Medical examinations of drivers: pre-trip, current, post-trip

Many people are terrified of air travel. They are frightened by the fact that they will be at a great height, and if something happens, there is practically no chance of salvation.

But few people know that airplanes are one of the safest modes of transport. Much more dangerous is a banal car trip. Every year, about 200,000 accidents occur on Russian roads, killing more than 20,000 people.

The causes of car accidents vary, and the driver’s health plays a significant role. If a person was driving a personal vehicle and an accident occurred through his fault, he is personally liable. If the driver of the employer’s car gets into an unpleasant situation, other persons will also be to blame.

The employer is required by law to provide safe working conditions for the employee. In the case of the driver, safe driving conditions. The person driving must feel well, be of sound mind, and not take alcohol or illegal substances.

The law provides for three types of honey. driver inspections:

1. pre-trip,
2. current (periodic),
3. post-voyage.

Why are driver medical examinations needed?

The list of specialists that you need to go through to get a driver’s license for 5 years is limited. For admission to the professional field, an extensive medical examination of vehicle drivers is required.

Pre-trip inspection of drivers

The driver not only drives passenger vehicles; his professional responsibilities may include driving a forklift, truck, or bus. If, due to a sharp deterioration in health, the equipment is left without control, a large number of people, both inside the vehicle and on the street, are at risk.

Due to production factors, an employee’s health may deteriorate within a short period of time. Therefore, it is necessary to exclude exposure to harmful working conditions at the frequency established by the safety instructions.

Blood certificate

It all started in April 2021, when the Ministry of Health posted a new procedure for obtaining a medical certificate for public discussion. It introduced a mandatory requirement for all drivers to undergo urine and blood tests at a drug dispensary. Urine was going to be taken for testing for the presence of psychoactive substances, and blood was going to be taken for carbohydrate-deficient transferrin (CDT) determination. This is a specific marker that shows regular alcohol load. If a person drinks every day to the point of intoxication, then the analysis will show this.

Tests are expensive. The first one is about 3 thousand rubles, the second one is about 6 thousand. In addition, they are not made quickly. Thus, the cost of a driver’s certificate increases significantly, and the time frame for receiving it extends for a week.

The document also spelled out a strange limiting threshold for CDT content - 1.2 percent. But even in the instructions for this extremely expensive analysis, the value of 1.2 is stated as normal, taking into account errors. If medical certificates began to be issued strictly according to the original version of the order, then all drivers, with rare exceptions, in our country would become suspected of alcoholism. And they would additionally and for a fee have to prove that they do not suffer from this disease.

At the public hearings, no one paid attention to this document. But when the order was approved and it became known that it would come into force on November 22, 2021, panic began. There were kilometer-long queues at the medical commission to get certificates according to the old rules. There were deaths - one person died in line. The scandal flared up so much that even Russian President Vladimir Putin rather sharply criticized the innovation.

After the innovation, the cost of a driver’s medical certificate will increase to 9 thousand rubles, and the time frame for obtaining it will extend for a week

The Ministry of Health issued a new order on November 21, postponing the implementation date of the scandalous regulations to July 1, 2021. Literally a month later, the department submitted for public discussion a draft of a new medical examination procedure, in which expensive and time-consuming tests had to be taken only from those who have severe symptoms or disease conditions that are a contraindication to driving. At the same time, the name of the expensive CDT test was removed from the text of the order. Instead, a “diagnosis of alcohol use” is prescribed. That is, if the symptoms are severe, the doctor will choose the diagnostic method available to him. It is not necessary to use only CDT if, for example, the clinic does not have such equipment.

But by July 1, despite positive feedback during public discussions, the new order had not been adopted. Instead, a new order appeared, which postponed the entry date of the old one, with controversial and expensive tests, to January 1, 2021. There are 25 days left until “H” time.

After July 1, the Ministry of Health repeatedly stated that a new procedure, in which these tests are mandatory only for those with pronounced symptoms of the disease, has already been developed and is about to be adopted. However, January 1 is just around the corner, and the new document is not yet in sight.

Let us remind you that experiments with driver’s medical certificates have never led to any success. When, in order to obtain a medical certificate, it was made mandatory to visit drug and mental health clinics at the place of residence, the latter immediately introduced a mandatory paid electroencephalogram for everyone, although the order of the Ministry of Health did not provide for it. After numerous complaints and scandals, the Ministry of Health issued a new order, which provided for a mandatory electroencephalogram only for those who work as drivers. However, mental health centers were in no hurry to implement the new order, and complaints continued to arrive.

Now the situation on the front of obtaining medical certificates is still calm, but uncertain. It is possible to add certainty to it, for example, by approving a new amended procedure for medical examination, in which normal drivers who do not abuse drugs and alcohol will not have to undergo this pointless, expensive and lengthy procedure for additional tests. Or again issue an order to postpone the date of entry, since the new order has not been approved for more than a year for unknown reasons. If this is not done in the near future, the rush demand for medical certificates will return again. And before the New Year, drivers and driver candidates, instead of standing in lines for gifts for their relatives, will stand in lines for a medical examination according to the old procedure that is still in effect.

No one argues that it is necessary to identify and prevent drug addicts and drunks from driving. But why do this at the expense of the money, time and nerves of those who do not suffer from such problems and who are the majority?

Let us remind you that a medical certificate is required to obtain a driver's license. That is, drivers who have not been caught drunk driving should receive it once every ten years when replacing their license due to their expiration. Those who want to open a new category will have to receive it ahead of schedule. After all, the certificate is valid for only a year.

Also, those who have been deprived of their license for driving while intoxicated or for refusing a medical examination will need to receive it ahead of schedule. Additional tests will not harm these drivers.

Which drivers need medical examinations and how often?

Pre-trip technical inspection of vehicles

According to the law, drivers are subject to periodic examination related to:

• transportation of passengers;
• transportation of food products;
• working at night;
• contact with disinfectant solutions, medicines, household chemicals.

Important! Working drivers undergo a health check once every 2 years.
If the employee is under 21 years old or has a chronic disease, then annually.

What specialists should you contact?

The new procedures have significantly reduced the number of doctors whose opinions are required to pass a driver’s medical examination. Thus, applicants for the most common categories need to be examined by only four specialists. However, at the direction of the therapist, they may be referred to other doctors.

So, for drivers with categories A, A1, B, BE, B1, M, the following medical commission is provided:

• Mandatory examination: psychotherapist, narcologist, ophthalmologist, therapist.
• As prescribed by a therapist - a neurologist.
• As prescribed by a neurologist - EEG.
• On the direction of a narcologist - a urine/blood test.

As for professional drivers, they will have to undergo a more serious medical examination. Applicants of categories C, CE, C1, C1E, D, DE, D1, D1E, Tm, Tb must undergo the following examination:

• Required: therapist, narcologist, ophthalmologist, otolaryngologist, psychotherapist, neurologist, as well as an EEG.
• If you are referred for a medical examination by a narcologist, you will need to submit your urine/blood for analysis.

If a driver intends to test for several categories of license at the same time in the near future, then he should notify doctors about this in advance so that, if necessary, he can immediately undergo a more extensive commission. This will help save money - you won’t have to spend money on going through the same specialists during a second medical examination for a new category of rights. However, in this case, you need to have time to pass all the necessary driving tests within a year. After all, this is how long certificate No. 003 is valid.

Types of medical examinations

Who can conduct a pre-trip medical examination of drivers?

Depending on the scope of the health check, the following types of examinations are distinguished:

• pre-trip;
• current;
• post-voyage.

The first and last types are held every flight. How often drivers must undergo periodic medical examinations is established by law, the period is once every 2 years. After work, certain categories of drivers should also be examined by a specialist in order to prevent and make cases of drunkenness in the workplace less common.

For professional drivers

Periodic medical examination of drivers is a mandatory procedure for professionals, for whom Russian legislation imposes stricter requirements than for ordinary car owners. Penalties are imposed for any violation of the prescribed procedure.

Let's look at specific examples from legislation:

• According to clause 4 of Federal Law No. 437, clause 1 of Art. 213 of the Labor Code of the Russian Federation introduces mandatory periodic inspection of drivers in the entire range of motor transport enterprises. Regardless of the distances that drivers cover, the type of vehicle they drive. The rule applies not only to ATPs with a large staff, but also to individual entrepreneurs.
• Part 7 art. 213 of the Labor Code of the Russian Federation indicates that driver’s medical examinations at the enterprise are paid not by the drivers themselves (as is the case with vehicle owners), but by their employers.

Preliminary medical examination

Control of vehicle vehicles

Preliminary medical examination is an examination of the applicant to determine suitability for the job. Before the examination begins, the occupational safety department prescribes the harmful factors that the employee will encounter. This determines the list of doctors to go through.

Rules for conducting periodic medical examinations

Preliminary, as well as periodic medical examination of vehicle drivers, must be carried out with the conclusions of the following specialists:

• therapist (with test results);
• neurologist;
• narcologist-psychiatrist;
• for women – a gynecologist, after 40 years – a mammologist;
• surgeon;
• otorhinolaryngologist;
• ophthalmologist;
• dermatovenerologist;
• according to indications - endocrinologist.

If a person undergoing a preliminary and periodic medical examination of drivers in an organization meets the proposed position in all respects, the employer enters into an employment contract with him.

Important! If occupational diseases or hazards associated with fulfilling labor obligations are detected, the applicant is not allowed to work. At the same time, he retains the right to drive a passenger car if it is not related to work activities.

When drivers are not allowed on a flight:

The driver's pre-flight medical examination ends in inadmissibility when:

• temporary disability of the worker was established. Signs - dizziness, high temperature, nausea, vomiting, upset stomach, high blood pressure, the onset of acute respiratory viral infection. In this case, the driver is sent to the hospital for examination, after which he may be sent on sick leave or allowed to “rest for a day” (according to a certificate).
• the test for alcohol or drugs was positive. The health worker’s procedure is as follows: draws up the relevant documents, samples of which are given in the methodological recommendations of the Ministry of Health (you can download the article at the beginning), and sends the driver to the hospital to undergo specified tests.
• The health worker noted the effect on behavior and reaction rate of medications that the driver takes when treating a general illness.

Pre-trip and post-trip medical examination

Pre-trip control includes measuring blood pressure, pulse, temperature, and checking the driver for sobriety. Before starting a shift, a person contacts a medical institution with which a corresponding agreement has been concluded, or an employee of the organization designated for permission to work. Which clarifies the presence of complaints about well-being, paying attention to the reaction of the pupils to light, rate of speech, and the presence of foreign odors. If all indicators are normal, the person in charge puts a mark on the clearance on the waybill.

After finishing work, some freight forwarders also undergo a health check. This is a disciplinary factor to prevent alcohol consumption during a shift. On the other hand, people with chronic diseases need regular examinations in order to promptly prevent exacerbations. The inspection sequence is the same as before the shift.

Post-trip inspection stamp

Passing the “new” medical examination

Let's look at the nuances of passing medical examinations for car owners in 2021:

• As before, you should contact only medical institutions authorized to conduct such medical examinations.
• The car owner must have a passport of a citizen of the Russian Federation with him. As for nonresident citizens, they must additionally present a certificate of temporary registration.
• Real car owners provide their driving license for the next medical examination. As for professionals, they must also present the conclusion issued at the previous examination.
• As before, the certificate is drawn up and issued by a general practitioner. The specialist analyzes the conclusions of other doctors and the results of examinations completed by the driver.
• The narcologist retains the right to prescribe a urine/blood test to rule out drug use or chronic alcoholism.
• If a psychiatrist discovers signs of diseases that make driving a vehicle dangerous, he has the right to order a psychiatric examination of the driver.
• The result of the medical examination is a certificate of standard form No. 003 with a physician’s conclusion on the suitability of this driver to drive a vehicle of a certain category.

How to equip a room for pre-trip medical examinations of drivers

To conduct a pre-trip inspection, you do not need sophisticated equipment. To obtain the right to carry out examinations, you need to allocate a room for work. It must meet the requirements:

• height more than 2.6 m;
• area more than 12 m2;
• have combined lighting;
• Windows must have protection against overheating;
• all surfaces must be smooth, easily treated with disinfectants;
• seams and joints of linoleum or other type of covering without protruding edges.

During the examination you will need medical equipment and products:

• tonometer;
• breathalyzer;
• thermometer;
• phonendoscope;
• emergency stowage;
• disposable spatulas;
• rapid tests for alcohol and potent substances.

The office should have additional equipment:

• table;
• chair;
• couch;
• wardrobe for outerwear;
• coat hanger;
• rug;
• safe;
• room for studying biological material.

Important! The employee conducting the examination must have a medical education as a nurse or paramedic and complete an examination course.

What changes in the procedure for conducting medical examinations does the Ministry of Health promise in 2021?

The Ministry of Health has prepared amendments to order No. 302n . It is unknown when they will be accepted. The bill is currently undergoing an independent anti-corruption review. The project entails major changes in the procedure for conducting medical examinations:

• The health passport may be cancelled, and the conclusion will indicate all the harmful factors that are contraindicated for the employee, as well as his health group. What is positive for the employer in the new project: he will be able to receive his own copy of the medical report, and not wait for the employee to provide him with this information upon request. This will make it easier and faster to remove an employee.
• The employer will be able to send an employee for a medical examination after long-term disability; currently he does not have such a right, and many employees abuse it.
• Clinics, with the permission of the employee, will transfer information about their health status to the Social Insurance Fund. It is also planned to take into account the results of the employee’s medical examination when conducting mandatory medical examinations. This is necessary to reduce the burden on medical commissions. However, whether this will affect the cost of medical examinations is unknown.
• A new term will appear for shift workers - mobile medical code . If the bill is passed, it will officially be allowed to conduct medical examinations on the road as part of a mobile team. This is not yet permitted, since medical services can only be provided at the address in the license. Time will tell how this will be implemented once the bill comes into force.

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Results of pre-trip and post-trip medical examinations of drivers

The employee conducting the survey must complete the appropriate paperwork. The following data is displayed there:

• Full name of the employee undergoing the examination;
• place of work;
• time of arrival for examination;
• blood pressure measurement results;
• pulse;
• breathalyzer readings;
• personal data of the person conducting the examination.

The inspection log must be laced, numbered, sealed and certified by the head of the institution conducting the admission.

Medical examination of drivers

When working in a taxi or any other organization related to transportation, you must be tested for the absence of alcohol vapor in your exhaled air. For this purpose, a breathalyzer is used, which is checked annually and approved for performance.

Important! Before the start of the shift, the device is turned on and warmed up. After pressing the power button and beeping, insert a disposable mouthpiece into the socket. The driver breathes until the beep sounds, then the device displays the result.

Medical examination of drivers

Where do the commissions take place?

Both public and private medical institutions have the right to issue certificates of passing a driver’s medical examination in Russia. But both of them must have a license to conduct such activities. Despite the fact that the driver can undergo a medical examination at any of these specialized institutions, a visit to a psychiatrist and narcologist means going only to a public clinic at the place of his registration or residence.

We have already discussed the cost of this service. Please note that obtaining a certificate from a narcologist and a psychiatrist is paid separately. An appointment with each of these specialists will cost you, on average, 300-1000 rubles. The price depends on the region of residence and the clinic you contact.

Governing legislation

The basis for a medical examination of any kind is legislative acts. The obligations of soldiers to undergo medical examinations are written in the Law “On Road Traffic Safety” No. 196FZ. A number of acts are associated with passing a medical commission and examination:

• labor code, art. 212, 213, 328, 76;
• types of medical examination – Art. 46 of Law 323FZ;
• Order of the Ministry of Health and Social Development No. 302n dated 04/12/11;
• No. 308 dated July 14, 2003;
• No. 835n.

Thus, drivers who get a job as an employee or as an individual entrepreneur are required to undergo several types of medical examination. Before leaving the line, they undergo an examination procedure to ensure that they are not at work in a sick or intoxicated state.

Who is responsible?

In short, everyone bears responsibility: the employee, the employer, and the doctor.

It is the driver’s direct responsibility to undergo an inspection before leaving the line. For violation of Article 11.32 of the Code of Administrative Offenses of the Russian Federation, a fine of 1000–1500 rubles is provided. For a medical worker, the fine will be 2000–3000 rubles.

Violation of the rules of labor protection and medical examinations will cost the employer the most: in accordance with the same article of the Administrative Code, you will have to pay 30,000 - 50,000 rubles.

The ProfMedLab medical center will undertake pre-trip and post-trip, ongoing medical examinations of drivers at your enterprise.

We know how to do this efficiently and quickly. Trust the professionals and be sure that law enforcement agencies will not have any complaints about the doctor’s notes and stamps in the documentation. Call us to discuss the terms of cooperation:

• For private individuals - reception phone number: +7 (495) 308-39-92.
• For legal entities - commercial department phone number: +7 (495) 120-81-30