Disability is a condition in which the normal functioning of a person is limited to some extent due to physical, mental, cognitive or sensory disorders. In diabetes, as in other diseases, this status is established for the patient based on the assessment of medical and social expertise (ITU). What type of disability in case of diabetes type 1 can a patient apply for? The fact is that the mere presence of this disease in an adult is not a reason for obtaining such status. Disability can be formalized only if the disease occurs with severe complications and imposes significant restrictions on the diabetic.
If a person suffers from insulin-dependent diabetes mellitus, and this disease progresses and significantly affects his normal lifestyle, he can consult a doctor for a series of examinations and possible disability. Initially, the patient visits a therapist who issues referrals for consultations with specialist specialists (endocrinologist, oculist, cardiologist, neurologist, surgeon, etc.). From the laboratory and instrumental methods of examination the patient can be assigned:
- general blood and urine tests;
- blood sugar test;
- Ultrasound of the vessels of the lower extremities with Doppler (with angiopathy);
- glycated hemoglobin;
- examination of the fundus of the eye, perimetry (determination of the completeness of visual fields);
- specific urine tests to detect sugar, protein, acetone;
- electroencephalography and rheoencephalography;
- lipid profile;
- blood chemistry;
- Ultrasound of the heart and ECG.
For registration of disability, the patient will need the following documents:
- discharge from hospitals where the patient underwent inpatient treatment;
- the results of all laboratory and instrumental studies;
- advisory opinions with seals and diagnoses of all the doctors that the patient visited at the time of the medical examination;
- the patient's application for disability and the referral of the therapist to the ITU;
- outpatient card;
- employment record and documents certifying the education received;
- certificate of disability (if the patient reaffirms the group).
If the patient works, he needs to receive a certificate from the employer, which describes the conditions and nature of work. If the patient is studying, then a similar document is required from the university. If the decision of the commission is positive, the diabetic receives a certificate of the disabled person, in which the group is indicated. Repeated passage of the ITU is not necessary only if the patient is assigned 1 group. In the second and third groups of disability, despite the fact that diabetes is an incurable and chronic disease, the patient must regularly undergo a repeated confirmatory examination.
If the doctor refuses to issue a referral to the ITU (which happens extremely rarely), the patient can independently undergo all examinations and submit a package of documents for consideration by the commission.
What to do in case of a negative ITU decision?
If the ITU made a negative decision and the patient did not receive any disability group, he has the right to appeal this decision. It is important for the patient to understand that this is a long process, but if he is convinced that the obtained health assessment is unfair, he should try to prove the opposite. A diabetic can appeal the results obtained by applying a written statement to the ITU main office, where a re-examination will be held, within a month.
If there is still a patient denied registration of a disability, he can contact the Federal Bureau, which is obliged to organize its own commission within a month to make a decision. The final authority that a diabetic can turn to is court. It can appeal the results of the ITU, held in the Federal Bureau in accordance with the procedure established by the state.
The most severe disability group is the first. It is assigned to a patient if he developed severe complications of the disease on the background of diabetes mellitus, which interfere not only with his work activity, but also daily self-care. These conditions include:
- unilateral or bilateral loss of vision due to severe diabetic retinopathy;
- limb amputation due to diabetic foot syndrome;
- severe neuropathy, which adversely affects the functionality of the organs and limbs;
- the final stage of chronic renal failure, which occurred on the background of nephropathy;
- 3rd degree heart failure;
- advanced mental disorders caused by diabetic encephalopathy;
- recurring hypoglycemic coma.
Such patients cannot independently serve themselves, they need third-party assistance from relatives or medical (social) workers. They are not able to properly navigate in space, fully communicate with other people and conduct any kind of work. Often these patients cannot control their behavior, and their condition is completely dependent on the help of other people.
Disability registration allows not only to receive monthly monetary compensation, but also to participate in the program of social and medical rehabilitation of disabled people.
The second group is established for diabetics who periodically need help, but they can take simple steps to take care of themselves. Below is a list of pathologies that can lead to this:
- severe retinopathy without complete blindness (with the growth of blood vessels and the formation of vascular anomalies in this area, which lead to a strong increase in intraocular pressure and disruption of the optic nerve);
- the end stage of chronic renal failure, which developed on the background of nephropathy (but subject to continuous successful dialysis or kidney transplantation);
- mental illness on the background of encephalopathy, difficult medical treatment;
- partial loss of ability to move (paresis, but not complete paralysis).
In addition to the above pathologies, the conditions for disability registration of the 2nd group are the impossibility of doing work (or the need to create special conditions for this), as well as the difficulty in performing household activities.
Most often, people with the 2nd group do not work or work at home, because the workplace must be adapted to them, and working conditions should be as gentle as possible. Although in some organizations with high social responsibility there are separate special jobs for people with disabilities. Exercise, travel and over-work are prohibited for such employees. They, like all diabetics, are entitled to legal breaks for insulin administration and frequent meals. Such patients need to remember their rights and not allow the employer to violate labor laws.
The third group of disability is given to patients with diabetes of moderate severity, with moderate functional impairment, which leads to complication of the usual work activity and difficulties with self-care. Sometimes a third group is drawn up for patients with type 1 diabetes of a young age for successful adaptation at a new place of work or study, as well as during a period of increased psycho-emotional stress. Most often, with the normalization of the patient's condition, the third group is removed.
Disability in children
All children with diabetes, after diagnosis, is issued a disability without a specific group. Upon reaching a certain age (most often the majority), the child must pass an expert commission, which decides on the further assignment of the group. Provided that during the time of illness the patient did not develop serious complications of the disease, he is able-bodied and trained in the skills of calculating insulin doses, disability in type 1 diabetes can be removed.
A disabled child with an insulin-dependent type of diabetes mellitus is assigned the status "disabled child". In addition to the outpatient card and research results, for its registration, you must provide a birth certificate of the child and a document of one of the parents.
For registration of disability after the child reaches the age of majority, 3 factors are necessary:
- persistent disorders of the body, confirmed by instrumental and laboratory;
- partial or complete limitation of the ability to work, interact with other people, self-serve and navigate in what is happening;
- need for social care and recovery (rehabilitation).
For disabled children, the state provides a full social package. It includes insulin and consumables for its introduction, monetary assistance, sanatorium-resort treatment, etc.
Diabetics with disability group 1 cannot work because they have serious complications of the disease and severe health problems. They are largely dependent on other people and are not able to serve themselves, so there is no question of any work activity in this case.
Patients with the 2nd and 3rd group can work, but at the same time working conditions must be adapted and suitable for diabetics. It is forbidden to such patients:
- work the night shift and stay overtime;
- to carry out labor activities in enterprises where toxic and aggressive chemicals are released;
- do physically hard work;
- go on business trips.
Disabled diabetics should not hold positions associated with high psycho-emotional stress. They may work in the field of intellectual labor or light physical exertion, but it is important that a person does not overwork or process above the prescribed rate. Patients cannot perform work that carries a risk to their lives or the lives of others. This is due to the need for insulin injections and the theoretical possibility of the sudden development of diabetes complications (for example, hypoglycemia).
Disability in type 1 diabetes is not a sentence, but rather social protection of the patient and help from the state. During the passage of the commission, it is important not to hide anything, but to honestly tell doctors about your symptoms. Based on an objective examination and examination results, specialists will be able to make the right decision and issue the disability group that is appropriate in this case.