If health problems are identified that lead to restrictions and difficulties with communication, self-care, work, etc., a citizen may receive a disability group. To do this, you must have an ITU conclusion. In particular, people with scoliotic disease, that is, with curvature of the spine (depending on the severity of the problem), have a chance to gain a special status and associated privileges. We will talk about cases of disability registration against the background of this illness, as well as other nuances within the framework of the topic.
Disability due to scoliosis: to whom and in what cases is it issued?
Let us immediately note that the assignment of a group for scoliosis during the course of the ITU is quite rare. The fact is that scoliotic disease at stages 2 and 1 practically does not manifest itself in the form of symptoms.
But in stages 3 and 4, there is a sharp deterioration in the condition, normal life and normal functioning are lost. And this can already serve as the basis for establishing a disability group.
As experts note, the appropriate status should be assigned if:
— scoliosis is accompanied by severe pain;
— the anomaly affected other organs;
— the progression of the problem is obvious;
— rehabilitation provoked complications;
— severe degrees of scoliotic disease were recorded, that is, 3 or 4;
— the opportunity to carry out professional duties is lost;
- the patient needs constant help from other people.
Important
! The commission members may not appoint a group during the first examination, so it is worth submitting the documents again after some time.
What is scoliosis?
Scoliosis is a serious deformity of the vertebrae. Such curvature manifests itself in most cases in the frontal plane, after which deterioration begins and the disease can move to the saginal plane. Gradually, the bending of the affected vertebrae increases and can be complicated by kyphosis and other associated disorders of the musculoskeletal system .
Scoliosis may be accompanied by complications such as kyphosis and lordosis
Violation leads to visible and dangerous deformation of the thoracic region and pelvis, and the functioning of the lungs, heart and reproductive system is disrupted.
In more than 80% of cases, the true cause of the pathology is unknown . All factors that are now called as provoking scoliosis are conditional and do not always trigger the disease. Most often, curvature of the spine begins during the period of active growth of the patient, which can occur between the ages of 3 and 6 years and during the period of maturation.
Injuries, metabolic processes in the body, congenital pathologies, lack of minerals, constant stoop, and weakness of the thoracic and lumbar muscles can affect the health of the spine.
Attention! Some patients experience so-called infantile scoliosis. It is diagnosed before the age of one year and is associated with the currently inadequate development of the musculoskeletal system. In the absence of other diseases of the spine and chest, as well as congenital and intrauterine pathologies, the curvature goes away on its own.
What disability groups can be obtained for scoliosis?
Taking into account the well-being and restrictions present in the subject, a specific group is given for MSE.
3 group
For a citizen with scoliosis, when assigning a “working” group, the following criteria will be taken into account:
- pathological phenomena are aggravated;
— the disease continues to develop;
— the spinal trunk is immobilized;
- severe pain in the back;
- there is respiratory failure;
— the functioning of the central sensory system is disrupted.
Important
! Despite the problems described, a person must retain the ability to work and self-care.
2nd group
This category is assigned if the expert commission has identified:
- presence of sharp exacerbations of scoliosis;
— failures in the central sensory system;
— 4 or 3 degrees of scoliotic disease;
- periodic respiratory failure;
- decline in performance and loss of previous functions;
— the need to provide constant assistance (here is control, etc.);
— the need for special technical means to normalize traffic, etc.
1 group
Finally, this degree of restrictions is assigned in extremely difficult cases when diagnosing:
— 4 stages of scoliosis;
- paralysis of arms and legs;
— loss of self-care skills;
- constant need for help;
- intolerance to even small loads.
Clinical manifestations
MRI of the spine
- Cost: 16,000 rub.
More details
Scoliosis of the fourth degree is manifested very clearly and is clearly visible to others. Its external signs include the following: different heights of the shoulder blades and shoulders, tilt of the torso to one side. In childhood, the disease progresses and worsens; in adulthood, the pathology develops more slowly, but the deformation does not stop. The most dangerous is thoracic scoliosis in childhood. Of course, this pathology is accompanied by pain and the inability to lead a normal lifestyle.
Specifics of assigning disability for scoliosis to children
According to experts, in relation to children, we can talk about establishing the status if an X-ray of the spine shows obvious abnormalities, as well as if the column deviates by 10-20 degrees.
Against this background, a child’s disability is given taking into account certain nuances, namely: - group 3 - during exacerbations of the disease in children no more than 1-2 times a year, despite all this, there is no strong and sharp pain in the spine;
- Group 2 - if the disease manifests itself in the form of exacerbations up to 3 times a year;
— Group 1 — the main joints and the spinal column practically do not move, so the patient needs to be constantly cared for.
Important
! The attending pediatrician has the right to refer children and their parents to the ITU commission.
How to apply for disability
The degree of scoliosis can be determined and disability can be registered after diagnosis.
The process of registering disability for scoliosis includes collecting certain documents, undergoing examinations, as well as direct examination. The documents include all extracts from the medical history, medical records of the outpatient, which indicate the studies and treatments completed. What examinations and how many tests need to be taken before passing the expert commission are reported individually by the attending physician.
Also, the patient first undergoes an X-ray of the spine in direct and lateral projection, spirography to determine indicators of the functional state of the lungs, an electrocardiogram, which evaluates the work of the heart, and takes blood and urine tests.
After submitting all documents and examination results to MSEC, a date for the examination is set. The patient comes to the doctors and must be prepared to answer questions regarding the disease, subjective sensations, which may include back pain. Members of the commission study the documentation, conduct a clinical examination, after which they give an opinion and assign the appropriate disability group.
Step-by-step scheme for obtaining disability for scoliosis
1
. First of all, the applicant for the group prepares and submits to the ITU Bureau a package of documents, which includes:
— passport of the subject (plus copies of the main pages);
— application form 088/у-06;
— SNILS;
— referral for medical and social examination;
— certificate about the conditions and nature of the work (for workers);
— a copy of the work book certified by a personnel employee;
- characteristics from an educational institution (for children and students);
— originals and copies of extracts, certificates, conclusions confirming the disease;
— IPR and conclusion from the previous examination (if the commission is repeated).
2
. Also, before the ITU, a citizen is required to be examined and take tests. For example, you will need the following results:
— ECG;
- myelography;
- spirometry;
— visual inspection;
- blood, urine and other general tests.
Important
! Often, X-rays or MRI (magnetic resonance imaging) are prescribed directly for MSE. The second method is preferable, as it makes it possible to examine the structure of the spine in detail.
3
. As soon as the bureau receives the necessary documentation, a medical examination will be scheduled starting from that day and within a month. In addition to the person being examined, three specialists are present during the examination. But the involvement of a third-party expert who has the same rights as the other members of the commission (can ask questions, vote, etc.) is not excluded.
The inspection process is recorded in a protocol where important information is indicated. Based on the latter, a patient with scoliosis is denied or assigned a disability group. If the decision is positive, the disabled person receives an act, a certificate of his status and an IPR with recommendations.
Important! According to the new rules, a difficult condition or living in a hard-to-reach area allows a citizen to be examined in absentia. Then the expert commission makes its decision based only on the documents.
Deciding on Disability
Obtaining disability is impossible without passing a medical and social examination. It is within her competence:
- conducting examinations of applicants to determine the degree of disability for which they may qualify;
- determining whether the ability to work is completely lost or only reduced;
- study of statistics on disability in this disease, as well as the expected symptomatic picture during its further course;
- determining the patient’s needs for social protection, guided by the medical documents provided to them.
Medical and social examination
On the territory of the Russian Federation, it is impossible to obtain disability without going through the ITU.
Permanent disability due to scoliosis
Special status is assigned to a person for life if:
- several years from the date of establishment of incapacity;
- four years since the disabled person was assigned group 2;
- six years from the date of assignment of group 2 to a disabled child.
Plus, the category is left indefinitely when scoliosis is declared incurable or no improvement is observed within 5 years.
However, even a permanent group in all the cases presented does not cancel the patient’s obligation to be periodically examined and send the obtained data to the ITU bureau. As a rule, inspections are repeated every year or two.
Important
! Pensioners can receive an unlimited group immediately.
Sequence of receipt?
After the patient has passed all the tests and passed all the required diagnostic studies, doctors gather a special medical commission that will decide whether or not to give him a disability. An examination when registering a disability is collected at the district clinic. After passing all the tests, the patient needs to go there.
Obtaining a degree begins with the fact that the patient needs to see an orthopedic doctor, traumatologist and surgeon. They give special conclusions, and only after that a medical commission meets.
Doctors must study the patient’s medical record and all the symptoms that accompany the development of a disease such as scoliosis. They also examine the degree of damage to neighboring organs and the development of the disease. Additionally, doctors study how the citizen previously received treatment: how he followed the specialist’s recommendations, followed the dosage and regimen of medications, and attended physical and other procedures. In order for the commission to make the right decision, they need to study how curved the spine is, how this change affected the functioning of the internal organs, and how it affected the general health of the patient.
If the commission gave the patient a 3rd degree of disability, this means that he can perform light physical work, in which he does not need to expend a lot of physical strength, so as not to overload the body.
If the patient is given the 2nd degree of disability, this indicates that his health condition is deteriorating faster than accepted norms.
In rare cases, the patient is assigned the first degree of disability. This degree is assigned when the patient was not treated or the prescribed treatment was incorrect, if scoliosis developed quickly or the patient had a deformity in the spinal column from birth.
Over the next 5 years, the patient is required to confirm his “disabled” status. If he continues to have a serious health condition without improvement, he will be given this status again.
Is disability removed after surgery?
For the most part, the disease in question is not eliminated through surgery. The operation alleviates the patient’s condition, but does not restore the full function of the spine. This means that usually people who have undergone surgery remain disabled.
Be that as it may, after such treatment, a second MSE is required. If an operation or other situation contributed to the cancellation of the status, you can challenge the experts’ decision. To do this, you need to submit a request to the same bureau where the examination took place.
Next, a new examination is scheduled. If, as a result of this, results that are not satisfactory to the citizen are obtained, he should file a complaint with the ITU federal commission.
Important
! The final authority for resolving such disputes is the court, for which it is important to prepare. Ideally, it would not hurt to contact a lawyer specializing in disability cases, as well as be examined by independent specialists, provide convincing evidence of health limitations, etc.
Scoliosis 4th degree: diagnosis and treatment
There are not too many patients with grade 4 scoliosis, however, the pathology significantly reduces the quality of life of those who suffer from it. Deformation of the spinal column in this case is immediately evident, so the question of diagnosing the disease disappears.
The problem of curvature correction is very important. Female representatives have especially strong feelings about this, because external data largely determines a person’s self-esteem.
Symptoms
Scoliosis of the 4th degree is characterized by the presence of a pronounced curvature of the spine. The angle of curvature is 50 degrees or more. The spine with this pathology in most cases resembles the letter “S”. This is the most advanced stage of scoliosis. In some cases, there are not two, but three bending arcs, and then the curvature of the spine has a Z-shape.
Because the curvature of the spine changes the tilt of the torso, the body becomes asymmetrical. Usually the bend is localized in the thoracic region, starting at the top and ending at the bottom. In this regard, the chest changes its normal shape and looks distorted. The area of the shoulder blades on one side increases in size, on the other side the liver region protrudes. Asymmetry leads to the formation of a hump.
Diagnosis of scoliosis 4th degree
As noted above, diagnosing the disease at this stage is not difficult; the manifestations are very noticeable. In most cases, patients with this pathology are already adults, their skeleton is formed. However, sometimes rapidly progressing forms of scoliosis occur in children.
To identify individual structural points, radiographic examination is carried out. In addition, the doctor identifies other disorders that could be caused by spinal deformity. With grade 4 scoliosis, there is a strong displacement of internal organs, which can affect their functions. They can be compressed, and the patient in this case may suffer from shortness of breath, pressure surges, and intestinal problems. Back pain and numbness in the limbs may also occur. Many patients find it difficult to stay upright for long periods of time.
Treatment
While the skeleton is not fully formed, curvatures can be corrected at any stage. This is possible until about 11 years of age. Upon completion of this stage, conservative methods will not be able to completely correct spinal scoliosis; treatment in this case can only help to stop further progression.
Physical therapy is widely used in therapy to help strengthen muscles. It is important to understand that physical exercise will help a person adapt to stress, but it cannot affect the shape of the bend.
To get rid of grade 4 scoliosis, surgery is used. Before the operation, the patient undergoes a series of examinations by doctors of various specialties. The therapist will tell the patient about the necessary physical exercises, the orthopedist will inform about the general principles of treatment and prognosis, the physiotherapist will determine the necessary procedures. The surgeon will provide information about the possibilities of surgery in a particular case.
The treatment method depends on the patient's goals and the impact of the pathology on his life, but only surgery can return the curves of the spine to their normal position. However, the vast majority of patients do not decide to undergo surgery for various reasons. Some are afraid of the very fact of the operation, others are afraid of the possible consequences, some hope for self-correction. Of course, until the age of 24-25 there is a chance to smooth out the curve a little; at this time the spine is still flexible. However, completely conservative methods cannot eliminate the deformation. They are aimed primarily at strengthening the muscle corset and stopping the further development of the disease, although some external improvement may also be present.
Pregnancy with 4th degree scoliosis
In most cases, such a serious spinal deformity does not interfere with the full gestation of the fetus. However, this only applies to patients over 23-24 years old; their growth period has already ended; complications are unlikely. Of course, the doctor will recommend a special set of exercises for such women. Scoliosis does not affect the process of pregnancy and childbirth.
Complications may occur in patients who have undergone surgery.
In this case, the lower spine may be immobilized. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
Symptoms of the disease
At the initial stage, scoliosis is noticeable only to a specialist. An experienced orthopedic surgeon can make a diagnosis based on the patient's story and special examination methods.
External signs that suggest the presence of scoliosis in a patient:
- distance between waist and arm;
- asymmetrical arrangement of the blades;
- When bending forward, there is a noticeable curvature of the spine.
Timely contact with an experienced orthopedist and early detection of scoliosis is extremely important and
necessary for the effective treatment of this disease and the prevention of its complications.
Diagnostic methods
Diagnosis of the disease takes place in several stages.
The first stage is a physical examination. During the examination, the orthopedic doctor examines the mobility of the spine, the symmetry of the shoulders, shoulder blades, and examines the chest, abdomen, lower back, and pelvis. The doctor measures the length of the spine, assesses the curvature of the spine, the location of the pelvis in different poses of the limbs, and measures the length of the legs. While lying down, the doctor will determine the level of curvature of the spinal arch and muscle tone.
The second stage of diagnosis is x-ray examination. The images allow you to determine the angle of curvature of the spine. The first x-ray is taken in a standing position, then in different positions, which allows you to determine the level of deformation.
The third stage is instrumental. Ultrasound is used to obtain new data about the patient's condition. In some cases, the patient is prescribed an MRI.