There are legal restrictions on some professions, where patients with epilepsy can cause harm to themselves or others from resulting attack, professions and activities that affect the lives and health of the patient and the people around him: the driver, pilot, surgeon, working at height, close to the moving machinery, water, fire, etc.
Compulsory preliminary medical examinations (surveys) for admission to work (hereinafter - the preliminary examinations) are conducted to determine whether the state of health of the person entering the work assigned to it by the work, as well as for early detection and prevention of diseases. The complex and controversial issues are decided by clinical expert commission.
Working at heights, steeplejack work and the associated rise in the height, as well as maintenance work on lifting equipment.
It is important to know what a "safe" absolutely mental ("sit-down"), the work has its "pitfalls". Emotional stress, strong emotions, stress, trouble at work, lack of adequate physical activity will inevitably cause neurotic anxiety disorders, depression, anxiety, sleep disorder and deficits, bad habits - all these factors provoking epileptic attack.
Successful work and good social adaptation of patients with epilepsy are real, and are made up of three components which are inseparable from each other.
1. Medical factors - the correct diagnosis and adequate antiepileptic treatment.
2. Social and personal motivations - the patient's responsibility for themselves and others, Compliance (English compliance -. Harmony, conformity) - voluntary, responsible action by the patient according to the physician's recommendations ("Adherence").
3. Vocational and biological aspects: correct choice of profession, a healthy lifestyle, regular daily routine.
It conducted many studies on the quality of the professional activity of patients with epilepsy. At present, it is conclusively proven that for professional and social success in patients with epilepsy do not need special support.
Highly patients with epilepsy are successfully working in many different fields and areas of production. Overall, a statistically significant frequency of occupational injuries and illnesses on passes was approximately the same in the control group of "healthy" and in patients with epilepsy, convincing evidence of the interdependence of gravity was found epilepsy with options and the nature of professional activity. It is also a clear link has not been proven, "epilepsy" diagnosis of the quality and level of professional qualifications.
Nevertheless, in our country, sometimes, or even often, in some places, at times, the diagnosis of epilepsy significantly narrows the possibility of getting a good job. Until now, some employers to work saved bias against employees with epilepsy, other things being equal, preference is given to the employee who does not have this diagnosis. In this case, patients with epilepsy, even if it comes to allowed and "recommended" specialties, we have to hold back some information about his health.
Modern concepts of registration and maintenance of patients with epilepsy are determined by the Commission on Employment of the International League Against in 1989.
EMPLOYMENT AND RIGHTS patients with epilepsy and match DISORDERS
(Employment Commission, ILAE, 1989)
• In most cases, seizures can be controlled fully adequate therapy.
• Neither the diagnosis of "epilepsy", or the possibility of attacks, are not an obstacle for obtaining gainful employment,
• In the small percentage of cases where there are restrictions on the selection of certain types of employment, the decision is made individually, taking into account the wishes of the patient and the requirements for this type of activity.
• All patients with epilepsy should have equal opportunities for health, rehabilitation and rest regime, as well as social support to increase employment opportunities and improve the social adaptation.
• Patients with epilepsy have equal rights with other members of society the right to seek work, choice of profession and employment.
Employment Commission highlighted four main areas, including health, the selection of profession selection for a particular job and help at work.
KEY ASPECTS OF EMPLOYMENT epileptics
(Employment Commission, ILAE, 1989)
When applying for a patient with epilepsy work the employer should know the basic facts about epilepsy, to take account of the possible impact of disease on quality of work.
• Seizures have different manifestations and many people noted just one episode in a lifetime.
• For the first time caused the attack could have a negative impact on a person's confidence in their own abilities.
• In most cases, seizures are completely controlled by adequate therapy.
• Correct the designated anticonvulsants do not cause any side effects that can affect the quality of work.
• Only some patients attacks may occur at work or pursued anticonvulsant therapy can affect the quality of work.
• In such cases advisable to consult a specialist, epileptologa to improve the efficacy and reduce side effects.
• Diseases of the work passes, accidents in patients with epilepsy do not occur more frequently than in healthy people.
• Patients with epilepsy should be provided with the same health insurance, as well as all other employees.
Most of the activities are suitable for patients with epilepsy.
The selection for a particular job.
The decision on the selection of a particular type of activity is taken by the employer in the first place, based on the skill level of the individual, and not on the basis of the available diagnosis.
If the attack happens the first time in my life at work, the employer must ensure that employee the possibility of obtaining necessary medical care before taking a decision on the compliance officer of its work. If there is a possibility of attacks at work, the employer should help "eliminate epilepsy" for other employees.
If necessary, special restrictions on work, these provisions need to articulate and discuss them is always individual.
TIPS FOR DRIVING FOR epileptics
(The American Academy of Neurology. Epileptologa US Society, the American Epilepsy Foundation, 1994)
1. How is the issuance of a driver's license? How important is the opinion of the attending physician?
The decision to issue a driving license to a greater extent depends on the state Department of Motor Vehicles (TTP) than by the attending physician.
The attending physician is obliged to fill in medical documents provided by DTN.
Medical documents required for issuing a driving license, must be carefully and accurately filled.
The medical form includes questions about medical opinions on the issuing of driving licenses the patient, as well as a column for the comments of the attending physician, if any.
The decision to issue a driver's license can be taken without regard to employees on the basis of TPA received medical documents.
The procedure for issuing driving licenses is governed by state law and is carried out TPA provides provisions to ensure appropriate protection from liability of persons involved in this procedure.
The criteria for the issuance of driving licenses and restrictions for medical reasons "are reflected in the rules and recommendations, specifically developed by the expert group in each case.
The process of issuing a driver's license must provide for the possibility of individual solutions in each case.
2. Do I need a certain period bespristupny?
Need bespristupny interval of 3 months from the date of the last attack
3. What factors may affect the duration of this period?
• Seizures arising from changes in therapy prescribed by a doctor;
• Simple partial seizures without impairment of consciousness, and / or motor control;
• Attacks as isolated auras:
• Attacks that occur only at night;
• Seizures caused by acute intoxication or metabolic disorders without the likelihood of recurrence;
• Seizures caused by sleep deprivation;
• Seizures caused by reversible acute diseases.
• Inadequate intake of drugs and doctor visits;
• Alcohol and / or drug dependence within the past 3 months;
• An increase in the frequency of attacks in the last year;
• Structural brain damage;
• Incurable functional or metabolic status of the brain;
• Frequent episodes after bespristupnogo interval;
• Accidents during the last 5 years.
4. Is it necessary for driving restrictions? Under what circumstances and what are the limitations?
TPA has the right to limitation of driving for those that do not meet the general criteria for driving licenses.
Physicians should not disclose information about their patients in the TPA, but must inform patients in a possible risk, TPA requirements, to give their own recommendations for driving. The patient must inform the TPA about their health status and the occurrence of seizures in writing. When. attack occurs, you need to take time off from driving, consult a doctor and inform the TPA. If the doctor believes that the patient is informed about his TPA and there is a threat to public safety, the doctor adderall drug has the right to do it myself. In the case of non-patients in the TPA, TPA has the right to impose a fine in its sole discretion.
6. Medical examination
Periodic medical examination is not required if the patient sends timely messages about their attacks in the TTP and regularly fills in a special form, represents TPA to extend or update a driver's license.
7. The degree of "immunity" for doctors
Physicians should have a certain "immunity" (protected) in the event that they do not send messages about patients in the TPA, because they consider it inappropriate. Physicians should also have "immunity" (protected) in the case when they send a first or recurrent reports of patients in the TPA.
8. Should each state have its own medical advisory committee? What are its functions?
Medical advisory committee or similar structure should be in every state. This committee approves the recommendations and regulations concerning the persons driving with various diseases. The Committee shall meet at least 1 time per year.
9. Should the law to carry out the function of failure in obtaining a driving license?
It is necessary to the existence of the official denial mechanism to obtain a driver's license.
10. What are the rules for hearings and appeals?
Before the official refusal to obtain a driver's license may be an appeal or hearing a particular case. If there is a real threat to public safety in obtaining a driving license refused.