The practice in applying and ways to improve criteria for establishing the degree of occupational disability in the territory of the Russian Federation

Abstract

Aim. To assess the practice in applying Temporary criteria of determination of extent of loss of professional working capacity currently in force in various constituent entities of the Russian Federation and to substantiate the main directions for their improvement.
 Methods. The analysis of expert decisions to establish the degree of occupational disability, adopted in the period from 2015 to 2017, was carried out in 77 subjects of the Russian Federation for two nosological forms: (1) consequences of lower limb injuries (T93) and (2) bilateral sensorineural hearing loss (H83.3). A comparative analysis of expert decisions made using current and proposed by the authors criteria in 2 constituent entities of the Russian Federation in 2018 was carried out. For data analysis, we used descriptive statistics methods.
 Results. Taking into account a high variability in expert decisions making in the constituent entities of the Russian Federation for similar cases (coefficient of variation 21.6%), the authors conclude that it is necessary to change approaches to the methodology for assessing the type of professional activity (qualifications, quality and volume of work, ability to perform it). Using the authors propose criteria based on the concept of reasonable accommodation allowed us to significantly reduce the variability of the decisions made in the pilot regions, the coefficient of variation decreased from 21.25 to 7.43%.
 Conclusion. High variability of decisions made during the examination of the degree of occupational disability is associated with the imperfection of the methods and criteria for assessing the victim's professional activities; the use of the criteria proposed by the authors allows for a higher reproducibility of the results of the examinations.