers to the provincial/municipal Medical Evaluation Councils (hereafter referred collectively to as provincial Medical Evaluation Councils) or the Central Medical Evaluation Council for evaluation.

1.4. Re-evaluation of labor accidents:

1.4.1. Cases of re-evaluation:

- Old injuries recur.

- The laborers, the employers or social insurance agencies disagree with the conclusion of the Medical Evaluation Councils (hereafter referred to as requestors for short).

1.4.2. Dossiers for re-evaluation shall include:

- An application for evaluation of working capacity affected by labor accidents (according to set form)

- Recommendation letter of the provincial Social Insurance (according to set form).

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- Copies of dossiers of the previous evaluation, including: the evaluation records, decisions of the directors of the provincial Social Insurance on payment of lump-sum or monthly labor accident allowances. For cases of re-evaluation upon the requests of the requestors, the dossiers for re-evaluation shall be the dossiers prescribed for first-time evaluation.

1.4.3. Procedures for re-evaluation:

- When the recurring injuries have been healed, the laborers shall file an application to the employers, if they are still at work, or to the provincial Social Insurance, if they have ceased working, together with papers on treatment of the recurring injuries.

- The employers shall have to receive papers on treatment of the recurring injuries, transfer dossiers and recommend the laborers to the provincial Social Insurance (if the laborers are still at work).

- The provincial Social Insurance shall have to make copies of dossiers, comprising: the record of the previous evaluation, decisions of the directors of the provincial Social Insurance on payment of lump-sum or monthly labor accident allowances, and papers on treatment of recurring injuries handed over by units, and transfer such dossiers together with a letter to recommend the laborers to the Medical Evaluation Councils for re-evaluation of the injuries caused by labor accidents (according to the assignment of the medical evaluation sector).

- For victims of labor accidents which had occurred before January 1, 1995, who have not yet been recommended for injury evaluation according to Document No. 843/LD-TBXH of March 25, 1996 of the Ministry of Labor, War Invalids and Social Affairs, basing itself on Document No. 908/TLD of July 25, 1996 of Vietnam Labor Confederation, the provincial Social Insurance shall have to request the Labor Federation and trade unions of the branch (which used to manage social insurance matters) to hand over all dossiers as prescribed, and recommend such laborers to take evaluation.

2. Dossiers and procedures for evaluation of working capacity for the implementation of retirement regime:

2.1. Subjects:

- Laborers suffering from health deterioration.

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2.2. Dossiers for first-time evaluation of working capacity shall include:

- The laborers application for evaluation of working capacity (according to set form).

- Brief files of the laborers (according to set form).

- Detailed clinical records (according to set form).

2.3. Procedures for first-time evaluation of working capacity:

2.3.1. For laborers who are still at work:

- The laborers shall, when suffering from ailments or working capacity decrease, file an application to the employers requesting the evaluation of their working capacity (according to set form).

- The employers shall have to receive the laborers’ applications, complete dossiers according to above-mentioned regulations, then make recommendation (according to set form) and transfer the laborers’ dossiers to the provincial Medical Evaluation Councils or the Central Medical Evaluation Council for evaluation of their working capacity.

2.3.2. For those who have ceased working and waited for retirement:

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- The provincial Social Insurance shall have to receive the applications, make copies of certificates of waiting for retirement entitlement, transferred by such subjects, and guide them to elaborate detailed clinical records to complete their dossiers, which shall include:

+ An application for the evaluation of working capacity (according to set form)

+ A copy of the certificate of waiting for retirement entitlement (in replacement of the laborers’ brief files)

+ Detailed clinical records (according to set form).

The detailed clinical records of those who have ceased working and waited for their retirement at the prescribed ages shall be made by State medical establishments, including: hospitals of central and provincial levels, hospitals of ministries and branches, hospitals of military zones and army corps, district medical centers, regional general clinics, dispensaries of armed force units, and grassroots medical stations, as prescribed by the Government’s Decree No. 01/1998/ND-CP of January 3, 1998 on the organization of local health system. After such dossiers are completed as prescribed, the provincial Social Insurance shall make recommendation and transfer the dossiers of such subjects to the Medical Evaluation Councils for evaluation of working capacity.

3. Dossiers and procedures for evaluation of working capacity affected by to occupational diseases:

3.1. Subjects:

- The laborers suffering from occupational diseases.

3.2 Dossiers and procedures for first-time evaluation of occupational diseases shall include:

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- The application for evaluation of working capacity (according to set form).

- Results of measurement of working environment (or a copy thereof, certified by the provincial/municipal Prophylactic Medical Centers), where the laborers have been working for the last 12 months. If such results fail to supply adequate grounds, the results of the preceding measurement of working environment must be enclosed therewith.

- Dossiers of persons suffering from occupational diseases, made according to Joint-Circular No. 08/1998/TT-LT of April 20, 1998 of the Ministry of Health and the Ministry of Labor, War Invalids and Social Affairs, and papers (copies) relating to the occupational diseases.

3.2.2. Procedures for the first-time evaluation of occupational diseases:

- The employers shall have to complete the dossiers according to the above-mentioned regulations, and transfer the dossiers of laborers affected with occupational diseases to the provincial Social Insurance, where their units register for social insurance participation.

- The provincial Social Insurance shall have to re-check such dossiers, and if the dossiers are complete and proper, make recommendation (according to set form) and transfer such dossiers to the Medical Evaluation Councils for working capacity evaluation as assigned by assignment of the medical evaluation branch.

- When such dossiers are fully submitted, the Medical Evaluation Councils shall receive them, and carry out the evaluation as prescribed by the medical evaluation branch.

3.3. Dossiers and procedures for evaluation of occupational diseases from the second time on:

3.3.1. Dossiers for evaluation of occupational diseases from the second time on shall include:

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- A record on the last evaluation of the Medical Evaluation Councils (the original)

- Results of measurement of working environment, if the laborers have ceased working, only the results of measurement of the working environment when such laborers were still at work are required.

- Dossiers of persons affected with occupational diseases, made according to Joint-Circular No. 08/19998/TT-LT of April 20, 1998 of the Ministry of Health and the Ministry of Labor, War Invalids and Social Affairs, and relevant papers (copies).

3.3.2. Procedures for evaluation of occupational diseases from the second time on:

- The laborer shall file an application for evaluation of working capacity, at the same time, have to submit all relevant papers to the employers, if they are still at work, or to the provincial Social Insurance, if they have relieved themselves from work.

- The employers shall have to receive dossiers sent by the laborers, complete such dossiers in strict accordance with the above-mentioned regulations, and transfer them to the provincial Social Insurance where their units register for social insurance participation.

- The provincial Social Insurance shall have to receive and check the dossiers transferred by the employers, or directly receive and complete dossiers as prescribed for those who have relieved themselves from work, then make recommendation and hand over the dossiers of the laborers affected with occupational diseases to Medical Evaluation Councils (according to assignment by the medical evaluation branch) for re-evaluation of working capacity.

4. Dossiers on re-evaluation of working capacity for those who are enjoying working capacity loss allowances:

For those who are enjoying monthly allowances for working capacity loss, when falling sick and being hospitalized or due getting accidents which result in their health deterioration, and if wishing to have their working capacity re-evaluated, they shall file applications, together with their medical books, papers on medical treatment and hospital-discharge papers, to the provincial Social Insurance,

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4.1. The application for re-evaluation of working capacity (according to set form).

4.2. Record on the last evaluation by the Medical Evaluation Councils (original).

4.3. Medical book, papers on the medical treatment, hospital-discharge paper.

After the dossiers are fully submitted as prescribed, the provincial Social Insurance shall make recommendation and transfer the dossier of application for re-evaluation of working capacity to the provincial Medical Evaluation Councils or the Central Medical Evaluation Council for evaluation.

Particularly for those who have retired and enjoyed the working capacity loss allowances according to the provisions of Resolution No. 16/HDBT of February 8, 1992 of the Council of Ministers (now the Government), the provincial Social Insurance shall make copy of the "summary of ailments", made by the units’ medical sections to replace the original record on the last evaluation of labor capacity. In cases where the dossiers for enjoyment of working capacity loss allowances do not contain the "summary of ailments", the provincial Social Insurance shall guide the elaboration of detailed clinical records as provided for relieved persons awaiting the first-time working capacity evaluation at Point 2.3.2, Section 2, Part II above. For these cases, the recommendation letters must be additionally inscribed with the words of retirement for loss of working capacity according to Resolution No. 16/HDBT of February 8, 1992 of the Council of Ministers (now the Government).

The time limit for re-evaluation of labor capacity shall be at least one full year (12 months or more), counting from the time of first-time evaluation.

Apart from the dossiers prescribed for evaluation of injuries caused by labor accidents or dossiers for evaluation of working capacity for the implementation of social insurance regimes, the involved persons, when coming to take evaluation at Medical Evaluation Councils, are requested to produce their people’s identity cards.

Dossiers shall be sent as registered postal mails to the Medical Examination Councils, if they are directly delivered, they must be packed in sealed envelops.

III. IMPLEMENTATION ORGANIZATION

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2. The Medical Evaluation Councils, including:

- The Central Medical Evaluation Council,

- Central Medical Evaluation Sub-Council I in Ho Chi Minh City,

- Central Medical Evaluation Sub-Council II in Da Nang city,

- Medical Evaluation Councils of the provinces and centrally-run cities,

- Medical Evaluation Councils of such branches as: defense, public security and communications and transport,

shall have to strictly abide by the inter-branch regulations, and must base themselves on the criteria already issued by the State to determine the working capacity loss percentage.

In cases where the employers, the laborers and social insurance agencies disagree with the conclusions of the Medical Evaluation Councils, they may lodge their requests to the Medical Evaluation Council of higher level for re-evaluation.

2.1. The Medical Evaluation Councils shall carry out the evaluation only after all legal procedures prescribed for documents and dossiers to be sent by the laborers or the provincial Social Insurance have been completed.

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2.3. When the Medical Evaluation Councils hold their final for the conclusions, the involved persons must not be absent.

The written conclusions of the Medical Evaluation Councils shall be made in five copies, with equal value:

- 1 copy to be kept at the Medical Evaluation Council

- 4 copies to be transferred back to the recommending agencies (1 copy for the employer, 1 copy for the laborer, and 2 copies for the social insurance agency) for the implementation of social insurance regimes.

2.4. The Medical Evaluation Councils shall only make the evaluation of injuries and/or illnesses recorded in the dossiers transferred by the employers or the provincial Social Insurance.

3. The provincial/municipal Social Insurance shall have to receive, elaborate, check, complete and transfer dossiers of the laborers to the Medical Evaluation Councils as prescribed, and base themselves on the conclusions of the Medical Evaluation Councils to carry out social insurance regimes for the laborers as stipulated.

IV. IMPLEMENTATION PROVISIONS

1. This Circular takes effect 15 days after its signing, replaces papers and procedures stipulated in the Appendix issued together with Inter-ministerial Circular No. 12/TT-LB of July 26, 1995 of the Ministry of Health and the Ministry of Labor, War Invalids and Social Affairs, applicable to subjects of evaluation of injuries caused by labor accidents, and evaluation of working capacity for enjoyment of social insurance regimes.

2. The Health Services of the provinces and centrally-run city, health sections of the branches, and the provincial Social Insurance shall have to propagate the provisions of this Circular to their attached units and guide and direct them in the implementation thereof.

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In the course of implementation, if there are any difficulties and troubles, units and localities are requested to report them promptly to the Ministry of Health (The Department for Therapy and the Medical Evaluation Institute) for study and timely settlement.

FOR THE MINISTER OF HEALTH
VICE MINISTER




Le Ngoc Trong