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MINISTRY OF
HEALTH
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SOCIALIST REPUBLIC
OF VIETNAM
Independence - Freedom - Happiness
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No. 14/2016/TT-BYT
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Hanoi, May 12,
2016
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CIRCULAR
GUIDELINES FOR SOME ARTICLES ON HEALTH OF THE LAW ON SOCIAL
INSURANCE
Pursuant to the Law on Social insurance No.
58/2014/QH13 dated November 20, 2014;
Pursuant to the Law on Occupational hygiene and safety
No. 84/2015/QH13 dated June 25, 2015;
Pursuant to the Law on Health insurance No.
25/2008/QH12 dated November 14, 2008 and the Law No. 46/2014/QH13 dated June
13, 2014 on amendments to the Law on Health insurance;
Pursuant to the Law on Medical examination and
treatment No. 40/2009/QH12 dated November 23, 2009;
Pursuant to the Government's Decree No.
63/2012/ND-CP dated August 31, 2012 defining the functions, tasks, powers and
organizational structure of the 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, Director of Health Insurance
Department,
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Chapter I
GENERAL PROVISIONS
Article 1. Scope
This Circular provides for:
1. List of diseases, the power to determine
diseases eligible for lump-sum social insurance payout.
2. Documents and procedures for assessment of work
capacity reduction as the basis for workers and their relatives to receive
social insurance payout.
3. Issuance of discharge notes, birth certificate,
copies of medical records, medical record summaries, confirmation of maternity
leave, confirmation of poor postpartum health and confirmation of eligibility
to receive social insurance benefits.
4. List of diseases that require long-term
treatment in Appendix 1 enclosed herewith.
Article 2. Regulated entities
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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 dead workers who participated in
social insurance applying for assessment of work capacity reduction to receive
death benefits for workers (hereinafter referred to as worker’s relative)
Article 3. Definitions
For the purpose of this Circular, the terms below
are construed as follows:
1. Worker means an employee who
participates in compulsory social insurance in accordance with the Law on
Social insurance.
2. 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.
3. First assessment means the
first assessment of work capacity reduction of a person who:
a) suffers from an occupational accident;
b) suffers from an occupational disease;
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d) is a relative of a social insurance participant and
has reduced work capacity that needs monthly benefits;
dd) suffers from any of the diseases specified in
Clause 6 Article 4 of this Circular;
4. Reassessment means assessment from
the second time onwards of work capacity reduction of a person who suffers from
a disease or disability because of an occupational accident or occupational
disease which recurs or develops after assessment.
5. General assessment means general
assessment of work capacity reduction of a person who suffers from both an
occupational accident and an occupational disease; suffers from multiple
occupational accidents or multiple occupational diseases.
6. Assessment by Central Medical Assessment
Council means an assessment carried out by Central Medical Assessment Council
in the cases beyond the capacity of a Provincial Medical Assessment Council.
7. Reassessment by Central Medical Assessment
Council means a reassessment carried out by Central Medical Assessment
Council after an appeal against the result given by Provincial Medical
Assessment Council is filed.
8. Final reassessment means the final
reassessment carried out by a Medical Assessment Council established by the
Minister of Health after an appeal against the result given by Central Medical
Assessment Council is filed.
9. Valid copy means a copy that is
extracted from the original book or authenticated by a competent authority or
has been compared with the original.
10. Medical record summary means the
summary of a medical record prescribed by regulations of law on medical
examination and treatment.
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LIST OF DISEASES, POWER
TO DETERMINE DISEASES ELIGIBLE FOR LUMP-SUM SOCIAL INSURANCE PAYOUT
Article 4. List of diseases
eligible for lump-sum social insurance payout
1. The diseases specified in Point c Clause 1
Article 60 of the Law on Social insurance.
2. Diseases that result in at least 81% work
capacity reduction which is unrecoverable.
Article 5. The power to
determine diseases eligible for lump-sum social insurance payout
1. The diseases eligible for lump-sum social
insurance payout mentioned in Clause 1 Article 4 of this Circular must be
determined at medical facilities specified in Clause 1, 2, 4, 5 and 8 Article 4
of Circular No. 40/2015/TT-BYT .
2. Work capacity reduction rate mentioned in Clause
2 Article 4 of this Circular shall be determined by a Medical Assessment
Council.
Article 6. Documents proving a
patient’s eligibility for lump-sum social insurance payout
1. A person who suffers from any of the diseases
mentioned in Clause 1 Article 4 of this Circular shall submit a medical record
summary specified in Clause 1 Article 5 of this Circular.
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Chapter III
ASSESSMENT AS THE BASIS
FOR SOCIAL INSURANCE PAYOUT
Section 1. ASSESSMENT DOCUMENTS
Article 7. Cases of assessment
1. Assessment of disability due to an
occupational accident.
2. Assessment of occupational diseases.
3. Assessment as the basis for provision of pension
or death benefits.
Article 8. Application for
first assessment
1. First assessment of disability due to an
occupational accident:
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b) A valid copy of the injury confirmation issued
by the health facility that provided treatment for the worker according to the
template in Appendix 4 enclosed herewith.
2. First assessment of occupational diseases:
a) The employer's letter of introduction according
to the template in Appendix 3 enclosed herewith or a written request for
assessment prepared by the worker whose social insurance participation period
is reserved or a retired worker pending pension or monthly benefits;
b) A discharge note or occupational disease record
or medical record summary.
3. Assessment as the basis for provision of pension
for a person paying compulsory social insurance:
a) The employer’s letter of introduction according to
the template in Appendix 3 enclosed herewith;
b) A valid copy of any of the following documents
(if any): medical record summary, disability confirmation, discharge note,
documents about examination or treatment of diseases, injuries or disabilities
such as: health book, prescriptions, follow-up appointment forms, outpatient
medical record summary.
4. Assessment pending early provision of pension
for a worker paying social insurance premiums or a worker whose social
insurance participation period is reserved or a retired worker pending pension
or monthly benefits; assessment as the basis for provision of death benefits;
assessment of a retired worker or a worker suffering an occupational disease
whose social insurance participation period is reserved:
a) A written request for examination according to
the template in Appendix 7 enclosed herewith.
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Article 9. Application for
assessment of relapse
1. Assessment of occupational accident relapse:
a) A written request for assessment according to
the template in Appendix 7 enclosed herewith;
b) Documents about treatment of injury relapse:
- For inpatient treatment: a valid copy of the
discharge note according to the template in Appendix 5 or medical record
summary according to the template in Appendix 6 enclosed herewith.
- For outpatient treatment: valid copies of
documents about examination and/or treatment of diseases, injuries or
disabilities caused by the occupational accident such as: health book,
prescriptions, follow-up appointment forms or outpatient medical record
summary.
c) Previous medical assessment record.
2. Assessment of occupational disease relapse:
a) A written request for assessment according to
the template in Appendix 7 enclosed herewith;
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c) Documents about treatment of the occupational
disease relapse:
- For inpatient treatment of the occupational
disease or diseases, injuries or disabilities related to the occupational
disease relapse: a valid copy of the discharge note according to the template
in Appendix 5 or medical record summary according to the template in Appendix 6
enclosed herewith;
- For outpatient treatment: valid copies of
documents about examination and/or treatment of diseases, injuries or
disabilities caused by the occupational disease relapse such as: health book,
prescriptions, follow-up appointment forms or outpatient medical record
summary.
d) A valid copy of the previous medical assessment
record.
Article 10. Application for
general reassessment
1. The employer's letter of introduction according
to the template in Appendix 3 enclosed herewith or a written request for
assessment according to Appendix 7 enclosed herewith if the worker is having
his/her social insurance participation period reserved or has retired.
2. A valid copy of the previous medical assessment
record.
3. Other documents specified in Clause 1 and Clause
2 Article 8 or Clause 1 and Clause 2 Article 9 depending on the patient and
type of assessment.
Article 11. Application for
assessment by Central Medical Assessment Council
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2. Valid copies of the application for assessment
specified in Article 8, 9 or 10 of this Circular depending on the patient and
type of assessment.
3. Any of the following documents:
a) A valid copy of the medical assessment record
prepared by the Provincial Medical Assessment Council if an assessment has been
carried out;
b) Minutes of meeting of the Medical Assessment
Council saying the case is beyond its capacity if no assessment has been
carried out.
Article 12. Application for
reassessment by Central Medical Assessment Council or final reassessment
1. Application for reassessment by Central Medical
Assessment Council:
a) If the reassessment is requested by an
organization: a written request for reassessment by Central Medical Assessment
Council prepared by the Ministry of Health, the Ministry of Labor, War Invalids
and Social Affairs, Social Security Administration of Vietnam or the employer;
b) If the reassessment is requested by an
individual: a written request for reassessment by Central Medical Assessment
Council prepared by the Provincial Medical Assessment Council bearing the
signature and seal of the head of the governing organization of the Medical
Assessment Council. The request shall specify the person that disagrees with
the conclusion given by the Council and requests the reassessment and be
enclosed with a written request for reassessment prepared by such person;
c) Valid copies of the application for assessment
specified in Article 8, 9 or 10 of this Circular depending on the patient and
type of assessment;
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2. Application for final reassessment:
a) If the reassessment is requested by an
organization: a written request for reassessment by Central Medical Assessment
Council prepared by the Ministry of Health, the Ministry of Labor, War Invalids
and Social Affairs, Social Security Administration of Vietnam or the employer;
b) If the reassessment is requested by an
individual: a written request for reassessment by Central Medical Assessment
Council prepared by the Provincial Medical Assessment Council bearing the
signature and seal of the head of the governing organization of the Medical
Assessment Council. The request shall specify the person that disagrees with
the conclusion given by the Central Medical Assessment Council and requests the
reassessment and be enclosed with a written request for final reassessment
prepared by such person;
c) Valid copies of the application for assessment
specified in Article 8, 9 or 10 of this Circular depending on the patient and
type of assessment;
d) The medical assessment record prepared by the
Central Medical Assessment Council.
Article 13. Responsibility for
preparing the application
1. The worker shall prepare the application and
send it to the Medical Assessment Council in the following cases:
a) The worker is having his/her social insurance
participation period reserved and applies for assessment to receive pension;
b) The worker is having his/her social insurance
participation period reserved and applies for assessment to receive lump-sum
social insurance payout;
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d) A retired worker applies for assessment of
relapse.
2. The employer shall prepare the application and
send it to the Medical Assessment Council in cases other than those specified
in Clause 1, Clause 3 and Clause 4 of this Article.
3. Governing organization of the Provincial Medical
Assessment Council shall prepare the application for reassessment by Central
Medical Assessment Council
4. Governing organization of the Central Medical
Assessment Council shall prepare the application for final reassessment.
Section 2. PROCEDURES FOR
MEDICAL ASSESSMENT
Article 14. Time limits
1. Reassessment of an occupational accident or
occupational disease shall be carried out at least after 02 years (24 months) from
the day on which Medical Assessment Council gives a conclusion of the rate of
work capacity reduction because of the occupational accident or occupational
disease.
2. Where the worker’s health deteriorates rapidly,
the governing organization of the Medical Assessment Council shall request the
Chairperson or Deputy Chairperson of the Medical Assessment Council to consider
carrying out a reassessment before the time specified in Clause 1 of this
Article.
Article 15. Power to carry out
medical assessment
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a) Carry out first assessment for workers or
workers’ relatives (who applies to receive death benefits);
b) Carry out assessment of relapse and general
assessment for workers, unless it has been carried out by another Medical
Assessment Council;
c) Send patients other health facilities for
clinical examination, testing or medical imaging where necessary.
2. Medical Assessment Councils affiliated to the
Ministry of Public Security, the Ministry of National Defense, the Ministry of
Transport are entitled to carry out assessments for workers of units under
their management. To be specific:
a) Carry out first assessment for workers or
workers’ relatives (who applies to receive death benefits);
b) Carry out assessment of relapse and general
assessment for workers;
c) Send patients to other health facilities for
clinical examination, testing or medical imaging where necessary.
3. Central Medical Assessment Council is entitled
to:
a) Carry out first assessment for workers or
workers’ relatives (who applies to receive death benefits);
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c) Carry out assessment of relapse and general
assessment for workers who have undergone first assessment by Provincial
Medical Assessment Councils;
d) Carry out reassessment requested by Provincial
Medical Assessment Council and the Minister of Health.
Article 16. Receipt of
application for medical assessment
1. Applications for medical assessment shall be received
as follows:
a) The governing organization of a Provincial
Medical Assessment Council or Central Medical Assessment Council shall receive
applications for first assessment, reassessment or general assessment;
b) The governing organization of Central Medical
Assessment Council shall receive applications for reassessment by Central
Medical Assessment Council;
c) Regarding applications for final reassessment:
The individual or organization that disagrees with
the result given by Central Medical Assessment Council shall send an
application for final reassessment to the Ministry of Health.
2. After an application is received, the governing
organization of the Medical Assessment Council or the Ministry of Health shall
send the applicant a receipt note according to the template in Appendix 9
enclosed herewith.
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a) The Medical Assessment Council shall carry out
assessment within 30 days from the day written on the receipt note;
b) The Minister of Health shall establish a Final
Medical Assessment Council to carry out the final reassessment within 20 days
from the day written on the receipt note.
Within 10 working days from the day on which a
decision to establish the Final Medical Assessment Council, the Council shall
carry out the final assessment.
4. If the application is not satisfactory, within
10 working days from the day written on the receipt note, the governing
organization of the Medical Assessment Council or the Ministry of Health shall
send a written notice to the applicant.
Article 17. Medical assessment
procedures
1. Comparison: the person who carries out the
medical assessment shall compare the patient with one of his/her documents: ID
card, passport, confirmation by the police department of the commune where he/she
resides (whether temporarily or permanently) which bears the patient’s picture
(the picture must be taken on a white background within 6 months before the
application is made out and bear a seal of the police).
2. Overall examination: a physician of the
governing organization of the Medical Assessment Council shall act as an
assessor who carries out the overall examination and prescribes specialist
examinations and subclinical examinations. If such physician is not an
assessor, the overall examination shall be carried out and the head of the
governing organization shall prescribes specialist examinations and subclinical
examinations.
3. Specialist examinations: specialists shall
examine and draw conclusion according to prescriptions of the competent person.
4. Consultation: Chairperson of the Council or head
of the governing organization of the Medical Assessment Council shall chair the
consultation before the meeting of the Council. Where necessary, the governing
organization of the Medical Assessment Council shall invite the patient and
specialists to participate in the meeting.
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a) Conditions for holding the meeting:
- The meeting is participated by more than 50% of
its members, two of whom must be specialists;
- The meeting is chaired by the chairperson or
deputy chairperson of the Medical Assessment Council.
b) Conclusion given by Medical Assessment Council:
- The conclusion shall be given by voting by every
member of the Council. In case of dissenting opinions, the chair of the meeting
shall consider prescribing additional examinations or treatment before holding
a ballot.
- In case of ballot, the result shall be announced
at the meeting. The conclusion must be concurred with by more than 50% of
participating members.
c) The conclusion shall be given in writing
according to the template in Appendix 2 enclosed herewith. The governing
organization of the Medical Assessment Council shall issue the medical
assessment record.
6. The medical assessment record shall be
circulated and retained by the governing organization of the Medical Assessment
Council as follows:
a) 02 copies shall be sent to the patient who shall
submit 01 copy to the social insurance authority (via the employer if the
patient is still working);
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c) 01 copy shall retain at the governing
organization of the Medical Assessment Council.
In case of assessment of relapse, reassessment by
Central Medical Assessment Council and final reassessment, the conclusion must
contain conclusions of all previous examinations.
7. The conclusion given by Medical Assessment
Council is permanent, unless another conclusion is given by another Medical
Assessment Council at the same or superior level.
8. Medical assessment documents shall be retained
at the governing organization of the Medical Assessment Council in accordance
with regulations of law on document retention.
Article 18. Assessment of work
capacity reduction
1. Work capacity reduction shall be assessed in
accordance with Circular No. 28/2013/TTLT-BYT-BLDTBXH .
2. Methods for assessment of work capacity
reduction are specified in Circular No. 28/2013/TTLT-BYT-BLDTBXH.
Assessment of work capacity reduction for general assessment:
a) Where a person who is already suffering from an
injury or disease or occupational diseases catches another injury or disease or
occupational disease which causes the same disability:
The rate of work capacity reduction shall be
determined according to results of examination of all the injuries, diseases or
occupational diseases.
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The rate of work capacity reduction caused by the
new injury, disease or occupational disease shall be aggregate with that of the
previous occupational accident or occupational disease written in the previous
medical assessment record.
c) In case of relapse of a person’s injury, disease
or occupational disease, the rate of work capacity reduction shall be
determined according to result of examination of the injury, disease or occupational
disease.
3. The rate of work capacity reduction specified in
this Article is valid until the next medical assessment record is issued.
Chapter IV
DISCHARGE NOTE, BIRTH
CERTIFICATE, CERTIFICATION OF MATERNITY LEAVE, CERTIFICATION OF INADEQUATE POSTPARTUM
HEALTH
Article 19. Discharge note
1. The following entities have the power to issue
discharge notes:
a) Licensed health facilities providing inpatient
treatment;
b) Practitioners at a health facility specified in
Point a of this Clause authorized by the head of such facility.
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Article 20. Birth certificate
1. The following entities have the power to issue
birth certificates:
a) Licensed health facilities providing midwifery
services;
b) Practitioners at a health facility specified in
Point a of this Clause authorized by the head of such facility.
2. Procedures for issuance of birth certificates
are specified in Circular No. 17/2012/TT-BYT and Circular No. 34/2015/TT-BYT .
3. The birth certificate template is provided in
Appendix 10 enclosed herewith.
Article 21. Confirmation of
maternity leave
1. The following entities are entitled to issue
confirmations of maternity leave:
a) Any hospital having an obstetrics department;
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c) Practitioners at a health facility specified in
Point a or b of this Clause authorized by the head of such facility.
2. The issuance of confirmation of maternity leave
by a general hospital or practitioner thereof shall be based on the result of
consultation held by departments relevant to the patient’s sickness.
3. Templates of confirmation of maternity leave:
a) The template provided Appendix 12 enclosed
herewith shall be used by hospitals specified in Clause 1 of this Article for
pregnant workers paying compulsory social insurance who receive outpatient
treatment.
b) The template provided Appendix 11 enclosed
herewith shall be used by hospitals specified in Clause 1 of this Article for
pregnant workers who resigned and receive outpatient treatment;
c) Template No. 2 provided in Appendix 2 enclosed
herewith shall be used by Medical Assessment Councils;
d) Discharge note template provided in Appendix 5
of medical record summary template provided in Appendix 6 enclosed herewith.
4. The confirmation of maternity leave specified in
Clause 2 of this Article must specifically describe the patient’s health and
necessary duration (days) of maternity leave. The duration shall comply with
instructions of the Ministry of Health and the patient’s health.
5. The conclusion specified in Clause 2 of this
Article is valid for 6 months from the date written on the medical assessment
record and only used for grant of maternity benefits.
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1. Provincial Medical Assessment Councils and above
have the power to issue confirmations of poor postpartum health.
2. The template of medical assessment record is
provided in Appendix 2 enclosed herewith, the conclusion in which shall
specifies that the mother is not healthy enough to provide care for her newborn
child.
3. The conclusion specified in Clause 2 of this
Article is valid for 6 months from the date written on the medical assessment record
and only used for grant of maternity benefits.
Chapter V
ISSUANCE AND MANAGEMENT
OF CONFIRMATION OF ELIGIBILITY TO RECEIVE SOCIAL INSURANCE BENEFITS
Article 23. Rules for issuance
of confirmation of eligibility to receive social insurance benefits
1. The issuance of a confirmation of eligibility to
receive social insurance benefits must:
a) be issued by a competent authority specified in
Article 23 hereof;
b) be appropriate for the scope of operation of the
health facility that issues the confirmation which is approved by a competent
authority;
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2. If a worker is issued with more than one
confirmations of eligibility to receive social insurance benefits by various departments,
the one with the longest duration shall apply.
Article 24. Power to issue
confirmation of eligibility for social insurance benefits
1. Licensed health facilities.
2. Practitioners of health facilities specified in
Point a of this Clause whose signatures have been registered with a social
insurance authority.
Article 25. Types of
confirmation of eligibility to receive social insurance benefits
1. The template provided in Appendix 5 enclosed
herewith shall be used for workers receiving inpatient treatment or children
aged under 7 of workers.
2. The template provided in Appendix 12 enclosed
herewith shall be used for workers receiving outpatient treatment.
If a patient needs to take a leave for outpatient
treatment after discharged from the hospital, the social insurance authority
shall provide social insurance benefits according to the leave duration (days)
written on the discharge note.
Article 26. Provision of blank
confirmations of eligibility to receive social insurance benefits
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2. Within 15 days from the receipt of the request,
the social insurance authority shall provide blank confirmation of eligibility
to receive social insurance benefits to the health facility. If the request is
rejected, a written notice and explanation shall be sent.
Chapter VI
ORGANIZATION OF
IMPLEMENTATION
Article 27. Responsibilities of
affiliates of the Ministry of Health
1. Medical Examination & Treatment
Administration shall:
a) Organize reviews of the implementation of this
Circular nationwide;
b) Carry out inspections and deal with violations
against this Circular in accordance with applicable law.
2. Mother and Child Health Department shall:
a) Cooperate with Medical Examination &
Treatment Administration in organizing the implementation and reviews of
implementation of this Circular nationwide;
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Article 28. Responsibilities
of Social Security Administration of Vietnam
1. Provide instructions for social insurance
authorities on implementation of this Circular.
2. Unify management of printing and provision of
blank confirmation of eligibility to receive social insurance benefits.
3. Instruct health facilities to register issuance
of confirmation of eligibility to receive social insurance benefits and post
the list of facilities entitled to issue confirmation of eligibility to receive
social insurance benefits on the websites of Social Security Administration of
Vietnam and provincial social insurance authorities. Inspect the issuance of
confirmation of eligibility to receive social insurance benefits by health
facilities.
4. Ex offico review the implementation of this
Circular and propose amendments to this Circular to competent authorities.
Article 29. Responsibilities
of Provincial Departments of Health
1. Organize reviews of the implementation of this
Circular within their provinces.
2. Carry out inspections and deal with violations
against this Circular in accordance with applicable law.
Article 30. Responsibilities
of health facilities and Medical Assessment Councils
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2. Provide documents for workers as the basis for
receipt of social insurance benefits in accordance with this Circular; examine
the content of documents specified in this Circular prepared by their
practitioners and take legal responsibility for the accuracy and truthfulness
thereof.
3. Update data about medical examination and
treatment, issuance of documents and medical assessment records on the national
medical examination and treatment database which is connected to the data of
social insurance authorities.
4. Transferring health facilities shall provide
copies of referral notes bearing their seals on request.
Chapter VII
IMPLEMENTATION CLAUSE
Article 31. Effect
This Circular comes into force on July 01, 2016.
Circular No. 11/1999/TTLB-BYT-BHXH, Circular No.
34/2013/TT-BYT, Circular No. 07/2010/TT-BYT , template of discharge note
enclosed with Decision No. 4069/2001/QD-BYT of the Minister of Health; birth
certificate template enclosed with Circular No. 17/2012/TT-BYT are no longer
effective from the effective date of this Circular.
Article 32. Transition clause
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Article 33. Organization of
implementation
Chief of the Ministry Office, Directors of
Departments of the Ministry of Health, Directors of Provincial Departments of
Health, Directors of health authorities and relevant units are responsible for
the implementation of this Circular.
Difficulties that arise during the implementation
of this Circular should be reported to the Ministry of Health for
consideration./.
PP MINISTER
DEPUTY MINISTER
Pham Le Tuan
APPENDIX 1
LIST OF DISEASES THAT REQUIRE LONG-TERM TREATMENT
(enclosed with Circular No. 14/2016/TT-BYT dated May
12, 2016)
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Disease
ICD 10 Category
I
Infectious and parasistic diseases
1.
Tuberculosis during treatment and sequelae
A15
to A19.
2.
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B90.2
3.
Leprosy (Hansen’s disease)
and sequelae
A30,
B92
4.
Chronic viral hepatitis
B
B1.8.1.
5.
Chronic viral hepatitis C
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6.
Acquired immunodeficiency syndrome (HIV/AIDS)
B20
to B24, Z21
7.
Sequelae of viral,
infectious and parasitic encephalitis and meningitis
B94.1,
B94.8, B94.9
8.
Candidal meningitis, cerebral
cryptococcosis
B37.5,
B45.1
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Neoplasms
9.
Malignant neoplasms and in situ neoplasms
C00
to C97; D00 to D09
10.
Benign neoplasm of bone and
articular cartilage
D16
11.
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D37
to D48
III
Diseases of the blood and
blood-forming organs and certain disorders involving the immune mechanism
12.
Polycythemia vera
D45
13.
Myelodysplastic syndromes
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14.
Myeloproliferative disease
D47.1
15.
Thalassemia
D56
16.
Hereditary haemolytic anaemias
D58
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Autoimmune haemolytic anaemias
D59.1
18.
Paroxysmal nocturnal
haemoglobinuria (Marchiafava syndrome)
D59.5
19.
Aplastic anaemia
D61.9
20.
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D66
21.
Hereditary factor IX deficiency (Hemophilia B)
D67
22.
Von Willebrand disease
D68.0
23.
Qualitative platelet defects
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24.
Idiopathic thrombocytopenic purpura (Evans syndrome)
D69.3
25.
Primary polycythaemia
D75.2
26.
Haemophagocytic syndrome,
infection-associated
D76.2
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Hypergammaglobulinaemia,
unspecified
D89.2
IV
Endocrine, nutritional and
metabolic diseases
28.
Hypothyroidism
E03
29.
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E04
30.
Hyperthyroidism (Basedow)
E05
31.
Subacute thyroiditis (de
Quervain and chronic)
E06.1
32.
Type 1 and Type 2 diabetes mellitus
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33.
Hyperfunction of pituitary gland
E22
34.
Hypofunction and other disorders of
pituitary gland
E23
35.
Cushing disease
E24.0
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Adrenocortical insufficiency
E27.4
37.
Hypoparathyroidism
E20
38.
Hyperparathyroidism and other
disorders of parathyroid gland
E21
39.
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E83.0
40.
Postprocedural hypothyroidism
E89.0
V
Mental and behavioural disorders
-
41.
Dementia in Alzheimer disease
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42.
Vascular dementia
F01
43.
Dementia in other diseases
classified elsewhere
F02
44.
Unspecified dementia
F03
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Mental disorders due to brain
damage and dysfunction and to physical disease
F06
46.
Mental and behavioural disorders
due to use of alcohol
F10
47.
Mental and behavioural disorders
due to use of opioids
F11
48.
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F12
49.
Mental and behavioural disorders
due to use of hallucinogens
F16
50.
Schizophrenia
F20
51.
Paranoid schizophrenia
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52.
Persistent delusional disorders
F22
53.
Schizoaffective disorders
F25
54.
Bipolar affective disorder
F31
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Depressive episode
F32
56.
Recurrent depressive disorder
F33
57.
Persistent mood [affective]
disorders
F34
58.
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F40
59.
Other anxiety disorders
F41
60.
Obsessive-compulsive disorder
F42
61.
Somatoform disorders
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62.
Disorders of adult personality and
behaviour
F60
to F69
63.
Mental retardation
F70
to F79
64.
Disorders of psychological
development
F80
to F89
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Behavioural and emotional disorders
with onset usually occurring in childhood and adolescence
F90
to F98
VI
Diseases of the nervous
system
66.
Systemic atrophies primarily
affecting central nervous system in diseases classified elsewhere
G13
67.
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G20
68.
Secondary parkinsonism
G21
69.
Dystonia
G24
70.
Alzheimer disease
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71.
Multiple sclerosis
G35
72.
Subacute necrotizing myelitis
G37.4
73.
Epilepsy
G40
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Myasthenia gravis
G70.0
VII
Diseases of the eye and adnexa
75.
Dry eye syndrome
H04.1.2
76.
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H16
77.
Lens-induced iridocyclitis
H20.2
78.
Harada disease
H30.8.1
79.
Chorioretinitis, choroiditis
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80.
Proliferative vitreo-retinopathy
with retinal detachment
H33.4.1
81.
Central retinal vein occlusion
H34.8
82.
Retinal vasculitis
H35.0.6
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Central serous chorioretinopathy
H35.7.1
84.
Retinal disorders due to
atherosclerosis
H36.6
85.
Glaucoma
B40
86.
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H44.1.2
87.
Nutritional optic neuropathy
H46.2
88.
Toxic optic neuropathy
H46.3
VIII
Diseases of the ear and mastoid
process
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89.
Ménière disease
H81.0
90.
Sudden idiopathic hearing loss
H91.2
91.
Progressive hearing loss
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Brain, meninges herniation into the ear - mastoid
93.
Cord VII tumor
94.
Cord VIII
tumor
95.
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96.
Sarcoidosis of the ear
97.
Occupational hearing loss
98.
Hearing loss acquired after temporal bone injury
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99.
Congenital malformations of ear
causing impairment of hearing
Q16
100.
Turner syndrome
Q96
IX
Diseases of the circulatory
system
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Acute coronary syndrome
I20,
I21, I22, I23
102.
Chronic ischaemic heart disease
I25
103.
Pulmonary embolism
I26
104.
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I27
105.
Acute pericarditis
I30
106.
Chronic constrictive pericarditis
I31.1
107.
Myocarditis
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108.
Infective endocarditis
I33;
I38
109.
Heart failure
I50
110.
Intracerebral haemorrhage
I61
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Cerebral infarction
I63
112.
Stroke, not specified as
haemorrhage or infarction
I64
113.
Aortic aneurysm and dissection
I71
114.
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I74
115.
Phlebitis and thrombophlebitis
I80
116.
Postprocedural disorders of
circulatory system
I97
X.
Diseases of the respiratory
system
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117.
Chronic laryngitis
J37.0
118.
Polyp of vocal cord and larynx
J38.1
119.
chronic obstructive pulmonary
disease
J44
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Asthma
J45
121.
Bronchiectasis
J47
122.
Coalworker pneumoconiosis
J60
123.
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J61
124.
Pneumoconiosis due to dust
containing silica
J62
125.
Pneumoconiosis due to other
inorganic dusts
J63
126.
Unspecified pneumoconiosis
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127.
Other interstitial pulmonary
diseases
J84
128.
Abscess of lung and mediastinum
J85
129.
Chronic pyothorax
J86
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Chronic respiratory failure.
J96.1
XI
Diseases of the digestive system
131.
Progressive chronic hepatitis
K73
132.
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K74
133.
Autoimmune hepatitis
K75.4
134.
Calculus of bile duct with
cholangitis
K80.3
135.
chronic pancreatitis
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XII
Diseases of the skin and subcutaneous tissue
136.
Pemphigus
L10
137.
Pemphigoid
L12
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Duhring Brocq disease
L13.0
139.
Epidermolysis bullosa
L14
140.
Exfoliative dermatitis
L26
141.
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L40
142.
Pityriasis rubra pilaris
L44.0
143.
Erythema nodosum
L52
144.
Pyoderma gangrenosum
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145.
Chronic ulcer of skin
L98.4
XIII
Diseases of the musculoskeletal
system and connective tissue
146.
Systemic lupus erythematosus
M32
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Tuberculous arthritis
M01.1
148.
Reactive arthropathies
M02.8,
M02.9
149.
Seropositive rheumatoid arthritis
M05
150.
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M07.3
151.
Gout
M10
152.
Other crystal arthropathies
M11
153.
Arthrosis of hip
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154.
Arthrosis of knee
M17
155.
Polyarteritis nodosa
M30
156.
Necrotizing vasculopathy,
unspecified
M31.9
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Dermatopolymyositis
M33
158.
Systemic sclerosis
M34
159.
Sicca syndrome (Sjogren’s syndrome)
M35.0
160.
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M43.1
161.
Ankylosing spondylitis
M45
162.
Spondylosis
M47
163.
Tuberculosis of spine
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164.
Cervical disc disorders
M50
165.
Chronic crepitant synovitis of hand
and wrist
M70.0
166.
Adhesive capsulitis of shoulder
M75.0
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Osteoporosis with pathological
fracture
M80
168.
Nonunion of fracture
[pseudarthrosis]
M84.1
169.
Pathological fracture
M84.4
170.
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M85
171.
Osteomyelitis
M86
172.
Osteonecrosis
M87
173.
Algoneurodystrophy
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174.
Fracture of bone in neoplastic
disease
M90.7
175.
Acquired deformities of
musculoskeletal system and connective tissue
M95
XIV
Diseases of the genitourinary system
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Recurrent and persistent haematuria
N02
177.
Chronic nephritic syndrome
N03
178.
Nephrotic syndrome
N04
179.
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N08
180.
Chronic tubulo-interstitial
nephritis
N11
181.
Chronic renal failure
N18
182.
Incontinence
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183.
Fistulae involving female genital
tract
N82
XV
Pregnancy, childbirth and the
puerperium
184.
Hydatidiform mole
O01
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Injury, poisoning and certain
other consequences of external causes
185.
Sequelae of injuries
S64,
S94, T09, T91, T92, T93
186.
Sequelae of burns of third degree and above
T20,
T21, T22, T23, T24, T25, T26, T29, T30
187.
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188.
Sequelae of war injuries
XVII
Factors influencing health status
and contact with health services
189.
Corneal transplant
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190.
Artificial openings of digestive
tract
Z43.4
191.
Artificial openings of urinary
tract
Z43.6
192.
Transplanted organ and
post-transplant treatment
Z94
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APPENDIX 2
MEDICAL
ASSESSMENT REPORT FORM
(Issued together with Circular No. 14/2016/TT-BYT dated May 12, 2016)
GOVERNING
BODY
MEDICAL ASSESSMENT BOARD
-------
SOCIALIST
REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
---------------
No.
……/GDYK - …..1...
..…[Location]……..,[date]……………
WORK-RELATED
IMPAIRMENT ASSESSMENT BY MEDICAL ASSESSMENT COUNCIL ….
Medical Assessment Council ……………………2........................................................
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Mr./Mrs.................................................................. Date
of birth………………………….
Address:....................................................................................................................
ID/Citizen/Passport number:… 3……
Date of issue: ……Place of issue:........................
Social security number (if any):...................................................................................
To undergo medical assessment at
the request/recommendation of: ………..(name)......
Letter of introduction/request No.
…. dated ………………… (if any)
Medical assessment …………………………….4............................................................
Work-related impairment or diseases
to be assessed: ……..5.......................................
Being eligible for benefits for…
(bodily injuries, diseases. Work-related diseases with the rate of…….%)
...
...
...
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(Specify the history of
illnesses, injuries and work-related diseases, contents of the previous
impairment assessment report as deemed necessary. The current clinical and
subclinical findings that are valid for the board to reach a conclusion)
HEREBY
DECIDES
Pursuant to Circular No.
14/2016/TT-BYT dated May 15, 2016 of the Ministry of Health on guidelines for
the Law on Social insurance.
Mr./Mrs......................................................................................................................
is determined as ……………………………6...................................................................
Percentage of impairment: ……………%
(in words .................................................. %)
In conjunction with percentage of
impairment due to ...7..., the total percentage of impairment
is: ………% (in words %)
Requests: .................................................................................................................
...
...
...
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Vice
President or the Standing Member or Specialized Member
(Signature and full name)
Chairman
(Signature, full name and seal8)
APPENDIX 6
MEDICAL
RECORD SUMMARY FORM
(Issued together with Circular No. 14/2016/TT-BYT dated May 12, 2016)
…………………….
Hospital: ……………….
MEDICAL
RECORD SUMMARY
...
...
...
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1. Full name (capital
letter): ........................................................ 2. Year of
birth: □□□□
3. Gender: Male □ Female □ 4.
Ethnic: ...................................................................
Health insurance card’s number (if
any):........................................................................
5. Occupation: ...........................................................................................................
Workplace: .................................................................................................................
6. Address: House No. …
village, neighborhood…., commune/ward/district-level town....
District (city):………………………Province,
city..............................................................
7. Date of admission ……………;
date of discharge ………………;
8. Admitting diagnosis: ..............................................................................................
...
...
...
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10. Medical record summary:......................................................................................
a) Pathological and clinical
progress:
...................................................................................................................................
b) Summary of subclinical test
results for diagnosis:
...................................................................................................................................
c) Treatment:
...................................................................................................................................
d) Patient’s medical conditions
when being discharged:
...................................................................................................................................
...
...
...
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...................................................................................................................................
……….[Location]………,[date]……………..
Head of hospital
(signature and seal)
Documentation guide:
1. The medical record summary is
documented in conformity with the respective medical record of the patient.
2. If the patient is a person who
lacks of legal capacity or has limited legal capacity or a child aged under 16,
full names of his/her parents or legal guardians must be inserted at the notes.
3. If the patient’s child/children
die(s) after birth, the child/children’s date of birth and date of death,
number of dead child/children will be inserted at the patient’s medical
conditions when being discharged
...
...
...
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2 Name of Medical Assessment Council that has held the meeting
3 If the citizen card or passport is
not available, other valid identity paper shall prevail (birth certificate, certification issued by police officer of the
commune of place
of residence enclosed
with a photo with fan
stamping)
4 First
assessment/Re-assessment/General assessment/Appeal assessment (Assessment
beyond professional qualification and requests)/Final appeal assessment
5 Work-related disease assessment (specify the name of the work-related disease to be assessed - the
duration of the disease), labor accident assessment (enclosed with the contents of the
injury extract - time of injury)/early retirement assessment/assessment for monthly death/general assessment (specify the contents of
the assessment, such as the name of the work-related disease, the contents of the injury
extract, the contents of the previous
medical assessment)/relapse assessment (referring to relapse or progressive injuries or work-related diseases)
6 Specify conclusion at the request
for assessment
7 Only insert in case of general
assessment
8 Use the seal of standing agency of Medical Assessment Council. In
case of final appeal assessment, the Department of Medical Examination and
Treatment will act as the standing agency of the Board and may use the Ministry
of Health’s seal.