Stroke is a dangerous neurological disease associated with a sudden interruption of blood supply to the brain. It comes in two types:

The described illness often has serious health consequences of varying severity, including disability and death.

The risk group for stroke includes both elderly people over 65 years of age and young people suffering from the following diseases:

A separate risk group includes people who are overweight and prone to bad habits, such as smoking and drinking alcohol.

Consequences of pathology

The consequences after a stroke vary and depend on the degree of circulatory impairment, as well as on the size of the affected area of ​​the brain.

Often, patients who have suffered a stroke develop:

Therefore, after returning home, a person who has suffered this illness, one might say, begins a different life. Recovery time varies for each individual patient.

But doctors insist that home rehabilitation requires introducing the patient to simple housework or helping him find a hobby, taking into account his functional capabilities.

After all, people after a stroke are often predisposed to depression and apathy due to their inability to control their own body and be useful to loved ones. The way out of this state can be found precisely in light work, which will give confidence in one’s own abilities and speed up the rehabilitation process.

Returning to work after an attack

The desire to return to full social life after a blow is easily explained and understandable, but rehabilitation until the cognitive and motor functions of the body are completely restored sometimes takes years. Only in rare cases does recovery after a stroke occur quickly and after a couple of months the patient can return to his job.

After recovery, the patient must undergo a mandatory medical occupational examination (VTE) in order to obtain a medical opinion on how ready the person is to return to work. labor activity and under what conditions.

Doctors evaluate:

If the consequences after a stroke are minimal or residual, then the VTE signs a work permit. IN otherwise, if the disturbances are still pronounced, but the basic functions are normal, then the patient is offered a lighter option of employment:

• reduced working hours;
• individual work schedule;
• work from home.

This is important to know. By Labor Code the employer is obliged, on the basis of a medical report, to provide the employee, after his written consent, with a position that is not contraindicated for him due to health reasons.

But even after VTE is resolved to return to work, there is the necessary conditions that must be followed to avoid stroke recurrence:

If the consequences after a stroke are serious and some of the brain functions have not been fully restored, there is loss of one of the sense organs, paralysis of the arms or legs, etc., then based on medical indications You can apply for disability.

The disability group is assigned according to the following criteria.

When the patient manages to restore the lost functions, the disability is accordingly removed or assigned to a lighter group. If improvements do not occur within 5 years, then disability is assigned indefinitely.

Driving after a stroke

The question of the ability to drive a car is decided by a medical commission. It determines the damage caused by the disease to the patient, the speed of his movements and the level of brain activity. Often, people who have suffered a stroke experience a slow reaction to what is happening, memory and vision decrease, and dizziness becomes frequent.

Also, after a stroke, any situations associated with stress are strictly contraindicated, and on the road they arise constantly. Any jump in blood pressure can trigger another stroke.

Therefore, you can get behind the wheel of a car only after a thorough examination by a neurologist and passing a test on the road in the presence of a driving instructor or on a computer simulator.

In recent years, another method has emerged, proposed by Belgian researchers at the Catholic University, to determine what kind of driver a patient will be. It takes less than 20 minutes and identifies unreliable drivers with 85% accuracy.

The test checks the level of knowledge according to the rules traffic and recognition of road signs, and also evaluates the driver's thinking speed, vision and alertness. It also checks a person’s motor functions and orientation in space.

Of course, there are people who, after a stroke, get behind the wheel again without a doctor’s permission. This can be dangerous not only for the patient himself, but also for the people around him, who may become victims of dangerous situations on the road caused by a person who is not ready to drive.

Making such a decision depends solely on the moral and ethical qualities of the individual himself.

It is better for sane people to refrain from driving until they fully recover from a stroke and undergo a medical examination. Take care of yourself.

Navigation

A stroke is a sudden cessation of blood supply to the brain, as a result of which the patient experiences obvious neurological disorders and negative changes in motor functions. The disease affects patients depending on age and general health, and the consequences reach varying degrees of severity - from minor disorders to disability and even death. Any patient needs a job after a stroke, since work for a person is not only a means of earning money, but also a way to feel in demand and self-realization.

But not every patient who has survived a brain catastrophe will be able to rehabilitate within a few months, get rid of negative consequences illness and return to full-time work. Next we will talk about what are the criteria for permission to go to work, what consequences interfere with the previous type of activity and whether the patient will be able to return to driving a car.

Consequences of a stroke

Negative influence stroke on the patient’s condition depends on how severe the circulatory disturbance in the brain was during the stroke and on the lesion - the larger the affected area of ​​the brain, the more pronounced the disturbances in emotional, intellectual, motor and motor functions will be.

There are two types of stroke:

• ischemic – occurs due to blockage of brain capillaries with thrombotic plaques;
• hemorrhagic - hemorrhage, as a result of which brain neurons die.

The risk group includes not only older people, but also young patients who suffer from diseases of cardio-vascular system, arterial hypertension, diabetes mellitus. Stroke is dangerous for smokers, overweight people and alcohol abusers.

Patients who have suffered a brain stroke suffer from the following dangerous consequences:

• disturbance of speech perception, when a person does not understand phrases addressed to him, although he hears, the inability to speak clearly himself, loss of the skill of reading and writing;
• loss of coordination and spatial orientation;
• motor dysfunction;
• absent-mindedness, inattention;
• hearing or vision loss;
• difficulty swallowing food and water;
• decreased tactile sensitivity.

As you can see, after a stroke a person literally begins to new life, in which children relearn the skills of speaking, walking, writing and reading. In the absence of radical consequences of the stroke, the patient recovers within 3-6 months and returns to work. The ability to work fully in patients with severe disabilities is assessed by a medical labor examination.

Why is it important to work after a stroke?

Patients who have experienced cerebral hemorrhage rehabilitation period prone to depression and apathy due to the inability to cope with things that they could easily do before. Worrying about one’s own uselessness does not in any way contribute to speeding up recovery; on the contrary, the patient gives up and thinks that he will not return to what he loves. For this reason, the patient’s loved ones must create conditions in which he can restore confidence in his own abilities, remember and consolidate lost motor skills.

This could be a favorite hobby related to knitting, embroidery, design, or simple help with housework, in accordance with the person’s functional capabilities. Rehabilitation after a stroke and returning to work in the same place is a long process, which sometimes drags on for years - to return to full-time work, you need to restore cognitive and motor abilities as best as possible.

A new remedy for the rehabilitation and prevention of stroke, which is surprisingly highly effective - Monastic Collection. The monastic collection really helps fight the consequences of a stroke. Among other things, tea keeps blood pressure normal.

Passing a medical labor examination

The examination is carried out with the aim of preparing a medical opinion on whether the patient can work after a stroke, under what conditions he will have to work, and whether it is possible to recognize him as incapacitated.

During the medical commission, the following is assessed:

• How much have you recovered? mental capacity sick;
• mental condition;
• whether there are speech, vision and hearing impairments and what their degree is;
• level of muscle tone;
• criteria for behavior and communication skills;
• condition of the heart and blood vessels;
• the presence or absence of coordination and spatial orientation disorders.

With minimal consequences of a brain stroke, a medical examination signs permission to return to work. If there is a pronounced degree of residual impairment, but vital functions are preserved, the patient is recommended to have one of the options for lighter work - reducing working hours, working according to an agreed (individual) schedule and working from home.

Criteria for assignment of disability

In order to determine the degree of impairment in a patient after a stroke, assign him a certain disability group and determine the amount of disability benefits, there are complex assessment systems, the essence of which boils down to the following:

1. The most severe disability group I is assigned to patients with a chronic form of insufficiency of blood supply to the brain, aggravated by severe disorders of the cerebellar and motor functions. These are speech disorders, parkinsonian syndrome, altered mental state (development of dementia) - in general, those conditions in which the patient is not able to care for himself and needs constant supervision.
2. Disability group II includes residual effects in the form of vascular diseases in a progressive form, a combination of high blood pressure with atherosclerosis, chronic coronary and heart failure, as well as disorders of motor, vestibular, visual or auditory functions. An indication for assignment to group II is also the risk of recurrent stroke due to the alternation of mild and severe hypertensive crises.
3. Group III is assigned to patients with symptoms of persistent arterial hypertension, insufficiency of blood supply to the brain of the second degree, as well as with mild residual effects of central nervous system disorders - moderate psychoorganic or neurasthenic syndrome.

How can a disabled person who has received group III earn money? Even with high professional qualifications, after a stroke a person will not be able to fully perform his or her activities, which will greatly affect the level of earnings. Such patients are offered a transfer to a similar place of work, but with a lower qualification level and a shorter day, or work from home. To return to his previous job, the patient must continuously undergo maintenance therapy, and after a year he will have the opportunity to prove his full working capacity.

Our readers write

Subject: Got rid of the pressure

From whom: Galina ([email protected])

To whom: Site administrator

At the age of 45, pressure surges began, I suddenly became ill, with constant apathy and weakness. When I turned 63, I already understood that I didn’t have long to live, everything was very bad... An ambulance was called almost every week, I always thought that this time would be the last...

Everything changed when my daughter let me read it on the Internet. You can’t imagine how grateful I am to her for this. This article literally pulled me out of that world. Over the last 2 years I have started to move more; in the spring and summer I go to the dacha every day, grow tomatoes and sell them at the market. My aunts are surprised how I manage to do everything, where so much strength and energy comes from, they still can’t believe that I’m 66 years old.

Who wants to live a long and energetic life without strokes, heart attacks and blood pressure surges, take 5 minutes and read .

Working conditions provided for disabled people

If a medical examination has recognized the patient’s limited ability to work and he has been asked to work from home or under easier conditions, then they should be as follows:

• the work place should be located away from temperature changes and strong vibration;
• during the working day, the patient should not remain in one position for a long time - the place should be comfortably equipped;
• activities should exclude excessive stress on the emotional, mental and physical sphere;
• no contact with household toxins.

With severe financial difficulties, many patients earn money not only at their main job, but also at home, completing simple orders according to their profile, taking advantage of a reduced working day. This is a natural need for a person, but it is better to undergo a full rehabilitation course and prove your ability to work after VTE in a year, than to expose yourself to the risk of another stroke due to overwork and stress.

Back behind the wheel

Patients ask whether they can work as a driver after a stroke, if this occupation was the only source of income before the brain stroke. The decision is made by a medical commission, which evaluates the patient’s reaction speed and movements, level of brain activity, vision and memory indicators.

Since there are stressful and conflict situations, and they are contraindicated for a patient in the rehabilitation period; before returning to the wheel, the driver must undergo a full examination by a neurologist.

Some people, having not received permission from a medical board to drive a car, get behind the wheel contrary to prohibitions, thereby endangering themselves and others. Not everyone can make such a decision; it rather depends on moral qualities man and his ethical standards.

The desire to quickly return to full activity after a brain accident is natural, but for this you need to go through a long period of rehabilitation and medical procedures. The more carefully the patient follows medical recommendations and works on lost functions, the faster he will be allowed to return to his favorite activity, earn decent money and feel in demand.

Drawing conclusions

Strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blocked arteries in the brain. And the very first and main sign of vascular blockage is a headache!

Blockage of blood vessels results in a disease known as “hypertension”, here are just some of its symptoms:

• Headache
• Increased heart rate
• Black dots before the eyes (floaters)
• Apathy, irritability, drowsiness
• Blurred vision
• Sweating
• Chronic fatigue
• Swelling of the face
• Numbness and chills in fingers
• Pressure surges

Attention! If you notice at least 2 symptoms, this is a serious reason to think about it!

The only remedy that gave significant results...

Telephone consultation 8 800 505-91-11

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Work after a stroke

I am disabled for 2 groups and I don’t work anywhere after the stroke, I’m already adjusting more than a year 50% of my pension is withdrawn from me and...

According to Article 99 Federal Law dated October 2, 2007 N 229-FZ “On Enforcement Proceedings” have the right to recover half of the income within the framework of enforcement proceedings. The fact that there is no work is not an obstacle to this.

By law, they can withdraw no more than 50 percent from their pension. But if the pension is small and you have nothing to live on, then you can apply to the court to reduce the percentage of deductions from the pension. In practice, you can reduce the amount of your pension by up to 10 percent through the court in this case. Article 99 of the Federal Law of October 2, 2007 N 229-FZ “On Enforcement Proceedings” Or you can get an installment plan or deferment of collection under Article 203 of the Code of Civil Procedure of the Russian Federation.

Hello dear site visitor, collector, debtor, The bailiff has the right to apply for a deferment or installment plan for the execution of a judicial act in the amount of no more than 25% of salary or other income (part 1 of article 37 of the Law on Enforcement Proceedings, part 1 of article 358 of the CAS RF, part 1 of article 324 of the Arbitration Procedure Code RF). The application is submitted to the court that considered the case in the first instance and issued the writ of execution, including in the case of cancellation (change) of a judicial act and the adoption of a new judicial act by a court of appeal, cassation or supervisory authority. Good luck to you and all the best, with respect, lawyer Ligostaeva A.V.

Regulatory legal acts allow debt collection: from an old-age pension; With pension provision, accrued for disability; from urgent pension payments. Most pensioners belong to the category of borrowers from whose pensions money can be collected into the debt fund. Federal Law of October 2, 2007 N 229-FZ (as amended on December 27, 2018) “On Enforcement Proceedings” Article 101. Types of income that cannot be levied.

The retention percentage is correct. Up to 50% can be withheld from old-age pensions and disability pensions in enforcement proceedings. An installment plan or deferment of execution of a court decision or court order must be requested in court. Article 203 of the Code of Civil Procedure of the Russian Federation, Article 99 of the Federal Law “On Enforcement Proceedings”. Find out the reasons for deduction from the FSSP (or from the Pension Fund of the Russian Federation, if you receive your pension in cash at the post office and the deduction is made by the Pension Fund of Russia).

If I work in trade, how long can I stay on sick leave after hemorrhagic stroke?

This is decided only by your attending physician.

After a stroke, speech is impaired and does not work right hand, capable, adequate, the notary refused to issue a power of attorney from him. Is this legal?

Hello! Contact another notary. It's easier than arguing or going to court. Notaries have different approaches to determine legal capacity, the ability to understand the meaning of one’s actions.

Will the commission allow me to work as a train station attendant on night shifts after an ischemic cerebral stroke?

This is not a legal, but a medical issue, ask for a referral to the commission, you should write the application in two copies, and the receiving party must sign yours.

Father after a stroke, he needs round-the-clock care. I work and can’t constantly ask for time off. And you can’t quit your job either, since you’re dependent on a young child. There is not enough money for paid transactions, I work alone. Maybe there is some way out? Care for your father without losing your job?

I’m not sure of the answer, but first, try contacting social security and find out how to register a visiting social worker, at least in your absence during the day.

I am a 61-year-old pensioner, group 3 disabled, after two strokes. What are the benefits for major repairs? I do not work. Owner.

Today there was information in the legal news that the President of the Russian Federation has exempted non-working disabled people and pensioners from the obligation to pay contributions for major repairs, but I have not yet seen the legal act.

After a stroke, my father is incapacitated and does not work. There is an extract from the hospital, he has a debt to the Post Bank, they do not have an insured event. There must be a disability group, but no one will issue it for us right away. They came to my father’s house from the bank and talked about debt regulation. They don't offer us any options. As soon as we arrived, our blood pressure increased and things got worse. What should we do? God forbid, they will lead him to a second stroke.

Marina, hello! If after your father there is something to inherit, then it is better for you to pay off the debt, no matter how blasphemous it sounds, since in the event of his death, you will have to inherit the debt along with the property. And since the father is incapacitated, it is necessary to arrange guardianship over him in order to receive his pension.

To do this, call doctors, get an opinion, and then formalize guardianship through the court.

Discharged from work after a stroke. What are the restrictions at work? Hello. Unfortunately, a stroke imposes a number of restrictions on many types of activities; such prohibitions greatly complicate the patient’s life and negatively affect his emotional background

. The ability to engage in one or another type of activity again depends entirely on the individual state of the body. Therefore, your doctor should give you his recommendations. After a stroke, how and where can I find a job? Left-hand side

doesn't work well.

Hello Irina. The site's lawyers do not provide employment services. It would be more advisable for you to register for disability and contact the employment center, perhaps they will find a vacancy for you.

How to achieve disability after a stroke, lost ability to work. Temporarily not working. The therapists remain stubbornly silent, a vicious circle.

First, you need to go to an appointment with your attending physician, explain your problem to him and tell him that you are going to get a disability. Your doctor should record everything in your outpatient record and write you a referral to professional specialists. After which you will have to undergo examination in a hospital. You should not hide your illness or injury that causes you to be disabled. Also explain to the doctors why you have all this, as well as how you can work at the moment. Doctors must record all this information in your outpatient record. When you undergo MSE (Medical and Social Examination), defend your rights. You will have to prove that your illness prevents you from living full life. Therefore, take all documents that can confirm your illness to the ITU.

How to achieve disability, lost ability to work after a stroke, temporarily did not work. I asked the therapists and they said I didn’t understand anything, it’s a vicious circle.

Good afternoon Sergey, your doctor should have recorded everything in your outpatient card and written you a referral to professional specialists. After which you will have to undergo examination in a hospital. You should not hide your illness or injury that causes you to be disabled. Also explain to the doctors why you have all this, as well as how you can work at the moment. Doctors must record all this information in your outpatient record. When you undergo MSE (Medical and Social Examination), defend your rights. You will have to prove that your illness prevents you from living a full life. Therefore, take to the ITU all documents that can confirm your illness. If you need detailed consultation, you can contact me via messages, consultation is free.

How to achieve disability, lost ability to work after a stroke, temporarily did not work at that time. Worked as a driver for 20 years.

Contact your local doctor for a referral to MSA. Only ITU specialists, based on examinations, make a decision on assigning a disability group.

My dad worked as an ambulance driver for 16 years, then after a stroke he was transferred to security guards on an ambulance, well, he was unable to work and quit his job. at will, but for some reason the payment was not made on the same day, but was issued only today, and he quit on 01/17/18. Do we have the right to sue them? and for what years are the calculations carried out?

Hello, Margirita Alexandrovna. In accordance with Art. 140 of the Labor Code of the Russian Federation: Upon termination of an employment contract, payment of all amounts due to the employee from the employer is made on the day of the employee’s dismissal. If the employee did not work on the day of dismissal, then the corresponding amounts must be paid no later than next day after the dismissed employee submits a request for payment.. When calculating, unpaid wages, compensation for unused vacation, and other payments provided for in the employment contract, collective agreement and other local regulations are taken into account. In accordance with Art. 236 of the Labor Code of the Russian Federation: If the employer violates the established deadline for payment of wages, vacation pay, dismissal payments and (or) other payments due to the employee, the employer is obliged to pay them with interest ( monetary compensation) in an amount not lower than one hundred and fiftieth of the key rate of the Central Bank in force at that time Russian Federation from amounts not paid on time for each day of delay starting from the next day after the established payment deadline up to and including the day of actual settlement. In case of incomplete payment of wages and (or) other payments due to the employee on time, the amount of interest (monetary compensation) is calculated from the amounts actually not paid on time. The amount of monetary compensation paid to an employee may be increased by a collective agreement, local regulation or employment contract. The obligation to pay the specified monetary compensation arises regardless of the employer’s fault. Your father can file a lawsuit to recover monetary compensation for violation of dismissal payments.

I am disabled. After. Stroke.3.group. Work. I can not. I have. Duty. on.loans. Cry. I can not. Please advise. I.tell me. Where can. Design. Bankruptcy. For free. A.the.money. To pay. A lot of. No. very much. Ask. Help.

Hello. Bankruptcy is possible by filing a petition in court. It won't be free. You need to pay a state fee of 300 rubles and make a deposit of 25,000; you can ask for a deferment or installment plan.

Have a nice day. No one will file bankruptcy for free; such benefits do not exist for anyone. The loan may be collected from you in judicial procedure You will pay from your pension.

Good day to you. No one will file your bankruptcy for free. I wish you good luck in resolving your issue and all the best.

Good afternoon, Olga Nikolaevna! No one will file bankruptcy for you for free; it is a long and expensive process. Creditors will go to court and collect the pension from the court.

Every problem has a solution, the main thing is to be able to find it. Thank you for using the site's services!

Good afternoon, dear Olga You won’t file bankruptcy for free, wait for the trial and then apply for interest reduction. Good luck to you and your loved ones! Today, there are several effective legal ways to avoid collection under a loan agreement. These include termination of the contract, declaring it invalid, declaring the citizen bankrupt and ending enforcement proceedings. There are also some legal tricks that will allow you not to lose your property and income in a dispute with creditors (banks). A credit lawyer will help you do all this correctly, write to the email below.

Sincerely, credit lawyer – Stepanov Vadim Igorevich.

I work and take care of my bedridden mother after a stroke. Can I leave work a few minutes early according to the law?

Hello! You can resolve this issue only by agreement with the employer, outlining the reasons for leaving work early. You cannot make such a decision on your own. This is a violation of the employment contract and internal labor regulations. You need to draw up an agreement with the Employer to employment contract

about establishing working hours specifically for you. Then everything will be fine.

How can I pay child support if I have a stroke, they don’t grant me disability, and I won’t get me a job?

If arrears for alimony payments accumulate, then you have the right to apply to the court for exemption from payment of arrears or a reduction in its amount.

Is sick leave issued at the place of work for caring for bedridden patients? My uncle was hospitalized after a stroke. Order of the Ministry of Health and Social Development of Russia dated June 29, 2011 N 624 n (as amended on July 2, 2014) "On approval of the Procedure for issuing certificates of incapacity for work" (Registered with the Ministry of Justice of Russia on 07.07.2011 N 21286) V. Procedure for issuing certificates of incapacity for caring for a sick family member " "34. A certificate of incapacity for caring for a sick family member is issued one of the family members (guardian, trustee, other relative) who is actually providing care. 35. A certificate of incapacity for work is issued to care for a sick family member. Sick leave can be issued to you after your uncle is discharged from the hospital, if your uncle is a member of your family, that is, he lives with you

Wanted to know. Mom after a stroke. I'm looking after her. I am still filing for disability. If I don't work and look after my mother. What documents need to be collected? If you take out guardianship over her or whatever it is called correctly. And in what case they can refuse. And if you can find out the amount that is paid.

The guardianship and trusteeship authority can appoint you as a guardian if your mother is declared legally incompetent. How much do you expect to be paid? Guardianship is free of charge. As a guardian, you will receive the ward's pension.

When can I apply for disability after a stroke if I have not officially worked anywhere recently?

---on determination or refusal, in the disability group, ONLY ITU doctors decide, To establish the disability group (or strengthen it), you need to contact your attending physician and ask to fill out a mailing list on the ITU form Form No. 080/u. You receive this sheet and visit all the doctors listed on it, and then go through the ITU, in accordance with the Decree of the Government of the Russian Federation No. 95 of February 20, 2006 “On the procedure and conditions for recognizing a person as disabled.” Form No. 080/u-06 is signed by the head of the department, as the chairman of the Medical Commission. And if you refuse to establish a disability group, you will appeal the refusal in court within 3 months from the date of receipt. The court will appoint a commission examination and make its decision. Good luck to you and all the best.

Good afternoon The fact of work does not affect this in any way; you need to contact your doctor and get a referral to undergo an ITU medical commission, they will be the ones who will determine the disability.

My husband worked in IK-17, and he had a stroke while on duty. He was on sick leave for 3 months, after which they called him and asked him to resign on his own. Out of his stupidity, he did this. Was he entitled to any sick pay and is it possible to do something now?

Hello, depending on how much time has passed since that “stupidity”. We don't guess. And the question should be asked correctly, more fully. Good luck to you and all the best, with respect, lawyer Ligostaeva A.V.

Hello. If you quit voluntarily, of course no payments are provided. However, if no more than 1 month has passed since the dismissal or you have been on sick leave all this time, you can try in court to restore the deadline for filing a claim and demand that the dismissal be declared illegal.

A man worked in a budget organization.. he had a stroke.. half a year after the stroke the contract was terminated.. he was fired under clause 5.. part one of Article 83 of the Labor Code of the Russian Federation.. Tell me, for how long should the paycheck and the last sick leave be issued?..?

Good afternoon On the day of dismissal, a full payment must be issued for all days before the dismissal, including payment of sick leave.

I am now 53 years old, I don’t work because I am caring for a patient (semi-paralyzed after two strokes, and also with a hip fracture. Plus mental problems) 83 summer mom. Can I retire early?

There is no reason for early exit on retire. Apply for retirement in the Pension Fund, receive compensation, this period will be counted towards the length of service when assigning a pension.

I work under a contract, but I haven’t seen the contract, they didn’t give it to me, I’m on sick leave after a stroke, the employer doesn’t want to pay because I work under a contract. What to do?

Galina, do you work under a civil contract or an employment contract? If according to the GPA, then you will not receive any payments, alas. Article 62. Issuance of documents related to work and their copies [Labor Code of the Russian Federation] [Chapter 10] [Article 62] Upon a written application from the employee, the employer is obliged, no later than three working days from the date of filing this application, to issue the employee a work book for the purpose of his mandatory social insurance (security), copies of documents related to work (copies of orders for employment, orders for transfers to another job, orders for dismissal from work; extracts from the work book; certificates of wages, about accrued and actually paid insurance contributions for compulsory pension insurance, about the period of work with a given employer, etc.). Copies of work-related documents must be properly certified and provided to the employee free of charge.

Contact the labor inspectorate, the prosecutor's office and the court. Article 392 of the Labor Code of the Russian Federation. Your labor rights are being grossly violated. Good luck to you and all the best.

Hello, Galina! You need to receive your contract in hand, and after that it will be clear what rights you have. With respect and readiness to help, STANISLAV PICHUEV.

Hello. You need to look at what kind of contract: civil or labor. If you don’t have a contract in hand, it means your employer most likely doesn’t make any contributions and hasn’t officially registered you. Contact the labor inspectorate.

I am not working because I have been caring for my mother after a stroke for a year now, I have 2 minor children and 2 adults, 23 and 24 years old (the older children live in another city). We live only on our mother’s pension and alimony of 2,500 rubles, we cannot receive benefits since I do not work and according to the law of the Russian Federation, care is not provided for caring for a patient after a stroke (after a stroke: walking, visually impaired, dementia (does not call objects by their proper names) I am mentally unstable from time to time (registered with a psychiatrist). How can I pay the vacation tax in such conditions? Or do they not want to go on vacation at sea? their vacation during the holidays? The cost of a ticket to the sea is 100-180 rubles, depending on the distance. Previously, before the mother’s illness, there was an emergency (we had to close the emergency and transport all the remaining goods home. All the children and I are registered in the apartment. The mother is registered at a different address, but lives with us, since her living area and conditions do not allow it.

The bill “On conducting an experiment on the development of resort infrastructure in the Republic of Crimea, Altai Territory, Krasnodar Territory and Stavropol Territory” was approved by the Russian government at the end of April. The document assumes the introduction of a resort fee from January 1, 2018 on an experimental basis. The regions were asked to set the amount of the fee themselves, but it should not exceed 100 rubles per person per day. Heroes of the USSR and Russia, full holders of the Order of Glory, participants and disabled people of the Great Patriotic War, liquidators of the Chernobyl accident, disabled people of groups I and II, children under 18 years of age and students, as well as those who permanently live and work in the specified areas are exempt from the fee. regions or have their own housing there. The list of beneficiaries can be expanded by regional authorities.

Can a teacher continue to work at school after a stroke? The teacher periodically during the school period goes to the hospital in "neurology", continues to teach lessons, behaves absent-mindedly, sometimes it seems that he forgets what was covered in the lesson. Can a person continue to work as a teacher and generally work with children after such an illness?

Hello. A teacher can continue to work at school after a stroke if he has no medical contraindications for this.

After a stroke, my wife cannot walk, her right arm does not work and she does not speak. Can a husband get sick leave to care for a sick person?

Hello, Unfortunately, it can’t, but you can invite a notary, she will write out a notarized power of attorney for you in the clinic using this power of attorney. You can start registering for disability, then get a certificate from the attending physician about the need to care for her, and then you will be issued a sick leave.

Will you be granted disability after an ischemic stroke if your arms and legs work normally and there are no problems with your head?

Hello Yuri. A lawyer cannot know this. Disability is determined by a special medical examination, which you can contact and find out everything.

Good day! There is such a possibility, but we can only guess. Only ITU can establish disability, based on the results of a comprehensive examination. I wish you good luck and all the best!

A cerebral stroke is often accompanied by loss of consciousness, often a coma, since this involves the shutdown of a relatively large area of ​​the brain. The cause of a stroke may be a cerebral hemorrhage, sometimes with a breakthrough into the ventricles, intrathecal space, or cessation of blood supply to any area of ​​the brain for a period sufficient for necrosis and death of the brain parenchyma. The death of a part of an organ due to cessation of blood flow and deprivation of nutrition is usually called a heart attack. In relation to the brain, this term is rarely used; it is more common to designate this process as softening, since the necrotic parts of the brain disintegrate and appear softened at autopsy. Both with hemorrhages and softening of the brain, not only focal damage develops, but also a diffuse disorder of brain activity. Observed for stroke clinical picture depends on the totality of organic damage to one or another part of the brain and the severity and prevalence of diaschisis. Functional disorders caused by focal brain damage remain persistent unless compensation and the creation of new connections occur in the future.

Hemorrhage in the brain occurs either as a result of a rupture of the vessel wall, most often a miliary aneurysm, or as a result of increased permeability of the vessel walls (erythrodiapedesis). In the first case, a hematoma forms in the substance of the brain, sometimes blood breaks into the ventricles or intrathecal space; in the second case, the blood permeates the brain tissue.

The clinical prognosis for hemorrhages is poor. Therefore, among stroke survivors examined at the VTEK, the consequences of hemorrhage are many times less common than the consequences of brain softening. Those patients who survive often remain severely disabled.

Brain softening occurs when one or another part of the brain is deprived of blood flow. This may be a consequence of: 1) blockage of the feeding artery (embolus, thrombus, inflammatory or obliterative process); 2) drop in blood pressure. A drop in blood pressure is primarily reflected in the nutrition of precisely those parts of the brain that belong to the basin of a blocked vessel or a vessel with a sharply narrowed lumen. In cases where collateral blood supply is restored quickly enough, the process may be limited to ischemia, but if there is no blood flow for a long time, then the death of the brain parenchyma occurs, its necrosis with subsequent softening of the brain matter. Thus, it is now customary to talk not about thrombotic, but about ischemic stroke, since, in addition to thrombosis, often the cause of softening of the brain matter is a sharp sudden drop in blood pressure and weakening of cardiac activity, leading to the shutdown of blood supply to the brain (hypoxia) in the area of ​​atherosclerotic narrowed vessels.

As observations have shown recent years, blockage of a vessel can be clinically asymptomatic if the collateral blood supply sufficiently fully provides nutrition to the brain tissue. This is confirmed by angiography data indicating that the arteries through which compensatory connections are formed can increase in diameter up to 2.5 times. Therefore, a gradual cessation of blood circulation in one of the main vessels can be asymptomatic if the collateral blood supply is not impaired (in 15% of cases, blockage of the internal carotid artery is discovered by chance in the section). For the diagnosis of occlusion of the internal carotid artery, the following are important: 1) the absence of pulsation of the carotid artery, and sometimes the subclavian and radial arteries, on the side opposite to hemiplegia - “alternating asphygmopyramidal syndrome”; 2) decreased vision and often a drop in pressure in the central retinal artery on the side of the blockage; 3) Horner's sign on the side of thrombosis. A fairly common abroad, but not safe diagnostic method, which in no case can be recommended, is pressing the healthy carotid artery, which causes dizziness, convulsions in the opposite limbs, changes in the electroencephalogram, sometimes loss of consciousness with a drop in blood pressure and bradycardia.

Thanks to modern advances in the field surgical treatment carotid artery thrombosis, the clinical prognosis in cases where surgery is indicated is significantly improved. However, in the practice of VTEK it is necessary to approach very carefully when deciding on the ability to work of such patients and take into account the etiology of the process, the nature and severity of impaired functions (hemiparesis, pathology of the organ of vision, etc.), as well as the possibility of repeated thrombosis.

Pseudobulbar syndrome occurs as a result of multiple repeated disorders of cerebral circulation, occurring as small thromboses and leading to the development of multiple small cysts or lacunae in the brain. Micro-strokes pass unnoticeably for the patient: either a feeling of weakness and dizziness for several hours or days, then a short-term loss of speech, paresis of the limbs, an epileptiform seizure, then a feeling of numbness in the limbs, loss of the visual field, transient states of disorientation and confusion, etc. If softening is localized in the subcortical nodes, then akinesis or slowness of movements develops, a sharp rigidity of muscle tone, trembling of the hands, i.e., a picture of parkinsonism is noted. With bilateral foci of softening in the form of small cysts in the internal bursa, brain stem or subcortical white matter, tendon reflexes increase, coordinating synkinesis appears, pathological symptoms Babinsky, Rossolimo, etc., pseudobulbar symptoms occur (labial, palmomental, nasolabial, mental reflexes, choking, difficulty swallowing, dysarthria, violent crying).. When examining the ability to work of patients with pneudobulbar paresis, it must be taken into account that the severity functional disorders They are usually combined with a fairly rapid progression of the process, which indicates an unfavorable prognosis. Such patients are usually unable to work.

Restoration of work capacity after a stroke depends on the nature and severity of the stroke. After an acute period of stroke, significant recovery of impaired functions may occur, but this usually requires long time. Mortality with cerebral hemorrhages is higher than with thrombosis of cerebral vessels, but when patients survive, the restoration of impaired functions is usually better in them than in patients with thrombotic softening of the brain. In cases where thrombotic softening was clinically suspected, and subsequently a gradual and significant restoration of impaired functions is observed, it can be considered that there was predominantly ischemia without complete death of brain tissue.

The criterion for determining the degree of disability after a cerebrovascular accident in the long-term period is: the severity of dysfunction: motor, speech, visual, coordination, etc. Motor and speech disorders are especially important: if there is a need for outside care due to paralysis of the limbs or aphasia patients are assigned the first disability group; with severe hemiparesis or partial aphasia, when patients cannot perform any work but do not need constant outside care, they are assigned a second disability group. In case of mildly expressed hemi- or monoparesis, a slight decrease in muscle strength, mildly expressed restrictions on the movements of an arm and leg or only one limb - the question of the patients’ ability to work is decided taking into account their professions, and either they are assigned a third disability group, or, if there are no contraindications to continue working in their specialty, they are recognized as able to work.

Prevention after stroke is based on proper organization the patient’s lifestyle, systematic medical supervision and, if there are no contraindications to work, a rational work arrangement, it is advisable to use a dynamic stereotype.

Such patients can be recommended work that is not associated with significant neuropsychic and physical stress, without staying in conditions high temperature and humidity, out of contact with vascular and neurotropic poisons (lead, arsenic, etc.). With mildly expressed residual effects of hemiparesis and satisfactory general condition, patients can be employed in work that is not associated with significant physical stress, performed mainly with one hand, with the participation of the paretic in auxiliary operations, mainly sitting or with small movements (the work of a rejector, quality control inspector, if available). relevant knowledge, distributor of tools; small amount of economic, accounting, clerical work, many works in the professions of intellectual work). Skilled workers (turners, repairmen, milling operators, etc.) can be transferred to work using professional skills without significant physical stress, but in easier conditions (foreman, instructor, fitter on small parts).

Not only the first one has a huge impact on the dynamics of the recovery period. health care in the acute period, but also rational management of the patient for several months after the stroke. Observations conducted at CIETIN showed that patients treated at home remain more severely impaired than patients treated in a hospital. Currently, when organizing specialized neurological departments and neurosurgical departments where surgical treatment patients with stroke, and early transportation of patients in the acute period of stroke, the prospects for immediate treatment have increased significantly.

The issue of clinical and work prognosis after a cerebral stroke can be resolved no earlier than 3-4 months, although recovery period lasts much longer. Therefore, the period of temporary disability after a stroke ranges on average from 3-4 to 5-6 months. With a good prognosis and increasing recovery of impaired functions, the period of temporary disability should be extended to 5-6 months. For the clinical prognosis of cerebrovascular accidents, the dynamics of restoration of impaired functions, including the state of the psyche, are important. With an unfavorable clinical prognosis, as due to the severity of the underlying vascular disease, the presence of combined lesions of other organs (for example, myocardial infarction), the elderly age of the patient and concomitant diseases, and due to the poor dynamics of functional restoration, a referral to VTEK for transfer to disability is indicated. In most cases, after a severe stroke, recovery of impaired functions occurs at a slow pace, therefore, as a rule, any work in the patient should be considered contraindicated for patients. professional conditions during a year. Making an expert decision is greatly facilitated when a detailed diagnosis of the disease is clearly formulated, indicating the stage of the disease, its course, the nature and severity of impaired functions.

Disabled people with severe functional impairments (hemiparesis, ataxic disorders) may be recommended to work: 1) in special workshops where significantly easier working conditions can be created (shorter working hours, individual production standards, additional rest breaks); 2) at home - without mandatory production standards, with delivery to necessary cases(if it is difficult to move independently) raw materials to your home and reception finished products, and for persons of intellectual work - work of an advisory nature.

When issuing an expert opinion, VTEC must have comprehensive data on the nature of the disease and its dynamics. Therefore, during the initial examination at the VTEK of patients with vascular diseases of the brain and the consequences of previous cerebrovascular accidents, it is necessary to require medical institutions to provide the following information: a) about the nature, form, stage and features of the course of the main vascular process; b) detailed data from a neurological examination, information on the dynamics of blood pressure, electrocardiogram data, results of an examination by an ophthalmologist, laboratory tests and other special research methods that were carried out to clarify the diagnosis; c) a description of the nature and frequency of crises, including those that resulted in short-term breaks in work (without issuing sick leave); d) description of the stroke and its consequences, i.e. what functional disorders and neurological symptoms were noted in the acute period, what the dynamics of the further course were, when the improvement of the condition began, how it proceeded, how it manifested itself, what pathological symptoms lasted longer and what functional ones violations exist during the period of referral to VTEC; e) description of the complex of activities carried out therapeutic measures both the main vascular process and the consequences of stroke and their effectiveness.

It is important to establish whether the treatment was carried out only on an outpatient or inpatient basis, the duration and duration of hospitalization, and sanatorium treatment. During repeated examinations at the VTEK, it is necessary to obtain all observation data from medical institutions for past period and about the changes noted in the patient’s condition.

Resolving the issue of the working capacity of patients with vascular diseases of the brain with consequences of stroke is facilitated by the fact that VTEK also has its own dynamic observation data. These data make it possible to establish the dynamics of functional disorders noted during the previous examination and to judge whether there are signs of progression of the process or whether its course is favorable. When re-examining disabled people, the expert doctor must take into account the patient’s mental state (peculiarities of emotional reactions, characterological changes, organic changes in the psyche) and changes during the time that has passed since the previous examination.

When determining the state of working ability and making an expert decision, it is necessary, after clarifying the clinical diagnosis, the nature of the process and the clinical prognosis, to establish how much the patient’s profession and working conditions correspond to his health and functional capabilities. It is very important to clarify specific production conditions in each case, both during the initial examination and during the second examination, if the patient has already started work. Sometimes a household examination is also of considerable importance, which can help the expert doctor in objectifying a number of symptoms, especially the mental state, as well as the patient’s behavior and the actual state of his ability to work.

Retraining and retraining for patients with cerebrovascular diseases are usually not available.

Rational employment of patients with vascular diseases of the brain is the basis for preventing disability and preventing the onset of more severe disability. Preventive measures should be aimed primarily at preventing crises and cerebral stroke. On early stage the development of vascular diseases of the brain, prevention of disability is carried out mainly through medical institutions. In later stages, measures to prevent disability become the responsibility of VTEK. Establishing a disability group is at the same time a prevention of more severe disability.