Thông tư 02/2023/TT-BYT sửa đổi thông tư 15/2016/TT-BYT bệnh nghề nghiệp hưởng bảo hiểm

CIRCULAR

AMENDMENTS TO CIRCULAR NO. 15/2016/TT-BYT DATED MAY 15, 2016 OF THE MINISTRY OF HEALTH ON OCCUPATIONAL DISEASES COVERED BY SOCIAL INSURANCE

Pursuant to the Labor Code dated November 20, 2019;

Pursuant to the Law on Social Insurance dated November 20, 2014;

Pursuant to the Law on Occupational Safety and Hygiene dated June 25, 2015;

Pursuant to the Law on Prevention and Control of Infectious Diseases dated November 21, 2007;

Pursuant to the Law on Medical Examination and Treatment dated November 23, 2009;

Pursuant to Decree No. 88/2020/ND-CP dated July 28, 2020 of the Government elaborating certain Articles of the Law on Occupational Safety and Hygiene on compulsory insurance for occupational accidents and occupational diseases;

Pursuant to Decree No. 95/2022/ND-CP dated November 15, 2022 of the Government on functions, tasks, powers and organizational structure of the Ministry of Health of Vietnam;

At the request of the Director General of Health Environment Management Agency,

The Minister of Health promulgates a Circular on amendments to Circular No. 15/2016/TT-BYT dated May 15, 2016 of the Ministry of Health on occupational diseases covered by social insurance.

Article 1. Certain Articles of Circular No. 15/2016/TT-BYT dated May 15, 2016 of the Ministry of Health on occupational diseases covered by social insurance are amended

1. Clause 35 is added to the first Article 3 as follow: "35. Occupational COVID - 19 and guidelines for diagnosis and examination thereof prescribed in Appendix 35 enclosed herewith”.

2. The second Article 3 is renamed into Article 3a.

3. Appendix 35 - Guidelines for diagnosis and examination of occupational Covid-19 is promulgated together with this Circular.

4. Appendix 36 – Occupational SARS-CoV-2 exposure record is promulgated together with this Circular.

Article 2. Entry into force

1. This Circular comes into force from April 01, 2023.

2. If people having occupations and professions prescribed in Section 3, Appendix 35 enclosed herewith are diagnosed with COVID-19 due to occupational exposure from February 01, 2020 to the date before the effective date of this Circular, dossiers on their occupational disease examination shall be made and they are covered by social insurance under the applicable regulations.

3. In case the legislative documents referred to this Circular are amended or replaced, the newest document shall be applied.

Article 3. Organizing implementation

1. Chief of the Ministry Office, Director General of Health Environment Management Agency, Director General of the Department of Medical Service Administration, Chief Inspector of the Ministry, Director Generals of Departments and General Departments of the Ministry of Health of Vietnam, Heads of relevant units, agencies, organizations and individuals are responsible for the implementation of this Circular.

2. Difficulties that arise during the period of implementation of this Circular should be reported to the Ministry of Health (Health Environment Management Agency) for consideration and settlement./.

APPENDIX 35

GUIDELINES FOR DIAGNOSIS AND EXAMINATION of occupational Covid-19
(Issued together with Circular No. 02/2023/TT-BYT dated February 09, 2023 of the Minister of Health)

1. Definitions

“Occupational Covid-19” is a disease developing during the working process due to employees being exposed to  SARS-CoV-2 present in the working environment.

2. Pathogens

a) Exposing to SARS-CoV-2 in the working environment.

b) Having pathogens recorded in one of the following documents:

- Report determining occupational contacts with SARS-CoV-2 prescribed in Appendix 36 enclosed with this Circular.

- Document on appointment to prevention, control and relief of SARS-CoV-2 infected people signed and sealed by the head of a unit and other related documents issued by a competent regulatory authority.

- Assessment of occupational exposure factors prescribed in Section VI Form No. 04 Appendix 3 enclosed with Decree No. 44/2016/ND-CP dated May 15, 2016 of the Government elaborating certain Articles of the Law on Occupational Safety and Hygiene on technical verification of occupational safety, occupational safety and hygiene training and working environmental monitoring (WES).

- Report on confirmation of exposure to risk factors causing acute occupational diseases prescribed in Appendix 5 enclosed with Circular No. 28/2016/TT-BYT dated June 30, 2016 of the Ministry of Health providing guidelines on management of occupational diseases.

3. Employees having occupations, professions where they regularly work with and/or are exposed to SARS-CoV-2:

a) Employees having occupations and professions at healthcare facilities.

b) Employees working in laboratories, taking, transporting , analyzing, preserving and destroying samples of which SARS-CoV-2 is detected.

c) Employees working for COVID-19 prevention and control and relief of SARS-CoV-2 infected people including:

- Employees directly working in concentrated isolation areas, directly working for home quarantine, medical quarantine in affected areas, directly taking care of COVID-19 cases at home;

- People who transport and serve COVID-19 cases;

- People who transport, shroud, preserve, cremate and bury bodies of COVID-19 cases;

- Supervisors, investigators, verifiers regarding COVID-19;

- Customs staffs, diplomats, immigration officers;

- Officers, professional soldiers, non-commissioned officers, soldiers of the People's Army, defense officials, defense workers and defense public employees;

- Soldiers and officers of the police force;

- Employees having other occupations and professions appointed to participate in COVID-19 prevention and control.

4. Minimum exposure time (the shortest time of exposure to harmful factors during the working process to cause occupational diseases): 01 (one) time.

5. Guaranteed time (the period from the time that a worker has stopped exposing to a source of infection to the time of disease onset): 28 (twenty-eight) days.

6. Diagnosis of COVID-19

Diagnosis of COVID-19 shall comply with the guidelines for diagnosis and treatment of COVID-19 issued by the Minister of Health stated in Decision No. 250/QD-BYT dated January 28, 2022 on the issuance of Guidelines for diagnosis and treatment of COVID-19 and Decision No. 437/QD-BYT dated February 27, 2022 amending certain Points of the Guidelines for diagnosis and treatment of COVID-19.

7. Differential diagnosis

a) It involves distinguishing COVID-19 from acute respiratory infections caused by other common agents (seasonal influenza virus, parainfluenza virus, respiratory syncytial virus, rhinovirus, myxovirus, adenovirus, flu syndrome caused by common strains of Coronavirus, bacteria, avian influenza A/H5N1, A/H7N9, SARS-CoV-1, MERS-CoV).

b) A differential diagnosis is also used to distinguish severe conditions of patients (respiratory failure, organ failure) and sequelae due to other causes or due to severe conditions of concomitant chronic diseases.

8. Diagnosis of COVID-19 sequelae

a) Whole-body diseases: persistent symptoms such as fatigue (ICD-10: R53), arthralgia (ICD-10: M25.5), myalgia (ICD-10: M79.1), taste disorders ( ICD-10: R43.1), smell disorders (ICD-10: R43.2), hair loss (ICD-10: L65).

b) Respiratory diseases: pneumonia (ICD-10: J12), interstitial pneumonia (ICD-10: J84), pulmonary vein thrombosis which is pulmonary fibrosis (ICD-10: I26), alveolar dilatation, atelectasis , impaired respiratory function (ICD-10: R06.8).

c) Cardiovascular diseases: arrhythmia (ICD-10: I49.9), myocarditis (ICD-10: I41.1), coronary infarction (ICD-10: I21), myocardial fibrosis (ICD- 10: I42.3), chest pain (ICD-10: I20.9), hypertension (ICD-10: I15.8).

d) Neurological disorders:

- Motor paralysis (ICD-10: G83.9).

- Cranial nerve palsy (ICD-10: T90.3).

- Epilepsy (ICD-10:G40).

- Late-onset Guillain-Barré syndrome (ICD-10: G61.0).

- Autoimmune encephalomyelitis after COVID-19 infection (ICD-10: B94.1).

d) Mental disorders:

- Organic hallucinosis (ICD-10: F06.0).

- Organic catatonic disorder (ICD-10: F06.1).

- Organic delusional [schizophrenia-like] disorder (ICD-10: F06.2).

- Mood disorder due to known physiological condition (ICD-10: F06.30).

- Mood disorder due to known physiological condition with depressive features (ICD-10: F06.31).

- Mood disorder due to known physiological condition with major depressive-like episode (ICD-10: F06.32).

- Mood disorder due to known physiological condition with manic features (ICD-10: F06.33).

- Organic anxiety disorder (ICD-10: F06.4).

- Organic emotionally labile [asthenic] disorder (ICD-10: F06.6).

- Mild cognitive disorder (ICD-10: F06.7).

ICD-10 shall be applied under Decision No. 4469/QD-BYT dated October 28, 2020 of the Minister of Health on issuance of "ICD-10 International classification of diseases (ICD) codes and causes of death” and “ICD-10 Coding Guidelines” at examination and treatment facilities.

9. Time for examination of detecting sequelae: after at least six months since contracting COVID-19 and receiving treatment in a stable manner. In case the medical treatment is not provided stably, the applicable regulations shall be applied.

10. Examinations

a) Indication of examination:

- Diseases related to respiratory medicine.

- Diseases under the management and treatment of other specialties related to organic lesions caused by COVID-19 on a case-by-case basis.

- Do not examine the symptoms and signs specified at Point a, Clause 8 of this Appendix is ​​not indicated.

- Para-clinical assessment:

+ Mandatory X-ray and/or CT-scanner of the chest; measurement of respiratory function.

+ Other para-clinical examinations shall be prescribed by specialist examiners.

- Holding of occupational disease consultation when there are lesions or sequelae of occupational Covid-19 at two or more organs and parts according to the form specified in Appendix 8 issued together with Circular No. 28/2016/TT-BYT dated June 30, 2016 of the Minister of Health guiding the management of occupational diseases.

b) Criteria for disease elimination

Lesions in organs and organs caused by other factors other than SARS-CoV-2; lesions in organs and parts confirmed prior to infection with SARS-CoV-2 virus based on health management records or documents of diagnosis and treatment before contracting COVID-19 (if any).

c) Table of whole person impairment (WPI) caused by COVID-19: Apply the whole person impairment  caused by sequelae of COVID-19 in the respective organs and parts specified in Table 2 of the Joint Circular No. 28/2013/TTLB-BYT-BLDTBXH dated September 27, 2013 of the Minister of Health, the Minister of Labor, War Invalids and Social Affairs providing for the whole person impairment caused by injuries, illnesses, diseases and occupational diseases.

APPENDIX 36

Report on confirmation of occupational exposure to SARS-COV-2
(Enclosed together with Circular No. 02/2023/TT-BYT dated February 09, 2023 of the Minister of Health)

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
---------------

RECORD

Confirmation of occupational exposure to SARS-CoV-2 

Full name:………………………………………………….. Age:……………………. Sex:………………………

Occupation: ……………………………………………………………………………………..

Place of work: ……………………………………………………………………………………..

1. Circumstances of infecting with SARS-CoV-2, information on sources of infection during the working process: (detailed descriptions)

………………………………………………………………………………………………………

………………………………………………………………………………………………………

2. Suffering exposure to or infection with SARS-CoV-2 from family members, friends, relatives or people who are not in the working process:

Yes □                                        No □                                       

Yes: specify circumstance and period

………………………………………………………………………………………………………

………………………………………………………………………………………………………

3. The first positive test result for SARS-CoV-2: …. [date]…..

4. Health status after contracting COVID-19:

………………………………………………………………………………………………………

………………………………………………………………………………………………………