Thông tư 52/2016/TT-BYT quy định về nhiệm vụ, quyền hạn, mối quan hệ công tác và hoạt động của Hội đồng Giám định y khoa các cấp do Bộ trưởng Bộ Y tế ban hành

CIRCULAR

PRESCRIBING TASKS, POWERS, WORKING RELATIONSHIP AND OPERATION OF MEDICAL ASSESSMENT COUNCILS OF ALL LEVELS

Pursuant to the Government’s Decree No. 63/2012/ND-CP dated August 31, 2012 defining functions, tasks, powers and organizational structure of the Ministry of Health;

At the request of the Director of the Department of Medical Service Administration;

The Minister of Health promulgates a Circular prescribing tasks, powers, working relationship and operation of Medical Assessment Councils of all levels.

Chapter I

GENERAL PROVISIONS 

Article 1. Scope

This Circular introduces regulations on tasks, powers, working relationship and operation of Medical Assessment Councils of all levels, including:

1. Central Medical Assessment Councils, including: Central Medical Assessment Council No. I, Central Medical Assessment Council No. II, and Central Medical Assessment Council No. III.

2. Provincial Medical Assessment Councils, including: Medical Assessment Councils of 63 provinces and central-affiliated cities.

3. Ministerial Medical Assessment Councils, including: Medical Assessment Council of the Ministry of National Defence, Medical Assessment Council of the Ministry of Public Security, and Medical Assessment Council of the Ministry of Transport.

4. Medical Assessment Council for special reassessment.

Article 2. Regulated entities

1. Medical Assessment Councils of all levels, Ministerial Medical Assessment Councils, standing agencies of Medical Assessment Councils.

2. Assessors of Medical Assessment Councils of all levels and Ministerial Medical Assessment Councils, heads of specialized agencies, organizations, authorities, units and individuals having working relationship with Medical Assessment Councils of all levels and standing agencies of Medical Assessment Councils.

Article 3. Definitions 

For the purposes of this Circular, the terms below shall be construed as follows:

1. “first assessment” means the first assessment of a person, regardless of the assessment matters, including cases where a person has received disability level assessment from a communal disability assessment council or medical examination from a military medical examination council but that person or another relevant organization or authority disagrees with such assessment or examination results.

2. “reassessment” means the assessment from the second time onwards carried out at the request of a person who has undergone the first assessment or his/her managing agency.

3. “final reassessment” means an assessment carried out by a Central Medical Assessment Council of a person who has received the first assessment or reassessment from a Provincial or Ministerial Medical Assessment Council.

4. “special reassessment” means an assessment carried out by a Medical Assessment Council for special reassessment of a person who has received a final reassessment from a Central Medical Assessment Council.

5. “handling physician” means an official who is working at a standing agency of a Medical Assessment Council and is assigned by the head of the standing agency to prepare medical assessment case documents.

6. “assessor” means a person appointed by a competent authority to act as an assessor in charge of carrying out clinical or subclinical examination at the request of a standing agency of the Medical Assessment Council.

Chapter II

ORGANIZATION OF MEDICAL ASSESSMENT COUNCILS OF ALL LEVELS

Article 4. Central Medical Assessment Councils

1. Organizational structure, legal position and juridical person status of a Central Medical Assessment Council:

a) A Central Medical Assessment Council shall be established under the Minister of Health’s decision and composed of members who work under the dual office holding regime and have qualifications in health sector;

b) The Central Medical Assessment Council shall use its own seal for certifying the medical assessment reports given after its meetings within its jurisdiction as prescribed in this Circular. A Central Medical Assessment Council shall have neither juridical person status nor its own account;

c) The term of operation of a Central Medical Assessment Council shall be 05 (five) years from the day on which its establishment decision is signed. The Council’s members may be replaced during its term of operation according to the Minister of Health’s decision.

2. Composition of a Central Medical Assessment Council:

a) A Central Medical Assessment Council No. I is composed of 05 (five) members, including:

- The Council’s Chairperson who is a senior representative of Bach Mai Hospital;

- 01 Deputy Chairperson who is a senior representative of the Medical Assessment Institute affiliated to Bach Mai Hospital;

- 01 Standing Member who is an official of the Medical Assessment Institute and has been appointed as an assessor;

- 02 specialized members who are assessors of the Central Medical Assessment Council No. I.

b) A Central Medical Assessment Council No. II is composed of 05 (five) members, including:

- The Council’s Chairperson who is a senior representative of Da Nang C Hospital;

- 01 Deputy Chairperson who is a senior representative of the Council’s standing agency (Medical Assessment Department or Center affiliated to Da Nang C Hospital);

- 01 Standing Member who is an official of the Council’s standing agency and has been appointed as an assessor;

- 02 specialized members who are assessors of the Central Medical Assessment Council No. II.

c) A Central Medical Assessment Council No. III is composed of 05 (five) members, including:

- The Council’s Chairperson who is a senior representative of Cho Ray Hospital;

- 01 Deputy Chairperson who is a senior representative of the Council’s standing agency (Medical Assessment Department or Center affiliated to Cho Ray Hospital);

- 01 Standing Member who is an official of the Council’s standing agency and has been appointed as an assessor;

- 02 specialized members who are assessors of the Central Medical Assessment Council No. III.

A Central Medical Assessment Council may invite assessors included in the list of assessors of the Central Medical Assessment Council that previously carried out an assessment of the person to be assessed (hereinafter referred to as "patient") to its conclusion meeting, if necessary. In such case, the invested assessors shall be considered as the Council’s specialized members in that meeting.

3. Standing agencies of Central Medical Assessment Councils:

a) The standing agency of Central Medical Assessment Council No. I is the Medical Assessment Institute affiliated to Bach Mai Hospital. Persons working at this standing agency shall be regular employees in charge of medical assessment tasks of Bach Mai Hospital;

b) The standing agency of Central Medical Assessment Council No. II is the Medical Assessment Department or Center affiliated to Da Nang C Hospital. Persons working at this standing agency shall be regular employees in charge of medical assessment tasks of Da Nang C Hospital;

c) The standing agency of Central Medical Assessment Council No. III is the Medical Assessment Department or Center affiliated to Cho Ray Hospital. Persons working at this standing agency shall be regular employees in charge of medical assessment tasks of Cho Ray Hospital.

Article 5. Provincial Medical Assessment Councils

1. Organizational structure and legal position:

a) Each province or city shall have a Medical Assessment Council established according to a decision issued by the Director of the Department of Health of that province or city;

b) A Provincial Medical Assessment Council shall not have its own permanent staff but be composed of members who work under the dual office holding regime and have qualifications in health sector;

c) The Provincial Medical Assessment Council shall use its own seal for certifying medical assessment reports given after its conclusion meetings. A Provincial Medical Assessment Council shall have neither juridical person status nor its own account;

d) The term of operation of a Provincial Medical Assessment Council shall be 05 (five) years from the day on which its establishment decision is signed.

2. A Provincial Medical Assessment Council is composed of 05 (five) members, including:

a) The Council’s Chairperson who is a senior representative of the Provincial Department of Health;

b) 02 Deputy Chairpersons, including:

- 01 Standing Deputy Chairperson who is a senior representative of the Provincial Medical Assessment Center;

- 01 Specialized Deputy Chairperson who is a senior representative of the provincial general hospital.

c) 01 Standing Member who is an official of the Provincial Medical Assessment Center and has been appointed as an assessor.

d) 01 specialized member who is an assessor of the Provincial Medical Assessment Council.

A Provincial Medical Assessment Council may invite assessors included in the list of assessors of the Provincial Medical Assessment Council that previously carried out an assessment of the patient to its conclusion meeting, if necessary. In such case, the invested assessors shall be considered as the Council’s specialized members in that meeting.

3. The Standing Agency of a Provincial Medical Assessment Council shall be the Medical Assessment Center of that province or central-affiliated city.

Article 6. Ministerial Medical Assessment Councils 

1. The Medical Assessment Council of the Ministry of National Defence:

The Minister of National Defense shall consider deciding the organizational structure, legal position, composition, number of members, and standing agency of the Medical Assessment Council on the basis of the Council’s functions and tasks, and the provisions of this Circular.

2. The Medical Assessment Council of the Ministry of Public Security:

The Minister of Public Security shall consider deciding the organizational structure, legal position, composition, number of members, and standing agency of the Medical Assessment Council on the basis of the Council’s functions and tasks, and the provisions of this Circular.

3. The Medical Assessment Council of the Ministry of Transport:

a) Decisions on establishment, strengthening, appointment and dismissal of members of the Medical Assessment Council of the Ministry of Transport shall be signed by the Minister of Transport on the basis of suggestions of advisory agencies and regulations of the Ministry of Transport. The Medical Assessment Council of the Ministry of Transport shall have neither juridical person status nor its own account;

b) The Medical Assessment Council of the Ministry of Transport shall use its own seal for certifying medical assessment reports given after its conclusion meetings held within its jurisdiction, and other documents, relating to professional operations of the Council, which bear the signatures of the Council's Chairperson or Deputy Chairperson. The seal of the Medical Assessment Council shall be managed by the Transport Medical Assessment Center;

c) The Minister of Transport shall consider deciding the organizational model, composition and number of members of the Medical Assessment Council on the basis of the Council’s functions and tasks, and the provisions of this Circular;

d) The Standing Agency of the Medical Assessment Council shall be the Transport Medical Assessment Center;

dd) The term of operation of the Central Medical Assessment Council of the Ministry of Transport shall be 05 (five) years from the day on which its establishment decision is signed.

Article 7. Medical Assessment Council for special reassessment 

1. Organizational structure and legal position:

a) The Medical Assessment Council for special reassessment is the Medical Assessment Council carrying out the final assessment of the patient. The Medical Assessment Council for special reassessment is established under the Minister of Health’s decision to take charge of each assessment case at the request of the Director of the Department of Medical Service Administration affiliated to the Ministry of Health, and shall be automatically dissolved after issuing the medical assessment report;

b) The Medical Assessment Council for special reassessment shall use its own seal for certifying the medical assessment reports given after its meetings within its jurisdiction as prescribed in this Circular. The Medical Assessment Council for special reassessment shall have neither juridical person status nor its own account. The seal of the Medical Assessment Council for special reassessment shall be managed by the Department of Medical Service Administration affiliated to the Ministry of Health.

2. The Minister of Health shall decide the composition and standing agency of the Medical Assessment Council for special reassessment depending on the area at which the Central Medical Assessment Council is assigned to carry out final reassessment as prescribed in Clause 2 Article 8 of this Circular.

Chapter III

TASKS, POWERS AND WORKING RELATIONSHIP OF MEDICAL ASSESSMENT COUNCILS

Section 1. TASKS AND POWERS OF MEDICAL ASSESSMENT COUNCILS 

Article 8. Tasks and powers of Central Medical Assessment Councils 

1. Central Medical Assessment Councils shall carry out assessment and final reassessment in the following cases:

a) The assessment case is beyond the specialized capacity of Provincial or Ministerial Medical Assessment Councils;

b) The relevant individual or organization disagrees with the conclusion given by the Provincial or Ministerial Medical Assessment Council and requests for a final reassessment;

c) The assessment is carried out at the request of the Department of Medical Service Administration and to serve other tasks according to the Minister of Health’s decision.

2. Division of operating provinces of Central Medical Assessment Councils:

a) Central Medical Assessment Council No. I shall take charge of assessment and final reassessment of patients living in the following provinces or central-affiliated cities: Ha Noi, Hai Phong, Quang Ninh, Ha Giang, Lang son, Tuyen Quang, Lao Cai, Cao Bang, Yen Bai, Lai Chau, Dien Bien, Son La, Phu Tho, Vinh Phuc, Bac Can, Thai Nguyen, Bac Giang, Bac Ninh, Hai Duong, Hung Yen, Hoa Binh, Ninh Binh, Nam Dinh, Ha Nam, Thai Binh, Thanh Hoa, Nghe An, Ha Tinh and patients of the Ministry of Public Security, the Ministry of National Defence, and the Ministry of Transport at the request of managing agencies of such patients, depending on their places of residence or working;

b) Central Medical Assessment Council No. II shall take charge of assessment and final reassessment of patients living in the following provinces or central-affiliated cities: Quang Binh, Quang Tri, Thua Thien Hue, Da Nang, Quang Nam, Quang Ngai, Binh Dinh, Phu Yen, Kon Tum, Gia Lai, Dak Lak, and patients of the Ministry of Public Security, the Ministry of National Defence, and the Ministry of Transport at the request of managing agencies of such patients, depending on their places of residence or working;

c) Central Medical Assessment Council No. III shall take charge of assessment and final reassessment of patients living in the following provinces or central-affiliated cities: Khanh Hoa, Ninh Thuan, Binh Thuan, Tay Ninh, Binh Duong, Binh Phuoc, Dong Nai, Dak Nong, Lam Dong, Ba Ria - Vung Tau, Ho Chi Minh City, Long An, Tien Giang, Ben Tre, Vinh Long, Can Tho, Tra Vinh, Hau Giang, Soc Trang, An Giang, Dong Thap, Kien Giang, Bac Lieu, Ca Mau, and patients of the Ministry of Public Security, the Ministry of National Defence, and the Ministry of Transport at the request of managing agencies of such patients, depending on their places of residence or working.

Article 9. Tasks and powers of Provincial Medical Assessment Councils 

1. Provincial Medical Assessment Councils shall carry out the first assessment and reassessment of patients who are working, residing or staying in their provinces.

2. A Provincial Medical Assessment Council shall not carry out reassessment of a person who has been given assessment conclusion from a Central Medical Assessment Council in respect of the same matter of assessment.

Article 10. Tasks and powers of Ministerial Medical Assessment Councils 

A Ministerial Medical Assessment Council shall carry out the first assessment and reassessment of patients under the management of such Ministry as prescribed by law.

Article 11. Tasks and powers of Medical Assessment Council for special reassessment

Provide special assessment of patients who have received final assessment from Central Medical Assessment Councils, and perform other tasks according to the Minister of Health’s decision.

Section 2. WORKING RELATIONSHIP OF MEDICAL ASSESSMENT COUNCILS OF ALL LEVELS

Article 12. Working relationship of Central Medical Assessment Councils 

1. Ministry of Health:

The Minister of Health shall sign decisions on establishment, strengthening, appointment or dismissal of members of Central Medical Assessment Councils at the request of the Standing Agencies of Central Medical Assessment Councils and the Department of Medical Service Administration affiliated to the Ministry of Health, and direct all operations of Central Medical Assessment Councils.

2. Hospitals of which Departments are Standing Agencies of Medical Assessment Councils and other public health facilities:

a) Central Medical Assessment Councils and Hospitals of which Departments are Standing Agencies of Medical Assessment Councils and other public health facilities shall cooperate in performing medical assessment tasks;

b) Hospitals shall facilitate Central Medical Assessment Councils and their Standing Agencies’ use of their medical devices and facilities for carrying out medical assessment in accordance with regulations of law.

3. Standing agencies of Central Medical Assessment Councils:

Standing agencies of Central Medical Assessment Councils shall perform activities to fulfill the Council’s tasks as follows:

a) Review to ensure the compliance of assessment documents with regulations of laws;

b) Act as contact points in charge of organizing assessment sessions and conclusion meetings of Central Medical Assessment Councils in accordance with Chapter IV of this Circular and other relevant legislative documents;

c) Receive and handle works relating medical assessment and proposals or queries about the medical assessment given by Central Medical Assessment Councils;

d) Play the leading role and cooperate with relevant agencies in performing organizational structure and personnel-related tasks so as to ensure that a Central Medical Assessment Council shall have adequate members as prescribed in Clause 2 Article 4 of this Circular;

dd) Provide professional and specialized instructions about medical assessment for Standing Agencies of Provincial and Ministerial Medical Assessment Councils in their assigned operating provinces as prescribed in Clause 2 Article 8 of this Circular;

e) Manage the seals of Central Medical Assessment Councils;

g) Ensure funding for covering operating costs of Central Medical Assessment Councils and fulfilling liabilities as prescribed in regulations of law on medical assessment fees and charges;

h) Retain medical assessment case documents as prescribed by law.

4. Working relationship of Central Medical Assessment Councils:

Central Medical Assessment Council No. I, Central Medical Assessment Council No. II and Central Medical Assessment Council No. III maintain the same-level relationship and must not bear the direction from each other in performing their medical assessment tasks and powers.

5. Relationship between a Central Medical Assessment Council and a Provincial Medical Assessment Council:

The Central Medical Assessment Council shall take charge of carrying out final reassessment of patients who have received assessment from the Provincial Medical Assessment Council.

Article 13. Working relationship of Provincial Medical Assessment Councils 

1. Provincial Medical Assessment Councils shall maintain working relationship with Central Medical Assessment Councils as prescribed in Clause 5 Article 12 of this Circular.

2. Working relationship between a Provincial Medical Assessment Council and the Department of Health of that province or city:

a) Director of the Provincial Department of Health shall issue decisions on establishment, strengthening, appointment and dismissal of members of the Provincial Medical Assessment Council at the request of the heads of the Council's Standing Agency and the Personnel and Organization Division of the Provincial Department of Health;

b) The Provincial Department of Health shall be responsible for state management of medical assessment tasks performed by the Provincial Medical Assessment Council.

3. Working relationship between Provincial Medical Assessment Councils and their Standing Agencies:

The Standing Agency of a Provincial Medical Assessment Council shall be the Provincial Medical Assessment Center and perform activities to fulfill the Council’s tasks as follows:

a) Review to ensure the compliance of assessment documents with regulations of laws;

b) Act as the contact point that shall assist the Provincial Medical Assessment Council in organizing medical assessment sessions and conclusion meetings according to the provisions of Chapter IV of this Circular;

c) Handle works relating medical assessment sessions and proposals or queries about the medical assessment given by the Provincial Medical Assessment Council. Handling result reports on these works shall bear the signature of a competent person and the seal of the Provincial Medical Assessment Center. The seal of Provincial Medical Assessment Center shall not be used for certifying medical assessment reports;

d) Act as the contact point in proposing organization and performance of medical assessment tasks by the Provincial Medical Assessment Council. Play the leading role and cooperate with relevant agencies in performing organizational structure and personnel-related tasks so as to ensure that the Provincial Medical Assessment Council shall have adequate members as prescribed in Clause 2 Article 5 of this Circular;

dd) Manage the seal of the Provincial Medical Assessment Council;

e) Retain medical assessment case documents as prescribed by law;

g) Ensure funding for covering operating costs of the Provincial Medical Assessment Council and fulfilling liabilities as prescribed in regulations of law on medical assessment fees and charges.

4. Working relationship between Provincial Medical Assessment Councils and Medical Assessment Councils of Ministry of Public Security, Ministry of National Defence, and Ministry of Transport:

Carry out assessment of patients under the management of the Ministry of Public Security, Ministry of National Defence, or Ministry of Transport at the written request of managing agencies of such patients.

Article 14. Working relationship of Ministerial Medical Assessment Councils 

1. Working relationship between Ministerial Medical Assessment Councils and Central Medical Assessment Councils:

Central Medical Assessment Councils have higher authority than Ministerial Medical Assessment Councils. The final reassessment conclusion given by a Central Medical Assessment Council shall replace the assessment conclusion given by a Ministerial Medical Assessment Council in respect of the same patient and assessment contents/purposes according to provisions of this Circular.

2. Working relationship between Ministerial Medical Assessment Councils and Provincial Medical Assessment Councils:

If a Ministerial Medical Assessment Council refuses to carry out assessment of a patient under its management, it shall introduce that patient to the Provincial Medical Assessment Council of the province or city where he/she is living or working.

Article 15. Working relationship of Medical Assessment Councils for special reassessment 

1. Ministry of Health:

a) The Minister of Health shall take charge of signing the Decision on establishment of the Medical Assessment Council for special reassessment at the request of the Department of Medical Service Administration to perform specific tasks specified in the Minister of Health’s establishment decision;

b) Give comprehensive direction to the Medical Assessment Council for special reassessment.

2. Working relationship between a Medical Assessment Council for special reassessment and a Central Medical Assessment Council:

a) The conclusion given by the Medical Assessment Council for special reassessment shall replace the final reassessment conclusion given by the Central Medical Assessment Council to the same patient;

b) The Standing Agency of the Medical Assessment Council for special reassessment is the Standing Agency of either the Central Medical Assessment Council No. I or the Central Medical Assessment Council No. II, or the Central Medical Assessment Council No. III according to the decision issued by the Minister of Health in each specific assessment case, and shall perform the following tasks:

- Review the special reassessment documents as prescribed;

- Act as the contact point that shall assist the Medical Assessment Council for special reassessment in organizing its assessment sessions and conclusion meetings in accordance with the provisions of this Circular;

- Ensure funding for covering operating costs of the Medical Assessment Council for special reassessment and fulfilling liabilities as prescribed in regulations of law on medical assessment fees and charges;

- Retain special reassessment case documents in accordance with regulations of law.

Chapter IV

OPERATION OF MEDICAL ASSESSMENT COUNCILS

Article 16. Length and number of conclusion meetings 

1. Length of time of a conclusion meeting of the Medical Assessment Council shall be decided by the Council’s Chairperson or the person who is authorized by the Council’s Chairperson to chair the meeting.

2. Time and number of meetings of a Medical Assessment Council, and number of patients in each meeting shall be proposed by the Standing Agency of the Medical Assessment Council on the basis of applications for assessment and actual conditions of its personnel and medical devices.

Article 17. Participants in a conclusion meeting

1. The Council’s members:

The number of members of the Medical Assessment Council participating in the conclusion meeting must be at least 3/5 of the number of official members of the Council which is decided by a competent authority.

2. Patients

Patients must be present at the meeting in order to receive assessment of his/her injury, disease or disability from the Council. The Council shall not draw any conclusions about the patient who fails to present at the meeting, except for the following cases:

a) The patient is suffering from serious injury or disease or has a server disability so that he/she is unable to receive direct assessment from the Medical Assessment Council and has received on-the-spot assessment from the Council’s Standing Agency upon the written request of the relevant organization, or his/her relative or guardian, with the approval of the Council’s Chairperson or Deputy Chairperson. Audio and video recordings of on-the-spot assessment of this patient are required and shall be used at the medical consultation and conclusion meetings of the Council. In such case, the patient's relative or guardian as defined by law may participate in the conclusion meeting of the Council;

b) The patient has been present at the previous meeting of the Medical Assessment Council and has been requested by the Council to undergo clinical and/or subclinical examinations of which the results will be considered at this meeting.

3. Handling physicians

The physician who has handled the patient's documents is required to participate in the meeting and present his/her reports on assessment documents to the Medical Assessment Council, unless he/she has given legitimate reasons for his/her absence. In this case, the head of the Council’s Standing Agency shall appoint another person to present reports on behalf of the absent physician.

Article 18. Medical Assessment Council’s working principles at its conclusion meetings 

1. A Medical Assessment Council shall work on a collegial basis. The Chairperson of the Medical Assessment Council shall directly or authorize the Council’s Deputy Chairperson to chair the Council’s meetings. Such authorization must be made in writing.

2. The Council shall meet to reach the conclusion about the injury, disease, disability and whole person impairment rate (%) of the patient on the basis of medical assessment documents and actual examination or images of examination of the patient as prescribed in Point a Clause 2 Article 17 of this Circular, and enter that conclusion into the Council’s register of meetings and medical assessment records.

3. The conclusion given by the Council must be unanimously approved by at least 2/3 (two-thirds) of its official members who are present at the meeting.

4. The conclusion given by the Council shall be specified in the medical assessment report which is made using the template in the Appendix enclosed herewith. The medical assessment report shall bear the signature and full name of the Council’s Chairperson or the person who is authorized by the Council’s Chairperson to chair the meeting, and the seal of the Council.

5. Within 10 (ten) working days from the day on which the conclusion is given by the Council, the Council’s Standing Agency shall complete the medical assessment report.

Article 19. Processing of applications for medical assessment

1. Based on the application for medical assessment received from the patient, the Standing Agency of the Medical Assessment Council shall examine the received application and organize the medical assessment within the time limit prescribed by law.

2. If an application is refused, within 10 (ten) working days from the receipt of the application, the Standing Agency of the Medical Assessment Council shall give written response, in which reasons for refusal must be specified, to the introducing agency and/or the patient, and assume responsibility for its refusal.

3. In case an application is beyond the specialized capacity of a Provincial Medical Assessment Council:

a) In case the Provincial Medical Assessment Council does not yet carry out the medical assessment, within 10 (ten) working days from the receipt of the application, the Standing Agency of the Provincial Medical Assessment Council shall, based on the received application and conditions of the Council, report the case to the Council’s Chairperson to hold a meeting to reach the conclusion on the assessment case beyond its specialized capacity, transfer the application and letter of introduction of the patient to the Central Medical Assessment Council for carrying out the final reassessment, and enter the Council’s conclusion into the Council’s Register of meetings;

b) In case the Provincial Medical Assessment Council has carried out the medical assessment and reached the conclusion that the case is beyond its specialized capacity, within 07 (seven) working days from the date of the Council’s meeting, the Standing Agency of the Provincial Medical Assessment Council shall complete the medical assessment report, in which the conclusion that the case is beyond the Council’s specialized capacity must be specified, and transfer the received application and letter of introduction of the patient to the Central Medical Assessment Council for carrying out the final reassessment.

4. In case a competent authority disagrees with the conclusion given by the Medical Assessment Council, it shall send a written request to the Department of Medical Service Administration for final or special reassessment as prescribed.

Within 07 (seven) working days from the receipt of the request from the Department of Medical Service Administration, the Standing Agency of the Medical Assessment Council that has carried out assessment of patient must complete and transfer the medical assessment documents of that patient to the Medical Assessment Council for carrying out final or special reassessment as prescribed.

5. In case an entity disagrees with the conclusion given by a Provincial or Central Medical Assessment Council:

a) Within 60 (sixty) days from the day on which the medical assessment report is issued, the disagreeing entity shall provide reasons for its disagreement in writing for the Provincial or Central Medical Assessment Council that has carried out assessment of the patient. Any reasons provided after the abovementioned time limit shall not be accepted;

b) Within 07 (seven) working days from the receipt of the request from the disagreeing entity, the Standing Agency of the Medical Assessment Council that has carried out assessment of the patient shall consider the case and respond to the patient:

- If the requesting entity still disagrees with the conclusion given by the Provincial or Ministerial Medical Assessment Council, the Standing Agency of that Provincial or Ministerial Medical Assessment Council shall complete and transfer the medical assessment documents and letter of introduction of the patient to the Central Medical Assessment Council in accordance with regulations on division of operating provinces specified in Points a, b and c Clause 2 Article 8 of this Circular for carrying out the final reassessment;

- If the requesting entity still disagrees with the conclusion given by the Central Medical Assessment Council, the Standing Agency of the Central Medical Assessment Council that has carried out assessment of the patient shall complete and transfer the medical assessment documents and a report on the case to the Ministry of Health (via the Department of Medical Service Administration) for carrying out the special reassessment.

6. Some other cases:

a) In case a patient fails to receive the medical assessment or participate in the conclusion meeting without giving legitimate reasons after the Standing Agency of the Medical Assessment Council has sent 03 (three) letters of invitation to the patient, the Standing Agency of the Medical Assessment Council shall return the patient’s documents to the introducing organization;

b) Revocation of medical assessment report for invalidation or replacement:

- The Medical Assessment Council shall assume responsibility to revoke the issued medical assessment report for invalidating or issuing a new one.

- The Medical Assessment Council is entitled to invalidate or replace a medical assessment report issued within its jurisdiction when it finds that the medical assessment report has been issued inconsistently with regulations of laws in force at the time of the medical assessment, and replace it with a new medical assessment report. To be specific:

+ If the whole person impairment rate (%) specified in the revoked or invalidated medical assessment report (the former report) is kept unchanged, the Medical Assessment Council shall issue a new medical assessment report using the number and date of the former report;

+ If the whole person impairment rate (%) specified in the former report is changed, the Medical Assessment Council shall report the case to its supervisory authority for direction. If a new medical assessment report is issued according to the direction of the supervisory authority, the number and date of the new report shall be specified according to the conclusion meeting of the Medical Assessment Council which is held to modify the former conclusion.

- The Standing Agency of the Medical Assessment Council shall give a written notification of revocation or invalidation of a medical assessment report, and then issue and send the new medical assessment report to relevant entity. Documents concerning the revocation or invalidation of the medical assessment report, and the revoked or invalidated medical assessment report shall be kept together with the assessment documents of the patient and entered into the Council’s Register of meetings;

c) If the case has been transferred to the superior Medical Assessment Council for carrying out final reassessment or special reassessment, the issued medical assessment report shall implicitly have no legal validity for paying benefits to the patient. Benefits shall be paid to the patient only after the conclusion (or medical assessment report) has been given by the competent Medical Assessment Council in accordance with regulations of law.

Article 20. Medical assessment procedures

1. Comparison:

The person who carries out the medical assessment shall check and compare information about the patient with one of his/her documents: ID card, citizen’s identity card, passport or confirmation given by the police department of the commune, ward or town where he/she permanently or temporarily resides which bears the patient’s picture (the picture must have been taken on a white background, of a 4 cm x 6 cm size, within no more than 06 months before the date of application submission, and must bear the seal of the police department).

2. Overall examination:

A physician of the Standing Agency of the Medical Assessment Council who is assigned to handle the assessment case shall prepare assessment documents, carry out the overall examination and request the head of the Standing Agency of the Medical Assessment Council to prescribe specialist examinations (clinical and/or subclinical examinations) according to the received application for medical assessment.

3. Specialist examinations:

A specialist assessor shall carry out examination and draw the conclusion according to the prescriptions of the Standing Agency of the Medical Assessment Council. Where necessary, medical consultations may be held.

4. Medical consultation

The head of the Standing Agency of the Medical Assessment Council who is also a member of the Council shall organize and chair the consultation before the meeting of the Council. Where necessary, the Standing Agency of the Medical Assessment Council shall invite the patient and specialist assessors to the meeting.

5. Meeting of the Medical Assessment Council

Follow procedures of the conclusion meeting of the Council prescribed in Article 21 of this Circular.

6. Issuance of medical assessment report

The medical assessment report shall be given by the Standing Agency of the Medical Assessment Council according to Clause 4 Article 18 of this Circular.

7. Retention of medical assessment documents

a) Medical assessment documents shall be managed and retained at the Standing Agency of the Medical Assessment Council for 70 (seventy) years in accordance with regulations of law on document retention.

b) In case of medical assessment of the patient prescribed in Point a Clause 2 Article 17, 01 photo of the patient must be kept together with the medical assessment documents.

Article 21. Procedures of Council’s conclusion meeting

1. The physician who handles the medical assessment documents of the patient shall present the summary report on examination results specified in the medical assessment documents of that patient, including anticipated results of injury, disease or disability and whole person impairment rate of the patient. Medical assessment documents shall be submitted to the Medical Assessment Council only after they have been approved at the medical consultation held by the Council’s Standing Agency.

2. Representative of members participating in the Council’s meeting shall directly examine the patient to verify his/her injury, disease or disability status.

3. The patient or his/her relative or guardian shall state their opinions (if any) before the Council.

4. The Council shall discuss and vote for the conclusion:

a) The conclusion about the injury, disease, disability, whole person impairment rate and/or other conclusion given according to regulations of law and the application for medical assessment;

b) In case of insufficient grounds for the conclusion, the Council may prescribe additional clinical and/or subclinical examinations and/or treatment and/or reference to medical records and other relevant documents to have more grounds for reaching the conclusion;

c) In case provincial or regional health facilities are not capable of carrying out specialist examinations (clinical or subclinical examinations), the Council may send the patient to a qualified public health facility to receive specialist examinations of which results shall be used as the basis for the Council to consider and reach conclusion on the injury, disease, disability, and whole person impairment rate of the patient.

5. Members of the Council and participants in the meeting shall express their opinions. Dissenting opinions shall be recorded and entered into the Council’s Register of meetings.

6. Official members of the Council participating in the meeting shall append their signatures to the Council’s Register of meetings. The person in charge of the Council’s Register of meetings shall be appointed by the Council’s Standing Agency.

7. The handling physician shall complete the medical assessment report and submit it to the Council’s Standing Agency for approval before it is signed and sealed by the competent person as prescribed in Clause 4 Article 18 of this Circular.

Chapter V

MEMBERS OF MEDICAL ASSESSMENT COUNCIL

Article 22. Tasks and powers of Council’s Chairperson 

1. Chair or authorize the Council’s Deputy Chairperson to chair the conclusion meeting of the Medical Assessment Council in case he/she cannot participate in the meeting.

2. Give the conclusion to each patient which must be voted for by at least 2/3 of the Council’s official members participating in the meeting.

3. Assume the joint responsibility with other members of the Council for the conclusions drawn at the meetings in which he/she participates.

4. Append his/her signature to the Council’s Register of meetings and the medical assessment report issued at the meeting which he/she chairs.

5. Give and have his/her opinions about the medical assessment contents recorded in the Council’s Register of meetings which shall be then performed or proposed by the Council’s Standing Agency to competent authorities for consideration.

6. Play the leading role in settling issues arising during the Council’s meeting.

7. Direct settlement of medical assessment-related issues at the request of the head of the Council’s Standing Agency.

Article 23. Tasks and powers of Council’s Deputy Chairperson 

1. Chair medical consultations (if any).

2. Chair the conclusion meetings of the Council with authorization of the Council’s Chairperson and perform tasks of the Council’s Chairperson at the authorized meetings.

3. Assume responsibility for medical assessment documents.

4. Assume primary responsibility for professional and specialized conclusions given by the Medical Assessment Council and assume the joint responsibility with other members of the Council for conclusions given at the meetings in which he/she participates.

5. Append his/her signature to the Council’s Register of meetings in respect of the meetings in which he/she participates; sign the medical assessment reports issued at the meetings which he/she is authorized to chair.

6. Give and have his/her opinions about the medical assessment contents recorded in the Council’s Register of meetings which shall be then performed or proposed by the Council’s Standing Agency to competent authorities for consideration.

7. Engage in settlement of issues arising during the Council’s meeting at the request of the Council’s Chairperson.

8. Engage in settlement of medical assessment-related issues at the request of the head of the Council’s Standing Agency.

9. In addition to the abovementioned tasks, the Specialized Deputy Chairperson of the Provincial Medical Assessment Council shall assume the primary responsibility to ensure material facilities, equipment and personnel for carrying out specialist examinations and attend medical consultations, and conclusion meetings of the Council (without chairing such conclusion meetings).

Article 24. Specialized Members and Standing Members 

A Specialized Member or Standing Member of a Medical Assessment Council shall have the following tasks and powers:
1. Assume responsibility for results of specialist examinations which he/she carries out and assume the joint responsibility with other members of the Council for conclusions given at the meetings in which he/she participates.

2. Participate in all meetings of the Council at the request of the head of the Council’s Standing Agency. If a Specialized Member or Standing Member cannot attend the Council’s meeting, he/she must provide written reasons to the head of the Council’s Standing Agency.

3. Append his/her signature to the Council’s Register of meetings in respect of the meetings in which he/she participates.

4. Give and have his/her opinions about the specialist examination contents recorded in the Council’s Register of meetings which shall be then considered by the Council’s Standing Agency.

5. Engage in settlement of issues arising during the Council’s meeting at the request of the chair of the meeting.

6. Engage in settlement of medical assessment-related issues at the request of the head of the Council’s Standing Agency.

7. In addition to the tasks specified in Clause 1 through 6 of this Article, a Standing Member shall also perform other tasks as assigned by the Council's Chairperson or Deputy Chairperson.

Chapter VI

ASSESSORS OF MEDICAL ASSESSMENT COUNCIL

Article 25. Standards of assessors of Central Medical Assessment Councils

An assessor of a Central Medical Assessment Council is required to meet the following standards:
1. He/she must be a specialist level II physician or doctor of medicine working at a central-level public health facility and have at least 05 (five) years of working experience in his/her specialty, including training period in such specialty.

2. He/she has never violated specialized regulations and code of professional ethics. He/she is fit to work and perform tasks.

3. If an assessor fails to meet the standards set out in Clause 1 of this Article, the Standing Agency of the Central Medical Assessment Council and the Department of Medical Service Administration shall submit the case to the Minister of Health for consideration.

Article 26. Standards of assessors of Provincial Medical Assessment Councils

An assessor of a Provincial Medical Assessment Council is required to meet the following standards:

1. He/she must be a specialist level I physician or master of medicine, or higher, working at a provincial-level public health facility (including Medical Assessment Center) or a public health facility under the management of the Ministry of Health, and have at least 03 (three) years of working experience in his/her specialty, including training period in such specialty.

2. He/she has never violated specialized regulations and code of professional ethics. He/she is fit to work and perform tasks.

3. If an assessor fails to meet the standards set out in Clause 1 of this Article, the Standing Agency of the Provincial Medical Assessment Council shall submit the case to the Director of the Provincial Department of Health for consideration.

Article 27. Standards of assessors of Ministerial Medical Assessment Councils

Standards of assessors of the Medical Assessment Councils of the Ministry of National Defence, the Ministry of Public Security and the Ministry of Transport shall be decided by Ministers of such Ministries or their authorized persons on the basis of functions and tasks of the Medical Assessment Council and standards of assessors set out in Article 26 of this Circular.

Article 28. Number of assessors of a Medical Assessment Council

1. The number of assessors of a Medical Assessment Council shall be decided by its Chairperson depending on requirements and tasks of the Council. There are at least 02 (two) assessors in charge of each specialty.

2. If a Medical Assessment Council does not have any physician in cardiology, respiratory medicine, urology, digestion, muѕᴄuloѕkeletal ѕуѕtem, hematologу - blood transfusion, endoᴄrinologу, or immunologу, a physician of the general medicine department may be employed. In this case, each assessor shall be assigned to take charge of no more than 02 (two) specialties to ensure the quality of medical assessment.

Article 29. Appointment and reappointment of assessors 

1. Assessors of a Central Medical Assessment Council shall be appointed by the Minister of Health according to the proposal of the Department of Medical Service Administration affiliated to the Ministry of Health.

2. Assessors of a Provincial Medical Assessment Council shall be appointed by the Director of the Provincial Department of Health according to the proposal of the Standing Agency of that Provincial Medical Assessment Council and the Personnel and Organization Division of the Provincial Department of Health.

3. Assessors of the Medical Assessment Council of a Ministry shall be appointed by the head of the health agency of that Ministry according to the proposal of the Standing Agency of that Ministerial Medical Assessment Council.

4. Tenure of office of an assessor is 05 (five) years from the effective date of the appointment decision.

5. Appointment of additional assessors: During the operating term of the Medical Assessment Council, the head of the Council's Standing Agency may request a competent authority to appoint additional assessors, if necessary.

6. Reappointment: An assessor may be reappointed without term limit.

Article 30. Dismissal of assessors 

1. Dismissal of assessors: The head of the Standing Agency of the Medical Assessment Council shall request a competent authority to consider dismissing an assessor in one of the following cases:

a) He/she violates specialized regulations or code of professional ethics;

b) He/she is incapable of performing medical assessment tasks;

c) He/she is not fit to work;

d) He/she applies for resignation.

2. During his/her tenure of office, if a person who is appointed as an assessor retires or stops working at the public health facility, he/she shall be implicitly no longer an assessor from the date of retirement or secondment.

3. A competent authority that appoints an assessor shall have the power to dismiss that assessor.

Article 31. Tasks and powers of assessors 

1. Tasks of an assessor:

a) Carry out specialist examinations according to the request for specialist examinations received from the Standing Agency of the Medical Assessment Council. Send results of completed specialist examinations to the Standing Agency of the Medical Assessment Council and enter such results into the specialist examination record of the office where he/she is working.

b) Participate in medical consultations at the request of the Standing Agency of the Medical Assessment Council.

c) An assessor that works under the dual office holding regime shall assume legal responsibility for results of specialist examinations that he/she carries out.

d) Participate in a conclusion meeting of the Medical Assessment Council in the capacity as a Specialized Member of the Medical Assessment Council at that meeting when he/she is invited to the meeting as prescribed in Clause 2 Article 4 or Clause 2 Article 5 of this Circular.

2. Powers of an assessor:

a) Attend professional training courses in medical assessment.

b) Receive benefits when carrying out or participating in specialist examinations, medical consultations and meetings of the Medical Assessment Council in accordance with regulations of law and regulations of the Council’s Standing Agency.

c) Apply for resignation from the position of assessor.

Chapter VII 

FINAL PROVISIONS

Article 32. Effect

1. This Circular comes into force from March 01, 2017.

2. The Inter-Ministerial Circular No. 377/TT-LB dated March 21, 1977 of the Ministry of Health and the Ministry of Labour, War Invalids and Social Affairs and the Inter-Ministerial Circular No. 25/LB-TT dated August 29, 1979 of the Ministry of Health and the Ministry of Labour, War Invalids and Social Affairs, and other regulations contrary to this Circular cease to have effect from the effective date of this Circular.

Article 33. Transition 

1. The Medical Assessment Councils established by competent authorities before the effective date of this Circular will still operate until December 31, 2017 inclusively. From January 01, 2018, Medical Assessment Councils of all levels must comply with the provisions of this Circular.

2. Assessors of Medical Assessment Councils who have been appointed by competent authorities before the effective date of this Circular will still hold their positions until the end of their tenure. Reappointment or appointment of new assessors from the effective date of this Circular shall comply with the provisions of this Circular.

3. Templates of medical assessment reports enclosed with guidelines for medical assessment of each group of patients issued before the effective date of this Circular shall still be used until December 31, 2017 inclusively.

Article 34. Responsibility for implementation

1. The Department of Medical Service Administration affiliated to the Ministry of Health shall:

a) Direct operation of Medical Assessment Councils nationwide and their Standing Agencies.

b) Inspect medical assessment activities performed by Medical Assessment Councils nationwide and their Standing Agencies in accordance with regulations of law; suspend or request for suspension or take actions against violations committed by Medical Assessment Councils and their Standing Agencies within its jurisdiction.

2. Provincial People’s Committees shall:

Direct Provincial Departments of Health and relevant authorities to inspect operations of Provincial Medical Assessment Councils and Provincial Medical Assessment Centers in accordance with the provisions of this Circular.

3. Provincial Departments of Health shall:

a) Provide direction and instructions about medical assessment activities for Medical Assessment Councils under their management and Standing Agencies of these Councils.

b) Inspect medical assessment activities performed by Medical Assessment Councils and their Standing Agencies in accordance with regulations; suspend or request for suspension of operation of Medical Assessment Councils and their Standing Agencies or take actions against violations committed by Medical Assessment Councils and their Standing Agencies within its jurisdiction in accordance with regulations of law and the provisions of this Circular.

Difficulties that arise during the implementation of this Circular should be promptly reported to the Ministry of Health (via the Department of Medical Service Administration) for consideration./.

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