Who exercises state control over medical-social expertise
To ensure the measures provided for by law in the sphere of medical-social expertise, the Government of Georgia creates a legal entity of public law — the agency — which carries out its activity within the framework of the powers conferred on it by the law, by its statute and by other legal acts. The statute of the agency is approved, and the person authorized to represent it is appointed, by the Minister of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia, while state control over the agency's activity is exercised by the corresponding ministry.
It is precisely this agency that exercises state control over the activity of the establishments conducting the expertise and, selectively and/or as needed, checks the correctness of the conclusions issued by an establishment. This means that the correctness of your conclusion is monitored by the state even independently — control is not dependent solely on your complaint. The boundaries of agency action are determined by the law, its statute and other legal acts.
Selective inspection and its procedure
The agency may selectively inspect the activity of an establishment once a year. The procedure of conducting the inspection is likewise determined by law:
- the order of the head of the agency on the exercise of state control constitutes an administrative-legal act, which the agency is obliged to present to the medical establishment during the inspection;
- by decision of the head of the agency, a corresponding specialist may be invited to conduct the inspection;
- after the completion of the inspection the agency is obliged to draw up an act of inspection;
- taking the violation into account, the agency is authorized to issue a decision on the conduct of a repeated examination by the same or by another establishment.
The decision on a repeated examination is a significant guarantee for the injured person: if a conclusion is erroneous, in addition to a renewed consideration in the same establishment, the involvement of another establishment is also possible, which increases the impartiality of the renewed assessment.
Within the framework of state control, the agency checks the correctness of the conclusions issued by the establishment selectively and/or as needed — that is, an inspection is possible both selectively and in the case of a concrete need. Such a flexible system makes it possible to respond both to the general practice of an establishment and to an individual conclusion. The law directly obliges the agency, during the inspection, to present to the medical establishment the administrative-legal act issued by the order of its head.
Justified doubt and the path to the court
Where a justified doubt exists, the agency is authorized to raise before the court the question of canceling an expert conclusion incorrectly issued by the establishment. One of the law's most important safeguards then comes into operation: until the court issues its final decision, the operation of the expert conclusion is suspended.
The suspension of the conclusion means in practice that, on the basis of the disputed conclusion, the creation of new rights and obligations is precluded until the conclusion of the ongoing court proceedings. The court's final decision may either restore the operation of the conclusion or annul it definitively. If the annulled conclusion was issued against your interests, it is precisely this path that makes its legal removal possible. Raising the question before the court is the competence of the agency, which is why providing substantiated information to the agency matters.
The question of professional liability
The agency raises before the authorized organ the question of the professional liability of the members of the establishment. Bear in mind: the concrete forms and measures of professional liability are not detailed in these provisions of the law — they are determined by other legal acts. The fact itself — that persons participating in the expertise may be held professionally liable — is, however, established directly by the law.
Communication of documents to the injured person
In challenging a conclusion and dealing with its results, it also matters how the results are communicated: an extract from the examination act on the results of the determination of the degree of loss of professional work capacity and on the need for additional assistance is sent to the employer or to the court on whose application the victim underwent the examination. The certificate of the results of the examination is given to the victim or to the representative by hand — this is the document that becomes the basis for a complaint and for an application to the court. Hand delivery ensures that the results reach the injured person directly.
The instruments of state control — an overview
By way of summary, the law gives the agency the following instruments for controlling the activity of an establishment:
- a selective inspection of the activity of the establishment once a year;
- the presentation, during the inspection, of the administrative-legal act — the order of the head;
- the invitation of a corresponding specialist to conduct the inspection;
- the drawing up of an act of inspection after the completion of the inspection;
- a decision on the conduct of a repeated examination by the same or by another establishment;
- the raising before the court of the question of canceling an incorrectly issued conclusion, together with the suspension of the conclusion;
- the raising of the question of the professional liability of the members of the establishment before the authorized organ.
Early re-examination on the basis of justified doubt
The law provides that the re-examination of a person with limited capabilities before the set term, or the re-examination of a person whose status of limitation of capability has been established permanently, takes place when the state of health and functional capacity change, or where a justified doubt of the controlling body exists, or where a conclusion on the status of limitation of capability issued without foundation has been revealed. There are thus ways of correcting an erroneous conclusion: repeated examination and cancellation through the court, and each of them rests precisely on justified doubt.