Cabinet of Ministers Regulations No. 650 in Riga 2003. on 19 November (pr. No 60 9) disability expertise procedure health and capacity of the National Commission of physician expertise issued in accordance with the law "on medical and social protection" 10. the second paragraph of article 1. determines the order in which the health and integrity of the expertise of the national medical Commission and its departments, the General and special profile and capacity of health expertise doctor Commission (hereinafter the Commission doctor), disability expertise.
2. the Commission shall take the doctor disability expertise to Latvian citizens, non-citizens, stateless persons of Latvia, the Republic of Latvia received identity documents of stateless persons and foreigners who have received permanent residence permits, if that person has not reached the statutory retirement age (except this rule 3 and 5 in paragraph), including children up to 16 years of age (hereinafter referred to as the parties), according to the residence of the person concerned and disease profile.
3. The Person reached retirement age the doctor investigates the Commission, if the person concerned for the mental and physical limits is not related to the age of consequences.
4. If you have an accident at work, the doctor investigates the Commission employees and other persons in accordance with the laws and regulations are subject to compulsory social insurance against accidents and occupational disease.
5. Foreigners who have received permits, doctor termiņuzturēšan, the Commission investigates compliance with international agreements.
6. the Commission presented the doctor identity document and submitted to the referring physician referrals.
7. in addition to the provisions referred to in paragraph 6 of document in some cases to be submitted the following documents: 7.1 for accidents at work, act in accordance with the provisions of the Cabinet of Ministers on the accidents at work of investigation and accounting procedures;
7.2. the occupational diseases – a non-profit organisation State joint stock company "p. stradiņa clinical University Hospital ' occupational and radiation Medical Center doctor in the opinion of the Commission;
7.3. on disability from childhood – the hospital's certified;
7.4. the illness (disability) associated with the Chernobyl nuclear power plant emergency relief or with being in the Chernobyl nuclear power plant accident zone – a non-profit organisation State joint stock company "p. stradiņa clinical University Hospital ' occupational and radiation Medical Center doctors ' opinion of the Commission on the disease, disability and death in the causal relation with the Chernobyl accident;
7.5. the illness (disability) associated with the person's participation in such a force majeure event, accidental or other exceptional circumstances lead to consequences that could jeopardize or threaten public security or order, the treatment services and law enforcement authorities issued certificates;
7.6. the illness (disability) associated with the service in the armed forces or the National Defence Ministry, the national armed forces central medical expertise Commission decision;
7.7. the illness (disability) associated with the service system of the Ministry of the Interior, the Ministry of the Interior – central medical examiner's opinion of the Commission;
7.8. the disability suffered because of war or during the service in foreign armed forces, issued to the person concerned-war medical document.
8. If a person's State of health in accordance with the opinion of the treating physician is unable to attend a doctor on the premises of the Commission's work, the doctor, the Commission may carry out inspections in the residence of the person concerned or fixed.
9. If a person is defined in annex 1 of these rules that disease and anatomical defects, disability expertise doctor the Commission may carry out without the presence of the person concerned, on the basis of such medical documents submitted to the Commission: the application of the person with 9.1 current health and social functional description (if necessary, the application fills in the person's legal representatives or local social service);
9.2. the rules referred to in paragraph 6 referring physician referrals;
9.3. personal disposable medical documentation (excerpt from outpatient, hospital patient medical record).
10. After the person's doctor of the investigation the Commission decides and determines: 10.1 the severity of disability;
10.2. the cause of disability;
10.3. capacity loss percentage (if a person presented this rule 7.1, 7.2, 7.4, 7.5, 7.6, 7.7 and 7.8. documents referred to).
11. the Commission shall provide to the person the doctor recommendations for the necessary retraining according to health or other professions.
12. in the light of the severity of the disability, the first or the second group of disability (severe disability) or third disability group (moderate disability expressed). Children up to 16 years of age shall be determined without a breakdown of disability groups, taking into account the clinical indications and disease caused by the body's functional disorders (annex 2).
13. the Commission, after considering the Doctor dialed, and possible personal treatment and rehabilitation measures and their results, as well as opportunities to integrate into society, the disabled States: 13.1 for a certain period of time (six months, one year, two years or five years);
13.2. without repeating the references of the period of investigation in the following cases: 13.2.1. person's anatomical defect;
13.2.2. the person has the mental defect (idiotij);
13.2.3. diseases caused by organisms of morphological change and functional disorders after five years of observation is considered irreversible.
14. the disability for a certain period of time to determine the last date of the month in which the repeated disability expertise.
15. the disability determination date to be the day when all these rules 6 and 7 of the person referred to in paragraph the documents necessary for its investigation, the Commission registered doctors, irrespective of the person's actual date of the examination.
16. If the disability during the person's health status is changed, the doctor, the Commission shall, on the basis of a disability or other stakeholder submissions and referring physician referrals, carried out repeated inspection of disability before the deadline, as well as this rule 13.2. in the cases referred to.
17. Where a decision has been taken for the determination of disability, the date of adoption of the decision, the Commission shall issue to the person the medical disability certificate.

18. If a person is not a specific disability, the date of adoption of the decision, the Commission shall issue to the person a doctor extracts from inspection Act.
19. in determining the percentage of loss of capacity, on the date of adoption of the decision, the Commission shall issue to the person a physician statement from a physician concerning the capacity of the Commission for the determination of the percentage of loss.
20. the Person has the right to: 20.1. General profile to choose doctor by Health Commission and the capacity of the National Commission of physician expertise Manager motivated application;
20.2. to challenge and appeal against decisions of the Commission of doctors to the law "on medical disability and social protection".
21. Disability expertise to children up to the age of 16 the Commission doctor starts out by January 1, 2004.
Prime Minister e. Repše Welfare Minister d. Staķ is the Editorial Note: rules shall enter into force on 26 November 2003.
 
1. the annex to Cabinet of Ministers on 19 November 2003, the Regulation No. 650 diseases and anatomical defects, in which case the Commission may make the doctor repeated inspection of disability without personal presence of the upper limb: 1 1.1 the arms shortage hands or higher level;
1.2. the wrist three finger shortage except the first;
1.3. any two fingers and wrist bones corresponding shortage.
1.4. the first finger of both hands or one hand missing the first finger and the wrist bone shortage.
1.5. ankiloz or strong wrists CONTRACTURE.
2. In the lower limb, leg amputation 2.1, 2.2. foot amputation after Šopar or higher level; 2.3. both feet of the metatarsal bone amputation level after Šarp; ** 2.4 expressed one of the ankle joint Contracture or ankiloz;
2.5. the abbreviation for 7 cm feet and more; 2.6. path or hip joint ankiloz;
2.7. expressed both way or both hip joints Contracture;
2.8. the ankiloz of both hip joints that outline and with the x-ray examination data by a traumatolog certified ortopēd based (up to Arthroplasty).
3. Complete or practical blindness in one eye (Visual acuity less than 0.05 with correction or Visual field narrowing to 5 degrees of fixation point).
4. Bilateral deafness, kurlmēmum.
5. Constantly functioning traheostom.
6. The jaw or hard palate defects if the prosthesis does not support being chewed.
7. Face crippling wounds or kill defects.
8. Gastrektomij.
9. Pulmonektomij.
10. the only kidney pathology.
11. Dirt cause the digestive tract and urinary fistula.
12. Open (TM), lung or other organs if the diagnosis of tuberculosis, refine a tuberculosis eradication service certified ftiziopneimonolog.
13. Cancers of stages III and IV of the disease, which is the outline and substantiated certified oncologist, if a person receives combined or symptomatic therapy.
14. in cases of diseases, Haematological certified by the certified hematología national Hematology Center combined therapy.
15. Deep one foot or both feet moderate 16. Deep URparēze.* one hand or both hands of a moderate parēz.
17. Expressed or ekstrapiramidāl the URtraucējumi.* of cerebellar 18. Spinal Deformity-URpakāpē.* IV III 19. Expressed or agnosia or aphasia, apraksij.
20. ilgkatetr urīnizvadceļ damage is permanent.
21. Faecal incontinence anal ring gap.
22. the lower limb arterial disease with tromboobliterējoš dekompensēt blood circulation in one leg or subkompensēt in both the two-legged URkājās.* 23 elefantiāz IV grade or chronic venous insufficiency-and Supreme IV of URpakāpē.* Notes.
* Determining the disability the person is under 16 years of age, the issue of medical indication of compliance with the conditions for granting benefits to the person concerned the transport costs to compensate for the disabled who have mobility difficulties. Determining the disability the person who has reached 16 years of age, the issue of medical indication of compliance with the conditions for granting benefits to the person concerned the compensation of transport costs for disabled people who have difficulty moving around, and the person concerned could purchase customized passenger car.
The Party shall submit to the Commission the opinion of protēžortopēd.
Welfare Minister d. Staķ annex 2 of the Cabinet of Ministers on 19 November 2003, the Regulation No. 650 medical indications for determining disability children up to 16 years of age and pathological condition diseases names Clinical and functional characterisation of the situation 1 2 1. Nervous system diseases, congenital, acquired 1.1 or the inherited diseases of the nervous system and damage effect of moderate or expressed in movement disorders parēž, paralīž, hiperkinēž, movement coordination , language disorder, persistent, vegetative disorders sensors 1.2. Neuromuscular Synapse and muscle disease of muscle endurance and strength weakening, causing moderate or expressed movement into interference 1.3. Epilepsy note. This annex 1.1., 1.2. and 1.3. diagnosis referred to outline and justify the certified neurologist.
The big spasms and six times a year or more frequent small attacks (several times a week) 2. Mental and behavioural disorders 2.1. Schizophrenia, šizotipisk disorder, nightmares and šizoafektīv disorders during the course of the disease is progressive, lengthy to psychotic positions (three months and longer), with a distinctly negative simptomātik (match for easy, moderate, severe or profound mental retardation to) mental retardation 2.2 mild mental retardation, which in combination with hearing, vision , language, movement and support apparatus or other organ system dysfunction, behavioral disorders. Children with moderate, severe, expressed profound mental retardation (trainee at the individual program) 2.3. Organic psychotic, organic personality and behavioural disorders and organic dementia moderate or expressed disorders resulting from brain damage, dysfunction or somatic diseases, t.sk. epilepsy, resistant to therapy 2.4. Affective mood disorder disease process moderate or severe 2.5. Psychiatric and behavioural disorders due to psychoactive substance use (alcohol, opioids, kannabioīd, sedative, and hypnotic, cocaine, stimulants, hallucinogens, volatile solvents) with a heavy course of the disease (often aggravated, continuous progress) 2.6. Psychological development disorders different speech developmental disorders, autism, etc. of children mixed with severe disturbances of specific progress , smooth integration of children in society

2.7. Emotional and behavior disorders that start the child and adolescence note. This 2.1., 2.2., 2.3., 2.4., 2.5., 2.6 and 2.7. diagnosis referred to outline and justify a certified psychiatrist.
Hiperkinētisk, emotion and behavior of mixed disorder, social functioning and disturbance tikoz with serious, lasting progress, without therapy effect, interfere with the child's integration into society 3. Hearing organ diseases 3.1 Kurlmēmum, deafness or opinion Otorinolaringolog surdolog 3.2 degree of hearing loss Serious note. 3.2. To this annex referred to in point (audiogramm), diagnosis, and justified assessment certified otorinolaringolog or surdolog.
Starting with grade III or higher (if not you can improve your hearing with a hearing aid) 4. eye diseases 4.1. Congenital or acquired disorders of organs of vision with a steady decline in Visual acuity less than 0.3 (with corrections) in the eye again, or better field of vision in the eye again better tighten up to 20 degrees from fixation point in all directions 4.2. One eye or a heavy sight organs anatomical structure damage in one eye Visual acuity less than 0.05 with maximum adjustment, independently of the other eye sees the features of 4.3. Congenital or acquired visual organ pathology (congenital glaucoma, retrobulbār-fibroplāzij, diabetic retinopātij with proliferation or fibrosis, subtotāl, total of both eyes or only dream eye retinal detachment after potential therapy, the total oftalmoplēģij) notes. If the child up to the age of 7, Visual acuity is not clearly identifiable, disability is determined, if the objective of the organ of vision studies (instrumental and electrophysiological) corresponds to a possible reduction in Visual acuity less than 0.3. This annex 4.1, 4.2 and 4.3. diagnosis referred to in the outline and a certified ophthalmologist based.
The diagnosis confirms the objective investigation (instrumental and electrophysiological) regardless of the Visual acuity of 5. Visceral diseases respiratory diseases of the throat and larynx 5.1 cases constantly breathing 5.2. Respiratory diseases, pathological conditions, developmental disabilities Note. 5.1 and 5.2 of this annex. diagnosis referred to outline and justify a certified pneimonolog, ftiziopneimonolog.
The progress of the disease severity, frequency of flare, sustained moderate or expressed lung ventilation disorders, complications, treatment efficiency.
1. Children up to the age of seven, which can detect external respiratory function, take into account the clinical finding.
2. Children after seven years of age determines the external respiratory function: a) type: 1) obstructive, ² with 60%;
2) ² PEF 60%;
PEF and FEV1) 3 swings > 30%;
(b) restrictive type-CTR) < 50% of individual old-age provisions in asthma patients assessed the frequency of asthma attacks, severity (three or more heavy fits per year), the effectiveness of the therapy (bacilār) Open pulmonary tuberculosis form, process, complications, treatment efficiency, specific therapy resistance circulatory system diseases 5.3 heart, vascular diseases and developmental disorders Chronic heart failure III functional class and higher by NYH's 5.4. Heart rate and driving impairment paroksizmāl of supraventricular tachycardia attacks atrial fibrillation,, undulācij, combined rhythm disturbances more often than once a month, or severe seizures that are not of the drug two hours coupage or blending of which used electric shock therapy full blockade of atrioventrikulār with chronic heart failure – and higher functional class II by NYH 5.5. arterial hypertension Primary note. This annex 5.3, 5.4 and 5.5 diagnosis referred to outline and justify a certified cardiologist.
II-III degree with damage, non-drug therapies for refrakteritāt the muscle and connective tissue, skeletal system diseases Diffuse connective tissue 5.6 system diseases (lupus, Scleroderma, dermatomiozīt, mixed and undifferentiated connective tissue disease, vaskulīt) Process activity, the frequency of flare, moderately or highly damaged organ or organ system function disorders, complications, treatment efficiency 5.7. Chronic the juvenil rheumatoid arthritis (joint, visceral or eye form) Note. This annex 5.6 and 5.7 diagnosis referred to outline and justify a certified reimatolog.
Process activity and pace the stage, joints and other damaged organs to function disorders, therapy effectiveness Uro system disease kidney disease 5.8 note. 5.8. To this annex referred to outline and substantiated a diagnosis certified Nephrologists.
Chronic renal failure stage II and higher, or continuous process often aggravated, resistance to therapy or therapy-dependent variation, complications. Of Terminal renal insufficiency-renal substitution (peritoneal dialysis or kidney transplantation, hemodialīz) 5.9. Kidney and urinary tract permanently pathological conditions, developmental disorders (of one or both kidneys, or other urīnizvadorgān, or parts of such weaknesses) chronic renal failure and high grade II. Urinary fistula or urinary incontinence and urinary tract Kidney 5.10. congenital anomalies of note. 5.9 and 5.10 of this annex. diagnosis referred to outline and justify the certified urolog.
Urinary reflux or reflux disorders and obstructive in the uropātij that does not succumb to the adjustment or the surgical correction of time has come. Urinary fistula — until their surgical closure. The bladder and the urethra are not irogēn condition with enurēz or dysuria – to the digestive system diseases 5.11. Gastro-intestinal tract, liver and bile izvadceļ disease and developmental disorders Aggravated the frequency of recurrent bleeding in malabsorption, intestinal bacteria proliferation syndrome, complications, treatment efficiency. Moderate or expressed liver function disorders, portal hypertension 5.12. Coeliac disease – inherited the malabsorption syndrome note. 5.11 and 5.12 of this annex. diagnosis referred to outline and justify the certified gastroenterolog.
Malabsorption and expressed malnutricij syndrome 6. Surgical disease 6.1. Congenital and acquired the esophagus, gastrointestinal tract, bile path, developmental disorders and diseases of note. 6.1 of this annex the diagnosis referred to in the outline and a certified child based surgeon and/or gastroenterolog.

Moderately or highly stable, swallowing, digestion and feeding disorders, difficult hard or liquid nutrient ingestion, esophageal tightness, chronic konstipācij, sphincter dysfunction apparatus 6.2. Bone and joint diseases and pathological States a) traumatic amputation of hands and feet at a higher level and higher level b) of one or more limbs lack the segment with a modest or bold function disorders (c) III-IV) spine deformation grade with a moderate or strong spine function and lung ventilation problems d) based machine anomalies (for example , congenital foot, crooked hip joint dislocations, femur head osteohondropātij, in epifiziolīz) with moderate juvenil or bold into the course, mobility, e) inflammatory disease of the joints of the bone character (arthritis, osteomyelitis) process activity, course of the disease, the frequency and duration of flare, moderate or expressed in movement disorders, therapy effectiveness 6.3. Skeletal System lesions or moderately expressed movement into and over the course of the therapy efficiency 6.4. Injuries, poisoning and other external effects effects of note. This annex 6.2, 6.3 and 6.4. diagnosis referred to in the outline and the traumatolog of the ortopēd based certified, surgeon.
The progress of the process, the effectiveness of the therapy, complications, moderately or highly function disorders Inborn or acquired 6.5 facial soft tissue and/or skeletal diseases or damage it note. 6.5. To this annex referred to outline and substantiated a diagnosis certified face-jaw surgeon.
(a)) or moderately expressed in chewing, swallowing, breathing or speech disorder function b) heavy facial distortion (scary looking) 7 endocrine and metabolic disease.-7.1. Congenital or acquired diseases endocrine note. 7.1. This annex diagnosis referred to in the outline and substantiated certified endokrinolog, the pediatrician.
In the course of the disease (process activity, the frequency of relapse, remission duration), the function of the defective non interference, initial therapy effectiveness, complications of skin diseases 8.8.1. Skin diseases and disorders caused by the note. This annex 8.1. diagnosis referred to outline and justify a certified dermatologist.
In the course of the disease, the frequency of flare, skin damage localization and volume, the called function disturbance severity, treatment efficiency 9. Oncologic diseases, Malignant and benign 9.1 the tumors note. This annex 9.1. diagnosis referred to in the outline and substantiated certified oncologist, hematología, hematoonkolog.
Process stage, the histological studies, the severity of the disorder, treatment methods and their effectiveness, with a forecast 10. Blood and hematopoietic organs diseases and immune disorders Haematological diseases 10.1 note. 10.1. This annex referred to outline and substantiated a diagnosis certified hematología.
In the course of the disease (process activity, the frequency of relapse, remission duration), the function of the defective non interference, initial therapy, disease and the effectiveness of the therapy complications in immunodeficiency States 10.2. Congenital immunodeficiency States, with moderate or strong clinical phenomena, chronic sources of infection due of that prolonged therapy at (except the selective IGA deficiency) 10.3. Secondary immunodeficiency States, activity, process, function disturbance severity, treatment efficiency 10.4. HIV infection note. This annex 10.2., 10.3 and 10.4. diagnosis referred to in the outline and the certified imunolog based, infectious diseases physicians.
Process, activity, function disturbance severity, treatment efficiency 11. Congenital malformations, deformations and chromosomal anomalies in congenital malformation 11.1 and chromosomal abnormalities. This annex 11.1. diagnosis referred to in approved medical genetics Center assignment, according to experts.
In the non-affected function disorders, therapy effectiveness 12. Combined pathology 12.1. Combined pathology, in which each individual system of basic pathology to determine disability, but the combination is undoubtedly hamper the child's integration into society. In determining this annex referred to in point 12.1. diagnosis, konsilij contains the pediatrician or family doctor and two professionals in the sectors concerned.
Combined pathologies in the case the invalidity is based on the expertise of doctors in konsilij Welfare Minister d.-Staķ