In any country, people with disabilities are a special group of citizens who need benefits and benefits. They also need rehabilitation, or TSR. They are required to ensure a comfortable life for people with disabilities. They are provided by the state. You just need to know how and where you can get them.

For normal recovery, disabled people require many resources. They are selected based on the type of deviation. If there is a hearing impairment, then special devices are required. In other cases, other means are necessary. They must be provided by the state.

Types of collateral

TSR for people with disabilities is available, as well as the necessary activities and services. The issuance of funds implies:

• provision of technical means;
• performing product repair and replacement services;
• providing transportation for the child to the organization’s territory;
• payment for the child's accommodation;
• travel

Period of use

There are deadlines for using TSR for people with disabilities. This is approved by law:

• canes - at least 2 years;
• handrails - from 7 years;
• wheelchairs - over 4 years;
• dentures, depending on the type, - more than 1 year;
• orthopedic shoes - from 3 months.

For all other devices, certain deadlines are also provided. During this period, the products will be safe for rehabilitation. If the period of use has passed, it is necessary to change the product.

List of funds

According to the law, technical means include devices that make it possible to compensate for or eliminate a person’s life limitations. The list of TSR for disabled people consists of means for:

• self-service;
• care;
• orientation;
• training;
• movement.

People with disabilities need prosthetic products. They also need special clothing, shoes, and hearing aids. Disabled people need exercise equipment, sports equipment, and inventory.

The law specifies a list of TSR for people with disabilities. The federal list also contains specific technical means:

• supports and handrails;
• wheelchairs;
• prostheses;
• orthopedic shoes;
• anti-decubitus mattresses;
• dressing aids;
• special clothing;
• reading devices;
• guide dogs;
• thermometers;
• sound alarms;
• Hearing Aids.

Depending on the type of deviation, other remedies are prescribed to the person. The federal list of TSR for disabled people is approved by the state. The funds are provided free of charge and are therefore prohibited from being sold, gifted or transferred to others.

There are regions of the country where supports are understood only as structures for movement. Because of this, difficulties arise in the rehabilitation of a disabled person. If the rights to provide TSR for people with disabilities are violated, then interested parties must defend their interests. Indeed, depending on the limitation, special means are required.

Where to contact?

TSR is issued to disabled people after completing the procedure. You must submit an application to the Social Insurance Fund of the Russian Federation at your place of residence. Sometimes it is necessary to submit a document to the executive body that deals with these issues.

It is important to consider that foreigners and stateless persons who have a residence permit can also apply to the FSS of the Russian Federation. They are required to be given funds for rehabilitation if a disability has been recognized.

Required documents

Receipt of TSR by disabled people is possible after submitting an application, as well as several additional documents:

• birth certificate or passport;
• representative's passport;
• rehabilitation program;
• pension certificate.

Only when the entire list of documents is available will the application be accepted. They are provided in originals.

Application processing

The period for consideration of the application cannot be more than 15 days from the date of its submission. If a positive decision is made, the following is received by mail:

• notification confirming registration;
• direction for the creation of a technical product;
• coupon for a free travel pass.

The forms of all documents are accepted by the country's Ministry of Health and Social Development. They serve as confirmation that the necessary rehabilitation equipment has been issued.

Payment of compensation

Not only TSR for disabled people can be provided, but also compensation for the purchase of a necessary product. Parents have the right to independently choose the necessary technical equipment for their child. For this purpose, a wheelchair, prosthetic and orthopedic products, and printed publications with the desired font can be purchased. Parents have the right to pay for repairs themselves.

If the product was purchased or repaired at personal expense, compensation will be provided. It is paid only when the technical aid is actually required under the rehabilitation program. When disabled people are against providing the necessary product, they must be paid funds in the amount of the cost of the product.

How is the payment amount determined?

The amount of compensation is not taken arbitrarily, but is calculated according to certain rules:

• the size is equal to the price of the product;
• should not be higher than the cost of the product.

Payment of funds is documented. Those who need it are entitled to compensation.

To approve the amount of compensation for TSR for disabled people, a special classification is used. As an example, you can take the purchase of a hearing aid that has additional functions. The payout amount is based on the price of the device. It takes into account additional functions. The amount of payments is determined by:

• price of technical equipment;
• documents evidencing expenses for the purchase of the product.

Documents for payments

To receive compensation for the purchase of the desired product, you need to collect important documents. These include:

• statement;
• confirmation of expenses;
• child's birth certificate;
• representative's passport;
• individual rehabilitation program;

The compensation period is 1 month from the date of the decision. It is accepted by the FSS of the Russian Federation within 30 days.

What if compensation is not paid?

The right to receive technical means and monetary compensation is regulated by the state. If these rights are violated, then responsibility is provided for this. If the money for the purchase of the product has not been paid, then it is necessary to file a complaint. It is submitted to the Department social protection. Moreover, this can be done in paper and electronic form. If option 1 is selected, then it is necessary to obtain a confirmation of delivery.

The state guarantees not only the provision of TSR for disabled people, but also repairs. Moreover, this service is performed free of charge. Only to carry out repairs is it necessary that the disabled person’s opinion about the need to carry out the work agrees with the opinion of the experts.

Expertise

An inspection is required to verify the need for repairs. During this procedure, it will be determined whether parts or product elements need to be replaced. For the examination to be carried out, it is necessary:

• submit an application to the Federal Social Insurance Fund of the Russian Federation;
• provide technical equipment that requires repair or replacement.

If the remedy cannot be provided, then a decision is made to perform the examination at home. The impossibility of delivering the product is due to the difficulty of transportation and the health status of the disabled person.

The examination is carried out within 15 days from the date of receipt of the application. TSR users are informed about the time and place of the event. They can take part. As a result, an application is drawn up, one copy of which is provided to the disabled person. The reasons for the failure of the product are stated there. If restoration cannot be performed, then the need to replace the product is indicated.

Performing repairs and replacements

If the need for repairs is determined, then the FSS must provide:

• statement;
• examination document.

The replacement of the product is carried out by decision of the Social Insurance Fund based on the application. This procedure is only possible when the service life has expired or repairs cannot be performed.

Directions

Disabled people are given the right to free travel, since it is compensated by the Social Insurance Fund. To do this, a person with disabilities or his representative is given a ticket and directions for all types of transport. This document is provided for no more than 4 trips to the location of the organization to which the referral is provided. 4 free return trips are also provided.

Benefits are provided for such types of transport as:

• railway;
• water;
• automobile;
• air.

Travel compensation

When traveling for personal funds, compensation is paid. It is provided only if these types of transport were used. To receive compensation, you need the following documents:

• travel cards;
• confirmation of the need for travel.

Compensation is paid for no more than 4 round trip trips.

Payment for accommodation

If the technical device is just being manufactured, then compensation for the accommodation of the child and the responsible person is provided. Expenses are paid for the entire trip. The amount of compensation is equal to the amount of funds that are provided in case of business trips.

Reimbursement of expenses is carried out for the actual number of days of stay. In this case, certain conditions must be met:

• living in an area remote from the organization;
• The product was made in 1 trip.

Provision for rehabilitation of disabled people is guaranteed by the state. Ensuring their normal recovery occurs through compensation for various expenses.

Terms of use and repair of technical rehabilitation equipment, prostheses and prosthetic and orthopedic products

Terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement

The terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement are approved by Order of the Ministry of Health and Social Development of the Russian Federation dated December 27, 2011 N 1666n “On approval of the terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement.”

Repair of technical rehabilitation equipment

Disabled persons are provided with repair services for technical rehabilitation equipment.

As part of social services, disabled people are provided with:

necessary means of telecommunications services;

special telephone sets (including for subscribers with hearing impairments);

negotiation points for collective use;

household appliances;

typhlo-, surdo- and other means necessary for social adaptation.

A disabled person has the right not only to receive free of charge the specified special means for self-care and care, as well as other means of rehabilitation, but also to receive services for their repair.

Maintenance and repair of technical means of rehabilitation of disabled people are made out of turn with exemption from payment or on preferential terms.

Order of the Ministry of Health and Social Development of the Russian Federation dated August 21, 2008 N 438n "On approval of the procedure for carrying out and the form of the conclusion of a medical and technical examination to establish the need for repair or early replacement of technical means of rehabilitation, prostheses, prosthetic and orthopedic products" (Registered with the Ministry of Justice of the Russian Federation on September 16, 2008 N 12293) the procedure for the implementation and form of the conclusion of a medical and technical examination to establish the need for repair or early replacement of technical means of rehabilitation, prostheses, prosthetic and orthopedic products has been approved.

Procedure for maintenance and repair of rehabilitation equipment for disabled people

1. If a technical device or prosthetic-orthopedic product is faulty, the disabled person must submit an application to the body of the Social Insurance Fund of the Russian Federation at the place of residence for a medical and technical examination of this device or product.

2. An application is submitted by a disabled person or his representative in writing. Along with the application, a product or product is presented that must be checked for repair or early replacement.

3. Sometimes it is not possible to provide a means or product, for example, due to the difficulty of transportation or the health status of the disabled person. In this case, the disabled person needs to first obtain a conclusion from a medical institution (for example, about the impossibility of removing the prosthesis before receiving a new one) before contacting the Social Insurance Fund of the Russian Federation.

4. At the request of a disabled person, the body of the Social Insurance Fund of the Russian Federation may decide to conduct a medical and technical examination with a specialist expert visiting the disabled person’s home. For example, this is useful when a wheelchair is faulty.

5. The body of the Social Insurance Fund of the Russian Federation, which has received an application from a disabled person, must set a date for conducting a medical and technical examination and notify the disabled person of the exact time and place of its conduct. A disabled person has the right to take part in this examination at his own request. A disabled person must indicate his desire or unwillingness to take part in the examination in an application.

The maximum period during which the application is considered and the examination is carried out is 15 days from the date of receipt of the application.

6. The expert draws up a conclusion that provides an assessment of the performance status of a technical device or product, its compliance with the required functional parameters, medical purposes and clinical and functional requirements, and the causes of breakdown or malfunction.

In accordance with Art. 10, 11 of the Federal Law of November 25, 1995 No. 181-FZ “On social protection of disabled people in Russian Federation“(as amended on August 22, 2004) the state guarantees to disabled people, at the expense of the federal budget, the implementation of rehabilitation measures, the receipt of technical means and services provided for in the federal list approved by the Government of the Russian Federation.
For the first time, the Federal List of Rehabilitation Measures, Technical Rehabilitation Equipment and Services Provided to Disabled Persons was approved by Decree of the Government of the Russian Federation of October 21, 2004 No. 1343-r (hereinafter referred to as the Federal List), and came into force on January 1, 2005. A new one is now in force, expanded Federal list approved by Decree of the Government of the Russian Federation of December 30, 2005 No. 2347-r.
The main mechanism for implementing these guarantees is individual rehabilitation programs (IPR) for disabled people, developed by federal government institutions of medical and social expertise (ITU bureau).
The concept of medical and social examination, as determining in the prescribed manner the needs of the examined person for social protection measures, including rehabilitation, based on the assessment of disability (LD), is given in Article 7 of the said Federal Law. And the main functions of the ITU bureau are set out in Article 8. These include the development of IPR for people with disabilities.
Art. 11 of Law 181-FZ provides a definition of an individual rehabilitation program for a disabled person, which is a list of optimal rehabilitation measures for a disabled person, including types, forms, volumes, timing and procedures for the implementation of medical, professional and other measures aimed at restoring or compensating the functions of the body, restoring or compensation for a disabled person’s abilities to perform certain types of activities, i.e. OJD.
The volume of such recommendations cannot be less than the established federal minimum, determined by the federal list, with exemption from payment, but may also contain rehabilitation measures, in the payment of which the disabled person himself or other persons or organizations participate. If the chosen rehabilitation measure that is optimal for a disabled person is included in the Federal List, the bureau specialists do not have the right not to include it in the IPR.
On the one hand, the IPR is mandatory for execution by the relevant government bodies, local governments, as well as organizations and institutions, regardless of organizational, legal forms and forms of ownership. On the other hand, the IPR is of a recommendatory nature for a disabled person; he has the right to refuse one or another type of activity or the entire program as a whole.
The form of an individual rehabilitation program for a disabled person, issued by federal institutions of medical and social expertise, was approved by the Order of the Ministry of Health and Social Development of the Russian Federation dated November 29, 2004. No. 287.
The Law specifically stipulates the procedure and conditions for providing technical means of rehabilitation (TSR) to people with disabilities. Article 11.1 defines TSR and their classification. The decision to provide disabled people with TSR is made when establishing medical indications and contraindications, which are based on an assessment of persistent disorders of body functions. Financing of expenditure obligations to provide disabled people with TSR, including the manufacture and repair of prosthetic and orthopedic products, is carried out at the expense of the federal budget and the Social Insurance Fund of the Russian Federation. The list of TSR and indications for providing them to disabled people, as well as the procedure for providing them, are determined by the Government of the Russian Federation.
Thus, the state guarantees disabled people the provision of rehabilitation measures, technical means and services provided for in the Federal List approved by the Government of the Russian Federation.
Guaranteed provision of technical means of rehabilitation to citizens who are not disabled and injured at work is regulated by Federal Law of January 12, 1995 No. 5-FZ “On Veterans” (as amended on August 22, 2004). Articles 14 - 19, among other social support measures, provide for the provision of prosthetics (except dentures) and prosthetic and orthopedic products in the manner established by the Government of the Russian Federation. (it should be noted that the legislation of the Russian Federation on veterans, in addition to the aforementioned federal law, consists of other regulatory legal acts of the constituent entities of the Russian Federation). Veterans who have the right to be provided with prostheses (except dentures) and prosthetic and orthopedic products at the expense of the federal budget, excluding disabled people, include WWII participants, combat veterans, military personnel who served in military units, institutions, military educational institutions institutions that were not part of the active army in the period from June 22, 1941 to September 3, 1945 for at least 6 months, military personnel awarded orders and medals of the USSR for service during the specified period, persons awarded the badge “Resident of besieged Leningrad”, persons who worked during the Second World War at air defense facilities, local air defense, construction of defensive structures, naval bases, airfields and other military facilities within the rear borders of active fronts, operational zones of active fronts, and on front-line sections of railways and highways. If a veteran has grounds to receive the same form of social support on several grounds, i.e. for example, if he is both a veteran and a disabled person, then this form is provided on one basis at the veteran’s choice.
The formation of an IPR in determining the need of a disabled person for TSR is currently associated with certain difficulties associated with an insufficiently developed regulatory framework. At present, the procedure for the development and implementation of IRP, medical indications for providing disabled people with TSR, and the nomenclature of funds related to the Federal List have not been approved.
However, an analysis of existing regulatory and methodological documents shows that there is a sufficient information base for the work of specialists from ITU institutions.
What is TSR?
Federal Law 181-FZ defines them as devices containing technical solutions, including special ones, used to compensate for or eliminate persistent disabilities.
These include:
- special means for self-service;
- special care products;
- special means for orientation, communication and information exchange;
- special means for training, education and employment;
- prosthetic products;
- special training and sports equipment and inventory.
There are other classifications of TSR: by functional purpose (for taking off and putting on clothes and shoes, for personal hygiene, for preparing and eating food, etc.), by type of rehabilitation (TS medical, professional, social rehabilitation).
Separately in various literature, typhlotechnical and hearing aids can be distinguished, i.e. funds for “blind” and “deaf” disabled people. Typhlomedicines include means for optical vision correction (hyperocular glasses, hand-held magnifiers, telescopic glasses, magnifiers with hyperocular), for orientation in space (canes, photoelectric probe, ultrasonic locators and alarms), for reading and writing (writing instruments and Braille readers, typewriters, special drawing and measuring instruments, computers), household products (dispensers, sewing devices, Braille watches). Signless means include vibration alarms, amplifying means of communication and information transmission, decoders for televisions, telephone sets with amplifiers, ticker tape).
When determining the need for TMR, the IPR includes specific means, forms of provision of TMR (outpatient, inpatient, at home), volume (i.e. number of products and components for TMR), terms of provision (within a year, 1 time in 4 years and etc.), and in the case of complex or atypical prosthetics - and the performing institution. In other cases, the executor is determined by the executive body of the FSS of the Russian Federation.
When determining a specific TSR, you can rely on the following regulatory documents:
1. List of technical means used exclusively for the prevention or rehabilitation of disabled people, the sale of which is not subject to value added tax, approved by Decree of the Government of the Russian Federation of December 21, 2000 No. 998 (as amended by Decree of the Government of the Russian Federation of May 10, 2001 No. 357) (hereinafter - List of TSR used for rehabilitation);
2. An indicative list of technical and other means of rehabilitation for victims of industrial accidents and occupational diseases and the periods of their operation (reference material sent to the regional branches of the FSS of the Russian Federation by letter of the FSS of the Russian Federation dated 02/05/2002 No. 02-18/10-783) (hereinafter - Indicative list);
3. List of types of prosthetic and orthopedic products used in the implementation of work and services for the provision of prosthetic and orthopedic care, and subject to approval as licensed standard samples, approved by order of the Federal Service for Surveillance in Healthcare and Social Development dated October 21, 2004 No. 279 -PR/04 (hereinafter referred to as the List of type representatives);
4. Nomenclature of technical and other means of rehabilitation of disabled people of domestic and foreign production, subject to state registration, approved by order of the Federal Service for Surveillance in Healthcare and Social Development dated March 14, 2005 No. 505-Pr/05 (hereinafter referred to as the TSR Nomenclature);
5. Terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement, approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2006 No. 283 (hereinafter referred to as Terms of Use).
Which TSRs are currently included in the Federal List?
1. Support and tactile canes, crutches, supports, handrails.
Canes are produced in the following modifications: metal, wooden, fiberglass; solid and folding; with 1, 3, 4 and 5 legs. Components for them are also produced (tips, anti-slip devices, handles (handles), reflectors).
According to the regional branch of the Federal Social Insurance Fund of the Russian Federation, enterprises that passed the competitive selection for the supply of TSR in 2006 produce the following canes: support cane with a height of 800, 850, 900, 950 mm, four-legged cane with a pyramidal base (adjustable in height and intended primarily for stroke survivors), tactile folding cane (4 sections), lightweight.
The basis for determining the need for this TMR is a limitation of the ability to move 2, 1 degree; self-service 2, 1 degree; orientation 3, 2 degrees due to disease, consequences of injury, defect with impaired statodynamic or sensory functions of 2, 3 degrees.
Medical indications for provision:
1.1. A walking cane with one leg and a handle (various modifications) can be:
- diseases, consequences of injuries and deformations of the lower extremities, pelvis and spine with moderate or severe impairment of the functions of walking and standing;
- Moderate hemiparesis;
- Moderate paresis of one lower limb;
- Diseases of peripheral vessels of the lower extremities with chronic arterial insufficiency of the 2nd degree, chronic venous insufficiency of the 3rd degree;
- Elephantiasis of one lower limb;
- Endoprosthesis of the knee or hip joint;
1.2. A multi-legged cane (three-legged - tripod, four-legged - quadripod, five-legged) can be:
- Moderate paresis of both lower extremities;
- Moderate triparesis (paresis of both lower and one upper limbs;
- Moderate tetraparesis;
- Diseases of peripheral vessels of the lower extremities with chronic arterial insufficiency of the 3rd degree, chronic venous insufficiency of the 3rd-4th degree;
- Elephantiasis of both lower extremities;
1.3. Tactile cane, solid or folding (various sizes):
- Diseases, congenital anomalies, consequences of injuries to the organ of vision, leading to low vision or blindness (impaired visual functions of III, IV degrees)
Maintenance standards and service life (in accordance with the Terms of Use): 1 pc. for 2 years; for disabled children - sliding canes 1 pc. for 2 years, other models - taking into account the height and other anthropometric data of the disabled child; components - 5 pcs. for 2 years (issued in addition to the product in cases where the recommendation to provide them is indicated in the individual rehabilitation program for a disabled person or if they are included in the product as an integral part of it).

Crutches are also available in various modifications: wooden, metal; with support on the forearm, axillary, with support under the elbow; various sizes, adults and teenagers; adjustable length. Accessories for them are also provided (tips, anti-slip devices, handles (handles), reflectors).
According to the regional branch of the Federal Social Insurance Fund of the Russian Federation, enterprises that passed the competitive selection for the supply of TSR in 2006 produce the following crutches: axillary crutches that can withstand loads of up to 100 kg; with armrest support (height adjustable); with support on the forearm, withstanding a load of up to 110 kg with handle heights from 45 to 68 cm (small), from 53 to 76 cm (medium), from 73 to 96 cm (large).
The justification for determining the need for this TSR is a limitation of the ability to move 2 degrees, self-care 2, 1 degrees in combination with a limitation of the ability to move 2 degrees due to a disease, defect, accompanied by a violation of statodynamic or sensory functions of 2, 3 degrees.
Medical indications for support may include:
- Persistent deformities or diseases of the bones and joints of the lower extremities with ankylosis, severe contracture, bone defect, pseudarthrosis; persistent pain syndrome;
- Amputation stumps of one or both lower extremities;
- Defective position of the foot with trophic disorders when it is impossible to use orthopedic shoes;
- Fistula form of osteomyelitis of one lower limb with impairment of its ability to support;
- Endoprosthesis of the knee, hip joints;


- Diseases of peripheral vessels of both lower extremities with chronic arterial insufficiency of the 3rd degree; with chronic venous insufficiency of 3-4 degrees;

- Moderate, severe hemiparesis;
- Moderate, severe paresis of both lower extremities;
- Severe paresis of one lower limb in combination with paresis of one upper limb (crossed).
Supply standards (pieces, pairs) and service life: 1 pair for 2 years; for disabled children - 1 pair for 6 months; components - 5 pcs. for 2 years (issued in addition to the product in cases where the recommendation to provide them is indicated in the individual rehabilitation program for a disabled person or if they are included in the product as an integral part of it).

Supports (walkers, playpens, frames, support sticks) are available in various modifications (underarm, with support for the chest area, with support for the lumbar region, with armrests, with support for the arms, with body fixation; folding, adjustable, walking, on wheels , on hinges, with a seat for rest); and components for them (tips, wheels, anti-skid devices, handles (handles), clamps, tables, seats, bags).
According to the regional branch of the Federal Social Insurance Fund of the Russian Federation, enterprises that passed the competitive selection for the supply of TSR in 2006 produce the following supports: a) folding with a load-bearing capacity of up to 135 kg, height from the floor to the handrails 81-91 cm (large), 71-81 cm ( small); b) “step” supports, withstand load up to 135 kg, c) walking on 4 wheels with a hand brake, height-adjustable, with a shopping bag, a seat for rest.
The justification for determining the need for this TSR is a limitation of the ability to move 2nd degree, self-care 2nd, 1st degree in combination with a limitation of the ability to move 2nd degree due to a disease or defect, accompanied by a violation of static-dynamic functions of 2nd, 3rd degree.
Medical indications for support may include:
- Diseases, consequences of injuries and deformations of the lower extremities, pelvis and spine with severe impairment of the function of walking and standing;
- Severe paresis of both lower extremities;
- Moderate tetraparesis;
- Moderate triparesis;
- Severe hemiparesis;
- Severe vestibular-cerebellar disorders;
- Severe amyostatic disorders.
Maintenance standards and service life: 1 pc. for 2 years; for disabled children, taking into account the height and other anthropometric data of the disabled child; components - 5 pcs. for 2 years (issued in addition to the product in cases where the recommendation to provide them is indicated in the individual rehabilitation program for a disabled person or if they are included in the product as an integral part of it).

Handrails (continuous, removable, for toilets and bathtubs). A competitive selection of supplier enterprises has not yet been carried out. Security standards in accordance with the Terms of Use once every 7 years.

2. Wheelchairs with manual drive (indoor, walking, active type), with electric drive, small-sized.
Components and accessories for them are included in a single set with the stroller (wheels, backrests, removable sides, headrests, armrests, footrests, straps for fastening shoes, straps for fastening legs, heel pads, handles (handles) for pushing, seats (with adjustable spacer, for arthrodesis, leather for disabled people with high amputation of the lower limbs, with a removable segment for the toilet), pillows (side, back, seat, solid, anti-decubitus, head rollers, etc.), anti-tip supports, parking brakes).
When forming an IPR, it is necessary to indicate the anthropometric data of the disabled person (height, weight, hip volume), as well as the age of the child.
2.1. The need for indoor wheelchairs (of various modifications) is justified by a limitation of the ability to move 3.2 degrees, self-care 2.1 degrees in combination with a limitation of the ability to move 3.2 degrees.
There are modifications for adults (seat width from 340 mm to 490 mm, load capacity up to 100-150 kg), including models with reclining back, for teenagers, for children (ages 3 to 6 years and from 6 to 14 years), for children with cerebral palsy. The narrowest strollers for adults up to 61 cm wide. recommended for small apartments.






- Stage III rheumatoid arthritis with predominant damage to the joints of the lower extremities with severe dysfunction;
- Thrombobliterating diseases of the arteries of both lower extremities with chronic arterial insufficiency of the 3rd degree;
- Diseases of the veins of both lower extremities with chronic venous insufficiency of 3 (4) degrees;
- Elephantiasis of both lower extremities in the lymphodema stage;



- Tetraplegia, significantly pronounced, severe tetraparesis;
- Triplegia, significantly pronounced, severe triparesis;
- Significantly expressed, severe hyperkinetic disorders;
- Significantly expressed ataxia;
- Severe vestibular-cerebellar disorders;


- Diseases of the cardiovascular system with circulatory failure stage III, angina pectoris with functional class IV
- Diseases of the respiratory system with respiratory failure of the 3rd degree in combination with circulatory failure of any degree;
- Liver diseases with severe dysfunction, portal hypertension, ascites;
- Kidney diseases with chronic renal failure of the 3rd degree.
Maintenance standards and service life: 1 pc. for 4 years; for disabled children - taking into account the height and other anthropometric data of the disabled child.
2.1. The need for walking wheelchairs is justified by a limitation of the ability to move 3.2 degrees, self-care 2.1 degrees in combination with a limitation of the ability to move 3.2 degrees.
Models are available with manual drive from the wheel rim and with lever drive on the front wheels (a set with a lever for the left hand is possible), for adults (with plastic or spoked wheels, with solid or pneumatic tires, with or without parking brakes, folding or non-folding) and for children, incl. with cerebral palsy (equipped with belts to secure the head, torso and legs of a sick child).

Medical indications may include:
- Amputation stumps of one or both lower extremities at any level;
- False joint of the bones of the lower extremities with impaired walking and standing function;
- Defect of the bones of the lower extremities with impaired walking and standing function;
- Deforming arthrosis of the hip or knee joint Stage III with severe pain or pronounced flexion or adduction contracture;
- Ankylosis or pronounced contracture of both ankle joints with a vicious position of one or two feet;
- Stage III rheumatoid arthritis with predominant damage to the joints of the lower extremities with severe dysfunction;
- Thrombobliterating diseases of the arteries of the lower extremities with chronic arterial insufficiency of the 3rd degree;
- Diseases of the veins of the lower extremities with chronic venous insufficiency of the 3rd degree;
- Paralysis of both or one lower limb;
- Hemiplegia, significantly pronounced, severe hemiparesis;
- Significantly pronounced, severe paresis of both or one lower limb;
- Congenital anomalies (malformations) and deformations of both lower extremities, pelvis and spine with severe impairment of walking and standing functions;
- Stage III circulatory failure;
- Angina pectoris with functional class IV;
- Pulmonary heart failure of the 3rd degree.
The service life in accordance with the Terms of Use is 4 years.
2.3. The need for a small-sized wheelchair (and accessories for it, including insulated leather mittens and woolen covers on the stumps of the thighs) arises when the ability to move is limited 3, 2 degrees with high amputation stumps of both hips.
The period of use before replacement is 1.5 years.
2.4. On determining indications for the provision of a power wheelchair. The rationale for inclusion in the IPR is the presence of a limitation in the ability to move in combination with a limitation in the ability to self-care of degree II, III in the presence of established medical indications:
- Persistent deformities or diseases of the lower and upper extremities, pelvis or spine in combination with diseases of the upper extremities;
- paralysis, significant paresis of both lower extremities in combination with persistent diseases, deformities, as well as paralysis and paresis of the upper extremities;
- paralysis, significantly pronounced, severe paresis of one lower limb in combination with persistent diseases, deformities, paralysis and paresis of the upper limbs.
Terms of use - 5 years.
2.5. The said letter from the main bureau also concerns the indications for the provision of active wheelchairs, which have increased maneuverability and are intended for disabled people leading an active lifestyle, physically developed, and with the skills to independently actively move in manual wheelchairs.
It should be remembered that in order to travel on the last two types of strollers, you need hard surfaces of streets and sidewalks, and relatively flat terrain.
Before the approval of medical indications for technical means of rehabilitation, the use of “Medical indications for providing disabled people with wheelchairs”, approved by the instructional letter of the Ministry of Social Security of the RSFSR dated 06/09/1989 No. 1-79-I, is allowed.

Terms of use 4 years.

3. Prostheses, including endoprostheses and orthoses.
Prostheses (including prostheses of the upper and lower extremities, eye, ear, nose, palate, dental, breast, genital, combined facial and palate).
Orthoses (including orthopedic devices for the upper and lower extremities, reclinators, corsets, obturators, bandages, bras, semi-graces and graces for breast prosthetics, splints, corrective devices for the upper and lower extremities).
The need for prosthetics and orthotics, and the provision of orthopedic shoes is included in the IPR based on the conclusion of the medical and technical commission of the prosthetic and orthopedic enterprise (MTC POP). The conclusion must indicate the type of prosthesis and name. The specific type of prosthesis or product is determined taking into account the List of Type Representatives. This document provides a list of all prostheses and orthoses proposed for production, manufacture and sale for all types of lesions. Eg. Amputation or disarticulation of the shoulder. A shoulder prosthesis may be recommended, or after disarticulation of the shoulder a cosmetic prosthesis, traction-controlled, electrically operated, working. For scoliosis, a functional-correcting corset is individually made or made from semi-finished products of maximum readiness. After mastectomy, a mammary gland prosthesis is included: a bra, a cover and a mammary gland exoprosthesis. Etc. Those. this is a reference point for the bureau’s specialists. The TSRs presented in the List of Type Representatives are recommended for licensing as licensed reference samples. For each of them, a certificate was issued for inclusion in the register of samples of standards of prosthetic and orthopedic products. Thus, in the period before the approval of medical indications for the provision of TSR, the List of type representatives can serve as a justification for the selection of TSR by the ITU institution.
The terms of use before replacement (provision standards) are determined taking into account the Order of the Ministry of Health and Social Development of Russia dated April 12, 2006 No. 282 “On approval of the terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement,” brought to the attention of the ITU bureau by letter from the main bureau dated 18.05 .10.42/1233-2544.
Terms of use of cosmetic prostheses of fingers and hands of the upper extremities - 3 months;
Prostheses of the upper and lower extremities 2 years (for children - 1 year);
Lower limb orthoses - 1 year;
Lower limb prostheses for swimming - 3 years;
Woolen covers on the stump of the lower limb - 3 months;
Cotton covers for the stump of the lower limb - 3 months;
Covers made of polymer material on the stump of the lower limb - 1 year;
Covers for the stump of the upper limb - 6 months;
Spare cosmetic covers for upper limb prostheses - 4 items per prosthesis for 1 year;
Spare cosmetic covers for lower limb prostheses - 1 item per prosthesis for 1 year;
Support elements - 6 months;
Moisture-absorbing elements - 6 months.
Breast exoprostheses - 1 year;
A bodice (bra, grace or semi-grace) for fixing breast exorposis - 4 months;
Cover for breast exoprosthesis - 4 months;
Bandages for various parts of the body, inserted shoes - 1 year;
Orthopedic bandage for the upper limb to improve dimphovenous outflow, including after amputation of the mammary gland - 6 months.
It should be remembered that the performer is determined by the regional branch of the FSS of the Russian Federation in accordance with the results of the competitive selection. At the same time, if a disabled person (veteran) independently decides on the issue of his prosthetics in accordance with the IPR, he may be issued a letter of guarantee by the authorized body on payment to the relevant organization of the cost of manufactured products in amounts not exceeding the cost of products manufactured in organizations selected in in the prescribed manner.
Regarding endoprosthetics: The Social Insurance Fund (SIF) of the Russian Federation pays only for the endoprosthesis itself. Surgical intervention is paid for from the federal budget (in accordance with the order of the Ministry of Health of Russia and the Russian Academy of Medical Sciences dated March 19, 2004 No. 125/13 (see also order of the Ministry of Health of the Russian Federation dated December 29, 2000 No. 459). Endoprostheses can be of joints (the brand is indicated according to the conclusion of leading experts ), ligaments, blood vessels, heart valves, cochlear implants. Moreover, in accordance with the terms of use, the terms of replacement of endoprostheses, including joints, ligaments, vessels, heart valves, cochlear implants, are determined by medical and preventive institutions (health care facilities) and confirmed by ITU institutions .
The need for eye prosthetics is determined on the basis of the opinion of an ophthalmologist at a healthcare institution (for primary prosthetics - a regional consultative and diagnostic clinic). The contractor is also indicated by the executive body of the Federal Social Insurance Fund of the Russian Federation, however, you should know that if in 2005 17 manufacturing enterprises were selected, then according to the results of an open competition held in 2006, only three organizations were recognized as winners in eye prosthetics: FSUE “Ioshkar-Olinskoe POP”, Federal State Unitary Enterprise "Nizhny Novgorod Popular Population" and Kemerovo Clinical Ophthalmological Hospital. The executive bodies of the FSS may enter into government contracts with any of the above-mentioned organizations. At the same time, if a disabled person independently decides on the issue of eye prosthetics and has an IPR, by decision of the executive body of the Social Insurance Fund, a letter of guarantee can be submitted for payment of the cost of eye prostheses to the relevant organization.
The period of use of dental, eye, ear, nasal, combined facial, palate, and genital prostheses is 2 years (for children - 1 year).
The conclusion about the need for hearing aids is included in the IPR based on the conclusion of an audiologist at a healthcare institution. When preparing a medical report, the audiologist must determine the required model of the supplied hearing aids, taking into account the form and degree of hearing loss, the presence of FUNG and the conductive component, the development of hearing and speech, experience in wearing hearing aids and the state of motor function. In children, if indicated, binaural prosthetics is possible, i.e. provision of two hearing aids in accordance with the IPR.

4. Orthopedic shoes.
Orthopedic shoes (complex and uncomplicated), shoes for devices, and prostheses, orthopedic pads, in-lay orthopedic corrective devices (insoles, half-insoles).
Maintenance standards and terms of use:
- complex orthopedic shoes and shoes for orthopedic devices - 2 pairs for 1 year, including 1 pair with insulated lining (for children - 4 pairs for 1 year, including 2 pairs with insulated lining);
- simple orthopedic shoes (with or without insulated lining at the request of the disabled person) - 1 pair for 1 year (for children - 2 pairs for 1 year);
- inserted corrective elements for orthopedic shoes (including insoles and half-insoles) - 3 months;
Shoes for prosthetics - for bilateral amputation - 2 pairs for 1 year; for unilateral amputation - 2 pairs for 1 year (including 1 pair with an insulated lining at the request of the disabled person.

5. Anti-decubitus mattresses and pillows (seats for wheelchairs) are classified as special care products, and therefore need is determined when the ability for self-care and mobility is limited to the third degree.
Medical indications may include various diseases with a pronounced impairment of static-dynamic functions; dysfunction of blood circulation, breathing, digestion, urination (renal failure), mental disorders (dementia). The provision standard is once every 2 years.
Terms of use - 3 years.

6. Devices for dressing, undressing and grasping objects.

Devices for dressing and undressing (including for fastening buttons, for putting on and taking off items of clothing, special buttons, a rack for putting on outerwear).
The indicative list provides for the provision by the executive body of the FSS of the Russian Federation with the following products: aids for putting on socks and tights (once every 5 years), a shoe horn and a device for removing shoes (once every 10 years), clothing holders (once every 5 years ), hooks for dressing and undressing (once every 5 years), Velcro fastener (once every 5 years).
The justification for need is a limitation of the ability to self-care of the 1st and 2nd degree, caused by a violation of static-dynamic functions (mainly the upper extremities), blood circulation, respiration, digestion, liver), urination (renal failure).
Medical indications are:
- diseases, consequences of injuries and deformations of the lower extremities, pelvis and spine with severe dysfunction;
- diseases, consequences of injuries and deformations of the upper extremities, with severe dysfunction;
- moderate, severe tetraparesis, triparesis, hemiparesis;
- severe paresis of both lower extremities;

- pronounced vestibulocerebellar phenomena;
- pronounced amyostatic disorders;
- pronounced hyperkinetic disorders;
- severe paresis of one upper or one lower limb;
- liver diseases with impaired liver function, chronic renal failure III;
- kidney diseases with renal failure;

Devices for grasping and moving objects are recommended for limited ability to self-care of the 1st and 2nd degrees, associated with a violation of statodynamic functions.
Medical indications may include:
- moderately severe paresis of both upper limbs;
- moderate, severe vestibulo-cerebellar disorders;
- pronounced amyostatic disorders;
- moderate to severe hyperkinetic disorders;
- moderately severe paresis of one upper limb with minor paresis of the other upper limb;
- diseases, consequences of injuries and deformations of the upper limbs and shoulder girdle with severe dysfunction of the upper limbs;
The indicative list regulates the provision by the executive body of the FSS of the Russian Federation with the following products:
holder: for utensils (removable, stationary with suction cups) with a non-slip base, tiltable and non-tiltable with a flexible tripod, with fastening to a table, wheelchair, bed, with mounting on the ceiling); for keys (with fastening to a table, wheelchair, bed, with fastening to the ceiling); telephone handset (cuff holder for hand, wrist, palm); anti-slip coatings (mats); anti-slip tapes, stickers; magnetic tapes; clamp, including finger clamp; clamps; limiting frames; stickers, mats.
Terms of use - 5 years.

7. Special clothing
A competitive selection of supplier enterprises has not yet been carried out. In the List of TSR used in rehabilitation, these means are defined as clothing for special-purpose disabled people, made to order, or other special clothing (including compression clothing, compression and protective gloves, stockings, socks, helmets, vests, fastening belts, bags for legs, trousers and skirts for moving in a wheelchair).
Terms of use and security standards:
- functional and aesthetic clothing for disabled people with double amputation of the upper limbs - 2 sets of outerwear (winter and summer) for 1 year;
- leather or knitted gloves (for the prosthesis of the upper limb), leather glove for the prosthesis of the preserved upper limb with an insulated lining - 1 pair for 1 year;
- leather gloves for deformed upper limbs - 1 pair for 2 years;
- orthopedic trousers -1 year;
- leather insulated mittens (for disabled people using small wheelchairs) - 1 pair for 1 year);
- woolen covers for the stump of the thigh (for disabled people using small wheelchairs) - 3 pairs for 1 year);
.

8. Special devices for reading “talking books”, for optical correction of low vision.
A competitive selection of supplier enterprises has not yet been carried out.
Special devices for reading “talking books,” according to the Indicative List, include a specialized tape recorder for “talking books” of various modifications of domestic production and a specialized tape player for listening to “talking books” of various modifications of domestic production. The justification for inclusion in the IPR may be a limitation of the ability to learn II degree, communicate II, III degree, work activity II degree in case of impaired visual functions of the 3rd and 4th degree associated with diseases, consequences of injuries to the organ of vision, leading to low vision or blindness. Terms of use - 7 years.
For information and use in work, it is possible to take into account the letter of the President of the VOS A.Ya. Naumyvakin dated March 10, 2006 No. 1/10-21 to the chairmen of the RO VOS and regional branches of the FSS of the Russian Federation with a proposal to provide disabled people with a universal recording device TKD-K for listening to books on cassettes and CDs with the function of recording on cassettes, including with a CD player in four-track format (based on the Panasonic RX29 radio) (Price 5,700 rubles). This device allows you to play talking books recorded on cassettes, dub from a CD to a cassette (4 tracks), listen to music recordings on cassettes and CDs in stereo mode, as well as record from a microphone and other external source; has a built-in radio receiver.
Special devices for optical correction of low vision, according to the Indicative List, include:
a) 4-, 8-, 10-fold magnifying glasses (limitation of the ability to communicate II degree, learn II degree, work activity II degree in case of visual impairment of 3, 4 degrees due to disease, consequences of trauma to the organ of vision leading to low vision or blindness; b) hyperocular glasses (spectacle correction) (limitation of ability to orientation I, II degrees, communication I, II degrees, self-care I, II degrees, movement I, II degrees, learning I, II degrees, labor activity I, II degrees , in case of impairment of visual functions of 2, 3, 4 degrees due to disease, consequences of trauma to the organ of vision, leading to low vision or blindness;
c) contact lens (limitation of the ability to learn, work, self-care, movement, communication in case of visual impairment of 2, 3, 4 degrees due to refractive error, keratoconus, corneal dystrophy; d) intraocular lens (limitation of the ability to learn, work, movement in case of visual impairment of 2, 3, 4 degrees due to aphakia, cataracts; as necessary;
It is also possible to take into account the above-mentioned letter from the President of the All-Russia Organization A.Ya. Naumyvakin, proposing to provide disabled people with, among other things, a hand-held video magnifier ERVU-RM (a compact hand-held optical-electronic magnifier specifically for people with disabilities with visual acuity of 0.005. In shape and size it resembles a computer mouse, connects to a standard TV using the included adapter and cable (provides 21x magnification of text on a 20" TV screen).
Terms of use - 5 years.
9. Providing disabled people with guide dogs and equipment
regulated by the “Rules for providing disabled people with guide dogs, including the payment of annual compensation for the costs of maintaining and veterinary care of guide dogs,” approved by Decree of the Government of the Russian Federation of November 30, 2005 No. 708 (hereinafter referred to as the Rules).
There is no clear regulatory framework for medical indications, however, the Resolution of the Presidium of the Central Board of the Supreme Council of October 31, 1960 No. 28-2 approved the Instruction on the procedure for the distribution and use of guide dogs for the blind, according to which guide dogs are intended to ensure movement (in cities and rural areas) disabled people of group I, mainly working, without vision or with such residual vision that does not allow them to independently navigate in space. A set of special equipment (collar, leash, harness, muzzle, brush and comb) is provided free of charge with the dog.
The Rules do not provide for the provision of IPR for payment of compensation by a disabled person who has a guide dog for free use. When submitting an application to the Fund, a disabled person submits a passport of the disabled person or an authorized person, as well as a standard passport for the guide dog.

10. Medical thermometers and tonometers with speech output.
A competitive selection of supplier enterprises has not yet been carried out.
Tonometers with speech output, according to the above-mentioned Indicative List, are intended for people with disabilities with limited ability to self-care of I, II, III degrees with impaired visual functions of 3, 4 degrees due to disease, trauma of the organ of vision leading to blindness; terms of use 7 years;
According to BOS proposals, the most convenient device, which has been tested in Russian medical institutions and approved for use in Russia, is the TT-01 electronic tiflotonometer (TT-01P) with speech output of readings (TT-01P - with a memory for 14 readings).
The proposed medical thermometer is the DX6623B Medical Electronic Thermometer with Speech Output. Does not contain glass components or mercury, power consumption 50 mW (for voice messages). Weight 23g (with AG 12 batteries). Terms of use: 7 years.

11. Light and vibration sound alarms are classified as hearing aids (for people with hearing and speech impairments).

According to the above-mentioned Indicative List, these TSRs include a light telephone signal indicator, a vibrator and a strobe light for connecting to an alarm clock, doorbell and telephone bell.
Indications are impaired ability to communicate and orientation associated with impairment of auditory functions of the 3rd, 4th degree due to disease, consequences of trauma to the hearing organ, leading to hearing loss.
Terms of use - 5 years.
12. Hearing aids, incl. with custom made ear tips
They belong to the category of audiovisual aids (for people with hearing and speech impairments), and are available in various modifications (internal, behind-the-ear with automatic volume control, electronic, etc.), domestic and imported.

Terms of use: hearing aids - 4 years; custom made earmolds - 1 year.

13. Televisions with teletext for receiving programs with closed subtitles.
We do not have information about the types or brands of such products. Terms of use - 7 years.

14. Telephone devices with text output, i.e. text telephones can be recommended for people with disabilities with limited ability to communicate, orientation of the second degree, impaired hearing functions of the 3rd, 4th degree due to illness, consequences of injuries to the hearing organ, leading to hearing loss. Terms of use: 7 years.

15. Voice-producing devices are classified as hearing aids (for people with hearing and speech impairments).
According to the above-mentioned Indicative List, they are prescribed to disabled people with learning disabilities of I, II degree, labor activity of I, II degree, communication of I, II degree in case of impairment of voice-forming functions of the 4th degree due to illness, consequences of injuries of the larynx that led to impairment of voice formation; terms of use are 5 years.

16. Special means for violations of excretory functions (urine and colostomy bags) -
body care items - are included as TSR in the IPR of disabled people with limited ability to self-care of I, II, III degrees with disorders of visceral functions (pelvic organs) of 3, 4 degrees due to diseases or consequences of injuries to the pelvic organs, central nervous system with fecal or urinary incontinence . They are means of individual selection, and the choice of product model, as well as the size of the stoma, are determined by the location of the stoma. An opinion on the necessary modification and model of the product can be given by specialists (surgeon, oncologist, etc.) from an inpatient (before and after ostomy surgery) or outpatient clinic.
The performing enterprises produce the following types of products: one-component colostomy bags (for stoma diameters up to 60 mm and over 60 mm) and ileostomy bags (stoma size up to 60 mm); two-component ileostomy colostomy bags (stoma size over 60 mm) and two-component urostomy urinal bags (stoma diameter up to 60 mm).
Bureau specialists make a note in the IPR about the need for a colo- or urinal bag of a specific name and size (diameter) of the stoma.
Auxiliary products include numerous deodorants, protective creams and powders, protective films, wipes with various types of impregnations, sealing rings and pastes.
Security standards in accordance with the Terms of Use:
- two-component colostomy bags and urinal bags (with a plate and a bag): for plates up to 10 pcs. for 1 month; for ileo- and urostomy bags - up to 30 pcs. for 1 month; for colostomy bags - up to 90 pcs. for 1 month;
- one-component colostomy bags and urinal bags: ileo- and urostomy bags - for 30 pcs. for 1 month; for colostomy systems and children's colo- and urine collection systems - up to 90 pcs. for 1 month;
- clips for open bags - up to 2 pcs. for 1 month;
- belt for colo- and urinal bags - up to 2 pcs. for 1 year;
- sealing paste for colostomy or urine bag - 1 tube for 1 month;
- absorbent powder - 1 bottle for 1 month;
- protective cream - 1 tube for 1 month;
- protective film - 1 package for 1 month;
- cleaner - 1 bottle for 1 month;
- plastic colostomy bag on the belt, complete with bags - up to 6 pcs. for 1 year;
- catheters for ostomies, catheters for self-catheterization - up to 120 pcs. for 1 month;
- urine collection device included:
urocondoms up to 30 pcs. for 1 month;
day and night urine collection bags - for day leg bags - up to 4 pcs. for 1 month; for night leg bags - up to 2 pcs. for 1 month;
straps for attaching the leg bag to the leg - up to 2 pairs for 1 month.

17. Absorbent underwear, diapers.
Refers to body care items, prescribed to disabled people with limited ability to self-care of I, II, III degrees.
The total number of products paid for from the federal budget is up to 90 pieces. for 1 month (for polyuria syndrome - according to individual medical indications, up to 150 pieces for 1 month). The IPR indicates the type of product, size and degree of absorbency.
Absorbent underwear includes absorbent diapers (for additional protection of bedding) of various sizes and degrees of absorbency, urological pads and liners (to protect the clothing of bedridden and mobile disabled people), panties (mesh pants, elastic (for fixing pads and liners).
Pampers (diapers) are produced both for adults (for severe urinary and fecal incontinence for bedridden and mobile disabled people) and for children (for urinary and fecal incontinence).
For adults, diapers are indicated by size (S, M, L, XL) and absorbency (medium, high). The IPR must indicate the volume of the hips. When U = 50-80 cm, a small (S) size of diapers is prescribed, but they can be of medium (~830 ml) or high (~1300 ml) degree of absorbency; When U = 70-120 cm, the average (M) size of diapers is assigned, but they can be of medium (~1170 ml) or high (~2230 ml) degree of absorbency; When U = 100-150 cm, a large (L) size of diapers is prescribed, but they can be of medium (~1450 ml) or high (~2400 ml) degree of absorbency; When U= more than 150 cm, a very large (XL) size of diapers is prescribed, but they can only be of a high (~3200 ml) degree of absorbency;
For children, universal diapers are recommended for children of different age groups; The size is indicated according to the child’s weight (3-5kg, 5-10kg, 8-18kg, 15-30kg).
Can be recommended in varying quantities for night and day.

Absorbent diapers as additional protection for bedding.
Disabled people are provided with diapers of three sizes and varying degrees of absorbency:
Sizes 40 by 60 (absorbency 550 or 750 ml), 60 by 60 (absorbency 940 or 1150 ml), 60 by 90 (absorbency 1525 or 1750 ml).
Urological pads and liners:
- for mild and moderate incontinence in mobile disabled people) urological pads (for women) and urological inserts (for men);
- for moderate and severe incontinence in bedridden and mobile disabled people;
The dimensions and degree of absorption are indicated in accordance with the information letter of the regional branch of the FSS of the Russian Federation (they depend on the products supplied by enterprises that passed the competitive selection in the corresponding year). Panties (mesh, elastic panties) are recommended to secure any pads and liners.

18. Chairs with sanitary equipment,
as a means for the discharge of natural needs, it can be prescribed to disabled people with limited ability to self-care II, III degree in violation of static-dynamic functions, circulatory functions, breathing, digestion (liver), urination (renal failure), mental functions.
Terms of use 4 years.
Medical indications may include:
- diseases, consequences of injuries and deformations of the lower extremities, pelvis and spine with dysfunction;
- hemiplegia;
- paralysis of the lower limbs;
- pronounced, significantly pronounced tetraparesis;
- pronounced, significantly pronounced triparesis;
- pronounced, significantly pronounced lower paraparesis;
- pronounced, significantly pronounced hemiparesis;
- pronounced, significantly pronounced vestibulo-cerebellar disorders;
- pronounced, significantly pronounced amyostatic disorders;
- pronounced, significantly pronounced hyperkinetic disorders;
- diseases of the cardiovascular system with stage 3 circulatory failure or angina pectoris IV class;
- respiratory diseases with respiratory failure of the 3rd degree;
- liver diseases with dysfunction of the 3rd degree with portal hypertension and ascites;
- kidney disease with stage 3 chronic renal failure;
- severe mental disorders (dementia).
A competitive selection of supplier enterprises has not yet been carried out. There are various modifications of this product: without wheels, on 4 wheels, with a toilet lid, with adjustable legs.

Providing disabled people and veterans with technical means of rehabilitation, provided for by the Federal List, is carried out in accordance with the “Rules for providing, at the expense of federal budget funds, disabled people with technical means of rehabilitation and certain categories of citizens from among veterans with prostheses (except dentures), prosthetic and orthopedic products”, approved by a resolution of the Government of the Russian Federation dated December 31, 2005 No. 877.
The terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement were approved by order of the Ministry of Health and Social Development dated April 12, 2006 No. 282. Previously, the terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement, approved by order of the Ministry health and social development dated October 17, 2005 No. 638.
Repair of TSR, issued free of charge or purchased at one’s own expense with subsequent compensation, as well as replacement after the expiration of the period of use or the impossibility of repair, are carried out without IPR, at the request of the disabled person (paragraphs 7, 8). Early replacement of TSR is also possible based on the conclusion of the ITU Bureau.
The list of technical means of rehabilitation that are not subject to surrender after the expiration of their use period was approved by order of the Ministry of Health and Social Development dated April 12, 2006 No. 283.
You should focus on information letters from regional branches of the Social Insurance Fund about technical means of rehabilitation supplied by enterprises that passed the competitive selection in the corresponding year.

The majority of citizens who suffer illness or injury are unable to perform any actions without outside help or without the use of technical means of rehabilitation (TSR). Most often this is due to negative changes in the musculoskeletal system. The legislation of the Russian Federation provides. These measures include a number of different benefits, the most important of which include benefits for the purchase of medicines, medical care and the provision of individual means of rehabilitation for people with disabilities.

Legislative framework and special program for disabled people

Providing assistance to persons with disabilities is regulated by a number of government acts. Most of them were adopted in the 90s, so many articles of these laws have been repeatedly changed and supplemented.

Benefits provided to disabled people according to federal law and order of the Ministry of Labor

All benefits to which persons with disabilities are entitled are specified in the following documents. This is the Federal Law on Disabled Persons No. 181-FZ dated November 15, 1995, in the latest edition dated December 14, 2015 and the Decree of the Government of the Russian Federation on provision of disabled people TSR No. 240 dated April 7, 2008, in the latest edition dated December 7, 2015 2016 Issues about technical means of rehabilitation are discussed in more detail in Order of the Ministry of Labor No. 374 “n” dated July 18, 2016.

Classification - main and auxiliary means

It is very important for disabled people to receive technical means of rehabilitation. Classification - such means can be primary or auxiliary. Without basic aids, the patient cannot perform essential basic activities, such as movement and bowel movements. Assistive devices can be used in the process of rehabilitation and preparation of a disabled person for integration into social structures.

If for some reason the social protection department cannot provide a disabled person with the technical equipment he needs, he can purchase it on his own. Its cost will be paid only if the application for the provision of rehabilitation means has been officially registered with the relevant service. If the necessary equipment was purchased before submitting the application, its cost will not be paid.

List of technical means

Technical means of rehabilitation include the following devices:

• canes, crutches and other support products;
• manual and electric wheelchairs;
• various types of prostheses;
• special shoes;
• devices for grasping and holding objects;
• armchairs and chairs equipped with sanitary equipment.

One of the innovative developments – prostheses with bionic control – is being considered as a means of rehabilitation for people with disabilities. Such devices are still undergoing laboratory tests, but in the near future we can expect them to appear in medical centers.

Group of personal hygiene products

Personal hygiene products are included in a separate group of products. These include:

• urine and feces receivers;
• absorbent underwear with absorption function;
• special bedding;
• diapers.

For disabled people with visual, hearing and speech impairments, electronic technical means for self-service are provided:

• optical correctors for persons with severe visual impairments;
• e-books with voice text synthesizer;
• “talking” instruments for measuring pressure and temperature;
• speech synthesizers;
• vibration and light signaling devices for the deaf;
• individual hearing aids;
• TVs equipped with the Teletext function;
• telephones with information display.

In addition, for the rehabilitation of disabled people, they can be provided with guide dogs with additional equipment. To do this, a citizen who needs such a dog must write an application to the social service. After a certain time, he will be given a dog from the kennel. The dog’s food and treatment is provided from the funds of the social body.

If a dog is given or purchased, the state does not compensate for the costs of its maintenance.

Previously, technical means included special cars or motorized wheelchairs for disabled people, but since 2005 this benefit has been suspended.

Providing repair work

In accordance with Law No. 30-FZ dated March 7, 2017, changes and additions were introduced to Government Resolution No. 240. All work on the repair of rehabilitation technical equipment is carried out without a queue and free of charge. If a technical device cannot be repaired for any reason, it must be replaced free of charge. Early replacement of a product may require technical expertise, which is also provided free of charge.

Almost every region has municipal laws on supporting persons with disabilities. They may provide additional benefits to people with disabilities.

List of medications - how to get them

For persons with disabilities, medications are prescribed, including potent ones, which are provided with appropriate discounts or free of charge. This benefit is regulated by the list of medicines. This list was determined by Decree of the Government of the Russian Federation No. 2782 “r” dated December 30, 2014 and was increased by 25 names of medicines in 2017. This list includes the following groups of drugs:

• opioid analgesics;
• non-narcotic painkillers;
• gout remedies;
• anti-inflammatory drugs;
• antiallergenic and anticonvulsant drugs;
• agents for the treatment of Parkinson's disease;
• anti-anxiety medications and antidepressants;
• drugs affecting the central nervous system;
• antibiotics and synthetic antibacterial agents;
• antiviral and antifungal drugs.

There are two large groups of funds that affect cardiovascular system and gastrointestinal tract. One of the diseases for which you can receive a disability group is a sharp decrease in the level of insulin in the blood, therefore, for many disabled people, diabetes treatment is important and provided free of charge.

The list of medications that a disabled person can receive free of charge, but only by decision of a medical commission, includes a large group of medications. Some of them are narcotic or expensive foreign-made drugs and can be obtained in pharmacies with a special prescription.

A disabled person has the right to receive free of charge not only special means for self-care and care and other means of rehabilitation, but also services for their repair. For disabled people who need prosthetics and orthotics, such services are also provided free of charge.
The terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement are approved by order of the Ministry of Health and Social Development of the Russian Federation dated December 27, 2011 No. 1666n.
As a rule, the period of use of a technical rehabilitation device, prosthesis and prosthetic-orthopedic product is calculated starting from the date of its actual provision to the disabled person. If a technical device or prosthetic-orthopedic product breaks down, it is subject to free repair. After the expiration of its service life, the old device or product, at the request of the disabled person, must be replaced with a new one.
Order of the Ministry of Health and Social Development of the Russian Federation dated August 21, 2008 No. 438n approved the Procedure for the implementation by the executive body of the Social Insurance Fund of the Russian Federation of medical and technical expertise to determine the need for repair or early replacement of technical means of rehabilitation, prostheses, prosthetic and orthopedic products.
If a technical device or prosthetic-orthopedic product is faulty, the disabled person needs to submit an application to the Social Insurance Fund of the Russian Federation.
At the place of residence On conducting a medical and technical examination of this product or product.
The application is submitted by the disabled person or his representative in writing. Along with the application, the required product or product is presented. Please check for repairs or early replacement.
Sometimes the product or product is not provided before. becomes possible, for example, due to the difficulty of transportation or the health status of the disabled person. In this case, the disabled person needs to first obtain a conclusion from a medical institution (for example, about the impossibility of removing the prosthesis before receiving a new one) before contacting the Social Insurance Fund of the Russian Federation.
At the request of a disabled person, the body of the Social Insurance Fund of the Russian Federation may decide to conduct a medical and technical examination with a specialist expert visiting the disabled person’s home. For example, this is useful when a wheelchair is faulty.
The body of the Social Insurance Fund of the Russian Federation, which has received an application from a disabled person, must set a date for conducting a medical and technical examination and notify the disabled person of the exact time and place of its conduct. A disabled person has the right to take part in this examination at his own request. A disabled person must indicate his desire or unwillingness to take part in the examination in an application.
The maximum period during which the application is considered and the examination is carried out is 15 days from the date of receipt of the application. The experts draw up a conclusion that assesses the performance status of the technical equipment of the product, its compliance with the required functional parameters, medical purposes and clinical-functional requirements, the causes of breakdown or malfunction.
In the final part of the conclusion, the expert indicates whether the repair of a technical device or product is appropriate. If repairs are impractical (that is, too expensive compared to the cost of a similar new product) or impossible, then a conclusion is made about the need for early replacement of the technical device or product.
The conclusion indicates an organization that can carry out repairs or manufacture a new product or product. One copy of the medical-technical examination report is given to the disabled person against signature.
In addition, blind disabled people can be provided with guide dogs with a set of equipment that are included in the technical means of rehabilitation included in the federal list.
A disabled person who has a corresponding recommendation in an individual rehabilitation program can receive a guide dog by submitting an application to the Social Insurance Fund. An application for provision of a guide dog is submitted by a disabled person or a person representing his interests to the body of the Social Insurance Fund of the Russian Federation in accordance with the general procedure, which is discussed in the chapter “Free provision of technical means of rehabilitation.”
The rules for providing disabled people with guide dogs were approved by Decree of the Government of the Russian Federation of November 30, 2005 No. 708. This decree states that in the event of the loss of a guide dog or its loss of qualities as a guide, the disabled person will be provided with another dog. The previous dog, which has lost its qualities as a guide, remains with him at the request of the disabled person, that is, it is transferred to the property of the disabled person.