Procedure and content of medical assessment in Vietnam

Procedure and content of medical assessment in Vietnam (Internet image)

Regarding this issue, LawNet would like to answer as follows:

1. Time limit for reassessment of social insurance benefits in Vietnam

Time limit for reassessment of social insurance benefits according to Article 12 of Circular 56/2017/TT-BYT (amended in Circular 18/2022/TT-BYT) is as follows:

- As for cases of re-assessment of occupational accidents and occupational diseases, workers are entitled to take the initiative to take an assessment of the level of working capacity reduction and is paid a fee for assessment in case the assessment results are satisfactory to raise the allowance for occupational accidents and diseases

- In case of determination of continuously progressed injury from an occupational accident or occupational disease which leads to change in level of injury, the Medical Assessment Council may conclude the time limit for the next medical assessment shorter than the time limit prescribed in above.

- An assessed person other than the subjects defined above but have a new medical record summary or a new discharge note showing that they have other diseases or the assessed disease changes its level of illness compared to the status of the disease, disability concluded in the latest medical assessment record may be requested to be assessed in a period of 03 months from the issuance date of the new medical record summary or the new discharge note.

2. Procedure and content of medical assessment in Vietnam

Procedure and content of medical assessment according to Article 13 of Circular 56/2017/TT-BYT (amended in Circular 18/2022/TT-BYT) are as follows:

(1) The processing of documents of medical assessment and procedure of medical assessment shall comply with Circular 52/2016/TT-BYT on tasks, rights, liaison and operation of Medical Assessment Council at all level.

(2) Content of medical assessment of an occupational accident:

- Content of first medical assessment of an occupational accident according to the injuries recorded in the injury confirmation;

- Content of medical assessment of relapse: carry out medical assessment of all injuries recorded in the injury confirmation and:

+ Injury relapse recorded in the medical record summary in accordance with the injury confirmation;

+ Injury which cannot become stable after treatment and is recorded in the medical record summary regarding the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene;

+ Continuously progressed injury from an occupational accident which is recorded in the medical record summary as specified in Clause 2 Article 12 of Circular 56/2017/TT-BYT (amended in Circular 18/2022/TT-BYT);

- Content of general medical assessment of many occupational accidents under Point a and b this Clause 1 of Article 13 of Circular 56/2017/TT-BYT (amended in Circular 18/2022/TT-BYT) and in accordance with each case.

(3) Content of medical assessment of occupational diseases:

- Content of first medical assessment of occupational diseases under the occupational disease record and injuries due to occupational diseases within the occupational disease coverage period in accordance with law provisions;

- Content of medical assessment of occupational disease relapse: carry out medical assessment of all injuries recorded in the occupational disease record and:

+ Injury relapse recorded in the medical record summary in accordance with the latest occupational disease and assessment record of occupational disease;

+ Injury which cannot become stable after treatment and is recorded in the medical record summary regarding the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene;

+ Continuously progressed injury from an occupational accident which is recorded in the medical record summary as specified in Clause 2 Article 12 of Circular 56/2017/TT-BYT (amended in Circular 18/2022/TT-BYT);

- Content of general medical assessment of many occupational diseases under Point a and b Clause 2 of Article 13 of Circular 56/2017/TT-BYT (amended in Circular 18/2022/TT-BYT) and in accordance with each case.

(4) The checklist of assessment to qualify for retirement benefits, survivorship benefits and leave due to inability to take care of children after giving birth or taking maternity leave, receiving children through surrogacy, assessment to qualify for lump-sum social insurance payout according to the documents specified in Clause 3 or 4, Article 5 and Clause 2, Article 12 of Circular 56/2017/TT-BYT (amended in Circular 18/2022/TT-BYT), as the case maybe.

In case there is a record of assessment of occupational accident, occupational disease or wounded soldier or disease, illness, deformities or malformations related to toxic chemicals, the assessment of the injuries and diseases mentioned in that record shall not be carried out again. The Medical Assessment Council shall sum up the whole person impairment rating determined in the previous medical assessment minutes with the impairment rating seeking assessment does not collapse with acknowledged impairment.

If the worker is suffering from one of the life-threatening diseases such as cancer, polio, dropsy cirrhosis, leprosy, severe tuberculosis, HIV infection that has progressed to AIDS, the original or a valid copy of the hospital discharge note or the medical record summary shall prevail for claims of benefits.

If a worker suffers from other diseases or illnesses that eligible for lump-sum social insurance payout, the medical assessment record must clearly state in details the diseases or illnesses 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 keep personal hygiene and complete other everyday tasks without other people watching, helping and taking care of him/her.

(5) The content of general medical assessment shall be implemented as follows:

- Content of general medical assessment as specified in (2) and (3) and in accordance with each case;

- When a person who is already suffering from an injury or occupational disease catches another injury or occupational disease which causes the same disability:

The rate of work capacity reduction shall be determined based on results of examination of all current injuries and occupational diseases in accordance with Joint Circular 28/2013/TTLT-BYT-BLDTBXH.

- When a person who is already suffering from an injury or occupational disease catches another injury or occupational disease which causes a different disability:

The rate of work capacity reduction caused by the new injury or occupational disease shall be aggregated with that of the previous occupational accident or occupational disease written in the previous medical assessment record in accordance with Joint Circular 28/2013/TTLT-BYT-BLDTBXH.

- In case a person has been assessed due to an occupational accident or occupational disease for 02 or more times, but the impairment rating has not been summed up:

+ In case the medical assessment record acknowledges duplicate injuries in one or more organs or body parts, the Medical Assessment Council shall re-examine all the injuries acknowledged in the record.

This medical assessment record (including both duplicate and non-duplicate injuries) and combined with the whole person impairment rating stated in the medical assessment record does not have duplicate injuries as prescribed, and then issue a new medical assessment record;

+ In case a person has been assessed due to an occupational accident or occupational disease for 02 or more times but has a summary of the medical record or hospital discharge note or an occupational disease record that states the injuries that are more serious or minor than those stated in the medical assessment record of these assessment visits:

The Medical Assessment Council shall perform an assessment for all injuries stated in the medical assessment record that there is a change in the state of injuries and combining with the whole person impairment rating with the whole person impairment rating stated in the remaining medical assessment record according to regulations, and then issue a new medical assessment record;

+ In addition to the above cases, the Medical Assessment Council shall combine the whole person impairment ratings of those assessment records according to the method specified in Joint Circular 28/2013/TTLT-BYT-BLDTBXH.

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