40/2000 Sb.
DECREE
The Ministry of labour and Social Affairs
of 23 December 2003. February 2000,
amending the Decree of the Ministry of labour and Social Affairs No.
284/1995 Coll., implementing the law on the Pension Insurance Act, as amended by
amended
The Ministry of labour and Social Affairs shall lay down pursuant to § 108 paragraph. 1 of the law
No. 155/1995 Coll., on pension insurance, as amended by Act No. 136/1997
Coll.:
Article. (I)
In the Decree No. 283/1995 Coll., implementing the law on pension
insurance, as amended by Decree No. 157/1997 Coll. and Decree No. 302/1997
Coll., Appendix 2 is added:
"Annex 2
THE PERCENTAGE RATE OF DECLINE IN THE ABILITY OF CONTINUOUS EMPLOYMENT
Chapter I-
INFECTIOUS DISEASES AND PARASITIC DISEASES
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Viral infections and bacterial diseases | |
| | zoonoses, protozoal diseases, ricketsiózy, | |
| | helmintózy, fungal infection and its consequences | |
| | | |
| | The medical aspect: | |
| | | |
| | If the infectious disease goes in the long term | |
| | an adverse health condition, the rate | |
| | the continuous degradation of earning | |
| | activities according to the constituent functional | |
| | disability of the contested authority (System) and impact | |
| | on the overall performance of the organism. Jitter | |
| | health it is necessary to evaluate the average | |
| | rate. | |
+--------+----------------------------------------------+----------------------+
| | and with a functional form) limitations of light | |
| | degree and with a slight reduction in total | |
| | the performance of the body | 20-30 |
| +----------------------------------------------+----------------------+
| | b) moderate forms of disabled features | |
| | some organs or systems of the Middle | |
| | the degree or form of chronic, slowly | |
| | progressive, with a substantial reduction in total | |
| | the performance of the body | 40-60 |
| +----------------------------------------------+----------------------+
| | c) severe forms with serious and permanent | |
| | disorders of function of the affected organs | |
| | (systems), leading to a lasting and significant | |
| | reduce the overall performance of the organism, or | |
| | lengthy, highly active disease permanently, | |
| | defying treatment with severe total response | |
| | the organism | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+---------------------------------------------------------------------+
| 2. | Diseases of the human immunodeficiency virus (HIV) |
| | |
| | The medical aspect: |
| | |
| | HIV positivity without clinical symptomatology |
| | not expected to decline in the ability of systematic |
| | gainful employment. The accompanying mental symptoms |
| | shall be considered if they need special |
| | psychological or medical treatment |
| | psychiatric. |
+--------+---------------------------------------------------------------------+
| 2.1. | AIDS, or asymptomatic hedge |
| | virostatické therapy, with a slight reduction in |
| | the overall performance of 20-30 |
+--------+---------------------------------------------------------------------+
| 2.2. | AIDS, with mild or occasional clinical |
| | symptoms, with a substantial reduction in total |
| | the performance of the organism, 40-50 |
+--------+---------------------------------------------------------------------+
| 2.3. | AIDS, fully developed, with orgánovými |
| | complications and failure of immunity of 70-80 |
+--------+---------------------------------------------------------------------+
Chapter II-
BLOOD AND BLOOD-FORMING ORGANS
General evaluation policy:
The rate of decline in the ability of continuous employment for the diseases of the blood and
hematopoietic organs shall be determined according to the scale and severity of the disease,
established clinical stage and severity of the changes, according to the disorders
organ functions, as exposure to other authorities and under the influence of the
overall condition. The forecasting criteria are used to determine the risk of relapse and
estimation of the disease process. It is necessary to take into account the reviews
performance status according to the Karnofského index (KPS).
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | The loss of the spleen (without the presence of blood disease | |
| | and without complications) | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Chronic leukemia (lymphoid, myeloid) | |
+--------+----------------------------------------------+----------------------+
| | and with minor symptoms) or in remission (no | |
| | significant problems, without the overall symptoms | |
| | without treatment, without signs of haematological | |
| | progression-free survival), handles the normal social and work | |
| | things to do, KPS to 90 | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) with mild clinical and | |
| | the laboratory, with a slight reduction in total | |
| | the performance of the organism, normal life things to do | |
| | partially restricted, KPS to 70 | 25-40 |
| +----------------------------------------------+----------------------+
| | c) moderate clinical manifestations, medium | |
| | heavy restrictions on normal life | |
| | KPS to 60 | 50-60 |
| +----------------------------------------------+----------------------+
| | (d)) with distinctive manifestations (anemia under 100 g/l | |
| | HB, thrombocytopenia below 80, 000/mikrol, | |
| | the lack of antibodies, strong zoom | |
| | of the spleen) with a significant reduction in total | |
| | the performance of the organism, the activity | |
| | responsibility of healing | |
| | with repeated hospitalizacemi, common things to do | |
| | severely limited, KPS less than 50 | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Plasmocytom (myeloma) | |
+--------+----------------------------------------------+----------------------+
| | and with minor symptoms) or in remission (no | |
| | a significant effect on the overall State, without | |
| | Hematology treatment, no signs of progression-free survival) | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) with mild clinical and | |
| | the laboratory, with a slight reduction in total | |
| | the performance of the body | 25-40 |
| +----------------------------------------------+----------------------+
| | c) moderate, moderate | |
| | limitations of everyday life activities | 50-60 |
| +----------------------------------------------+----------------------+
| | (d)) with severe manifestations, extensive forms of highly | |
| | Active (osteolysis, anemia under 100 g/l of Hb | |
| | pain that requires continuous analgesia | |
| | treatment, severe functional limitations, restrictions | |
| | momentum) | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Hodgkin's Lymphoma (lymfogranulóm), primarily | |
| | localized non-Hodgkin's lymphoma | |
| | | |
| | The medical aspect: | |
| | | |
| | After their treatment is necessary to haematological | |
| | usually wait for two years to reach | |
| | stabilisation of health, (complete | |
| | remission), then determine the rate of decline in skills | |
| | continuous employment. | |
+--------+----------------------------------------------+----------------------+
| | and with minor symptoms) or in remission, | |
| | with clinical and laboratory findings, positive | |
| | light the subjective difficulties, KPS 90 | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) with mild symptoms or in remission, with clinically | |
| | and laboratory findings, stationary | |
| | with a significant reduction in overall performance | |
| | the organism, KPS of 70 | 25-40 |
| +----------------------------------------------+----------------------+
| | (c) significantly reduced) immunological resistance | |
| | and with a significant reduction in overall performance | |
| | the organism, KPS 60 | 50-60 |
| +----------------------------------------------+----------------------+
| | (d)) with severe manifestations of clinical and | |
| | the laboratory, a large, active, | |
| | systematic treatment, with severe alterations | |
| | total State | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Myeloproliferative disease | |
| | (e.g., polycythaemia, thrombocythemia, | |
| | Myelofibrosis) | |
+--------+----------------------------------------------+----------------------+
| | and) with minor manifestations, in good overall | |
| | stavu | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) with mild symptoms and laboratory | |
| | clinical, with a slight reduction in total | |
| | the performance of the body | 20-40 |
| +----------------------------------------------+----------------------+
| | (c)) with moderate symptoms (anemia under 100 | |
| | g/l, Hb, thrombocytopenia below 80, 000/mikrol, | |
| | enlargement of the spleen, polycythaemia), with substantial | |
| | by reducing overall performance | 50-70 |
| +----------------------------------------------+----------------------+
| | (d)) with severe symptoms and laboratory | |
| | clinical and with severe alterations | |
| | the overall State, requiring | |
| | systematic treatment | 80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Therapeutic removal of the spleen for | |
| | haematological diseases | |
+--------+----------------------------------------------+----------------------+
| | and during his convalescence, to) achieve | |
| | stabilisation of health | 50-70 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (usually after one year), with clinical and | |
| | in the laboratory the favourable finding | 15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Acute leukemia (lymphoid, myeloid) | |
+--------+----------------------------------------------+----------------------+
| | and active disease) | 70-90 |
| +----------------------------------------------+----------------------+
| | (b)), when converted into the stage of remission, and after | |
| | the two-year stabilisation of health | |
| | when stationary, clinical and laboratory | |
| | the award, with a reduction in overall performance | |
| | the organism | 30-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Malignant neoplasms, lymphatic and haematopoietic | |
| | relatives of the tissue or other undifferentiated | |
| | forms of malignant neoplasms (e.g. malignant | |
| | Lymphoma) | |
+--------+----------------------------------------------+----------------------+
| | and during the treatment of cancer) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | having regard to the degree of restriction of everyday life | |
| | activities | 30-45 |
| +----------------------------------------------+----------------------+
| | c) moderate residual disability | |
| | severe restrictions on normal life activities | 50-60 |
| +----------------------------------------------+----------------------+
| | d) forms of adverse, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Anemia (regardless of etiology) | |
+--------+----------------------------------------------+----------------------+
| | and mild) (manifesting | |
| | premature fatigability) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with severe manifestations (repeated the need | |
| | transfusions, permanent immunosuppression, with substantial | |
| | by reducing the overall efficiency of the organism) | 25-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Panmyelopathy and | |
+--------+----------------------------------------------+----------------------+
| | trombocytopénií under a) with 80 000/mikrol, | |
| | bleeding symptoms | 20-40 |
| +----------------------------------------------+----------------------+
| | (b)) with trombocytopénií under 20 000/mikrol and | |
| | severe granulocytopénií (neutropénií) | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 11. | Bleeding (regardless of etiology) | |
+--------+----------------------------------------------+----------------------+
| | and with rare hemorrhages) form, with a light | |
| | by reducing the overall performance of the body | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) with frequent typical periods (several times | |
| | per year). with emerging complications | |
| | and with a significant reduction in overall performance | |
| | the organism | 30-50 |
| +----------------------------------------------+----------------------+
| | c) severe, bleeding light | |
| | traumas or spontaneous bleeding, with a heavy | |
| | disabilities mobility and with a significant reduction in | |
| | the overall performance of the body | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
12. | State transplant bone marrow | |
+--------+----------------------------------------------+----------------------+
| | remission of the disease), without buying | |
| | léčby | 20-35 |
| +----------------------------------------------+----------------------+
| | b) remission of the underlying disease, requiring | |
| | léčby | 40-70 |
| +----------------------------------------------+----------------------+
| | c) period of up to one year after transplantation | 80-90 |
+--------+----------------------------------------------+----------------------+
Chapter III-
IMMUNE DEFICIENCY DISORDERS
SECTION A-
IMMUNODEFICIENCIES
General evaluation policy:
Immunological disorders must be shown detailed immunological
in tests. The degree and extent of the complications arising from the identified
disorders of the posudkově must have a significant impact on the overall performance
the body of the person assessed.
Laboratory of autoimmune syndrome posudkově rank (the presence of
one or more autoantibodies in serum, disproportionate changes in values
imunoglobulínů, elevation of circulating immune complexes, reduction
the percentage or absolute amount of lymphocytes forming E rosettes for example. u
dysgamaglobulinémie IV. type, past infections, bacterial and
virus, EB virus diseases in chronic or relapse).
For the determination of the rate of decline in the ability of the continuing activity is not
a critical failure, but especially the etiology of the impact of disability on the total
status, and the overall performance of the organism.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Deficits of antibody immunity with disabilities | |
| | functions of B lymphocytes, with frequent occurrence of | |
| | microbial infections (pneumonia, sinusitity, | |
| | infections of the urinary tract, adnexitidy, etc.) | |
| | with a significant reduction in overall performance | |
| | the organism | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Immunity deficiency of cell type with defect | |
| | or by reducing the amount of T-lymphocytes and | |
| | with the appearance of fungal and parasitic | |
| | infections, with a substantial reduction in total | |
| | the performance of the body | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Deficits of immunity system fagocytárního | |
| | with a lack of or absence of Phagocytic | |
| | cells or individual phases | |
| | phagocytosis, with recurrent skin | |
| | infections, abscesses, pyogenními flegmonózními | |
| | inflammation and septickými States, with substantial | |
| | by reducing the overall performance of the body | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Immunity deficiency complement system | |
| | with the absence of, or a reduction or impairment | |
| | each component complement particles | |
| | with a significant reduction in overall performance | |
| | the organism | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Combined immune deficiency disorders accompanied by | |
| | prolonged or recurrent infectious | |
| | speeches, with a substantial reduction in total | |
| | the performance of the body | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Severe immunodeficiencies with extensive and | |
| | repeated or permanently active | |
| | infectious complications vzdorujícími | |
| | the treatment, with a significant reduction in overall performance | |
| | the organism | 70-80 |
+--------+----------------------------------------------+----------------------+
SECTION B-
HYPERIMUNNÍ STATES
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Systemic connective tissue disease | |
| | | |
| | The medical aspect: | |
| | | |
| | When determining the level of decline in skills | |
| | systematic work based on | |
| | resulting from a functional disability | |
| | from the localization, the process of the activity range | |
| | and severity of disability and the different institutions | |
| | systems, the potential side effects of treatment, | |
| | the effects on the overall status and any other | |
| | complications. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) disorders moderate, stable | |
| | When the maintenance treatment | 30-40 |
| +----------------------------------------------+----------------------+
| | (c)), a non-stabilized moderate disorders | |
| | during maintenance treatment, with volatile conditions | |
| | high activity | 50-70 |
| +----------------------------------------------+----------------------+
| | (d) the fault of a heavy grade) | 80 |
+--------+----------------------------------------------+----------------------+
Chapter IV-
ENDOCRINE DISORDERS, NUTRITION, AND THE CONVERSION OF SUBSTANCES
General evaluation policy:
The rate of decline in the ability of systematic work stoppages
metabolic and endocrine glands depends on the implications of these
disorders, IE. on the range, and borne by the disability of the individual organs and systems,
the impact on the overall health and performance of the organism. Deviations from the norm
laboratory values shall not subject the continuous decrease in the ability of earning
activity.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Diabetes mellitus | |
+--------+----------------------------------------------+----------------------+
| | and kompenzovatelný diet or diet) and | |
| | oral antidiabetic agents, without complications, | |
| | with a larger fluctuation of tolerance | 5-20 |
| +----------------------------------------------+----------------------+
| | (b)) kompenzovatelný diet, insulin or | |
| | oral antidiabetic agents, with the occasional | |
| | metabolic variations, ranging from how | |
| | complications | 25-40 |
| +----------------------------------------------+----------------------+
| | (c)) it is difficult to kompenzovatelný insulin or | |
| | oral antidiabetic agents, with repeated | |
| | conditions of metabolic fluctuations and developed | |
| | diabetickými complications | 50-70 |
| +----------------------------------------------+----------------------+
| | (d)) with severe complications diabetickými | |
| | several systems, daily activity, hard | |
| | limited | 80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Dna | It is determined by |
| | | the prevailing |
| | | complications |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Disorders of fat metabolism | It is determined by |
| | | the prevailing |
| | | complications |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Obesity-obesity | |
| | | |
| | The medical aspect: | |
| | | |
| | Obesity alone does not make the decline in skills | |
| | continuous employment. Consequences and | |
| | the accompanying disabilities especially cardiopulmonary | |
| | or support system and the musculoskeletal system | |
| | may justify recognition of degradation | |
| | continuous employment. While | |
| | is based on the body mass index | |
| | (BMI = weight (kg)/výška2 (m)). | |
+--------+----------------------------------------------+----------------------+
| | a) grade I Obesity (BMI up to 30.0 34.9) without | |
| | the reduction in overall performance, defying efforts | |
| | on the weight reduction | 10-25 |
| +----------------------------------------------+----------------------+
| | (b)), Obesity (II). (BMI up to 39.9 35.0) | |
| | with a significant reduction in overall performance, | |
| | defying treatment to professional | |
| | (specialized) | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)), Obesity (III). (BMI 40 +) | |
| | with severe cardiovascular or | |
| | respiratory complications. with a strong | |
| | disabilities momentum | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Phenylketonuria | It is determined by |
| | | the prevailing |
| | | complications |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Cystic fibrosis (mucoviscidosis) | |
| | pulmonálními, pancreatic and liver | |
| | complications | |
+--------+----------------------------------------------+----------------------+
| | (a) mild bronchitis light | |
| | failure of ventilation, light, almost | |
| | normal bowel movements, physical development appropriate | |
| | věku) | 10-20 |
| +----------------------------------------------+----------------------+
| | (b) moderate (peribronchitické) | |
| | infiltration, the incipient bronchiektazie, | |
| | the incipient emphysema, moderate ventilation | |
| | disorder, slightly changed bowel movements, alterations | |
| | hepatic and pancreatic function, | |
| | with a significant reduction in overall performance | |
| | the organism) | 35-50 |
| +----------------------------------------------+----------------------+
| | (c) heavy (heavy) bronchitis, | |
| | bronchiektazie, emfysém, disorder of ventilation | |
| | heavy grade, massive barely formed | |
| | stools, severe hepatic and pancreatic function | |
| | jater) | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Diencefalopituitární syndromes | |
+--------+----------------------------------------------+----------------------+
| 7.1. | Hypopituitarism (insufficiency in adults | |
| | front lobe of the pituitary gland, Simmondsova | |
| | cachexia, Sheehanův syndrome, | |
| | posthypofyzektomický syndrome) | |
+--------+----------------------------------------------+----------------------+
| | and with a slight reduction in total) performance | |
| | the organism, while good hormonal substitution | 10-25 |
| +----------------------------------------------+----------------------+
| | (b)) with moderate reduction in total | |
| | the performance of the organism despite well-established treatment | |
| | with orgánovými complications | 35-50 |
| +----------------------------------------------+----------------------+
| | (c)) with a significant reduction in overall performance | |
| | the body despite the established replacement therapy | |
| | with heavy orgánovými complications | 60-80 |
+--------+----------------------------------------------+----------------------+
| 7.2. | Pituitary dwarfism | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to annex | |
| | 4. | (35-50) |
+--------+----------------------------------------------+----------------------+
| 7.3. | Acromegaly | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the degree of adynamie and | |
| | present organ complications. | |
+--------+----------------------------------------------+----------------------+
| | and with a slight reduction in total) performance | |
| | the organism | 10-30 |
| +----------------------------------------------+----------------------+
| | (b)) with serious complications (disability | |
| | the skeleton, heart involvement, hypodynamie) | 40-60 |
+--------+----------------------------------------------+----------------------+
| 7.4. | Gigantism | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the degree of reduction | |
| | muscle performance. | 10-20 |
+--------+----------------------------------------------+----------------------+
| 7.5. | Diabetes insipidus | |
+--------+----------------------------------------------+----------------------+
| | linear substitution treatment) if | |
| | the cause of the disease is cancer | 10-25 |
| +----------------------------------------------+----------------------+
| | (b)), despite the established nekompenzovaný | |
| | substitution treatment | 30-50 |
+--------+----------------------------------------------+----------------------+
| 7.6. | Tumors of the pituitary gland | |
| | | |
| | The medical aspect: | |
| | | |
| | It mainly the scope and gravity | |
| | disabilities, clinical stage, a type of cancer | |
| | (benign, malignant), the forecasting criteria | |
| | the progress and outcome of treatment with impact on | |
| | psyche, sensory, neurological function | |
| | of 138.39 days; and hormonal activity. | |
+--------+----------------------------------------------+----------------------+
| | and during surgical and Oncology) | |
| | healing | 80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | with a good functional result | 30-40 |
| +----------------------------------------------+----------------------+
| | c) after treatment with persistent | |
| | more severe complications | 50-70 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | relapsing, refractory to treatment, with heavy | |
| | the functional consequences | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Hypothalamické endocrine syndromes | |
| | manifestation | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the type of fault, | |
| | with regard to the present complications (disturbance | |
| | intake of food and fluids, obesity | |
| | vegetative disorders, galaktoreu, etc.). | |
+--------+----------------------------------------------+----------------------+
| | and when a satisfactory compensation) | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) when developed complications, with substantial | |
| | by reducing the overall performance of the body | 30-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Disorders of thyroid function | |
+--------+----------------------------------------------+----------------------+
| 9.1. | An overactive thyroid gland | |
+--------+----------------------------------------------+----------------------+
| | and) light with a good response to treatment | |
| | (mainly vegetative disorders) | 10-20 |
| +----------------------------------------------+----------------------+
| | b) moderate, with persistent | |
| | orgánovými and psychological changes | 30-50 |
| +----------------------------------------------+----------------------+
| | (c) the heavy grades, strong) weight loss | |
| | tyreotoxické damage to the heart, severe eye | |
| | psychological phenomena requiring | |
| | professional psychiatric treatment | 60-70 |
+--------+----------------------------------------------+----------------------+
| 9.2. | An underactive thyroid gland, regardless of the | |
| | the etiology of | |
+--------+----------------------------------------------+----------------------+
| | and in the long term "substitutions) | |
| | with mild disorders | 10 |
| +----------------------------------------------+----------------------+
| | b) compensated substitution, incompletely | |
| | with the present complications, and reduction | |
| | the overall performance of the body | 20-40 |
+--------+----------------------------------------------+----------------------+
| 9.3. | Malignant tumor of the thyroid gland | |
| | | |
| | The medical aspect: | |
| | | |
| | The assessment of functional status | |
| | be based on the extent and severity of disability, | |
| | Clinical stages, the progress and outcome of treatment | |
| | the occurrence of the adverse factors, local and | |
| | the overall impact of the disease on the complications and | |
| | the performance of the organism. | |
+--------+----------------------------------------------+----------------------+
| | and for the Oncology treatment) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (usually after two years after the end of treatment) | |
| | with light disorders | 30-40 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (usually after two years after the end of treatment) | |
| | with more severe consequences | 50-60 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent,-treatment with heavy | |
| | consequences | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Parathyroid disease | |
+--------+----------------------------------------------+----------------------+
| 10.1. | Hypoparathyroidism | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the nature, incidence and | |
| | the frequency of seizures. Normokalcemické and | |
| | idiopathic tetany usually have lighter | |
| | progress than tetany strumiprivní. | |
+--------+----------------------------------------------+----------------------+
| | and) light (fleeting paraesthesia, | |
| | light organ spasms), unresponsive to treatment | 5-10 |
| +----------------------------------------------+----------------------+
| | (b) moderate (large) fits in the distance | |
| | months, heavier or more frequent spasms, organ | |
| | in particular, bronchial spasm), unresponsive to | |
| | léčbu | 20-30 |
+--------+----------------------------------------------+----------------------+
| 10.2. | Hyperparathyroidism | |
+--------+----------------------------------------------+----------------------+
| | a) primary hyperparathyroidism | It is determined by |
| | | the prevailing |
| | | speeches |
| | | the organ |
| | | systems |
| +----------------------------------------------+----------------------+
| | b) secondary hyperparathyroidism | It is determined by |
| | | the basic |
| | | disease |
| | | (renal, |
| | | gastrointestinal |
| | | , etc.) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 11. | Adrenal disorders | |
+--------+----------------------------------------------+----------------------+
| 11.1. | Chronic insufficiency of the adrenal cortex | |
+--------+----------------------------------------------+----------------------+
| | (a) a light form of premature fatigue, | |
| | Orthostatic disorders, without a reduction in total | |
| | the performance of the organism) | 10-20 |
| +----------------------------------------------+----------------------+
| | b) moderate form of (substantial reduction | |
| | the overall performance of the organism and the lack of | |
| | a stress reaction and in substitution treatment) | 30-50 |
| +----------------------------------------------+----------------------+
| | (c) severe form (adynamie), disorder | |
| | elektrolytového and water management and | |
| | their saccharide metabolism, weight loss, hard | |
| | stomach and intestinal disorders, replacement | |
| | little effective treatment) | 60-70 |
+--------+----------------------------------------------+----------------------+
| 11.2. | The flip side of the adrenal cortex (Cushing's is determined by |, |
| | syndrome, Conn's syndrome, predominant manifestations | adrenogenitální |
| | syndrome) on various organ |
| | | systems (hypertension, |
| | The medical aspect of heart insufficiency: | |
| | diabetes, osteoporosis, | |
| | Iatrogenic Cushing's syndrome, psychological changes, | |
| | the purpose of the determination of the degree of degradation | muscle weakness) |
| | continuing professional posudkově | |
| | rank. | |
+--------+----------------------------------------------+----------------------+
| 11.3. | An overactive adrenal gland | |
+--------+----------------------------------------------+----------------------+
| | and when serious speeches () paroxysmal | |
| | or persistent hypertension, disturbance of the heart | |
| | rhythm, psychological changes, weight loss) for | |
| | surgical treatment, chemotherapy or | |
| | in cases in which surgical treatment is not possible | |
| | and pharmacological treatment is ineffective | 60-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (with a rating of functional consequences of remaining | |
| | symptoms) | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
12. | Polyglandular insufficiency | |
+--------+----------------------------------------------+----------------------+
| | and) light form with a clinical compensation | |
| | by reducing the overall efficiency of the organism and | |
| | exercise tolerance | 20-40 |
| +----------------------------------------------+----------------------+
| | b) severe inadequately i | |
| | under resting conditions and a substantial decline in | |
| | the overall performance of the organism when the ineffectiveness of | |
| | léčby | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 13. | Hormonally active tumors GIT | |
| | | |
| | The medical aspect: | |
| | | |
| | The assessment of functional status | |
| | be based on the extent and severity of the disability, the course | |
| | and the outcome of treatment, incidence of adverse | |
| | the factors of local and total complications and | |
| | influence on the performance of the organism. | |
+--------+----------------------------------------------+----------------------+
| | and for the Oncology treatment) | 60-70 |
| +----------------------------------------------+----------------------+
| | b) stabilized form, feature-rich | |
| | compensated, with a slight reduction in performance | |
| | (as a rule, two years after the end of treatment) | 20-40 |
| +----------------------------------------------+----------------------+
| | c) stabilized forms of major functional | |
| | the consequences of (usually two years after | |
| | the end of treatment) | 50-60 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent, with severe functional consequences | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 14. | Disorders of nutrition, malnutrition and other disorders | |
| | metabolism | |
+--------+----------------------------------------------+----------------------+
| | and with a slight reduction in total) performance | |
| | the organism | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) with a significant reduction in overall performance | |
| | the organism | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) with a significant reduction in overall performance | |
| | the organism | 70-80 |
+--------+----------------------------------------------+----------------------+
Chapter V-
MENTAL DISORDERS AND BEHAVIOURAL DISORDERS
General evaluation policy:
When you determine the ability of continuous employment must be assessed
the level of psychological, mental, social, and job functions, and
to assess an individual's ability to perform work activities in such a
manner or in such limits, which are considered normal in the
the socio-cultural environment. It is primarily from the progress and
the severity of the illness, total body condition, adaptation, personality
characteristics, level of intellect, social adaptability and
psychosocial burden.
An essential part of the function of the assessment must be both psychological
examination.
Functionally, it is necessary to distinguish the scope of the disability. The minimum disability
means that is present a departure from standards in one or in several
the expected tasks or areas, or mild disability in certain
periods. When you see (light) disability is a striking departure from the norm,
dysfunction worsens social adaptability, light disability takes
most of the reference period or medium disabilities in certain
shorter periods. Essential (moderate) disability is accompanied by a
a significant departure from the norm in the majority of the expected outputs and roles
moderate disability lasts for most of the period under examination or heavier
disability is recorded in certain enclosed by periods. Serious
(severe) disability represents a significant departure from the norm in all
the expected outputs and roles, the disability lasts for most of the reference
period. A particularly severe disability means a departure from the norm, which reached
the crisis stage.
In severe mental disorders (items 1, 2, or 3) it is necessary to examine
whether the range, weight, and the progress of disability corresponds to the criteria
Annex 3, paragraph 9.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Organic mental disorders, disorders | |
| | intellect, emotivity, affective disturbances (organic | |
| | psychosyndrom different etiology, perinatal, | |
| | after injuries and inflammation of the brain, metabolic | |
| | or vascular origin) | |
| | | |
| | The medical aspect: | |
| | | |
| | The most important and permanent manifestations are | |
| | cognitive impairment (intellect, learning | |
| | the ability to differentiate and classify external | |
| | incentives, plan, organize, create | |
| | abstraction, nevýpravné thought, reducing the volume | |
| | information), then the fault in the area of perception | |
| | content of thought, mood, and emotion, personality and | |
| | behavior. The assessment must take account | |
| | the scale of the organic affections, speed | |
| | the development of the personality of the period, disability | |
| | intelligence and education, level premorbidní | |
| | adaptability and social influences. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 20-40 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 50-70 |
| +----------------------------------------------+----------------------+
| | (d)) too difficult disorders, severe dementia | 80-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Schizophrenia, schizotypal disorder, and disorder | |
| | with delusions | |
| | | |
| | The medical point of view | |
| | | |
| | When determining the level of decline in systematic | |
| | gainful employment should be assessed | |
| | the presence of psychotic symptoms, disorders | |
| | thinking and perception, reality checks, violation | |
| | social and occupational dysfunction, duration and | |
| | progress. Violation can include most | |
| | the basic functions that normal individuals | |
| | provide a sense of individuality, uniqueness, | |
| | self-control. When the assessment is | |
| | need to take into account the průběhovým variants | |
| | the disease, while the reference period should not | |
| | be less than 1 year. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 20-40 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 50-80 |
| +----------------------------------------------+----------------------+
| | (d)) too difficult disorders (florid process | |
| | heavy defect) | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Mood disorder (affective disorder)-manic, | |
| | bipolar, depressed | |
| | | |
| | The medical aspect: | |
| | | |
| | The function must contain the exact award | |
| | classification; data on the nature and severity of | |
| | episodes of mood disorders, the time of their duration, | |
| | on the frequency and the intervals between each | |
| | phases and the length and quality of remission or subsequent | |
| | changes in personality. When the assessment should be | |
| | take into account the degree of ability | |
| | to cope with the demands of everyday life and | |
| | permanently reduced resistance to stress. | |
| | Reference period should last at least one year, | |
| | as the episode takes on average 6 disorders | |
| | months. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 20-40 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 50-70 |
| +----------------------------------------------+----------------------+
| | d) particularly difficult disorders | 80-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Neurotic, stress and somatomorfní disorders | |
| | anxiety and fobické disorders, obsessive | |
| | compulsive disorders, reactions to stress, disorder | |
| | customization, dissociative disorders | |
| | | |
| | The medical aspect: | |
| | | |
| | The assessment of the systematic degradation | |
| | gainful employment is to be presumed a type | |
| | the extent and severity of psychic symptoms, duration | |
| | disorders as well as somatic symptoms | |
| | that, however, are not accompanied by organic | |
| | correlate. The assessment must take account | |
| | to the extent that restrictions on ability to cope | |
| | with the requirements of everyday life, to permanently reduced | |
| | stress resilience and reduce performance | |
| | physical and psychological. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-10 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 15-20 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 25-50 |
| +----------------------------------------------+----------------------+
| | d) especially severe disorders (e.g. hard | |
| | obsessional neuroses) | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Personality disorders and behavioural disorders | |
| | | |
| | The medical aspect: | |
| | | |
| | Functional find must objectify permanent | |
| | manifestations of maladaptivního behaviour laid down in | |
| | the structure of the personality, of peace and of the significance of deviations | |
| | from the way in which the average person in the given | |
| | socio-cultural environment perceives, thinks, feels | |
| | and shapes the relationships of others. Disorders can be | |
| | accompanied by problems in adaptation in | |
| | social activities and achievement | |
| | desired objectives. When determining the level of decline | |
| | skills continuous employment is | |
| | need to assess the extent and shall be payable by the deviations from | |
| | the acceptable average behavior of the | |
| | social norms, and this derogation shall | |
| | must manifest itself in more than one | |
| | of the following areas-cognition (ways | |
| | the perception and interpretation of things, people and events | |
| | formation of the approaches and ideas), emotivity | |
| | (range, intensity, and appropriateness of emotional | |
| | vznětu and answers), control their impulses | |
| | and meeting the needs, how behavior | |
| | to others, and management of interpersonal | |
| | situations. Decompensation is manifested above all | |
| | akcentací features of specific personality disorders | |
| | and the precarious social and work | |
| | adaptability. Some types of disorders | |
| | personality may also occur to the development of psychosis | |
| | schizophrenic circuit. | |
+--------+----------------------------------------------+----------------------+
| | and with a slight disturbance of personality) is preserved | |
| | the overall performance of the body | 5-10 |
| +----------------------------------------------+----------------------+
| | (b)) with moderate disturbance of personality | |
| | with a slight reduction in overall performance | |
| | the organism | 20-30 |
| +----------------------------------------------+----------------------+
| | (c)) with severe distortions of personality and with a pronounced | |
| | by reducing the overall performance of the body | 40-60 |
| +----------------------------------------------+----------------------+
| | d) particularly heavily disturbed personality | |
| | dezintegrované | 70-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Mental retardation | |
| | | |
| | The medical aspect: | |
| | | |
| | With mental retardation cannot be evaluated only | |
| | the mental defect by numerical | |
| | the value of IQ, but it is necessary to assess the level of | |
| | cognitive functions, in particular the attention | |
| | performance, capacity, memory | |
| | skills, soustředivost and other ingredients | |
| | personality (ability to sociability, afektivitu, | |
| | behavioral disorders, volition) | |
| | emphasize talent for certain activities, | |
| | incentives to work, manual dexterity. When | |
| | reviews should be taken into account even if | |
| | mental defect associated with another mental | |
| | or organic impairment, disruption | |
| | personality or severe behavioural disorders and | |
| | Customizing. | |
+--------+----------------------------------------------+----------------------+
| | and mental retardation (light) light | |
| | dumbness, light mental Serbian | |
| | and the imbecile, IQ in the band of 50-69) | 15-40 |
| +----------------------------------------------+----------------------+
| | b) medium mental retardation (idiocy, | |
| | IQ in the band of 35-49) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3 | |
| +----------------------------------------------+----------------------+
| | c) severe mental retardation and deep | |
| | mental retardation (IQ below 34) | 100 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Mental disorders and behavioural disorders caused by | It is determined by |
| | the use of psychoactive substances (alcohol, the predominant species | |
| | drug addiction), accompanied with somatic disorders | organ or |
| | | psychological |
| | | disability of that |
| | | in this annex |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Behavioral syndromes United | |
| | physiological disorders and somatic | |
| | factors (mental anorexia, sexual disorders | |
| | that are not caused by organic disorder | |
| | or disease), food intake, sleep disorders, | |
| | sexual dysfunction, etc. | |
+--------+----------------------------------------------+----------------------+
| | and) light to medium with permanent disorders | |
| | outpatient treatment or lighter injury and nutrition | |
| | reduce the overall performance of the body | |
| | the psychological origin | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) very heavy disorders, life-threatening, | |
| | an unmanageable primitive instinctive behaviour-| |
| | only States requiring treatment in a special | |
| | medical treatment device | |
| | hospitalization or States with severe injury | |
| | nutrition and the significant reduction in total | |
| | the organism (severe decrease in performance | |
| | weight, adynamie, anaemia, hypoproteinaemia) | 70-80 |
+--------+----------------------------------------------+----------------------+
Chapter VI-
THE NERVOUS SYSTEM
SECTION A-
IMPAIRMENT OF THE BRAIN
General evaluation policy:
To weaken the brain performance counts above all the reduction of vštípivosti and
concentration, premature fatigue, loss, loss of ability to overview
adaptation, psychological and Autonomic instability (e.g., sleep disorders,
affective lability, vasomotorické disorders, persistent headaches, etc.).
Personality disorder based on brain-related disorders and dysfunction is intended
zchudnutím and otupením personality, is thickened (degradation) of the personality with the
mood disorders and their control, limited ability to preview,
critics and contact with the outside world from light to the most difficult change of personality.
Impairment of the brain can be caused by a disorder of brain development, by
external violence, disease, toxic effects, disorders of the blood supply.
Decisive for the determination of the rate of decline in the ability of continuing professional
activity is persistent scope and degree of výpadových phenomena, not
the etiology of disabilities. In doing so, it is necessary to take into account the neurological findings
striking phenomena of the cerebral and emotional, the valuation premorbidní
personality.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Personality disorders, behavioral disorders, and disorders | |
| | intellect-induced disease, damage | |
| | or dysfunction of the brain (encephalopathy, dementia, | |
| | conditions after craniocerebral trauma, vascular | |
| | and inflammatory disorders-hydrocephalus, States | |
| | po DMO) | |
+--------+----------------------------------------------+----------------------+
| | and) brain damage with a slight reduction in mental | |
| | and the overall performance of the body | 5-15 |
| +----------------------------------------------+----------------------+
| | b) brain damage with moderate reduction | |
| | the intellectual and the overall performance of the body | 20-40 |
| +----------------------------------------------+----------------------+
| | (c)) with a significant reduction in brain damage | |
| | the intellectual and the overall performance of the body | 50-70 |
| +----------------------------------------------+----------------------+
| | d) brain damage especially hard, with a heavy | |
| | disruption of the integrity of brain functions | 80-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Facial neuralgia (e.g. neuralgia n. | |
| | trigeminal neuralgia) | |
+--------+----------------------------------------------+----------------------+
| | and) light (rare, light | |
| | pain) | 5 |
| +----------------------------------------------+----------------------+
| | (b) moderate (pain) light up | |
| | the Middle degree, induced by the already light | |
| | irritation) | 10-20 |
| +----------------------------------------------+----------------------+
| | c) heavy (common, several times a month | |
| | onset of pain, or pain) attack | 25-40 |
| +----------------------------------------------+----------------------+
| | (d)) very heavy (severe persistent pain or | |
| | attacks of pain more than once a week) | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Migraine | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by the frequency, length and | |
| | the duration of the seizure and the occurrence of accompanying phenomena | |
| | (vegetative disorders, eye symptoms, other | |
| | cerebral irritating speeches). | |
+--------+----------------------------------------------+----------------------+
| | and with a light form of course) (fits average | |
| | Once a month) | 5 |
| +----------------------------------------------+----------------------+
| | (b)) form with moderate progress (more common | |
| | seizures usually once a week) | 10-20 |
| +----------------------------------------------+----------------------+
| | (c)) the form with a heavy course of (long-running | |
| | seizures are strongly expressed by the attendant | |
| | phenomena, pause between bouts of just a few days, | |
| | status migrenosus) | 25-35 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Peripheral facial nerve paresis n. | |
+--------+----------------------------------------------+----------------------+
| | and unilateral paralysis or complete) hyzdící | |
| | Contracture | 10-20 |
| +----------------------------------------------+----------------------+
| | (b) unilateral or bilateral) complete | |
| | palsy with permanent functional complications | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) double-sided paralysis with permanent | |
| | complications (an eating disorder, disorder | |
| | articulation, eye complications) | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Conditional Cerebrálně 's palsy and plegie | |
| | (the pyramid and the origin of movement | |
| | According to the dominance of the limbs) | |
+--------+----------------------------------------------+----------------------+
| | and light residual paresis) two limbs | |
| | (frustní), or akroparézy | 10-20 |
| +----------------------------------------------+----------------------+
| | b) moderate's palsy two limbs | 30-50 |
| +----------------------------------------------+----------------------+
| | (c) two limb paresis) | 60-80 |
| +----------------------------------------------+----------------------+
| | (d)) plegie two limbs | 80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Epileptic seizures and different seizure | |
| | disease | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the nature, gravity and | |
| | the frequency of seizures is objectively proven | |
| | According to the compensation level treatment, duration | |
| | disability, controlled levels | |
| | AEDs, the ability to cooperate in | |
| | treatment and according to the gravity of the deficit neuropsychického | |
| | (an objectified by the competent examination). | |
| | The negative factor is the low age | |
| | the presence of multiple types of epilepsy and seizures. | |
+--------+----------------------------------------------+----------------------+
| | and) form of compensated | |
| | sporadic large seizures usually once | |
| | up to twice a year and small seizures usually | |
| | Once a month, the need for anticonvulsant | |
| | treatment for ongoing emergency | |
| | of seizures | 10 |
| +----------------------------------------------+----------------------+
| | (b)) form of partially compensated | |
| | large seizures usually once to two times | |
| | monthly, or small seizures usually | |
| | once to twice a week | 10-25 |
| +----------------------------------------------+----------------------+
| | (c) partially compensated) form of light | |
| | neuropsychickým deficiency | 35-50 |
| | large seizures usually three times per month, or | |
| | small bouts of usually five times a week | |
| +----------------------------------------------+----------------------+
| | (d)) form of nekompenzovaná | |
| | large seizures more than once a week, small | |
| | seizures more than five times a week, with severe | |
| | neuropsychickým deficiency | 60-70 |
| +----------------------------------------------+----------------------+
| | e) refractory to treatment form | |
| | with the sluggishly seizures, or with severe | |
| | neuropsychickým defect | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Narkoleptické seizures, Hypersomnia | |
+--------+----------------------------------------------+----------------------+
| | and) light form, with a slight reduction in psychic | |
| | and physical endurance | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)), severe form, with a severe reduction in psychic | |
| | and physical endurance | 30-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Postkomoční syndrome | 10-20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Subarachnoideálním condition after bleeding | |
| | aneurysms cerebral vessels | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the final | |
| | functional neurological, or | |
| | psychiatric and psychological award | |
| | the extent of involvement of the brain taking into account | |
| | to locate the aneurysm, made operation | |
| | and the source of bleeding. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 25-50 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 65-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Multiple sclerosis and other MS | |
| | demyelinating diseases | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by the výpadových phenomena | |
| | disease activity (attacks, remission) and clinical | |
| | the course. In the evaluation of functional disability | |
| | into account the reviews of the individual disorders | |
| | functional systems, IE. pyramid, | |
| | mozečkového, senzitivního, optic, | |
| | stem and sfinkterových functions, higher | |
| | brain function and other functions (EDSS). | |
| | The finding of CT, MRI without a clinical correlate | |
| | It is not the decisive criterion of the officer. | |
+--------+----------------------------------------------+----------------------+
| | and lightweight form,) completely without rougher disorders | |
| | function (benign forms, spinal, | |
| | with monoatakou, eye and vestibular disorders | |
| | dysesthesia), full mobility and self-sufficiency | 5-15 |
| +----------------------------------------------+----------------------+
| | (b)) with a reduction in the total disturbance lighter | |
| | the performance of the organism, the mild Central's palsy | |
| | and paraparézy, or the combination of spastic | |
| | easier involvement of several functional systems, | |
| | the mobility of the preserved, occasionally needed | |
| | help | 20-40 |
| +----------------------------------------------+----------------------+
| | c) moderate disorder motor skills | |
| | with a significant reduction in overall performance | |
| | the organism (or frequent attacks with progression | |
| | the award), daily activity substantially limited | 50-60 |
| +----------------------------------------------+----------------------+
| | d) hard to fault motor skills, mozečková form | |
| | with significant ataxia, severe movement disorder | |
| | Coordination (usually also the fault of sphincters) | |
| | daily activities severely restricted | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 11. | Parkinson's disease and other hypokinetické | |
| | extrapyramidal disorders | |
+--------+----------------------------------------------+----------------------+
| | and lighter forms, unique), involuntary movements, | |
| | intermittent blockade of momentum, moderate rigidity, | |
| | bradykineza or tremors, full mobility and | |
| | self-sufficiency | 5-15 |
| +----------------------------------------------+----------------------+
| | b) moderate forms | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)), with a permanent severe forms of tremors, rigidity, | |
| | and bradykinézou or with dyskinezami | |
| | or with heavy akinetickými conditions | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
12. | Dystonia, chorea and other hyperkinetic | |
| | disorders | |
+--------+----------------------------------------------+----------------------+
| | and form) | 5-15 |
| | dyskinetické no more restrictions | |
| | mobility and self-sufficiency | |
| +----------------------------------------------+----------------------+
| | b) moderate forms | 30-50 |
| | permanently abnormal head, limb disability | |
| | or other parts of the body, or transitional | |
| | involuntary movements with the reduction in mobility | |
| | and restrictions on specific activities | |
| +----------------------------------------------+----------------------+
| | c) severe forms | 60-80 |
| | consistently abnormal position or involuntary | |
| | moves one or more parts of the body, most | |
| | daily activity is substantially limited | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 13. | Conditions after vascular cerebral events | |
| | (transient ischemic attack, hemorhagické | |
| | organised crime, etc.) | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the resulting disorders | |
| | functions of the central nervous system and peripheral | |
| | innervation, according to the resulting function | |
| | neurological or mental health | |
| | and psychological findings. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-20 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 30-50 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 60-70 |
| +----------------------------------------------+----------------------+
| | (d)) too difficult disorder, with severe disruption | |
| | the integrity of brain function and mobility, | |
| | daily activities severely restricted | 80-90 |
| +----------------------------------------------+----------------------+
| | (e) severe combined motor disorders) and | |
| | mental skills, daily things to do | |
| | substantially limited | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 14. | Inflammatory diseases of the central nervous system | |
| | neurodegenerative diseases, System | |
| | atrophy | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the resulting disorders | |
| | functions of the central nervous system and peripheral | |
| | innervation with regard to neurological, or | |
| | psychiatric and psychological findings, total | |
| | the performance of the organism and other complications. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 30-50 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 60-70 |
| +----------------------------------------------+----------------------+
| | d) especially heavy disorders of the psyche, intellect, | |
| | motor skills. and sensory functions | 80-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
1. | Tumors of the skull cavity and the spinal canal | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, the type of cancer | |
| | (benign, malignant), location, course and | |
| | the result of the treatment, prognostic criteria and | |
| | According to neurological, or | |
| | psychiatric, psychological and | |
| | sensory disorders. | |
+--------+----------------------------------------------+----------------------+
| | and after the removal of the tumor), while the ongoing | |
| | cancer treatment | 80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching a stabilisation of health | |
| | State (typically after two years after their | |
| | treatment) with light functional disorders | 30-40 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (usually after two years after the end of treatment) | |
| | with heavier functional consequences | 50-60 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | relapsing, refractory to treatment | 90 |
+--------+----------------------------------------------+----------------------+
SECTION B-
DAMAGE TO THE SPINAL CORD
General evaluation policy:
The rate of decline in the ability of continuous employment shall be determined according to the
functional sorties on the limbs and disorders of the urinary bladder and rectum.
In doing so, it is necessary to differentiate whether the dominant limb is affected and
whether it is a mild, moderate or severe parézu or plegii.
Heaviness and the type of fault should be objektivizovány EMG testing,
where appropriate, the dynamometrickým examination, findings of muscle tone and strength
etc.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Monoplegie | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-55) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Hemiplegia | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Paraplegia | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Quadriplegia | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Monoparéza | |
+--------+----------------------------------------------+----------------------+
| | and) light | 20-25 |
| +----------------------------------------------+----------------------+
| | b) moderate | 30-40 |
| +----------------------------------------------+----------------------+
| | (c) monoparéza to plegie) heavy | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-55) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Hemiparesis | |
+--------+----------------------------------------------+----------------------+
| | (a) light less muscle strength and dexterity, | |
| | changes in reflexes, changes in quality of sensation) | 20-30 |
| +----------------------------------------------+----------------------+
| | b) moderate (impairment arm | |
| | violations of the gripping hand skills and serious | |
| | gait disturbance) | 45-60 |
| +----------------------------------------------+----------------------+
| | (c) severe hemiparesis-plegie) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Paraparesis | |
+--------+----------------------------------------------+----------------------+
| | and) light | 20-30 |
| +----------------------------------------------+----------------------+
| | b) moderate (severe gait disturbance) | 45-60 |
| +----------------------------------------------+----------------------+
| | (c) severe paraparesis) to paraplegia | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Triparéza | |
+--------+----------------------------------------------+----------------------+
| | and) light | 40 |
| +----------------------------------------------+----------------------+
| | b) moderate | 50-60 |
| +----------------------------------------------+----------------------+
| | c) heavy | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Kvadruparéza | |
+--------+----------------------------------------------+----------------------+
| | and) light | 60 |
| +----------------------------------------------+----------------------+
| | b) moderate | 70 |
| +----------------------------------------------+----------------------+
| | c) heavy | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Polyradikuloneuritidy, polyneuropathy | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 5-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 30-60 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 11. | Myelopathy | 50-70 |
| | accompanied with severe motor deficits | |
+--------+----------------------------------------------+----------------------+
Chapter VII-
SENSORY ORGANS
SECTION A-
VISION
General evaluation policy:
The rate of decline in the ability of continuous employment shall be determined according to the
sharpness of vision achieved with correction to the near and far field of view
and problems with regard to the abilities or intelektovým
disability hearing.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Medium low vision (Visual acuity | |
| | with the best possible correction: a maximum of less | |
| | than 6/18 (0.30)-minimum and equal or better | |
| | than 6/60 (0.10); 3/10-1/10, category | |
| | Visual impairment 1) | |
| | | |
| | The medical aspect: | |
| | | |
| | In the case that the extent and severity of health | |
| | disability matches the criteria of annex # 4 | |
| | proceed as indicated in this annex. | (15-20) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Strong low vision (Visual acuity | |
| | with the best possible correction: a maximum of less | |
| | than 6/60 (0.10)-minimum and equal or better | |
| | than 3/60 (0.05); 1/10-10/20, category | |
| | Visual impairment 2) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-40) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Severely low vision | |
+--------+----------------------------------------------+----------------------+
| | and) Visual acuity with the best possible | |
| | correction: a maximum of less than 3/60 (0.05) | |
| | -minimum equal to or better than 1/60 | |
| | (0.02); 1/20-1/50, category optic | |
| | disability 3 | 45-60 |
| | | |
| | The medical aspect: | |
| | | |
| | In the case that the extent and severity of health | |
| | disability matches the criteria of annex # 4 | |
| | proceed as indicated in this annex. | (35-40) |
| +----------------------------------------------+----------------------+
| | (b) the concentric narrowing of the Visual field), both eyes | |
| | below 20 degrees, or a single functionally athletic | |
| | the eye under 45 degrees | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-40) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Practical blindness (acuity | |
| | with the best possible correction 1/60 (0.02), 1/50 | |
| | up to světlocit or Visual field restriction to 5 | |
| | degrees around a central fixation, although | |
| | Central sharpness is not affected by category | |
| | Visual impairment 4) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Complete blindness (vision loss involving | |
| | States from utter loss to světlocitu | |
| | the preservation of světlocitu with the wrong light | |
| | projection, Visual impairment category 5) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Visual field defects | |
+--------+----------------------------------------------+----------------------+
| | and Visual field defects) sector and smaller | 5-15 |
| +----------------------------------------------+----------------------+
| | (b)) the full half or quadrant lunges | |
| | double sided | 20-25 |
| +----------------------------------------------+----------------------+
| | (c)) double-sided, narrowing concentric restriction | |
| | the field of view below 45 degrees, without more serious | |
| | the limitations of Visual acuity | 30-35 |
| +----------------------------------------------+----------------------+
| | (d)) double-sided central scotomas decreasing | |
| | Visual acuity significantly, in particular, to the | |
| | at close range (Sa 5 and more) | 30-35 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | The loss of one eye (accident or other | |
| | etiology), or loss of vision in one eye | |
+--------+----------------------------------------------+----------------------+
| | and good visual acuity when preserved) feature on | |
| | the second eye | 20-35 |
| +----------------------------------------------+----------------------+
| | (b)) with more severe restrictions of Visual feature | |
| | the second eye, concentric constriction of the field of view | |
| | below 45 degrees, the Visual acuity with the best | |
| | possible corrections reduced to 6/36 or less | 45-60 |
| | | |
| | The medical aspect: | |
| | | |
| | In the case that the extent and severity of health | |
| | disability matches the criteria of annex # 4 | |
| | proceed as indicated in this annex. | (35-40) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Upper eyelid paralysis, with full closure of the eye | |
| | the slots. blepharospasmus, paraspasmus | |
| | the facial nerve, lagophtalmus | 20-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Polio, eye muscles in one eye if | |
| | the eye must be excluded from vision | 20-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Other vision disorders | |
+--------+----------------------------------------------+----------------------+
| | and persistent diplopia when looking) straight forward | 10-30 |
| +----------------------------------------------+----------------------+
| | (b) loss of binocular vision) | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 11. | Other disorders and diseases of the eye | |
+--------+----------------------------------------------+----------------------+
| 11.1. | A light, steady-state forms without impairment of the eye | 5-15 |
+--------+----------------------------------------------+----------------------+
| 11.2. | Light, lingering or established forms of partially | |
| | affecting the function of the eye, which affect the | |
| | job title | |
+--------+----------------------------------------------+----------------------+
| | and unilateral) | 20-30 |
| +----------------------------------------------+----------------------+
| | (b)) two-sided | 40-50 |
+--------+----------------------------------------------+----------------------+
| 11.3. | Heavy, prolonged, treatment of recalcitrant forms | |
| | permanently affecting the Visual feature | |
+--------+----------------------------------------------+----------------------+
| | and unilateral) | 40-50 |
| +----------------------------------------------+----------------------+
| | (b)) two-sided | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
12. | Conditions after intraocular operations, conditions after | |
| | implantation of lenses | |
+--------+----------------------------------------------+----------------------+
| | and the established forms without limitation) vision | |
| | features | 10 |
| +----------------------------------------------+----------------------+
| | (b)) to established forms with more serious postoperative | |
| | the functional consequences | 25-35 |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be assessed under continuing | |
| | disorders of Visual acuity with correction achieved | |
| | and if necessary. of the problem. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 13. | Tumors of the eye | |
+--------+----------------------------------------------+----------------------+
| | and enukleace bulbu in progress) | |
| | cancer treatment | 80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | When the good function of the second eye | 30-50 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
SECTION B-
HEARING
General evaluation policy:
The rate of decline in the ability of continuous employment shall be determined according to the
rate of reduction of hearing for speech, the presence of ear noises, pain,
disorders of balance, dizziness or speech disorders, with an impact on the ability to
communication and social integration.
Hearing impairment is assessed in% by Fowler at a frequency of 500-4000 Hz.
Evaluation of hearing loss in dB is carried out on a better ear and calculate the
as the average hearing loss measured in tonal audiometry (without
hearing aid) on the frequencies 500 Hz, 1000 Hz and 2000 Hz.
Complete deafness means that the hearing impaired with any amplification
the sound does not perceive the sound, only the vibrations (loss of hearing 100%, more
than 90 dB).
Practical deafness means that the hearing impaired, equipped with a hearing aid
the sound of speech perception (hearing loss, 85-90%, more than 70 dB), but
does not understand.
Hearing loss means that the hearing impaired, equipped with a hearing aid in the
a quiet room in which the noise level does not exceed 50 dB,
means without lip reading the meaning of spoken simple sentences in at least 90
%.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Double-sided complete deafness | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-60) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Double-sided practical deafness | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-60) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Double-sided complete or practical deafness | |
| | with a severe violation of the communication skills | |
| | in the speech, and social disintegration | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Reversible severe hearing loss (loss | |
| | hearing loss in the range of 56 to 70 dB; hearing loss | |
| | 65 - 85 %) | 30-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Bilateral moderate hearing loss | |
| | (hearing loss in the range of 41 to 55 dB; loss | |
| | hearing 40-65%) | 20-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Double-sided light conductive hearing loss (loss | |
| | hearing loss in the range of 20 to 40 dB; loss | |
| | hearing 10-40%) | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Objektivizovatelné balance disorders (disorders | |
| | the vestibular tract) | |
+--------+----------------------------------------------+----------------------+
| | and with light effects), light the uncertainty | |
| | slight symptoms of dizziness when a day | |
| | load, stronger uncertainty and symptoms | |
| | dizziness when higher loads, the psychic | |
| | and physical | 5-15 |
| +----------------------------------------------+----------------------+
| | (b)) with the consequences of the middle grades, stronger | |
| | uncertainty and Vertigo when | |
| | full loads or repeated sharp | |
| | dizziness with vegetal plant phenomena, or | |
| | with nausea, vomiting at higher | |
| | mental and physical loads | 15-25 |
| +----------------------------------------------+----------------------+
| | (c)) with severe consequences, sudden dizziness, | |
| | considerable uncertainty and difficulties when walking, | |
| | parking and other physiological loads, | |
| | Alternatively, when the inability of unsupported go | |
| | or State | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Diseases of middle ear and mastoid | |
| | Tip | |
+--------+----------------------------------------------+----------------------+
| | and the protracted inflammation,) often recurrent | |
| | discharge, chronic perilymfatická fistula, | |
| | mild hearing impairment | 20-40 |
| +----------------------------------------------+----------------------+
| | (b)) States after surgery with open trepanning | |
| | cavity, with continuous discharge vzdorujícím | |
| | the treatment, depending on the extent of complications | 40-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Malignant tumors of the head and neck | |
| | (tonsils, larynx, salivary glands, tongue, | |
| | the pharynx and rtu) | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, type of cancer, | |
| | localization, progress and outcome of treatment | |
| | prognostic criteria and residual | |
| | functional consequences, especially in the area of speech | |
| | eating and facial disfigurement. | |
+--------+----------------------------------------------+----------------------+
| | and after the removal of the tumor), while the ongoing | |
| | cancer treatment | 80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | with functional consequences | 30-40 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization, with serious | |
| | functional impairments in speech, receiving | |
| | food, znetvořením and adverse | |
| | psychiatric disorders | 60-70 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | A complication accompanying ear disease such as | |
| | It is heavy, persistent dizziness, tinnitus bad | |
| | cefalea, hearing impairment, continuous discharge | 30-50 |
+--------+----------------------------------------------+----------------------+
Chapter VIII-
RESPIRATORY SYSTEM
SECTION A-
UPPER RESPIRATORY TRACT
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | States after operations of cleft lip, jaw, | |
| | patra | 15-25 |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by the persistent | |
| | eating disorders, speech and | |
| | cosmetic defect. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Severe impairment of the tongue, jaw, | defect |
| | disturbances of articulation, chewing and mimic | |
| | with the need to receive only a liquid diet | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-60) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Narrowing of the nasal passages, especially repeated | |
| | polyps-sided with a restriction of breathing | |
| | the nose and the impairment of sense of smell, if you cannot correct | |
| | surgical treatment | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Allergic or vasomotor rhinitis | |
+--------+----------------------------------------------+----------------------+
| | and form without alergologické) therapy | |
| | with occasional clinical manifestations and seasonal | |
| | the occurrence | 10 |
| +----------------------------------------------+----------------------+
| | b) severe forms of relapsing, alergologicky | |
| | proven, with frequent clinical manifestations | 15-20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Chronic inflammation of the sinus heavy | |
| | degree with complications (hnisanou secretion, | |
| | symptoms of irritation of the trigeminal, creation | |
| | polyps, intracranial and eye complications) | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Complete loss of smell and related influence | |
| | chuti | 10-20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Permanent tracheostomy, conditions after the exclusion of larynx | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-60) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Tracheal stenosis clinically and functionally | |
| | significant difficulties with brass, repeated | |
| | infectious and inflammatory complications and | |
| | by reducing the overall performance of the body | |
| | (according to spirometry) | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Polio recurrentu | |
+--------+----------------------------------------------+----------------------+
| | and), with a good voice "| 5-10 |
| +----------------------------------------------+----------------------+
| | (b)) with a permanent chrapotem | 15-25 |
| +----------------------------------------------+----------------------+
| | (c)) double-sided, with breathing difficulties, and | |
| | voice disorder | 30-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Articulation disorder and other speech disorders | |
+--------+----------------------------------------------+----------------------+
| | and with hard-to-understand language) | 20-40 |
| +----------------------------------------------+----------------------+
| | (b)) with an unintelligible speech | 50-60 |
+--------+----------------------------------------------+----------------------+
SECTION B-
LOWER RESPIRATORY TRACT
General evaluation policy:
In chronic diseases, Crohn's disease, Lung parenchyma and pleura
srůstech down the rate of decline in ability to continuous professional
activities in accordance with restrictions on lung function, the effect on the overall status of and according to the
sequelae of other organ systems (e.g., cor
pulmonale), when diseases conditional allergies also under options
avoid allergens.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | A lingering bronchitis | |
+--------+----------------------------------------------+----------------------+
| | and) without ventilation disorders | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) with impaired ventilation | the |
| | | by item |
| | | 5 this |
| | | section |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Bronchiectasis | |
+--------+----------------------------------------------+----------------------+
| | and), small-scale light form, without permanent | |
| | restriction of pulmonary function (symptomless | |
| | After intervals over several months, the occasional cough, | |
| | a slight expektorace) | 10-20 |
| +----------------------------------------------+----------------------+
| | b) moderate form with intervalovými | |
| | difficulties | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) with severe restrictions, severe form of lung | |
| | features and frequent acute relapses | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Bronchial asthma | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by pulmonary disorders | |
| | functions, in particular the values of FEV1 and PEF, nature | |
| | and the intensity of the therapy and the course of the disease. | |
+--------+----------------------------------------------+----------------------+
| | and intermittent asthma) 1. degree | |
| | | |
| | Clinical symptoms are brief, their | |
| | the incidence is less frequent than once or twice | |
| | within a week, short episodes of worsening, night | |
| | symptoms occur less than 2 x per month | |
| | between exacerbations is a symptomless phase | |
| | PEF or FEV1 is equal to or greater than 80% | |
| | reference or best personal | |
| | PEF variability values is less than 20% | |
| | PEF normalizes after bronchodilatanciích | 10-20 |
| +----------------------------------------------+----------------------+
| | (b) the light of persistent asthma) 2. degree | |
| | | |
| | Exacerbations are more common than twice a week, but | |
| | less than once a day, a night time symptoms | |
| | occur more frequently than twice a month, | |
| | exacerbations can interfere with daily activities and | |
| | PEF or FEV1, equal to or greater than | |
| | 80% of the reference or the best personal | |
| | values, variability is between 20-30%, after | |
| | application of bronchodilators occurs | |
| | to normalize | 25-35 |
| +----------------------------------------------+----------------------+
| | c) moderate persistent asthma 3. degree | |
| | | |
| | Everyday difficulties, exacerbation of regularly | |
| | affect daily activities and sleep, night | |
| | the symptoms more than once a week, daily | |
| | the need for beta 2, beta-agonists, PEF or FEV1 | |
| | in the range of 60-80% of the expected values | |
| | variability is greater than 30% | 40-50 |
| +----------------------------------------------+----------------------+
| | (d) severe persistent asthma) 4. degree | |
| | | |
| | Almost daily, and the exacerbation of symptoms | |
| | continuous, frequent night-time symptoms | |
| | asthma, asthma severely limits the body | |
| | PEF or FEV1 activity equal to or less | |
| | than 60% but greater than 30% of the reference | |
| | or the best of personal values, even when | |
| | optimal treatment | 60-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Dust on the lungs (pneumoconiosis, uhlokopů | |
| | silicosis, asbestóza) and pneumoconiosis in | |
| | connection with tuberculosis | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the resulting disorders | |
| | lung function, or cardiovascular | |
| | complications, taking into account the dynamics of the | |
| | of the disease and whether it is simple or | |
| | complex pneumokoniózu. The importance of the award | |
| | must be assessed taking into account the age, | |
| | the duration, nature and intensity of the dusty | |
| | exposure and possible accompanying diseases. | |
+--------+----------------------------------------------+----------------------+
|: 4.1. | Without substantial limitations in lung function, | |
| | in the initial stage of clinical and x-ray | 10-15 |
+--------+----------------------------------------------+----------------------+
| 4.2. | Developed disease | |
+--------+----------------------------------------------+----------------------+
| | and the fault light, without) disabilities lung | |
| | features | 20-25 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders with reducing | |
| | the performance of the body | 35-50 |
| +----------------------------------------------+----------------------+
| | (c)), with the significant disorders heavy reduction | |
| | performance | 60-70 |
| +----------------------------------------------+----------------------+
| | (d)) too difficult disorders (cor pulmonale, | |
| | pulmonary hypertension, circulatory failure) | 80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Diseases of the lungs and pleura (SCAR adhesions | |
| | the pleura, birth defects and conditions after injuries, | |
| | After Lung post-transplant embolizacích | |
| | Alveolitis, pulmonary and other pneumopatie | |
| | emphysema, lung conditions after operations with permanent | |
| | limitations in lung function, according to the scale and | |
| | limitations in lung function) | |
+--------+----------------------------------------------+----------------------+
| | and) light, shortness of breath more than | |
| | the usual rate in the medium-heavy loads | |
| | (e.g. vigorous walk 5-6 km/h, medium | |
| | heavy physical work), with a small deterioration | |
| | static and dynamic values in lung | |
| | functions, FEV1 80-70% NH | 10-20 |
| +----------------------------------------------+----------------------+
| | b) moderate, shortness of breath more than | |
| | the usual rate is already in daily light | |
| | load (e.g., walk 3-4 km/h | |
| | climb up the stairs to the first floor | |
| | light physical labor), reducing the static | |
| | and dynamic values in lung function up to | |
| | about 2/3 of the predicted FEV1, 69-50% NH | 30-60 |
| +----------------------------------------------+----------------------+
| | (c) the heavy degree, shortness of breath) minimum | |
| | load or at rest, reducing static and | |
| | dynamic values in lung function by more | |
| | than 2/3 of appropriate values in FEV1 less than | |
| | 50 % NH | 60-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Malignant tumors of the respiratory tract, lungs and | |
| | mediastinum | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, type of cancer, | |
| | the progress and outcome of treatment, prognostic | |
| | criteria and according to the residual term of Office | |
| | limitations of respiratory rhythm disorders, or | |
| | swallowing. | |
+--------+----------------------------------------------+----------------------+
| | and after the removal of the tumor or) during | |
| | cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | When the lung function as a result of constraints | |
| | lobectomie or other functional problems | 50-60 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
| +----------------------------------------------+----------------------+
| | d) after reaching stabilization of health | |
| | (usually two years), conditions after | |
| | pneumonectomii) | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Tuberculosis and other mykobakteriózy | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by the extent of the disease | |
| | and the degree of activity, according to the classification | |
| | Tuberculosis and other mykobakterióz | |
| | (dispensary group, P, M, card | |
| | Mycobacteria), degree of limitation in pulmonary function | |
| | and the overall state of the organism. | |
+--------+----------------------------------------------+----------------------+
| 7.1. | Tuberculosis of the respiratory system | |
+--------+----------------------------------------------+----------------------+
| | and) for disease activity with functional | |
| | restrictions or other complications | 50-80 |
| +----------------------------------------------+----------------------+
| | (b)) for the activity, without limitation of lung | |
| | features and performance | 20-40 |
| +----------------------------------------------+----------------------+
| | c) inactive tuberculosis, without failure | |
| | features | 10 |
| +----------------------------------------------+----------------------+
| | d) inactive tuberculosis with functional | |
| | limitations of medium to heavy grade | 40-70 |
+--------+----------------------------------------------+----------------------+
| 7.2. | Tuberculosis of other organs and systems | |
+--------+----------------------------------------------+----------------------+
| | and) for things to do with functional restrictions | |
| | medium to heavy grade or with other | |
| | complications | 50-80 |
| +----------------------------------------------+----------------------+
| | (b)) for the activity, without functional limitations | 20-40 |
| +----------------------------------------------+----------------------+
| | c) inactive tuberculosis, without disorder | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Sarcoidosis | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the degree of activity | |
| | process and the resulting disorders features | |
| | the affected organs. | |
+--------+----------------------------------------------+----------------------+
| 8.1. | Magnification of intrathoracic lymph | |
| | uzlin | |
+--------+----------------------------------------------+----------------------+
| | and) without clinical symptomatology, without | |
| | functional restrictions | 5 |
| +----------------------------------------------+----------------------+
| | (b)) with clinical symptomatologií or | |
| | with functional limitations of moderate degree | 10-15 |
+--------+----------------------------------------------+----------------------+
| 8.2. | Pulmonary parenchymal involvement | |
+--------+----------------------------------------------+----------------------+
| | and) without clinical symptomatology and | |
| | functional restrictions | 5 |
| +----------------------------------------------+----------------------+
| | (b)) with clinical symptomatologií in medium | |
| | severe functional limitations | 30-60 |
| +----------------------------------------------+----------------------+
| | c) extensive scar-like stadium with functional | |
| | by limiting the heavy degree | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Conditions after lung transplant | |
+--------+----------------------------------------------+----------------------+
| | and to stabilize the health condition), | |
| | as a rule, within two years of operation | 80 |
| +----------------------------------------------+----------------------+
| | (b)) after conditioning, health | |
| | According to the degree of functional lung restriction | |
| | functions and the degree of limitation of overall performance | 50-70 |
+--------+----------------------------------------------+----------------------+
Chapter IX-
CIRCULATORY SYSTEM
General evaluation policy:
The rate of decline in the ability of continuous employment shall be at the
the basis of the functional tests of the circulatory system (e.g., cardiac stress test,
resting and stress echocardiography, the determination of left ventricular ejection fraction,
flebografie, radionuclide angiography examinations, etc.).
SECTION A-
AFFECTION OF THE HEART
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Coronary artery disease | |
| | | |
| | The medical aspect: | |
| | | |
| | The assessment of functional status | |
| | be based on the determination of echokardiografického | |
| | the ejection fraction of the left ventricle, stress | |
| | tests-a cardiac stress test. stress | |
| | echocardiography and stress the isotopic | |
| | method. The assessment of functional groups by | |
| | classification of NYHA or according to CCSC is to be taken | |
| | into account as a pointer. Prognostic | |
| | the negative factor is the presence of rest | |
| | left ventricular dysfunction with EF below 40% or | |
| | diastolic dysfunction, the presence of | |
| | complex ventricular arrhythmias or bundle branch | |
| | the blockade after myocardial infarction, implemented | |
| | positive koronarografický award | |
| | with the impossibility of revascularization, disability | |
| | more of the coronary arteries and the presence of more | |
| | risk factors of CORONARY HEART DISEASE. | |
+--------+----------------------------------------------+----------------------+
| | and without any substantial decrease in performance) when | |
| | the usual physical strain (walking speed | |
| | 7 to 8 km/hr, no restriction envisaged | |
| | performance, VO2 max. According to Weber's more than 20 | |
| | mL/kg/min, no more than 7 METs from Goldman, in | |
| | load test performance 2.0 W/kg and more, EF | |
| | the left ventricle for more than 50%, NYHA I, CCSCI.) | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) with a decrease in performance when the usual physical | |
| | load | |
| | | |
| | (walk at a speed of 4 to 6 km/h, medium | |
| | heavy physical work, VO2 max. According to Weber's 16-| |
| | 20 ml/kg/min, 5-7, when the METs from Goldman | |
| | load test performance of 1.0-2.0 W/kg, EF | |
| | 40-50% of the CCSC, NYHA II, II.) | 30-45 |
| +----------------------------------------------+----------------------+
| | (c)) with a decrease in performance when you moderate | |
| | load | |
| | | |
| | (walking at 3 to 4 km/h, light | |
| | work, VO2 max. According to Weber's 10-15 ml/kg/min, | |
| | 2-5 the METs from Goldman, when a load test | |
| | the performance of 0.5-1.0 W/kg, EF of 30-40%, NYHA III | |
| | CCSC III.) | 50-60 |
| +----------------------------------------------+----------------------+
| | d) decrease in performance at light load | |
| | | |
| | (the difficulties present in repose, VO2 max by Weber | |
| | less than 10 ml/kg/min, less than 2 METs from | |
| | Goldman, in a load test performance less | |
| | than 0.5 W/kg, EF below 30%, NYHA IV., CCSC IV | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Acquired and congenital heart defects | |
| | | |
| | The medical aspect: | |
| | | |
| | When determining the level of decline in skills | |
| | continuous employment for assessed | |
| | with acquired or congenital heart disease | |
| | It is necessary to be based on the following criteria: | |
| | | |
| | Hemodynamic significance of defects should be | |
| | fixed echokardiograficky. | |
| | for the worse under consideration vyšetřitelných | |
| | transezofageálně. Haemodynamic significance | |
| | Specifies the index of the mouth of the surface defects, above | |
| | the gradient degree of regurgitation, size | |
| | short circuit, if necessary. other performance parameters. | |
| | | |
| | Assessment of functional status may not be | |
| | some defects in accordance with the degree of | |
| | hemodynamic disorders. We use functional | |
| | classification of NYHA, objektivizujeme | |
| | load test-bicyklovou ergometrií | |
| | eventually. lifting by echocardiography. Reviews | |
| | must be done at the optimal therapy. | |
| | | |
| | From the medical point of view, it should be for the adverse | |
| | factors to consider several disability | |
| | valves, the simultaneous presence of ISCHEMIC HEART DISEASE, severe | |
| | pulmonary hypertension, trikuspidalizaci defects, | |
| | Mitral or aortic regurgitaci and significantly | |
| | dilatovanou left the Chamber. | |
+--------+----------------------------------------------+----------------------+
| | and without any substantial decrease in performance) when | |
| | the usual physical strain | 10-15 |
| | | |
| | (mitral stenosa with the index of the mouth area (MVA) | |
| | 1.2 cm2/m and more, the aortic stenosa | |
| | with the top systolic gradiendem lower | |
| | than 50 mm Hg, the mouth of the aortic area index | |
| | (AVA) greater than 0.5 cm2/m2, 1. - | |
| | 2. the degree of aortic and mitral regurgitation in, | |
| | for short circuit defect size L-P short circuit less | |
| | than 1.5:1, EF LK 55%, higher than the walk | |
| | at a speed of 7 to 8 km/hr, no limit | |
| | performance, engine power when bicyklové | |
| | stress test (BE) 2 W/kg and higher, more than | |
| | METs 7, VO2 max. more than 20 ml/kg/min, | |
| | NYHA I) | |
| +----------------------------------------------+----------------------+
| | (b)) with a decrease in performance when the usual physical | 30-45 |
| | load (mitral stenosa with the index area | |
| | Ústí (MVA) 0.8-1.2 cm $/m2, aortic stenosa | |
| | with the top systolic gradient lower | |
| | than 50-70 mm Hg, the aortic area index | |
| | Ústí (AVA) greater than 0.5 cm2/m2, regurgitation | |
| | 2.-3. the degree of the aortic and mitral | |
| | regurgitation, shorting more than 1.5:1, EF LK | |
| | more than 55%, walk at a speed of 4 to 6 | |
| | km/h, moderate labor does not throw | |
| | difficulties, achieved performance at bicyklové | |
| | stress test (BE) 1-2 W/kg, 5 to 7 METs, | |
| | VO2 max. 16-20 ml/kg/min, NYHA II) | |
| +----------------------------------------------+----------------------+
| | (c)) with a decrease in performance when less than usual | 50-60 |
| | load (mitral stenosa with the index area | |
| | Ústí (MVA) less than 0.8 cm2/m2, aortic | |
| | stenosa with the index faces the mouth of less than 0.5 | |
| | cm2/m, 3. -4. degree in aortic | |
| | and mitral regurgitation, shorting more than | |
| | 1.5:1, volume overload the right side | |
| | Cardiac dilation LK (final | |
| | systolic dimension in mitral and aortic | |
| | regurgitation of 55 mm and higher) for stenotic | |
| | the defects of the EF lower than 55%, the signs of pulmonary | |
| | hypertension, walking speed of 3-4 km/hr, | |
| | light physical work, engine power when | |
| | bicyklové stress test (BE) 0.5-1 W/kg | |
| | 2 to 5 METs, VO2 max. 10-15 ml/kg/min, | |
| | NYHA III) | |
| +----------------------------------------------+----------------------+
| | d) decrease in performance during minimum load or | 70-80 |
| | difficulties in peace (echocardiographic signs | |
| | severe valvular or short-circuit faults, heavy | |
| | dysfunction of the left ventricle, EF lower than | |
| | 40%, pulmonary hypertension, arrhythmia, clinical | |
| | signs of cardiac insufficiency, in | |
| | bicyklové performance testing less than | |
| | 0.5 W/kg, less than the 2 METs, VO2 max. less | |
| | 10 ml/kg/min, NYHA IV) | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Inflammatory diseases of the heart | |
| | | |
| | The medical aspect: | |
| | | |
| | Assessing the rate of decline in the ability of systematic | |
| | work is to be carried out after | |
| | alleviation of the acute stage. | |
+--------+----------------------------------------------+----------------------+
| | and after the acute stage) without signs | |
| | damage to the circulatory system diseases | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) with signs of circulatory disorders | |
| | tract in normal physical strain | 30-45 |
| +----------------------------------------------+----------------------+
| | (c)) with a decrease in performance when you moderate | |
| | load | 50-60 |
| +----------------------------------------------+----------------------+
| | (d)) with a decrease in performance during light load | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Cardiomyopathy | |
| | | |
| | The medical aspect: | |
| | | |
| | When determining the level of decline in skills | |
| | the systematic employment of assessed | |
| | with kardiomyopatiemi it is necessary to build on | |
| | from the current working state and in particular | |
| | degree of limitation, the determination EF LK, determining | |
| | functional capacity by using a cardiac stress test, bicyklové | |
| | determine the functional classification of NYHA or | |
| | Holterova monitoring. | |
| | | |
| | Posudkově unfavourable factor is the progressive | |
| | drop in the systolic function LK on load, max. | |
| | VO2 consumption less than 1 ml/kg/min, time | |
| | load duration shorter than 7 min and the presence of | |
| | serious ventricular arrhythmias. | |
+--------+----------------------------------------------+----------------------+
| | and without any substantial decrease in performance) when | |
| | the normal load | 10-15 |
| | | |
| | (walk at a speed of 7 to 8 km/hr, no limit | |
| | predicted performance, engine power when | |
| | bicyklové stress test 2 W/kg and higher, more | |
| | than 7 METs, VO2 max. more than 20 ml/kg/min, | |
| | EF LK higher than 50%, NYHA I) | |
| +----------------------------------------------+----------------------+
| | (b)) with a decrease in performance when the usual physical | |
| | load | 30-45 |
| | | |
| | (walk at a speed of 4 to 6 km/h, moderate | |
| | Labor does not raise difficulties, engine power | |
| | When bicyklové testing 1-2 W/kg, 5-7 | |
| | The Mets, VO2 max. 16-20 ml/kg/min, EF LK 40-| |
| | 50%, NYHA II) | |
| +----------------------------------------------+----------------------+
| | (c)) with a decrease in performance when you moderate | |
| | load | 50-60 |
| | | |
| | (walking at 3 to 4 km/h, light natural | |
| | work, engine power when bicyklové | |
| | ergometry 0.5-1 W/kg, 2-5 METs, VO2 max | |
| | 10-15 ml/kg/min, EF LK 30-40%, NYHA III) | |
| +----------------------------------------------+----------------------+
| | d) decrease in performance at light load | 70-80 |
| | | |
| | (clinical signs of cardiac insufficiency, | |
| | engine power when bicyklové stress test | |
| | less than 0.5 W/kg, less than the 2 METs, VO2 | |
| | Max. less than 10 ml/kg/min, less than EF | |
| | 30%, NYHA IV) | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Arrhythmia (cardiac pacemakers, implantable | |
| | Defibrillators (ICD) | |
| | | |
| | The medical aspect: | |
| | | |
| | In determining the overall rate of decline in skills | |
| | the systematic employment of assessed | |
| | with arrhythmias should be taken into account above all | |
| | the seriousness of the underlying heart disease | |
| | functional limitation, the risk of arrhythmia | |
| | associated with severe haemodynamic impairment and | |
| | Options affecting the arrhythmia treatment. Between | |
| | arrhythmia haemodynamically significant include | |
| | supraventricular arrhythmias with high | |
| | frequency Chambers leading to syncope, ventricular | |
| | extrasystolie Lown III and IV with high | |
| | frequency during ECG monitoring, | |
| | sustained ventricular tachycardia, KES Lown in a | |
| | Ventricular fibrillation. | |
| | | |
| | The evaluation assessed with elapsed time | |
| | severe arrhythmias without the need of acute | |
| | myocardial infarction is necessary to take into account | |
| | the fact that the chances of recurrence of this serious | |
| | arrhythmia is greatly reduced after 8 months | |
| | from the events. | |
+--------+----------------------------------------------+----------------------+
| | and rhythm disturbances or haemodynamically) | |
| | resulted in a few significant, good effect of treatment | 5-10 |
| +----------------------------------------------+----------------------+
| | b) rhythm disturbances or haemodynamically | |
| | resulted in a few significant partial effect | |
| | pharmacological or non-pharmacological treatment | |
| | or is indicated by the implantation of permanent | |
| | the pacemaker | 15-25 |
| +----------------------------------------------+----------------------+
| | c) rhythm disturbances or haemodynamically | |
| | prognostically significant, good effect of treatment | |
| | a decrease in performance during normal load | 35-50 |
| +----------------------------------------------+----------------------+
| | d) rhythm disturbances or haemodynamically | |
| | resulted in significant, lingering over | |
| | pharmacological or non-pharmacological treatment | |
| | or requiring the ICD implantation, with heavy | |
| | by limiting the performance of the heart | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Hypertensive disease | |
| | | |
| | The medical aspect: | |
| | | |
| | When determining the rate of decrease in the percent of total | |
| | the abilities of continuous employment | |
| | hypertension is under consideration to be taken into account | |
| | to present and borne by the organ changes or | |
| | damage and to the presence of other risk | |
| | factors. It is necessary to proceed from objective | |
| | examination (repeated long-term measurement of TK) | |
| | the results of blood and urine biochemical, | |
| | ECG, echokardiografického examinations, | |
| | examination of the eye, where | |
| | of sonographic examination of the kidneys, etc. | |
| | In the case of secondary hypertension must be | |
| | take into account the nature of the particular basic | |
| | the disease. | |
+--------+----------------------------------------------+----------------------+
| | and no objectively provable) organ | |
| | morphological and functional changes | 10 |
| +----------------------------------------------+----------------------+
| | (b)) the presence of light functional or | |
| | Morphological changes as a result of hypertension: | |
| | renal impairment creatinine rise to | |
| | 150 μmol/l, or drop kreatininové | |
| | clearance below 1.7 ml/s, proteinuria and | |
| | 2.0 g/24 h, a normal heart function, changes | |
| | on the back-stage angiopatie or | |
| | angiosklerosy | 15-25 |
| +----------------------------------------------+----------------------+
| | (c)) the presence of moderate functional or | |
| | Morphological changes, values of creatinine to | |
| | 180 μmol/l, a decrease in clearance of kreatininové | |
| | under 1.4 ml/s, hypertofie the left ventricle, decreased | |
| | overall performance | 35-50 |
| +----------------------------------------------+----------------------+
| | (d) the presence of serious functional or) | |
| | Morphological changes as a result of hypertension: | |
| | renal impairment creatinine rise above | |
| | 180 μmol/l or decrease kreatininové clearance | |
| | under 0.8 ml/sec, proteinuria over 2.0 g/24 h | |
| | elapsed or systolic myocardial infarction | |
| | left ventricular dysfunction or presence | |
| | the left-sided cardiac insufficiency, changes on | |
| | back at the stage of retinopathy, exudátů | |
| | on the retina, the recent emergent hypertensive | |
| | crisis, stroke under cover | |
| | ischemia or bleeding in the CNS, the presence of | |
| | hypertensive encephalopathy | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Cor pulmonale chronicum | |
| | | |
| | The medical aspect: | |
| | | |
| | When assessing the total percentage rate | |
| | the continuous degradation of earning | |
| | the activities of patients with cor pulmonale to be | |
| | always take into account the basic disease | |
| | where there has been a development of cor pulmonale and | |
| | be based on the presence or absence of | |
| | circulatory insufficiency, effect of treatment and weight | |
| | respiratory insufficiency. | |
+--------+----------------------------------------------+----------------------+
| | and long-term compensation Circulator) | 30-60 |
| +----------------------------------------------+----------------------+
| | (b) signs of right sided cardiac insufficiency) | |
| | persistent despite adequate comprehensive | |
| | treatment (treatment of the underlying disease) | |
| | oxygen therapy, diuretics) | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Conditions after heart surgery | |
| | | |
| | The medical aspect: | |
| | | |
| | When assessing the State after revascularization | |
| | infarction and PTCA should be based on the reviews | |
| | functional status, determination of EF LK | |
| | echokardiograficky, stress tests | |
| | with regard to the classification of NYHA or CCSC, | |
| | the completeness of revascularization and the degree of dysfunction | |
| | the left ventricle, where Holterova | |
| | monitoring. At the same time it is necessary to take into account | |
| | the presence of risk factors for HEART DISEASE. Posudkově | |
| | the negative factor are signs of residual | |
| | ischemia on load, systolic dysfunction LK. | |
| | | |
| | Assessed after correction for the operating of the heart | |
| | defects and coronary revascularisation is recommended | |
| | functional assessment with an interval of 3-6 months | |
| | After a total of readjustment and rehabilitation. | |
| | About the cost/benefit or nepříznivosti result | |
| | by type of heart defect, degree | |
| | correction of hemodynamic disorders, presence of | |
| | residual defects or defects of the associated, status | |
| | function of the left ventricle, the presence and degree of | |
| | pulmonary hypertension. | |
+--------+----------------------------------------------+----------------------+
| | and without any substantial decrease in performance) when | |
| | the usual physical strain | 10-15 |
| | | |
| | (full correction of the defects, good function LK, EF | |
| | more than 50%, without limitation, the anticipated | |
| | performance bicyklové performance testing of 2 W/kg | |
| | and higher, more than 7 METs, VO2 max. more than | |
| | 20 ml/kg/min, NYHA I) | |
| +----------------------------------------------+----------------------+
| | (b)) with a decrease in performance when the usual physical | |
| | load | 30-45 |
| | | |
| | (almost a full correction of the defects, reduced function | |
| | LK, EF 40-50% power at bicyklové | |
| | testing 1-2 W/kg, 5-7 METs, VO2 max. | |
| | 16-20 ml/kg/min, NYHA II) | |
| +----------------------------------------------+----------------------+
| | c) decrease in performance when a medium-heavy loads | 50-60 |
| | | |
| | (a partial correction of defects, residual defect | |
| | more severe impairment LUKE, EF of 30-40%, performance | |
| | When the stress test bicyklové 0.5-1.0 W/kg | |
| | 2-5 METs, VO2 max. 10-15 ml/kg/min, | |
| | NYHA III) | |
| +----------------------------------------------+----------------------+
| | d) decrease in performance during light load | 70-80 |
| | | |
| | (Advanced defect late indicated for the operation, | |
| | defects that could not be satisfactorily | |
| | correct, severe impairment LUKE, EF lower | |
| | than 30%, bicyklové performance testing | |
| | less than 0.5 W/kg, less than the 2 METs, VO2 | |
| | Max. less than 10 ml/kg/min, NYHA IV) | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | State transplant heart | |
| | | |
| | The medical aspect: | |
| | | |
| | In the assessment to be made of the reviews | |
| | graft function according to the ECHO, the determination of the functional | |
| | classification and objectification performance | |
| | load test result, where | |
| | endomyokardiální biopsy (chronic rejection) | |
| | koronarografického testing (development | |
| | vaskulopatie the graft), Holterova monitoring. | |
| | Posudkově adverse factor are recurring | |
| | rejekční episodes, the incidence of serious infections, | |
| | toxic damage to the parenchymatozních organs | |
| | and the emergence of malignancies in immunosuppressive treatment | |
| | the development of obstructive vaskulopatie graft. While | |
| | It is necessary to consider the immune response | |
| | system, and side effects of immunosuppressant | |
| | treatment. | |
+--------+----------------------------------------------+----------------------+
| | and to stabilize the health condition), | |
| | as a rule, within 2 years of operations | 80 |
| +----------------------------------------------+----------------------+
| | (b)) after consolidation of the health condition, according to | |
| | the degree of functional limitation and the total of the heart | |
| | performance | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Conditions after the implantation of the pacemaker | |
| | (an implantable defibrillator) | |
+--------+----------------------------------------------+----------------------+
| | and States without restrictions) of cardiac function and | |
| | performance | 15-25 |
| +----------------------------------------------+----------------------+
| | (b)) for rhythm disturbances without heart involvement, | |
| | with a decrease in performance during light load | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) for heart rhythm disturbances with disabilities | |
| | with a decrease in performance when you moderate | |
| | load | 60-75 |
+--------+----------------------------------------------+----------------------+
SECTION B-
INVOLVEMENT OF THE BLOOD VESSELS
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Aterosklerosa | |
+--------+----------------------------------------------+----------------------+
| | and light, with stages) mild signs of disorders | |
| | organ function | 20 |
| +----------------------------------------------+----------------------+
| | (b) the stage with serious) heavier marks | |
| | impairment | 40-60 |
| +----------------------------------------------+----------------------+
| | c) advanced stage with heavy orgánovými | |
| | check-in | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Arteriovenous fistula with disorders | |
| | peripheral blood circulation | 20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Aneurysms (according to location, size) | |
+--------+----------------------------------------------+----------------------+
| | and) without functional disorders (a small peripheral | |
| | aneurysms) | 10-20 |
| +----------------------------------------------+----------------------+
| | dissecting aneurysms of the aorta in b) and United | |
| | Aortic abdominal aneurysms and large | |
| | pelvic arterial disease, conditions after operations | |
| | aneurysms, with severe functional injury and | |
| | a substantial decline in performance | 40-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Arterial Obliterative disease, functional | |
| | circulation disorders (angioneuropatie) | |
| | closures in the arteries of the lower limbs | |
| | (Division according to Fontaine Fables) | |
+--------+----------------------------------------------+----------------------+
|: 4.1. | Stage I-the asymptomatic, or | |
| | claudication extreme loads, little | |
| | significant stenosis, functional fitness slightly | |
| | limited, index pressure above the ankles is | |
| | borderline (1.0-0.8) | 10-20 |
+--------+----------------------------------------------+----------------------+
| 4.2. | Stadium II. a-klaudikační distance 200 | |
| | and more yards, tight stenosis around 60-80% | |
| | with a good kolaterálním circulation, pressure index | |
| | above the ankles under 0.8, functional fitness slightly | |
| | limited | 25-30 |
+--------+----------------------------------------------+----------------------+
| 4.3. | Stadium II. b-klaudikační distance below | |
| | 200 m, respectively. in combination with the | |
| | stenosis, with a circulation of kolaterálním, positioning | |
| | and the stress test is positive, the pressure index | |
| | above the ankles around 0.5, functional fitness | |
| | considerably limited | 40-50 |
+--------+----------------------------------------------+----------------------+
|: 4.4. | Stage III. -rest and night ischemic | |
| | pain, combined with small development | |
| | collateral circulation, are not present skin | |
| | defects, the pressure above the ankles is 50 mm Hg and | |
| | less, functional fitness is considerably limited | 60-70 |
+--------+----------------------------------------------+----------------------+
| 3.5. | Stage IV. -Ischemic skin defects, | |
| | necrosis and gangrene | 80 |
+--------+----------------------------------------------+----------------------+
| 4.6. | Closures on the upper extremities, arterial, | It is determined by |
| | functional circulatory disorders (angioneuropatie) | extent of the problem and |
| | | functional restrictions |
| | | (compared |
| | | with vascular |
| | | disabilities |
| | | lower limbs) |
+--------+----------------------------------------------+----------------------+
| 4.7. | Free from blockages in the carotid artery without disorders | |
| | oběhu | 15-20 |
+--------+----------------------------------------------+----------------------+
| 4.8. | Blockages in the carotid artery accompanied by | |
| | disorders of the circulation (transient ischaemic attack | |
| | attacks, short-term outages of consciousness, lighter | |
| | psychological changes) | 50-70 |
+--------+----------------------------------------------+----------------------+
| 4.9. | Conditions after Vascular Surgery of arteria | |
| | Carotid with a good functional result | 20-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Conditions after the desobliteraci or | |
| | large artery bypass graft | |
| | | |
| | The medical aspect: | |
| | | |
| | Is assessed having regard to the persisting vascular | |
| | disability. | |
+--------+----------------------------------------------+----------------------+
| | and when a successful revascularization) | 30-40 |
| +----------------------------------------------+----------------------+
| | (b)) when the medium of functional disorders | 50-60 |
| +----------------------------------------------+----------------------+
| | (c)) with severe functional limitations | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Vazoneurózy, illness from oppression in the field top | |
| | thoracic Aperture or carpal tunnel | |
| | embolization, Vasculitis | |
+--------+----------------------------------------------+----------------------+
| | and I)-slight (reversible disorders | |
| | changes), occasional bouts of affecting tips | |
| | prstů | 5-15 |
| | | |
| | (b) Stage II). -Occasional attacks affecting | |
| | the distal and middle phalanges, double sided | |
| | moderate disorders, without failure, trofiky | |
| | certified thermal imaging clamp testing | 25-35 |
| +----------------------------------------------+----------------------+
| | (c) Stage III). -frequent seizures affecting | |
| | all articles of the fingers, double sided heavy | |
| | disorders, with permanent displays of vazospastickými | |
| | and vazoparalytickými, trofiky skin disorder | |
| | they are not defects | 45-60 |
| +----------------------------------------------+----------------------+
| | d) Stadium IV. -chronic closures | |
| | Digital arteries, trophic skin changes | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Varicose veins, posttrombotický syndrome, | |
| | recurrent thrombophlebitis | |
+--------+----------------------------------------------+----------------------+
| 7.1. | Stadium-with load-dependent | |
| | edema, without ulcerózních, without skin changes | |
| | significant difficulties of stasis, venous drainage | |
| | slightly decreased, the perimeter of the derogation, good performance | |
| | venous pump | 10 |
+--------+----------------------------------------------+----------------------+
| 7.2. | Stadium II. -single or double sided | |
| | disability, difficulty of engorgement, | |
| | often multiple times in recurrent inflammation | |
| | He lived, Dermatitis, deep vein involvement, | |
| | venous regurgitation, reduced performance of the vein | |
| | pumps, abbreviated venous filling time, maximum | |
| | the outflow has greatly reduced | 15-25 |
+--------+----------------------------------------------+----------------------+
| 7.3. | Stage III. -disability is zhojenými | |
| | recurrent ulcers, according to the scale and | |
| | the frequency, greatly reduced the performance of the venous pump | |
| | and venous filling time of deep veins | |
| | or regurgitation of the deep veins or | |
| | connectors, on the superficial veins regurgitation | |
| | hitting up on lower leg | |
+--------+----------------------------------------------+----------------------+
| | and unilateral) | 20-30 |
| +----------------------------------------------+----------------------+
| | (b)) two-sided | 40-60 |
+--------+----------------------------------------------+----------------------+
| 7.4. | Stage IV. -very hard to functional disability, | |
| | skin defects, having regard to the extent of the disability | |
| | (single-sided or double-sided find) | 40-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Lymph edema on one or both limbs | |
+--------+----------------------------------------------+----------------------+
| | and I)-without substantial restrictions | |
| | function, small chronic swelling (differential | |
| | the volume of up to 4 cm), the request compression bandages | 10 |
| +----------------------------------------------+----------------------+
| | (b) Stage II). -Permanent swelling with stronger | |
| | by increasing the volume (over 4 cm), with the constraint ' | |
| | the mobility of the limbs and joints | 20-35 |
| +----------------------------------------------+----------------------+
| | (c) Stage III). -Permanent big swelling | |
| | with the development of trophic skin changes with considerable | |
| | impairment of function of the affected limb | 40-50 |
| +----------------------------------------------+----------------------+
| | d) Stadium IV. -with a heavy lymfedemem of both | |
| | the lower limbs and with substantial restrictions | |
| | the overall performance and mobility | |
| | elephantiasis | 60-70 |
+--------+----------------------------------------------+----------------------+
Chapter X-
THE DIGESTIVE SYSTEM
SECTION A-
DISEASES OF THE ESOPHAGUS
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Diverticulum (by size and problems) | 10 |
+--------+----------------------------------------------+----------------------+
| | and) without significant barriers to food intake, | |
| | Depending on the size and problems | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with considerable obstacle to food intake, | |
| | According to the effect on the overall health (disorders | |
| | nutrition, anemia, weight loss), if not | |
| | Maybe the surgical treatment | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Chronic inflammation of the esophagus with gastro-oesophageal reflux | |
| | reflux and anemia | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Functional or organic esophageal stenosis | |
+--------+----------------------------------------------+----------------------+
| | and) without significant barriers to food intake by | |
| | the size of the problem | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with considerable obstacle to food intake by | |
| | the effect of the restrictions on forms of diet (extended | |
| | time for food) | 20-40 |
| +----------------------------------------------+----------------------+
| | (c)) with considerable disorder of nutrition and health | |
| | with a significant reduction in overall performance | |
| | the organism | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Malignant tumor of the oesophagus | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage and localization | |
| | the nature of the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and during the treatment of cancer) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | 60-70 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Total replacement of esophagus stent deployment | 70-80 |
+--------+----------------------------------------------+----------------------+
SECTION B-
DISEASES OF THE STOMACH AND DUODENUM
General evaluation policy:
When organic and functional diseases of the gastrointestinal tract is
establishes the rate of decline in ability to continuous employment according
the degree and severity of the injury, the overall state of organ failures and by buying
special diet diet and mode, and their impact on the overall performance
of the organism.
Allergic disease (food allergies) can rarely cause
the decline in ability to continuous employment.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Ulcer disease of the stomach and duodenum | |
+--------+----------------------------------------------+----------------------+
| | and recurring seasonal recurrence) in the past | |
| | three years later, clinically proven (x-ray | |
| | examination, fibroskopie), conservatively | |
| | treated, interval problems | 5-10 |
| +----------------------------------------------+----------------------+
| | (b)) often recurrent processes, in the meantime | |
| | with erosive gastritis, conservative treatment | |
| | Healing with significant deformation and repeatedly | |
| | dyspeptickými difficulties | 20-30 |
| +----------------------------------------------+----------------------+
| | c) operated by forms, with the recurrent processes | |
| | While considerable functional disorders and | |
| | with permanent significant deterioration of the status of the forces and | |
| | nutrition or with considerable complications and | |
| | by reducing the overall performance of the body | 40-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Irritating the stomach (malfunction) | 5-10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Conditions after stomach surgery (resection, clutch | |
| | operation, vagotomie) | |
+--------+----------------------------------------------+----------------------+
| | and functional) | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) with light functional disorders | 25-35 |
| +----------------------------------------------+----------------------+
| | (c)) with severe injury and substantial nutrition | |
| | by reducing the overall performance of the body | 40-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Malignant tumour of the stomach | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage and localization | |
| | the nature of the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and when the ongoing cancer treatment) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | |
| | with the ongoing problems, dyspeptickými | |
| | disorders of nutrition and substantial reduction | |
| | performance | 50-70 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
SECTION C-
DISEASES OF THE SMALL AND LARGE INTESTINES
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Chronic inflammation of the intestines, divertikulitis, | |
| | diverticulosis, partial resection of the intestine or | |
| | other intestinal disorders | |
+--------+----------------------------------------------+----------------------+
| | and) without significant problems, and the effects (eg. | |
| | irritable bowel syndrome) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with stronger permanent symptoms (eg. | |
| | diarrhea, spasms, several times a day reduction | |
| | the overall performance of the organism) | 20-35 |
| +----------------------------------------------+----------------------+
| | (c)) with a significant reduction in nutrition and health | |
| | with a significant reduction in overall performance | |
| | the organism with passages, decrease | |
| | weight, anemia, bleeding, recurring | |
| | inflammation, narrowing of the bowel | 40-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Colitis ulcerosa, Crohn's disease | |
+--------+----------------------------------------------+----------------------+
| | and having a low response) (no or negligible | |
| | reduce the overall performance of the organism | |
| | nutrition, intermittent diarrhea, no derogations | |
| | in laboratory findings) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with mild response (reduction of total | |
| | the performance of the body, and nutrition, frequent diarrhea | |
| | significant deviations in laboratory findings | |
| | with notable passages, disorders | |
| | with the kolonoskopicky discovered a slight activity | |
| | or occasional relapses) | 20-40 |
| +----------------------------------------------+----------------------+
| | (c)) with serious complications (e.g., heavy | |
| | malnutrition, fistula, perforation, resection, | |
| | disorders of passages) and a substantial reduction in | |
| | the overall performance of the body | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Intestinal malabsorption (e.g., celiac disease, sprue, | |
| | malabsorbsční syndrome) | |
+--------+----------------------------------------------+----------------------+
| | and) without significant sequelae in | |
| | diet and therapy | 5-10 |
| +----------------------------------------------+----------------------+
| | (b)) with a significant reduction in overall performance | |
| | the body, nutrition, and lack of | |
| | response to drug therapy and dietetic | |
| | režim | 30-40 |
| +----------------------------------------------+----------------------+
| | c) advanced forms-therapy | |
| | with a significant reduction in overall performance | |
| | the body and nutrition | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Malignant tumour of the small intestine and the colon, | |
| | anus | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage and localization | |
| | the nature of the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and) after removal of intestinal lokalisovaných | |
| | malignancies, colon or rectal tumors during | |
| | cancer treatment, without stoma | 50-70 |
| +----------------------------------------------+----------------------+
| | (b)) with colostomy, during cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | solved Ostomy (also valid for the stoma from other | |
| | causes of) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (50) |
| +----------------------------------------------+----------------------+
| | (d)) after their treatment, after reaching stabilization | |
| | health status (usually two years) | |
| | solved Ostomy, stoma function disorders | 60-70 |
| +----------------------------------------------+----------------------+
| | e) after achieving stabilisation of health | |
| | (as a rule, two years after the end of treatment), | |
| | No stoma, with lighter disorders | 30-40 |
| +----------------------------------------------+----------------------+
| | f) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Radiculopathy rectum, hemorrhoids and rectal | |
| | Fistula | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by the position and extent, | |
| | the influence of the sphincter and the intestinal wall, with a view | |
| | on the overall condition of the body. | |
+--------+----------------------------------------------+----------------------+
| | and with stronger permanent difficulties) (diarrhea | |
| | spasms, bleeding or secretion) | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) with complications and a strong response to the | |
| | overall status (repeated passages disorders | |
| | resection, persistent secretion) | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) with incontinence sphincter | 80-90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Fistula around anus | |
+--------+----------------------------------------------+----------------------+
| | and tiny, with occasional) secretion | 10 |
| +----------------------------------------------+----------------------+
| | (b)) a large anus prolapse, artificial anus and | |
| | heavily exuding 2nd degree sterkorální fistula, which | |
| | lead to significant pollution | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Adhesions abdominal lining | |
+--------+----------------------------------------------+----------------------+
| | and without a substantial response to) the intestinal passage | 5-10 |
| +----------------------------------------------+----------------------+
| | (b)) with significant disabilities passages | 20-30 |
+--------+----------------------------------------------+----------------------+
SECTION D-
DISEASES OF THE LIVER, BILIARY TRACT AND PANCREAS
General evaluation policy:
The rate of decline in the ability of continuous employment shall be at the
the basis of metabolic impairment of liver function (lab, skríningem
scintigrafií, where Doppler, CT SCAN, biopsy), the scope of the
functional and morphological disability, injury and the overall state of nutrition and
the need to adhere to the regime measures. It should also take into account the
the etiology of disabilities, the adverse side effects of treatment (flu-like
syndrome) as well as the fact that in advanced chronic lesions
the liver may not be normal values transaminas more proof of stabilization
the disease.
Morphological changes of the liver can reliably assess if available
qualitatively-quantitative evaluation. If the index of severity 1-3,
a completely insignificant changes. If the index of severity 4-8, it comes to light
hepatopatii and if the index of the severity of the 9-12, is a moderate
hepatopatii; When severity index over 12 of severe hepatopatii
(Knodellovo score-histological activity index).
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Liver disease | |
+--------+----------------------------------------------+----------------------+
| | and with a slight degree of disorder) | 5-10 |
| +----------------------------------------------+----------------------+
| | (b)) light disorders | 20 |
| +----------------------------------------------+----------------------+
| | c) moderate disorders | 30-50 |
| +----------------------------------------------+----------------------+
| | d) difficult disorders | 60-70 |
| +----------------------------------------------+----------------------+
| | e) States with severe urinary, portálním | |
| | oesophageal varices, bleeding, | |
| | signs of ascites, encephalopathy | 80-90 |
| +----------------------------------------------+----------------------+
| | f) conditions after clutch operation (portokavální | |
| | anastomosis) | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Conditions after resection of hepatic lobe, without | |
| | function disorders | 30-40 |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined after reaching stabilization. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Malignant tumour of the liver | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage and localization | |
| | the nature of the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and during the treatment of cancer) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | with heavy functional consequences | 60-70 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | State transplant | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Diseases of the gallbladder and bile ducts (litiáza, | |
| | chronic relapsing inflammation) | |
+--------+----------------------------------------------+----------------------+
| | and with colic in intervals) over several months, inflammation | |
| | at intervals of years | 5 |
| +----------------------------------------------+----------------------+
| | (b)) with more frequent colic (once a month) | |
| | and the occasional inflammation treated with antibiotics | |
| | as well as with intervalovými problems | 10-20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | The loss of the gallbladder | |
+--------+----------------------------------------------+----------------------+
| | and) without significant disorders | 5 |
| +----------------------------------------------+----------------------+
| | (b)) with functional residual disorders | |
| | (postcholecystektomický syndrome), on | |
| | lasting colic | 10-20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Malignant tumor of the gallbladder, the bile ducts or | |
| | papilla | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and during the treatment of cancer) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | |
| | with heavy functional consequences | 60-70 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Conditions after surgical and endoscopic | |
| | performances at the papilla and biliary tract | |
+--------+----------------------------------------------+----------------------+
| | and with persistent problems dyspeptickými) | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) status after repeated with subsequent performances | |
| | functional and morphological changes of pancreas | |
| | the bile ducts and liver, according to the degree of disorders | 30-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Chronic diseases of the pancreas under the effect | |
| | on the overall status of | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the degree of the scale and | |
| | the destruction of the parenchyma and the extent of disruption to externally | |
| | or secretory pancreatic function internally. | |
+--------+----------------------------------------------+----------------------+
| | and diarrhea only when dietary) errors | 5-10 |
| +----------------------------------------------+----------------------+
| | (b) more frequent diarrhea, slight) reduction in total | |
| | the performance of the body, and nutrition, dyspeptic | |
| | difficulties, intermittent pain | 20-25 |
| +----------------------------------------------+----------------------+
| | (c) more severe reduction in overall performance) | |
| | the body and nutrition with signs malabsorbce | 30-50 |
| +----------------------------------------------+----------------------+
| | (d)) a significant reduction in overall performance | |
| | the body and nutrition to kachektizace | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Malignant tumour of the pancreas | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and during the treatment of cancer) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | |
| | with heavy functional consequences | 60-70 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
SECTION E-
HERNIA
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Inguinal or femoral hernia (by size | |
| | and reponovatelnosti) | 5-10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Umbilical hernia or rupture in the white line | 10-15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Abdominal hernia scar | |
+--------+----------------------------------------------+----------------------+
| | and) with impaired abdominal organs (when | |
| | disorders of passages) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with a larger eventerací the bowels before belly | |
| | wall, mechanically limiting the performance | 35-50 |
| +----------------------------------------------+----------------------+
| | (c)) with an extensive eventerací the bowels before belly | |
| | wall, unsolvable, usually by surgery | |
| | with the significant limitations of cardiopulmonary | |
| | performance | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Diaphragmatic hernia reflux oesophagitis acting | 10-15 |
+--------+----------------------------------------------+----------------------+
Chapter XI-
URINARY SYSTEM
General evaluation policy:
The rate of decline in the ability of continuous employment shall be determined according to the
the degree of activity, the extent and gravity of the changes of the uropoethican function disorders
the system, which is necessary to determine the special functional tests (e.g..
by specifying the creatinine and urea, glomerular filtration rate, and
isotope concentration skills examination, urografií, urodynamickým
examination, endoscopy, Doppler). It is necessary to take account of disability
other authorities, the activity of the inflammatory process, the effects on the overall condition of the
the body and its performance.
SECTION A-
RENAL INVOLVEMENT
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Developmental anomalies of the kidney and urinary tract, | |
| | without substantial functional limitations | 5-10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Without functional limitations nephrolithiasis | |
| | with more frequent and colic problem | |
| | at intervals (infection, hematúrie) | 5-10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Renal impairment without functional limitations | |
| | with the kind of findings in urine light | |
| | (discreet proteinuria, bakteriurie, | |
| | microscopic hematuria) | 5-10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Renal impairment with a restriction of a function (without | |
| | regardless of the etiology of injury) | |
+--------+----------------------------------------------+----------------------+
| | and) light (reduced operational performance | |
| | the boundary values of creatinine and urea, light | |
| | reduction in glomerular filtration rate, light | |
| | the reduction in tubular resorbtion, no retention | |
| | katabolitů) | 10-20 |
| +----------------------------------------------+----------------------+
| | b) moderate degree (long term mild | |
| | clinical signs of renal insufficiency, | |
| | disorders of Glomerular filtration, tubular | |
| | resorbtion, the rise of creatinine | |
| | creatinine clearance, retention, katabolitů | |
| | changes in serum osmolality and urine, renal | |
| | hypertension, anemia, osteopathy option) | 30-50 |
| +----------------------------------------------+----------------------+
| | (c) heavy (clear) clinical signs | |
| | renal insufficiency of the managable | |
| | conservative measures, azotemia, | |
| | uremia, electrolyte disorders, severe changes | |
| | serum and urine osmolality, heavy find in urine | |
| | significant changes in the acid-base balance) | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Loss of function of one kidney or a swipe at | |
| | good second kidney function | 20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Loss or swipe function of one kidney | |
| | with functional restrictions the second kidney | |
+--------+----------------------------------------------+----------------------+
| | and) light | 25-35 |
| +----------------------------------------------+----------------------+
| | (b)) of the middle grades | 40-60 |
| +----------------------------------------------+----------------------+
| | (c) heavy (significant) alteration of total | |
| | the State, a significant reduction in overall performance | |
| | the organism) | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Kidney dialysis treatment | |
| | (dialysis or other eliminačními methods) | |
| | with regard to the present complications | |
+--------+----------------------------------------------+----------------------+
| | and with slight complications) | 35-50 |
| +----------------------------------------------+----------------------+
| | (b)) with severe complications | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Malignant tumour of the kidney | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and) during treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | |
| | When the good function of the solitary kidney | 30-50 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | |
| | When the reduced function of the solitary kidney | 50-70 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
| +----------------------------------------------+----------------------+
| | e) after resection of tumor with preservation of kidney | |
| | or after the removal of a kidney for tumor without | |
| | the need for subsequent cancer treatment, when | |
| | good healthy kidney function | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | State transplant | |
+--------+----------------------------------------------+----------------------+
| | and after reaching stabilization) of health | |
| | (usually one year) | 70 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | with regard to the persistent functional disorder | |
| | and possible complications | 30-60 |
+--------+----------------------------------------------+----------------------+
SECTION B-
DISABILITY OF THE URINARY TRACT
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Chronic inflammation of the urinary tract infection | 5-20 |
| | | |
| | The medical aspect: | |
| | | |
| | When determining the level of decline in skills | |
| | systematic work based on | |
| | from the range of disability (simple infection | |
| | lower respiratory, chronic recurrent infection | |
| | lower respiratory, pyelonephritidy), finds | |
| | significant bakteriurie, pyuria, proteinuria, | |
| | Leukocytosis and more of the total marks | |
| | inflammation and disease symptoms. Adverse | |
| | factor is obstruction or dysfunction of the urinary | |
| | paths, konkrement, impaired renal function, | |
| | the weakening of the immunity of the organism. | |
+--------+----------------------------------------------+----------------------+
| | and chronic or recurrent) pyelonephritida | 20-40 |
| +----------------------------------------------+----------------------+
| | (b)) a chronic or recurrent bacterial | |
| | inflammation of the lower urinary tract | 10 |
| +----------------------------------------------+----------------------+
| | c) interstitial cystitis demonstrated | |
| | clinically, endoscopically or histopatologicky | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Bladder emptying disorders | |
| | heavier grades according to the need of catheterization, | |
| | relapses uroinfekce | 30-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Malignant tumor of the urinary bladder | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and during the treatment of cancer) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | with functional consequences | 30-40 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | more serious surgery, a substantial reduction | |
| | the capacity of the bladder, or when | |
| | replacement bladder | 50-60 |
| +----------------------------------------------+----------------------+
| | (d) the form of untreatable) | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Urinary incontinence | |
| | | |
| | The medical aspect: | |
| | | |
| | When determining the level of decline in skills | |
| | gainful employment is to be objectively | |
| | quantify the incontinence of urine, to distinguish | |
| | its cause, whether the incontinence | |
| | stress, eg. reflective, urgent or | |
| | extraureterální. It is necessary to build on | |
| | the results of the expert examination, in particular | |
| | urodynamického, for example. cystoscopy, | |
| | cystografie, ultrasonography. If the | |
| | evidence of another type of incontinence than | |
| | stress incontinence is necessary to peace | |
| | functional consequences of compare with conditions here | |
| | referred to. | |
+--------+----------------------------------------------+----------------------+
| | and occasionally, and a unique departure) of urine when | |
| | load | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) light stress incontinence (urine loss | |
| | stressful maneuvers are less than 30 ml | |
| | leakage of urine when coughing, laughing, sneezing or | |
| | lifting heavy objects, use | |
| | assistive devices irregular) | 25-35 |
| +----------------------------------------------+----------------------+
| | c) medium stress incontinence (loss | |
| | urine when stressful maneuver are between 30-| |
| | 80 ml, leakage of urine occurs when you change the position, | |
| | running, walking, walking up the stairs, when lighter | |
| | physical work. The use of equipment is required | |
| | a day, each time a stressful maneuver) | 40-60 |
| +----------------------------------------------+----------------------+
| | d) severe urinary incontinence (loss of urine when you | |
| | stressful maneuvers are greater than 80 ml | |
| | leakage of urine occurs already at the minimum | |
| | the rise of the intra-abdominal pressure, urine leaks | |
| | virtually permanently. The use of assistive devices | |
| | incontinence is a constant necessity) | 80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Artificial drainage of urine | |
| | | |
| | The medical aspect: | |
| | | |
| | In assessing the extent of decline in earning | |
| | skills you need to be based on the scale and | |
| | severity of disability, which turned to artificial | |
| | dispersal of urine (especially if it is a | |
| | the cause of cancer) and rate | |
| | other causes and functional | |
| | consequences, with regard to possible disability | |
| | renal function. | |
+--------+----------------------------------------------+----------------------+
| | and, after the ortotopické) with a good functional | |
| | the result | 40-50 |
| +----------------------------------------------+----------------------+
| | (b)) into the intestine by disability, kidney function | |
| | and other functional disorders | 40-60 |
| +----------------------------------------------+----------------------+
| | (c)) on the outside (exhaust to a receiver or drénem) | |
| | or on the outside with kontinentním mechanism | |
| | (i.e. need regular catheterization) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (50-60) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Chronic digestive, urinary fistulas and | |
| | genital tract | |
+--------+----------------------------------------------+----------------------+
| | and a chronic fistula) with persistent mild | |
| | secretion | 20-40 |
| +----------------------------------------------+----------------------+
| | b) chronic fistula with hearty secretion | |
| | especially sterkorální, purulent or urinary | 60-80 |
+--------+----------------------------------------------+----------------------+
Chapter XII-
THE MALE SEXUAL ORGANS
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Diseases of male genitals, protracted | |
| | inflammatory processes associated with serious | |
| | disorders of urination, etc. | 10-20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Malignant tumour of the penis | |
| | | |
| | The medical aspect: | |
| | | |
| | In assessing the extent of decline in earning | |
| | capacity has to be considered out of scope and gravity | |
| | disabilities, clinical stage, type of cancer, | |
| | the progress and outcome of treatment, prognostic | |
| | criteria and functional consequences, mainly | |
| | the extent of surgery, removal of urine and | |
| | psychological disorder. | |
+--------+----------------------------------------------+----------------------+
| | and) after removal at an early stage | 30-40 |
| +----------------------------------------------+----------------------+
| | (b)) after removal in the late stages, during | |
| | cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | with respect to the outflow of urine | 30-60 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Malignant tumor of the testicle | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and) after removal in the early stages and after | |
| | adjuvant treatment, usually after | |
| | one year | 20-40 |
| +----------------------------------------------+----------------------+
| | (b)) after removal in the late stages, during | |
| | cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | 30-50 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Chronic inflammation of the prostate and benign | |
| | prostate hyperplasia with permanent significant | |
| | urinary disorders and conditions after operations | 10-20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Malignant tumour of the prostate | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and) after removal at an early stage | 20-40 |
| +----------------------------------------------+----------------------+
| | (b)) after removal in the late stages, during | |
| | cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | 30-50 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
Chapter XIII-
FEMALE REPRODUCTIVE ORGANS
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Breast diseases (inflammatory diseases, benign | |
| | tumors, cosmetic issues) | 10 |
| | | |
| | The medical aspect: | |
| | | |
| | The decisive criterion is the size of the tumour, | |
| | his character, the amount of the affected lymph nodes, | |
| | the extent of surgery, and other functional | |
| | restrictions in the shoulder or arm as pletenci | |
| | the consequences of the operation (e.g., Lymphedema, defects | |
| | muscles, lesions of the nerves), or unfavorable | |
| | psychological symptomatology. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Malignant tumor of the mammary gland | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and) after removal of stage I. | 30-40 |
| +----------------------------------------------+----------------------+
| | (b)) after removal of stage II, with regard to | |
| | the amount of the affected lymph nodes | 40-60 |
| +----------------------------------------------+----------------------+
| | (c)) after removal in the late stages-during | |
| | cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | d) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | For more advanced stages | 50-60 |
| +----------------------------------------------+----------------------+
| | e) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Status after the removal of the uterus for benign tumor, | |
| | endometriosis, etc. | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Malignant tumour of the uterus | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and after the removal of the tumour) of the body or neck in | |
| | stage I. | 30-40 |
| +----------------------------------------------+----------------------+
| | (b)) after removal of the tumour of the body or neck in | |
| | stage II, in the light of borne by function | |
| | the consequences, in particular, the inflammation of the bladder and | |
| | gut | 40-60 |
| +----------------------------------------------+----------------------+
| | (c)) after removal of the tumour in more advanced | |
| | stages, during cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | d) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment), | |
| | For more advanced forms of, in the light of borne by | |
| | functional consequences | 40-60 |
| +----------------------------------------------+----------------------+
| | e) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | The loss of the ovaries for inflammatory disease | |
| | a benign tumor, cyst | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Malignant tumor of ovary | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and during the treatment of cancer) | 70-80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | 60-70 |
| +----------------------------------------------+----------------------+
| | c) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Chronic or chronically relapsing | |
| | the inflammatory process appendages, or parametrial | |
| | the uterus | |
+--------+----------------------------------------------+----------------------+
| | and occasionally exacerbující) | 5 |
| +----------------------------------------------+----------------------+
| | (b)) often recurrent (3-4 times per year) | 10-15 |
| +----------------------------------------------+----------------------+
| | (c)), with extensive heavy grade palpačním | |
| | findings the necessity of repeated ATB therapy | |
| | with the dysurickými difficulties, recurrent | |
| | uroinfekcí | 20-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Endometriosis severe degree | 20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | The decline in the walls of the vagina, prolapse of the vagina or | |
| | the uterus | |
+--------+----------------------------------------------+----------------------+
| | and) without incontinence or with a minor | |
| | stress incontinence (grade I) | |
| | with regard to the pursued gainful activity | 10-25 |
| +----------------------------------------------+----------------------+
| | (b)), the more severe stress urinary incontinence | It is determined by |
| | | urologického |
| | | disability |
| | | referred to in this |
| | | Annex v, chapter |
| | | XI, section B, |
| | | item 4 (b), (c), (d) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | The supporting tissue weakness after exercise | |
| | plastic surgery | |
+--------+----------------------------------------------+----------------------+
| | and good operating effect) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with functional difficulties and reziduálními | |
| | by reducing the overall efficiency of the organism (without | |
| | urinary incontinence) | 20-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 11. | Kraurosis vulvae stronger degree | |
| | (substantial difficulties, secondary changes, eczema, | |
| | ulcers, scars) | 20-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
12. | Malignant tumor of the vagina and vulva genitals | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, nature | |
| | the tumor, the progress and outcome of treatment | |
| | residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and) after removal of stage I. | 30-40 |
| +----------------------------------------------+----------------------+
| | (b)) after removal in the late stages, during | |
| | cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | 30-50 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 13. | Menopausal and perimenopauzální disorders | |
| | persistent even in the established replacement | |
| | léčbě | 10-20 |
+--------+----------------------------------------------+----------------------+
Chapter XIV-
DISEASES OF THE SKIN AND SUBCUTANEOUS TISSUE
General evaluation policy:
The rate of decline in the ability of continuous employment shall be determined according to the
the location of the impact on the overall health of the body, accompanying symptoms,
alert to the relapses or to chronicitě. It is necessary to take into account whether or not the
the accompanying organ or system changes, abnormal, infectious complications,
restrictions on movement, etc.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Infections of the skin and subcutaneous tissue (a chronic | |
| | Pyoderma) | |
+--------+----------------------------------------------+----------------------+
| | and bounded processes, the temperate) extensions | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) signs, with a total response | |
| | the organism | 30-40 |
| +----------------------------------------------+----------------------+
| | (c) extensive, long-term), active travel | |
| | defying treatment with substantial reduction | |
| | the overall performance of the body | 50-60 |
| +----------------------------------------------+----------------------+
| | d) forms of particularly adverse course | |
| | (septic States) | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Blistering-Bullous disease (Pemphigus, | |
| | Pemphigoid) | |
+--------+----------------------------------------------+----------------------+
| | and bounded processes, the temperate) extensions | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) signs, with a total response | |
| | the organism | 30-40 |
| +----------------------------------------------+----------------------+
| | (c) extensive, long-term), active travel | |
| | defying treatment with substantial reduction | |
| | the overall performance of the body | 50-60 |
| +----------------------------------------------+----------------------+
| | d) forms of particularly adverse course | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Dermatitis and eczema | |
+--------+----------------------------------------------+----------------------+
| | and bounded by the speeches) (predilection place) | |
| | stabilized forms, sparse exacerbation | 5-15 |
| +----------------------------------------------+----------------------+
| | (b)) significant speeches, with frequent exacerbations | |
| | or generalized stabilized forms | 25-35 |
| +----------------------------------------------+----------------------+
| | (c)), the long-term recurrent broad hard | |
| | form-defying treat with substantial reduction | |
| | the overall performance of the body | 50-60 |
| +----------------------------------------------+----------------------+
| | d) forms of progress, particularly adverse | |
| | ongoing | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Papuloskvamózní disease (psoriasis, | |
| | Lichen), keratodermie | |
+--------+----------------------------------------------+----------------------+
| | and a bounded form, small) the intensity of the process | |
| | sparse exacerbation or forms widespread, | |
| | stabilized with long lasting remissions | 5-15 |
| +----------------------------------------------+----------------------+
| | (b)) significant speeches, frequent exacerbation or | |
| | generalized forms with long lasting remissions | 25-35 |
| +----------------------------------------------+----------------------+
| | (c) extensive, long-term), active travel | |
| | defying treatment with substantial reduction | |
| | the overall performance of the body | 40-60 |
| +----------------------------------------------+----------------------+
| | d) forms of the adverse course or separately | |
| | with severe permanent joint disability | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Urticaria and Erythema | |
+--------+----------------------------------------------+----------------------+
| | and) Urticaria often recurrent | 5 |
| +----------------------------------------------+----------------------+
| | (b)), angioedema, often relapsing, without | |
| | the permanent somatic consequences | 5 |
| +----------------------------------------------+----------------------+
| | (c)), the lasting nature of angioedema, with | |
| | serious reziduálními consequences, reduce | |
| | the overall performance of the organism (persistent | |
| | lymfedémy) | 25-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Diseases of the skin and subcutaneous tissue United | |
| | with chronic exposure (of the disease from the effects | |
| | mechanical, thermal, physical, | |
| | diseases from radiation) | |
+--------+----------------------------------------------+----------------------+
| | and bounded processes, the temperate) extensions | |
| | stabilized forms, sparse exacerbation | 15 |
| +----------------------------------------------+----------------------+
| | (b)) significant speeches, on exposed parts | |
| | the body, or generalized stabilized | |
| | forms, sparse exacerbation | 25-35 |
| +----------------------------------------------+----------------------+
| | c) generalized symptoms or status | |
| | with adverse course and unfavourable | |
| | localization | 40-60 |
| +----------------------------------------------+----------------------+
| | d) forms of particularly adverse course | |
| | (e.g., necrotic changes) | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Diseases of skin appendages (nail disease | |
| | alopecia, acne rosacea, etc.) | |
+--------+----------------------------------------------+----------------------+
| 7.1. | Attack all the nails, with eventually. the distraught woman | |
| | nail plates | 10-30 |
+--------+----------------------------------------------+----------------------+
| 7.2. | Alopecia, regardless of etiology | 10-20 |
+--------+----------------------------------------------+----------------------+
| 7.3. | Acne vulgaris heavier grades | 10-20 |
+--------+----------------------------------------------+----------------------+
| 7.4. | Acne conglobata, with total response | |
| | the organism (febrile States, arthralgia, | |
| | Fistula formation, limitation of movement) | 40-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Other diseases of the skin and subcutaneous tissue | |
| | (vitiligo, pigmentation disorder) | 5 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Malignant skin tumors | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage, localization | |
| | and the nature of the tumor, the progress and results | |
| | treatment, residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and in the process) after removal of the event as well. (II) | 20-30 |
| +----------------------------------------------+----------------------+
| | (b)) after removal in the late stages, during | |
| | cancer treatment | 70-80 |
| +----------------------------------------------+----------------------+
| | c) after reaching stabilization of health | |
| | (as a rule, two years after the end of treatment) | 30-50 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
Chapter XV-
SUPPORT AND THE MUSCULOSKELETAL SYSTEM
General evaluation policy:
The rate of decline in the ability of continuous employment shall be determined according to the
a functional disability (disability movement, load capacity) and the impact on
other organ systems.
When it detects movement, and degenerative changes it is necessary to compare, whether
their range and goes beyond the occurrence of changes typical of a certain age.
X-ray detection of degenerative changes only not expected
the continuous decrease in the ability of working activities, as well as the fact
the operation was performed on the leg or on the spine or the
to the accident. While chronic inflammation of the joints must be taken into account in addition to the
fault function also to the activity of the process.
When the total or osteomalácii osteoporosis (e.g., hormonal
disorders, gastrointestinal disorders, resorbčních
the kidneys) is the rate of decline in ability to continuous employment dependent
on the scope and degree of pathological changes of the skeleton and the resulting
disorders of function.
The rate of decline in the ability of continuous employment injuries
muscles and tendons shall be determined according to the functional injury and blood by disability
and the lymphatic system. Injuries can occur in the muscle fascia
rupture, but only in rare cases makes the decrease in the ability
continuous employment.
SECTION A-
DEGENERATIVE JOINT DISEASE, OSTEOARTHRÓZY
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| |% activities |
+-------------------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Osteoarthrózy | |
| | | |
| | The medical aspect: | |
| | | |
| | When determining the level of decline in skills | |
| | continuous employment should be | |
| | be based on the clinical findings, localization | |
| | and extent of the process, the quantity (number) | |
| | the affected joints, limiting the scope | |
| | Joint motion, to a bad position | |
| | instability of the joints, the accompanying expressions | |
| | in soft tissues, muscle atrophy and | |
| | Working limits of the resulting benefit. | |
| | The degree of X-RAY changes is not the essential application | |
| | criterion, significant changes are posudkově | |
| | in the load area. | |
+--------+----------------------------------------------+----------------------+
| | and light forms) ranging from how degenerative | |
| | changes the momentum of the joints is limited as a rule | |
| | about 1/4, is impeded by the long walk | |
| | stání | 10-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disability of one to two | |
| | bearing joints with functional restrictions of movement | |
| | in the affected joints by more than 1/4 | 20-35 |
| +----------------------------------------------+----------------------+
| | c) heavy impairment of two load-bearing joints or | |
| | more large joints, or severe disability | |
| | most of the small joints with advanced X-RAY | |
| | changes and functional restrictions on more than 1/3 | 40-50 |
| +----------------------------------------------+----------------------+
| | d) heavy deformation disability three and more | |
| | bearing joints or extensive distorting | |
| | affection of small joints, fast | |
| | progressive, limiting mobility | |
| | as a rule, by more than 1/2, with severe restrictions | |
| | performance | 60-80 |
+--------+----------------------------------------------+----------------------+
SECTION B-
INFLAMMATORY JOINT DISEASE
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Rheumatoid arthritis and its variants, | |
| | reactive arthritidy (Reiter's syndrome), | |
| | rheumatic fever, psoriatic arthritis, | |
| | infectious arthritidy. | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the general symptoms | |
| | and expressions of affection, the range of process | |
| | activities process (set out sérologicko | |
| | immunological testing, humorálními | |
| | indicators of inflammation, clinical and biochemical | |
| | laboratory findings), localization (mono-, | |
| | polyarticular form, small large joints) | |
| | changes in the X-RAY findings, accompanying symptoms | |
| | such as contractures, deformity, atrophy | |
| | muscle and according to the changes in the function of other organs | |
| | and systems. | |
+--------+----------------------------------------------+----------------------+
| | and lightweight form, rarely) recurrent, mild | |
| | renal impairment the affected system, with mild | |
| | humoral activity usually disability | |
| | a few small joints, with repeated | |
| | difficulties, if aggravated by prolonged standing and only | |
| | walk or limited capacity of limbs | 10-15 |
| +----------------------------------------------+----------------------+
| | b) protracted neprogredující forms, at times | |
| | recurrent, with less impairment | |
| | (limits about 1/3), with accompanying | |
| | difficulties, stationary x-ray findings | |
| | EV. occasional inflammatory findings, including laboratory | |
| | with a disability of one or more joints, | |
| | with a slight reduction in overall performance | |
| | the organism | 25-40 |
| +----------------------------------------------+----------------------+
| | c) moderate forms, with a permanently increased | |
| | humoral activity, with a significant reduction in | |
| | the overall performance of the organism, the more pronounced | |
| | impairment or frequent recurrences | 50-60 |
| +----------------------------------------------+----------------------+
| | (d)), or other severe forms, | |
| | always active, progressive, with distinctive | |
| | destructive x-ray changes and | |
| | severe hepatic impairment, affecting several | |
| | the joints, with a severe reduction in overall performance | |
| | the organism | 70-80 |
+--------+----------------------------------------------+----------------------+
SECTION C-
METABOLIC BONE DISEASE, OSTEOPOROSIS, OSTEOPATHY AND BONY
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Osteoporosis (regardless of cause), | |
| | osteomalacia, osteopenia, osteopathy | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by the function | |
| | disability resulting from the localization and | |
| | of the process activities (calcium metabolism | |
| | and phosphate, vitamin D, repeatedly | |
| | densitometricky proven pathology in | |
| | more bones), reduction of total bone mass, | |
| | architektoniky disorders of the bones, X-RAY changes | |
| | in predilekčních areas, the overall range of | |
| | disability, age, and continuous responses to | |
| | treatment. Bone loss by 10% corresponds to | |
| | Tskóre-1 (osteopenii). | |
+--------+----------------------------------------------+----------------------+
| | and) affecting the light form total | |
| | load capacity, with restrictions for long standing | |
| | and walking (whole body bone density decreased | |
| | about 10-20%, Tskóre-up to 1.0-2,0). | 10-15 |
| +----------------------------------------------+----------------------+
| | b) moderate form, with a substantial reduction in | |
| | the overall performance of the body and usually | |
| | significant impacts on mobility (whole body | |
| | bone density decreased by 25-30%, Tskóre | |
| | - 2,5 až - 3) | 35-50 |
| +----------------------------------------------+----------------------+
| | c) severe form, with increased lomivostí bones | |
| | and pathological fractures, severe deformation | |
| | the spine and long bones (whole body bone | |
| | density decreased by more than 35%, Tskóre | |
| | greater than-3.5) | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Sudeckova dystrophy | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the degree of the range | |
| | functional disturbances and localization process. | |
+--------+----------------------------------------------+----------------------+
| | and mild form) | 15-25 |
| +----------------------------------------------+----------------------+
| | (b)) or severe form an unfavourable location | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Chronic osteomyelitis | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | the activity is determined by functional disability | |
| | arising from the location, scope and activities | |
| | the process of with its effects on overall health and | |
| | any subsequent disease (e.g., anemia, | |
| | Amyloidosis). | |
+--------+----------------------------------------------+----------------------+
| | and light (localized), with negligible | |
| | activity, occasional and minor suppuration | |
| | in the fistula) | 10-20 |
| +----------------------------------------------+----------------------+
| | (b) moderate chronic ulceration | |
| | with the bones in the brain, mild persistent secretion | |
| | of the fistula, the signs of activity in the laboratory | |
| | Awards) | 30-40 |
| +----------------------------------------------+----------------------+
| | (c) heavy (larger) chronic | |
| | ulceration of the hitting to a bone, common hard | |
| | attacks of fever, clear infiltration | |
| | soft parts, suppuration and excretion | |
| | sekvestrů, signs of significant things to do | |
| | in laboratory findings) with alterations | |
| | total State | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Short stature, chondrodystrofie, | |
| | chondrodysplasie | |
+--------+----------------------------------------------+----------------------+
| | and) body height affected does not exceed 120 | |
| | cm (after their growth) | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-50) |
| +----------------------------------------------+----------------------+
| | (b)) with heavy deformitami limbs, chest | |
| | and with a significant reduction in overall performance | |
| | the organism, momentum, ventilation | 70-80 |
+--------+----------------------------------------------+----------------------+
SECTION D-
OTHER DISEASES OF SOFT TISSUES, TENDONS, LIGAMENTS, FASCIA, SYNOVIAL MEMBRANES AND
STOCK EXCHANGES
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Soft tissue disease | |
+--------+----------------------------------------------+----------------------+
| | and lightweight form, rarely) Relapsing, | |
| | with mild renal impairment the affected | |
| | the system, with repeated difficulties, if | |
| | aggravated by prolonged standing and walking only or limited | |
| | only load-carrying capacity of limbs | 10-15 |
| +----------------------------------------------+----------------------+
| | b) protracted neprogredující forms, at times | |
| | recurrent, with less impairment | |
| | (limits about 1/3), with considerable difficulties | |
| | EV. the occasional lab inflammatory findings | |
| | with disabilities usually one joint | 25-35 |
| +----------------------------------------------+----------------------+
| | c) forms with the joints or | |
| | structures and significant reduction in total | |
| | performance | 40-50 |
| +----------------------------------------------+----------------------+
| | (d)), or other severe forms, | |
| | always active, progressive, with severe | |
| | impairment, affecting several joints | 60-80 |
+--------+----------------------------------------------+----------------------+
SECTION E-
DISEASES OF MUSCLE
General evaluation policy:
The rate of decline in the ability of continuous employment shall be determined according to the
disorders of muscle function on each of the limbs and the torso
analogous to subsequently referred to disabilities and obrnám, in relation to the
total mobility, performance and fine motoric development.
The involvement of the muscles (regardless of cause), if it does not affect the
the overall performance of the organism and work inclusion, posudkově
rank.
However, it is necessary to take account of the specific disorders such as
lack of body proportions (e.g., chondrodystrofie), deformity
limbs, disorders of joint function, muscle function and structural analysis,
neurological disorders and EMG of the award. Likewise, it is necessary to take into account the
the degree of adaptation and compensation for the disorder.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Muscular dystrophy, myopathy, Myositis | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined without regard to etiology | |
| | the disease, with regard to the resulting disorder | |
| | function, mobility and overall performance | |
| | of the organism. | |
+--------+----------------------------------------------+----------------------+
| | and light with mild disorders) or local | |
| | dystrophy and atrophy, with restrictions only for | |
| | long standing and walking | 10-15 |
| +----------------------------------------------+----------------------+
| | b) moderately impaired, with slightly limited | |
| | mobility and a reduction in the overall performance of the | |
| | the organism | 30-40 |
| +----------------------------------------------+----------------------+
| | (c) serious disability a few combinations) | |
| | functional units | 50-60 |
| +----------------------------------------------+----------------------+
| | d) hard to fault with severe restrictions | |
| | mobility, daily activities heavily restricted | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Syndromes, muscle paralysis, myasthenia gravis | |
+--------+----------------------------------------------+----------------------+
| | and subjective problems, occasional) ability to | |
| | to cope with the day-to-day burden | 10 |
| +----------------------------------------------+----------------------+
| | (b)), the minimum fatigue, mild clinical | |
| | symptoms after performing clinical tests | |
| | (functionally insignificant ptoza, slight weakening | |
| | extensors after stress, abduction of the arms longer than | |
| | 2 min.), the inability to exercise harder | |
| | physical work | 15-25 |
| +----------------------------------------------+----------------------+
| | (c)) to fatigue, subjective symptoms after | |
| | load, partial restriction of normal daily | |
| | activities, intermittent diplopia and ptoza, | |
| | the inability to lift heavier objects, constraints | |
| | range, are not expressed in bulbar symptoms | |
| | weakness in the muscles of the pletencového | |
| | or extraokulárního muscles | 30-40 |
| +----------------------------------------------+----------------------+
| | d) moderate fatigue and weakness, | |
| | that part will improve after a rest, | |
| | restrictions on normal operating activities | |
| | may also be due to subjective symptoms | |
| | and clinical difficulties are present continuously, or | |
| | during the frequent attacks of the disease, medium | |
| | severe functional limitations | 50-60 |
| +----------------------------------------------+----------------------+
| | e) very severe fatigue and weakness, | |
| | the need for constant support in the daily | |
| | activities, bulbar symptoms or | |
| | clinical signs of impairment of muscle | |
| | pletencových, either permanently or when | |
| | minimum stress, severe functional limitations | 70-80 |
+--------+----------------------------------------------+----------------------+
SECTION F-
DORZOPATIE, DORZOPATIE AND SPONDYLOPATIE SOCIETY
General IRC policy
The rate of decline in the ability of continuous employment shall be determined according to the
the range of anatomical and functional disability of the spine, the resulting
performance limitations and mobility. The significance of the disability professional
Specifies the range of capabilities and localization of disability (monosegmentální,
plurisegmentální disorders), timing, nature and scope of
structural adjustment (compression, dislocation, instability, osteoporosis,
degenerative changes, inflammatory changes), limitation of movement,
Neurological symptomatology, in particular the presence of sensitive and motor
lesions, muscle weakness, spazmu, palsy, atrophy, etc. It is necessary to
exclude any extravetebrální problem.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Conditions after fractures of the spinous processes of the or | |
| | the transverse processes vertebral | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Degenerative changes in the spine and ploténkách | |
+--------+----------------------------------------------+----------------------+
| | and) without static effect, faulty posture, | |
| | muscle imbalance, disability usually | |
| | one section of the localized blockages | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with a light functional disabilities usually | |
| | more segments of the spine, with the occasional performers | |
| | symptoms of nerve and muscle stimulation | |
| | (e.g. cervical-cranial syndrome | |
| | cervikobrachiální syndrome, lumbar syndrome | |
| | ischialgie, sakroiliakálního | |
| | combining a, intermittent blockade), weakness | |
| | the muscle corset, restrictions of movement | |
| | in the affected section, limitations for enforced | |
| | position, and physically demanding activities | 15-25 |
| +----------------------------------------------+----------------------+
| | (c)) moderate disability usually more | |
| | sections of the spine, the recurrent stronger symptoms | |
| | nerve and muscle stimulation proven | |
| | EMG, moderate statickodynamická | |
| | insufficiency | 30-40 |
| +----------------------------------------------+----------------------+
| | (d)) with a permanent severe disabilities more features | |
| | sections of the spine and often recurrent | |
| | stronger, longer-lasting, irritating | |
| | signs of nerves and muscles proven EMG, | |
| | heavy staticko-dynamic insufficiency | |
| | significant impairment of muscle corset and | |
| | a substantial reduction in overall performance | |
| | the organism | 50 |
| +----------------------------------------------+----------------------+
| | (e)) with permanent adverse operational findings | |
| | Permanent strong expressions of irritation of the nerves and | |
| | muscles, severe parézami, bold | |
| | muscle atrofiemi, usually with disorders | |
| | These features (the severity of disability must | |
| | be accompanied by the outcome of the EMG) | 60-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | States after operations of spine and the discs, the States | |
| | after injuries of the spine and the discs | |
+--------+----------------------------------------------+----------------------+
| | and the States with mild residual) functional | |
| | finding | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) States with often recurrent or | |
| | longer-lasting symptoms of nervous and | |
| | muscle stimulation proven EMG, | |
| | insufficiency of the muscular corset and substantial | |
| | by reducing the overall performance of the body | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) with adverse residual functional discovery | |
| | and permanent strong expressions of irritation of the nerves and | |
| | the muscles of the proven EMG, severe out | |
| | symptomatologií, usually with disorders of functions | |
| | sphincters, severe parézami, bold | |
| | muscle atrofiemi, substantial restrictions | |
| | mobility and severe restrictions on daily activities | 70-80 |
| +----------------------------------------------+----------------------+
| | (d)) States in the perioperative period and | |
| | recovery (usually for one | |
| | roku) | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Congenital or acquired deformities of the spine | |
+--------+----------------------------------------------+----------------------+
| | and with negligible impairment) is impeded by the | |
| | long walk and parking | 10 |
| +----------------------------------------------+----------------------+
| | (b)) with moderate renal impairment (e.g. | |
| | in multiple motion segments expressed | |
| | restrictions to stiffness, also for scoliosis | |
| | 40-75 degrees for the wedge-shaped vertebrae, | |
| | motýlkovitých vertebrae, frozen round | |
| | the back, blocked the vertebra with the formation of gibu) | 25-40 |
| +----------------------------------------------+----------------------+
| | (c) the combination of more severe) sections | |
| | with adverse neurological symptomatologií, | |
| | persistent or severe root stimulation | |
| | striking phenomena, proven EMG | 50-60 |
| +----------------------------------------------+----------------------+
| | (d)) with severe hepatic impairment (e.g. solidification | |
| | large sections of the spine, the lasting sleep | |
| | position in the fuselage, which includes the brace | |
| | 3 sections of the spine, extremely created scoliosis | |
| | under the circumstances, with rotary slide, | |
| | spondylolisthesis slide and symptoms of irritation | |
| | or spinal cord compression) | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Scheuermann's disease | |
+--------+----------------------------------------------+----------------------+
| | and with severe hepatic impairment) | 20 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching stabilization of health | |
| | (usually after five years) | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Ankylosing spondylitis (spondylitis ankylosans) | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined according to the course, the range | |
| | disability (clinical and X-RAY), and localization | |
| | process activities and functional disorders of the joints | |
| | and spine, taking into account the other manifestations of | |
| | disability. | |
+--------+----------------------------------------------+----------------------+
| | and) light | 20-30 |
| +----------------------------------------------+----------------------+
| | b) moderate-IV. a degree of (current | |
| | solidification of several sections of the spine) | |
| | | |
| | The medical aspect: | (35-60) |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | |
| +----------------------------------------------+----------------------+
| | (c) heavy grade-V) degree, with stiffness | |
| | more sections of the spine or the large joints, | |
| | ventilation, heart disorders and performance | |
| | overall performance | 70-80 |
+--------+----------------------------------------------+----------------------+
SECTION G-
CONDITIONS AFTER INJURIES
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Conditions after fractures of the skeleton skull | |
+--------+----------------------------------------------+----------------------+
| | and) without involvement of brain functions | 5-10 |
| +----------------------------------------------+----------------------+
| | (b)) in the light of the malfunction of brain functions | 15-20 |
| +----------------------------------------------+----------------------+
| | (c)) at moderate brain failure | |
| | features | 30-45 |
| +----------------------------------------------+----------------------+
| | (d)) with severe and substantial reduction | |
| | overall performance | 50-70 |
| +----------------------------------------------+----------------------+
| | e) too difficult a disability, invasive | |
| | the integrity of brain functions | 80-100 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Conditions after fractures of the jaw | |
+--------+----------------------------------------------+----------------------+
| | and) without function | 5 |
| +----------------------------------------------+----------------------+
| | (b) the) wrong with the defect, healed, affecting | |
| | innervation, chewing, mimic, voice | 20-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | Conditions after fractures of the ribs of the isolated | 5 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | Conditions after fractures of the skeleton of the chest | |
+--------+----------------------------------------------+----------------------+
|: 4.1. | Conditions after injuries to the chest, a serial fracture | It is determined by |
| | ribs, breast bones with more severe fracture | the degree of disorder |
| | by limiting the momentum of the chest and chest wall | by item 5 |
| | with a violation of the functions of the lungs and heart | section B of chapter |
| | | (VIII) and item 1 |
| | | section A |
| | | Chapter IX |
+--------+----------------------------------------------+----------------------+
| 4.2. | The subsequent conditions without failure of lung function and | |
| | heart rate | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | Conditions after injuries of the pelvis, fractures | |
| | the pelvic bones and the symphysis, conditions after | |
| | fracture of sacrum and coccyx | |
| | | |
| | The medical aspect: | |
| | | |
| | Violation of related pelvic girdle | |
| | statics and dynamics of disorder of the spine and | |
| | the function of the lower extremities assessed | |
| | the persistent severity of the disorder. | |
+--------+----------------------------------------------+----------------------+
| | restrictive disorders) light and long standing | |
| | walking, with slight subjective problems | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) are moderate and statics | |
| | the dynamics of the spine and lower limbs | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) with a severe disruption of the statics and dynamics | |
| | the spine, severe movement disorders of the lower | |
| | persistent stimulation of the limbs, usually | |
| | hepatic sphincters, severe paresis, | |
| | muscle atrophy | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Complicated, multiple traumatic consequences | |
| | on a number of organs or systems. | |
| | | |
| | The medical aspect: | |
| | | |
| | Is assessed having regard to the overriding function | |
| | disability, in particular, limit the total rate | |
| | performance, the amount and intensity of the adverse | |
| | the accompanying consequences. | |
+--------+----------------------------------------------+----------------------+
| | and the fault light) | 10-15 |
| +----------------------------------------------+----------------------+
| | b) moderate disorders | 25-40 |
| +----------------------------------------------+----------------------+
| | c) heavy disorders | 50-70 |
| +----------------------------------------------+----------------------+
| | d) particularly difficult disorders | 80 |
+--------+----------------------------------------------+----------------------+
SECTION H-
DISABILITIES OF THE LIMBS
General evaluation policy:
The rate of decline in the ability of continuous employment shall be fixed with
given the scale and borne by the loss of injury, congenital or acquired
defects, after operations and injuries, inflammatory and degenerative
the disease.
When determining the level of decline in ability to continuous employment is
When the upper limb disability should be based on whether it is a
dominant or non-dominant limb disability.
Referred to systematic degradation rate of employment for
amputačních losses is based on the favourable conditions of the residual limb and the neighboring
the joints. In a decidedly unfavourable state of the residual limb, as well as serious
malfunction of the adjacent joint is necessary to increase these rates in accordance with § 6
paragraph. 4 Decree.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Conditions after injuries or operations of the skeleton | |
| | limbs and pelvis with and more | |
| | complicated wound (lack of | |
| | ossification, persistent inflammatory changes | |
| | disorders of blood circulation, muscles, vychudnutí | |
| | disorders of innervation, Sudeckova dystrophy) | |
| | with the impossibility of normal load disabled | |
| | limbs, to functionally satisfactory adjustment | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 2. | Aseptic necrosis | |
| | | |
| | The medical aspect: | |
| | | |
| | After an active stage, the rate of decline in skills | It is determined by |
| | continuing professional activity determined by | the function of the award |
| | the persistence of functional disorders. | on the affected |
| | | Joint |
| | | limb |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 3. | The loss of both upper limbs in the wrists | |
| | a výše | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 4. | The loss of one upper limb and one lower | |
| | limb | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 5. | The loss of one of the upper limb in the shoulder | |
| | joint or with very short stump arm | |
+--------+----------------------------------------------+----------------------+
| | and the dominant limb) | 60-70 |
| +----------------------------------------------+----------------------+
| | (b)) on the nondominant limb | 55-60 |
| +----------------------------------------------+----------------------+
| | (c) more extensive loss of upper amputační) | |
| | limb | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-50) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 6. | Stiffening of the shoulder joint | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position when) well my motion | |
| | shoulder pletenci | 15-20 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position on the non-dominant | |
| | limb | 20-30 |
| +----------------------------------------------+----------------------+
| | (c)) in a hostile position on dominant | |
| | limb | 30-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 7. | Restrictions on the mobility of the shoulder joint | 10-15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 8. | Habitual dislocation of the shoulder | |
+--------+----------------------------------------------+----------------------+
| | and) isolated dislocated | 10 |
| +----------------------------------------------+----------------------+
| | (b)) more frequent dislocations with performance restrictions | |
| | limb | 15-20 |
| +----------------------------------------------+----------------------+
| | sternoclavicular joint dislocation or c) | |
| | the restricted performance akromioklavikulární | |
| | limb | 15-20 |
| +----------------------------------------------+----------------------+
| | d) joint viklavý | 20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 9. | Clavicle Pseudoartróza | 5-10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 10. | Status after hip humerus healed | |
| | in a hostile position with considerable | |
| | by limiting the exercise of limbs | 20-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 11. | Conditions after ruptures of the muscles and tendons (possibly | |
| | even on the lower extremities) | 10-15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
12. | Pseudoartróza humerus | |
+--------+----------------------------------------------+----------------------+
| | and the dominant limb) | 40-50 |
| +----------------------------------------------+----------------------+
| | (b)) on the nondominant limb | 25-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 13. | Chronic radial and ulnar epicondylitis | |
| | the load capacity of the limb-restricted (with light | |
| | Motor innervation and vasomotoriky) | |
+--------+----------------------------------------------+----------------------+
| | a) disability of one limb | 10-15 |
| +----------------------------------------------+----------------------+
| | (b) disability of both limbs) | 20-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 14. | Stiffness in the elbow | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position) | 20-30 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-45) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
1. | Restrictions on movement in the elbow | |
+--------+----------------------------------------------+----------------------+
| | and a slight degree of free) Rotary | |
| | the mobility of forearm | 10 |
| +----------------------------------------------+----------------------+
| | (b) a more severe degree of (including) | |
| | the rotational movement of the forearm) | 20-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 16. | Failure of rotational movement of the forearm | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position) (medium pronační | |
| | position) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position | 20 |
| +----------------------------------------------+----------------------+
| | (c)) disappearance of rotational mobility | 25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 17. | Viklavý elbow joint | 20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 18. | Pseudoartróza one or both of the bones of the forearm | 15-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 19. | Status after hip bones RADIUS and ulna | |
| | healed with dislocation | 10-15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 20. | Status after hip bones RADIUS and ulna | |
| | healed with significant dislocations and functional | |
| | disorder of the adjacent joints, limited | |
| | the performance of limbs | 25-35 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 21. | Stiffness in the wrist-joint | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position) (light dorsal | |
| | extension) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position | 15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 22. | Movement restrictions in the carpal joint | |
+--------+----------------------------------------------+----------------------+
| | a slight degree) | 5 |
| +----------------------------------------------+----------------------+
| | (b) more serious degree) | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 23. | Poorly healed or unhealed broken bones | |
| | the carpal bones or one or more | |
| | záprstních bone with considerable impairment | |
| | ruky | 10-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 24. | Carpal tunnel syndrome (limited | |
| | the load capacity of the limb. treated | |
| | operationally, with regard to the detriment of neuromuscular | |
| | According to EMG disorder) | |
+--------+----------------------------------------------+----------------------+
| | and involvement of one limb) reduction | |
| | load capacity | 10-15 |
| +----------------------------------------------+----------------------+
| | (b)) with a reduction in both limbs disability | |
| | the load capacity and with a slight disruption of the delicate | |
| | motor skills | 20-30 |
| +----------------------------------------------+----------------------+
| | (c) the involvement of both legs) with moderate | |
| | disruption of the fine motor skills and atrofiemi | |
| | the small muscles of the hand | 35-45 |
| +----------------------------------------------+----------------------+
| | (d)) with severe impairment of both hands, | |
| | in particular, a violation of the grip and the essential | |
| | the downturn forces | 50-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 25. | Stiffening of the joints of the thumb on the hand in good | |
| | position | 5 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 26. | Solidification of one finger | 5 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 27. | The loss of the final article and half of the basic | |
| | article at the dominant hand | 5 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 28. | The loss of inches on your dominant hand | 25-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 29. | The loss of one finger (in addition to the inch) | 10-15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 30. | The loss of three fingers except thumbs | |
+--------+----------------------------------------------+----------------------+
| | and dominant limb) | 25-30 |
| +----------------------------------------------+----------------------+
| | (b)) the nondominant limb | 20 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 31. | The loss of all 10 fingers on both hands | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 32. | The loss of grip of the hand on the basis of ability | |
| | the absence or stiffness of all fingers one | |
| | a hand or a few fingers of both hands | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-45) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 33. | Deformity of the fingers of both hands when preserved | |
| | the function of the hand. the combined losses | |
| | several fingers of both hands (except thumb) | |
| | When preserved function of grip | |
+--------+----------------------------------------------+----------------------+
| | and) lighter find | 10-20 |
| | | |
| | (b)), a more serious violation of the heavier find function | |
| | rukou | 40-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 34. | Nervous forays | |
| | | |
| | The medical aspect: | |
| | | |
| | When the dominant limb down | |
| | the rate of decline in the ability of systematic professional | |
| | activities higher than when non-dominant | |
| | the limb. | |
| | | |
| | Referred to systematic degradation rates | |
| | gainful activity corresponding to hard failure | |
| | to complete a lunge from EMG findings. | |
| | | |
| | Sensitive innervation of isolated outages | |
| | rank, only in case of loss of sensitive | |
| | innervation of the whole limb rate | |
| | the continuous degradation of earning | |
| | the activities of the 20%. At moderately heavy outage | |
| | Motor innervation of the drop rate | |
| | the abilities of continuous employment | |
| | Typically, half the rate than they are | |
| | subsequently listed. | |
+--------+----------------------------------------------+----------------------+
| 34.1. | Plexus brachialis | 60-70 |
+--------+----------------------------------------------+----------------------+
| 21.3. | The upper portion of the plexus brachialis | 40-50 |
+--------+----------------------------------------------+----------------------+
| 21.3. | The lower portion of the plexus brachialis | 50-60 |
+--------+----------------------------------------------+----------------------+
| 21.4. | N. axillaris | 20-25 |
+--------+----------------------------------------------+----------------------+
| 21.4. | Radial, the entire nerve | 25-35 |
+--------+----------------------------------------------+----------------------+
| 21.5. | Radial-middle or distal area | 10-20 |
+--------+----------------------------------------------+----------------------+
| 21.6. | N. ulnaris proximal or distal | 25-35 |
+--------+----------------------------------------------+----------------------+
| 21.6. | Proximal median | 25-35 |
+--------+----------------------------------------------+----------------------+
| 21.7. | Distal median | 30 |
+--------+----------------------------------------------+----------------------+
| 34.10. | NN radial et axillaris | 30-40 |
+--------+----------------------------------------------+----------------------+
| 34.11. | NN radial et ulnaris | 30-40 |
+--------+----------------------------------------------+----------------------+
| 34.12. | NN radial et median nerve | 30-40 |
+--------+----------------------------------------------+----------------------+
| 34.13. | NN radial, median nerve in the area of ulnaris et | |
| | forearm | 40-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 35. | The loss of both legs in Chopartových | |
| | joints, your shins and above | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 3. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 36. | The loss of one leg in the hip | |
| | joint or with very short stump thighs | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 37. | The loss of one leg at the thigh | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-60) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 38. | The loss of lower extremity amputees, instep or | |
| | Chopartově joint | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-40) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 39. | The loss of inches and feet with the loss of the header. | |
| | the bones of the instep or the loss of another finger | 10 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 40. | The Loss Of II. -Finger or even in..-III. your finger | |
| | nohy | 10-15 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 41. | Loss of all toes of one foot. | |
| | amputation in Lisfrankově joint | 20-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 42. | Loss of all toes of both feet by State | |
| | stump | 30-60 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 43. | Solidification of both hip joints in a hostile | |
| | position | 70-80 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 44. | Stiffening of the one of the hip joint in good | |
| | position (flexion, external rotation of 20 degrees | |
| | 20 degrees, the middle position between abdukcí | |
| | and addukcí) | 30-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 45. | Solidification of a hip joint | |
| | in a hostile position | |
| | | |
| | The medical aspect: | |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | (35-50) |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 46. | Restrictions on the movements of the hip joints | |
| | | |
| | The medical aspect: | |
| | | |
| | Posudkově important is mainly the limits | |
| | internal rotation, extension and flexion. Degree | |
| | X-RAY changes is significant if posudkově | |
| | are localized in the load area. | |
+--------+----------------------------------------------+----------------------+
| 28.6. | Light | |
+--------+----------------------------------------------+----------------------+
| | a) unilaterally | 10 |
| +----------------------------------------------+----------------------+
| | (b)) two-sided | 20 |
+--------+----------------------------------------------+----------------------+
| 28.7. | Middle grades | |
+--------+----------------------------------------------+----------------------+
| | a) unilaterally | 20-25 |
| +----------------------------------------------+----------------------+
| | (b)) two-sided | 40-45 |
+--------+----------------------------------------------+----------------------+
| 28.8. | Heavier grades | |
+--------+----------------------------------------------+----------------------+
| | a) unilaterally | 30-40 |
| +----------------------------------------------+----------------------+
| | (b)) two-sided | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 47. | Necrosis of the bone of the thigh | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activity is dependent on continuing | |
| | disability, mobility and carrying capacity | |
| | as a rule, for the duration of the activity. | |
+--------+----------------------------------------------+----------------------+
| | and when the good function of the limb) | 30-40 |
| +----------------------------------------------+----------------------+
| | (b)) with significantly impaired limb function | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 48. | Pseudoartróza femoral neck or | |
| | the femur | 50-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 49. | The status of the broken femur (neck, | |
| | the diaphysis, epicondyle disorders) treated conservatively | |
| | I osteosyntézou | |
+--------+----------------------------------------------+----------------------+
| | and when the good function of the limb) | 20-30 |
| +----------------------------------------------+----------------------+
| | (b)) with significantly impaired limb function | |
| | (marked deformity, muscle atrophy, disorder | |
| | Motor innervation, the short circuit by 4 cm and more) | 40-45 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
|-50. | Endoprosthesis of the hip, knee joints | |
| | | |
| | The medical aspect: | |
| | | |
| | When Endo-replacement joints is the rate of decline in | |
| | the abilities of continuous employment | |
| | dependent on the continuing disability | |
| | mobility and carrying capacity, for example. | |
| | impaired Motor innervation, muscle | |
| | atrophy, a shortening of the limb more than 4 cm. | |
+--------+----------------------------------------------+----------------------+
| 31.1. | Simplex (total joint replacement) | 20-35 |
+--------+----------------------------------------------+----------------------+
| 31.2. | Double-sided (total joint replacement) | 40-70 |
+--------+----------------------------------------------+----------------------+
| 50.3. | States in the perioperative period and | |
| | recovery (usually for one | |
| | roku) | 70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 51. | Stiffness in both knee joints | 60-70 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 52. | Stiff one knee replacement surgery | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position () bend around | |
| | 10 degrees) | 25-30 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position | |
| | | |
| | The medical aspect: | (40-50) |
| | | |
| | This disability is assessed according to | |
| | Annex No. 4. | |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 53. | The release cord apparatus of knee | |
+--------+----------------------------------------------+----------------------+
| | and unstable place) | 10 |
| +----------------------------------------------+----------------------+
| | (b)), unstable, precarious, incomplete walk | 20 |
| +----------------------------------------------+----------------------+
| | (c) requiring the securing of significant instability) | |
| | supporting apparatus, according to the position and axis | |
| | deviation and violation of the functions of the limb | 25-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 54. | Permanent damage after the exclusion of meniscal pathology | |
+--------+----------------------------------------------+----------------------+
| | and with good stability and) range | 10 |
| +----------------------------------------------+----------------------+
| | (b)) when you moderate a failure | 20 |
| +----------------------------------------------+----------------------+
| | (c)) when heavy function of the knee joint, | |
| | significant instability | 25-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 55. | Fracture of patella kostně nezhojená, with limited | |
| | functions of the extension assist apparatus, uncertain gait, | |
| | the need to use supporting apparatus | 20-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 56. | Restrictions on movement in both knee joints | |
| | | |
| | The medical aspect: | |
| | | |
| | Posudkově important is mainly the side | |
| | instability and limits extension. The Degree Of RADIOLOGY | |
| | change is significant if the posudkově | |
| | located in the stress field of the joints. | |
+--------+----------------------------------------------+----------------------+
| | and) light-tailed | 10 |
| +----------------------------------------------+----------------------+
| | (b) moderate-tailed) | 15-20 |
| +----------------------------------------------+----------------------+
| | (c) heavy-tailed degree) | 25-30 |
| +----------------------------------------------+----------------------+
| | d) light-sided | 20 |
| +----------------------------------------------+----------------------+
| | (e)) of the middle grades-double sided | 25-30 |
| +----------------------------------------------+----------------------+
| | (f) the heavy degree-double-sided) | 40-50 |
| +----------------------------------------------+----------------------+
| | g) too difficult two-sided disorders | |
| | with a strong deflection and desaxací | 55-65 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 57. | The status of the broken tibia | |
+--------+----------------------------------------------+----------------------+
| | and) well healed | 5 |
| +----------------------------------------------+----------------------+
| | (b)), the short angulací healed and well | |
| | impaired limb function | 30-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 58. | Pseudoartróza tibia | 30-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 59. | Status after hip external and internal | |
| | the ankle | |
+--------+----------------------------------------------+----------------------+
| | and) well healed | 10-20 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position with healed | |
| | greatly impaired limb function | 30-40 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 60. | The status of the broken heel bone | |
+--------+----------------------------------------------+----------------------+
| | and) well healed | 10-20 |
| +----------------------------------------------+----------------------+
| | b) healed with severe structural engineering | 30-40 |
| +----------------------------------------------+----------------------+
| | (c)) after bilateral fractures | |
| | healed with severe stability and | |
| | chůze | 40-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 61. | Stiffening of the upper ankle | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position () stiffness | |
| | in neutral position) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position | 15-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 62. | Stiffness in the lower ankle | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position) (middle position) | 10 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position | 15-25 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 63. | Stiffening of the top and bottom of the foot | |
| | Joint | |
+--------+----------------------------------------------+----------------------+
| | and in a favourable position) | 15 |
| +----------------------------------------------+----------------------+
| | (b)) in a hostile position | 20-30 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 64. | PES equinovarus (according to the function-| |
| | with severe deformities and severe liver impairment | |
| | chůze) | |
+--------+----------------------------------------------+----------------------+
| | and) single sided | 20-30 |
| +----------------------------------------------+----------------------+
| | (b)) two-sided | 30-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 65. | The other foot deformity | |
+--------+----------------------------------------------+----------------------+
| | and) without significant static effects (e.g. | |
| | reduction of the foot arch, dog transversoplanus, | |
| | PES excavatus, pes valgus, also | |
| | Posttraumatic) | 5 |
| +----------------------------------------------+----------------------+
| | (b)) with a static effect by functional | |
| | disorders | 10-30 |
| +----------------------------------------------+----------------------+
| | (c)) with double-sided heavy deformitami and | |
| | the heavier the mobility disorder | 40-50 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 66. | Solidification or deformity of the fingers of the foot | 5 |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 67. | Nervous forays | |
| | | |
| | The medical aspect: | |
| | | |
| | Vasomotorické and trophic disorders are already | |
| | in the continuous degradation rates rates | |
| | gainful activities included. | |
| | | |
| | Referred to systematic degradation rates | |
| | gainful activity corresponding to hard failure | |
| | to complete a lunge from EMG findings. | |
| | | |
| | Partial strikes nerve is assessed appointed | |
| | třetinovými values moderate | |
| | motor thrust is usually assessed | |
| | half the values. Sensitive lunges | |
| | innervation for the entire lower limb to be assessed | |
| | directly 30%. Isolated sensitive disorders | |
| | rank. | |
+--------+----------------------------------------------+----------------------+
| 41.7. | Plexus lumbosacralis | 65-70 |
+--------+----------------------------------------------+----------------------+
| 41.8. | N. femoralis | 40-45 |
+--------+----------------------------------------------+----------------------+
| 41.8. | N. ischiadicus | 50-70 |
+--------+----------------------------------------------+----------------------+
| 41.9. | N. tibialis | 30 |
+--------+----------------------------------------------+----------------------+
| 67.5. | N. fibularis | 30 |
+--------+----------------------------------------------+----------------------+
SECTION I-
TUMORS OF THE BONE, CARTILAGE, MUSCLE AND SOFT TISSUE
General evaluation policy:
Is assessed having regard to the prevailing functional disability, in particular restrictions
the overall performance, the amount and intensity of the adverse movement
the consequences, the nature of the tumor (malignant, benign, metastasis), and the result
treatment.
If as a result of cancer treatment to perform amputations, the
the continuous decrease in the ability of working activities, depending on the
Chapter.
Similarly, in cases where a tumour or its removal
There has been a violation of the stability of the carrier or of the musculoskeletal system and restrictions
momentum.
+--------+----------------------------------------------+----------------------+
| Item | Type of disability | Drop rate |
| | | abilities |
| | | constant |
| | |-gainful |
| | |% activities |
+--------+----------------------------------------------+----------------------+
+--------+----------------------------------------------+----------------------+
| 1. | Malignant tumors of the bone, muscle and soft | |
| | tkání | |
| | | |
| | The medical aspect: | |
| | | |
| | The rate of decline in the ability of systematic professional | |
| | activities shall be determined by the extent and severity of | |
| | disabilities, clinical stage and localization | |
| | the nature of the tumor, the progress and results | |
| | treatment, residual functional disorders and | |
| | prognostic criteria. | |
+--------+----------------------------------------------+----------------------+
| | and when the ongoing cancer treatment) | 80 |
| +----------------------------------------------+----------------------+
| | (b)) after reaching a stabilisation of health | |
| | State (usually two years after | |
| | the end of treatment) | 30-50 |
| +----------------------------------------------+----------------------+
| | (c)) after reaching a stabilisation of health | |
| | State (usually two years after | |
| | the end of treatment) with severe functional | |
| | deficits, in particular amputačními | |
| | loss of limbs | 60-70 |
| +----------------------------------------------+----------------------+
| | d) adverse forms, progressive, | |
| | recurrent | 90 |
+--------+----------------------------------------------+----------------------+
Note:
If for some disability percentage rates are
the continuous degradation of working activities in parentheses,
This is an approximate figure for cases in which the decisive cause of
long term adverse health condition is a disability
considerably hamper the general living conditions and posudkově are detected
the operative event for the recognition of full disability. ".
Article II
This Decree shall enter into force on 1 January 2000. April 2000.
Minister:
PhDr. In r.
