Circular No. 56/2017/TT-BYT dated December 29, 2017 of the Ministry of Health guiding a number of Articles on health of the Law on Social Insurance and the Law on Occupational Safety and Hygiene

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Circular No. 56/2017/TT-BYT dated December 29, 2017 of the Ministry of Health guiding a number of Articles on health of the Law on Social Insurance and the Law on Occupational Safety and Hygiene
Issuing body: Ministry of HealthEffective date:
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Official number:56/2017/TT-BYTSigner:Pham Le Tuan
Type:CircularExpiry date:Updating
Issuing date:29/12/2017Effect status:
Known

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Fields:Insurance , Medical - Health

SUMMARY

Diseases eligible for lump-sum social insurance payout

On December 29, 2017, the Ministry of Health issues the Circular No. 56/2017/TT-BYT guiding a number of Articles on health of the Law on Social Insurance and the Law on Occupational Safety and Hygiene.

Accordingly, Cancer, polio, cirrhosis of the liver, leprosy, severe tuberculosis, HIV/AIDS and total loss of the worker’s functions, self-control or he/she is unable to move, dress, keep personal hygiene and complete other everyday tasks without other people watching, helping and taking care of him/her.  Diseases other than those specified in Clause 1 this Article that result in at least 81% of work capacity reduction or and complete other everyday tasks without other people watching, helping and taking care of him/her.

Besides, only one confirmation of eligibility to receive social insurance benefits shall be issued each doctor visit. In cases the patient needs to rest for more than 30 days or when the term of leave inscribed on the granted confirmation of eligibility to receive social insurance benefits is almost over, the patient must be conducted a follow-up examination so that the practitioner can consider and decide.

If a worker is issued with more than one confirmations of eligibility to receive social insurance benefits by various departments of different health facilities, the one with the longest duration shall apply.

This Circular takes effect on March 01, 2018 and replaces the Circular No. 14/2016/TT-BYT dated May 12, 2016.

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Effect status: Known

THE MINISTRY OF HEALTH 

Circular No. 56/2017/TT-BYT dated December 29, 2017 of the Ministry of Health guiding a number of  Articles on health of the Law on Social Insurance and the Law on Occupational Safety and Hygiene

Pursuant to the Law on social insurance No. 58/2014/QH13 dated November 20, 2014;

Pursuant to the Law on occupational safety and hygiene No. 84/2015/QH13 dated June 25, 2015;

Pursuant to Decree No. 75/2017/ND-CP dated June 20, 2017 of the Government defining functions, tasks, powers and organizational structure of Ministry of Health;

At the request of Director of the Legal Department, Director of Medical Examination & Treatment Administration, Director of Mother and Child Health Department,

The Minister of Health promulgates a Circular providing guidelines for some articles on health of the Law on social insurance and the Law on occupational safety and hygiene.

Chapter I

GENERAL PROVISIONS

Article 1. Scope of adjustment

This Circular provides for:

1. Diseases, the authority to determine diseases eligible for lump-sum social insurance payout.

2. Medical assessment of work capacity reduction (whole person impairment) as the basis for workers and their relatives to receive social insurance payout.

3. Issuance of discharge notes, birth certificate, copies of medical records, confirmation of maternity leave, confirmation of poor postpartum health and confirmation of eligibility to receive social insurance benefits.

Article 2. Subject of application

1. Workers participating in social insurance as specified in Clause 1 and Clause 4 Article 2 of the Law on social insurance and Article 43 of the Law on occupation safety and hygiene.

2. Workers specified in Clause 1 of this Article whose social insurance participation period is reserved or retired workers pending pension or monthly benefits; voluntary social insurance participants who have paid compulsory social insurance premiums for at least 20 years.

3. Relatives of workers who participated in social insurance applying for medical assessment of work capacity reduction to receive death benefits for the workers (hereinafter referred to as worker’s relative).

Article 3. Definitions

In this Circular, these terms are cons

trued as follows:

1. “Sick leave” means a period of time over which a worker is not healthy enough to work and is required by a physician to take a sick leave.

2. “Valid copy” means a copy that is extracted from the original book or has been compared with the original by a competent authority.

3. “Medical record summary” means the summary of a medical record prescribed by regulations of law on medical examination and treatment.

Chapter II

DISEASES ELIGIBLE FOR LUMP-SUM SOCIAL INSURANCE PAYOUT AND DOCUMENTS OF MEDICAL ASSESSMENT FOR SOCIAL INSURANCE PAYOUT

Article 4. Diseases eligible for lump-sum social insurance payout

The diseases eligible for lump-sum social insurance payout include:

1. Cancer, polio, cirrhosis of the liver, leprosy, severe tuberculosis, HIV/AIDS and total loss of the worker’s functions, self-control or he/she is unable to move, dress, keep personal hygiene and complete other everyday tasks without other people watching, helping and taking care of him/her.

2. Diseases other than those specified in Clause 1 this Article that result in at least 81% of work capacity reduction or impairment level and total loss of the worker’s functions, self-control or he/she is unable to move, dress, keep personal hygiene and complete other everyday tasks without other people watching, helping and taking care of him/her.

Article 5. Documents of first medical assessment

1. Documents of first medical assessment due to an occupational accident:

a) Letter of introduction of the employer according to Appendix 1 enclosed herewith in case the victim of occupational accidents is under the management of the employer at the time of medical assessment or the application for medical assessment according to Appendix 2 enclosed herewith in case the victim is no longer under the management of the employer at the time of application for medical assessment;

b) Original copy or valid copy of the injury confirmation issued by the health facility (that provided treatment for the worker) in accordance with the template specified in Decision No. 4069/2001/QD-BYT dated September 28, 2001 of the Minister of Health;

c) Original copy or valid copy of the record of occupational accident investigation in accordance with Appendix 7 enclosed together with Joint Circular No. 12/2012/TTLT-BLDTBXH-BYT dated May 21, 2012 of the Ministry of Labor, War Invalids and Social Affairs and the Ministry of Health guiding the statement, investigation, statistics and reports on occupational accidents;

d) Discharge note as specified by the Minister of Health or the medical record summary. If the worker is not an outpatient or patient, papers of treatment for injury in conformity with the time of occurrence of the assessed occupational accident and injury.

In case the assessed person is one of the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene: the medical record summary must clearly state that the injury from occupational accident cannot become stable after treatment.

dd) One of the following documents with photo: ID; Citizen Identification; passport that remains valid. If there are no abovementioned documents, a written confirmation with a photo bearing a seal issued by the police authority of the Commune within the last 03 months from the time of application for medical assessment.

2. Documents of first medical assessment of occupational diseases:

a) Letter of introduction of the employer according to Appendix 1 enclosed herewith in case the person being assessed of occupational diseases for the first time is under the management of the employer at the time of medical assessment or the application for medical assessment according to Appendix 2 enclosed herewith in case the worker is retired or no longer does the jobs posing risk of occupational diseases is detected any occupational disease within the coverage period of the disease, including workers whose social insurance participation period is reserved, retired workers pending pension or monthly benefits and workers on pensions or monthly benefits;

b) Original copy or valid copy of the occupational disease record;

c) Medical record summary of treatment for occupational diseases of the worker relevant to occupational diseases (if any).

In case the assessed person is one of the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene: the medical record summary must clearly state that the occupational diseases cannot become stable after treatment.

d) One of the documents specified in Point dd Clause 1 this Article.

3. Documents of medical assessment as the basis for provision of pension for a worker:

a) Letter of introduction of the employer according to Appendix 1 enclosed herewith in case the worker is paying compulsory social insurance or the application for medical assessment according to Appendix 2 enclosed herewith in case of workers whose social insurance participation period is reserved and retired workers pending pension or monthly benefits;

b) Original copy or valid copy of at least one of the following medical documents: Medical record summary, disability confirmation, discharge note, prescriptions, copy of occupational disease record and assessment record of occupational diseases or occupational accidents in case the worker has been medically assessed occupational diseases or occupational accidents;

c) One of the documents specified in Point dd Clause 1 this Article.

4. Documents of medical assessment as the basis for provision of death benefits:

a) Application for medical assessment according to Appendix 2 enclosed herewith;

b) Original copy or valid copy of at least one of the following medical documents: Medical record summary, disability confirmation, discharge note, prescriptions and assessment record of occupational diseases or occupational accidents in case the worker has been medically assessed occupational diseases or occupational accidents;

c) One of the documents specified in Point d Clause 1 this Article.

5. Documents of medical assessment for confirmation of inadequate postpartum health, inadequate health after receiving the child due to surrogacy or maternity leave;

a) Application for assessment according to Appendix 2 enclosed herewith;

b) Original copy or valid copy of at least one of the following medical documents: Medical record summary (maternity record or other diseases), disability confirmation, discharge note, prescriptions, copy of occupational disease record and assessment record of occupational diseases or occupational accidents in case the worker has been medically assessed occupational diseases or occupational accidents;
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