SECTION II: MEDICAL BOARD WORK RULES AND PROCEDURES
SECTION II
MEDICAL BOARD WORK RULES AND PROCEDURES
ARTICLE (4)
The following procedures shall be followed upon receiving a request for establishment of an occupational or a non-occupational disability state of a contributor:
1. The contributor’s case shall be presented to the Office physician who may medically examine the contributor or refer him to the appropriate medical body for undergoing the necessary medical examinations before being presented to the Board. The contributor shall submit his medical reports to the said Office physician.
2. Where all the medical reports and examinations deemed to be necessary by the Office physician are completed, the Secretary to the Medical Board shall refer the contributor to the Board on the date fixed by the Office Director for the session and shall notify the contributor of the fixed time of the session.
3. As an exception of the provisions of the preceding two paragraphs, there shall be no consideration of the employment injury cases for which five or more years have elapsed without submission of an application and receipt of an injury notification, unless the Governor's approval of the tolerance of the delay is issued.
ARTICLE (5)
1. The Medical Board itself shall examine the contributor or beneficiary or delegate one of the Board members or the one the Board authorizes to do so and submit thereto a report, if the Board or Office physician is of the opinion that the physical condition of the contributor or beneficiary does not enable him to appear before the Board.
2. For the purposes of determining the jurisdiction of the Primary Medical Board, if the contributor or beneficiary is present in a place falling within the jurisdiction of another Medical Board, his case may be examined by the Medical Board operating in the place where he is present.
3. As an exception of the provisions of paragraph (1), the Medical Board may consider the medical reports and laboratory tests as sufficient for the purposes of establishment or continuity of the disability state in the following cases:
a. If the case is appealed against to the Appeal Medical Board, the contributor has left the Kingdom and the Board is satisfied with the adequacy of the report submitted in respect of this case.
b. In case the medical reports required by the Medical Boards for the establishment of the state of disability are submitted after the contributor’s departure from the Kingdom as supplementary to previous medical examination by the Medical Board.
c. If the contributor, who is afflicted with a non-occupational disability, is only entitled to a lump sum compensation.
d. In case of submission of the medical reports required by the Medical Boards for periodical re-examination of the contributor or beneficiary.
e. Where the case of any family member is considered for the establishment of his earning incapacity.
f. Such other cases as the Governor may permit the Board to be satisfied with the medical reports without the requirement of the contributor to appear before the Board.
4. In all cases referred to in sub-paragraphs (a), (b), (c), (d) and (e) of paragraph (3), the Governor may require to have the contributor or beneficiary subjected to medical examination under the supervision of the Organization, if he deems such action to be necessary in any of the cases.
5. The Governor shall determine the conditions that shall be satisfied by the medical reports and the tests that shall be made outside the Kingdom in order to be considered as reliable.
ARTICLE (6)
1. The appropriate Medical Board may request the presence of a competent Organization officer to be selected by the concerned Director to explain the provisions of the Law and implementing regulations relevant to the case being presented to the Board.
2. The Medical Board may call for the advice of a specialized medical consultant, and the Secretary to the Board shall record the advice of such consultant or attach his relevant report, if any. If the Board is not of the opinion to adopt the consultant's advice, it should mention in detail the reasons therefore, and the secretary shall record such reasons.
3. The Board may, as necessary, consult the representative of the Minister of Labour and Social Affairs on the available job opportunities that may be suitable to the condition of the contributor. The said representative shall be invited by a decision from the concerned Director. The representative of the Ministry of Labour shall be designated by virtue of such regulating rules as may be issued by coordination between the Organization and the Ministry.
4. The Medical Board may request making any laboratory tests or any other tests if the contributor’s condition necessitates such tests in the opinion of the Board.
5.a The Organization shall bear the costs of the medical reports and examinations made within the Kingdom so long as they are made upon the request of the Medical Board.
b. The Organization shall not bear the costs of the medical reports and examinations made outside the Kingdom except in such cases as may be approved by the Governor.
ARTICLE (7)
1. Without prejudice to the provisions of paragraph (2) of Article (39) of the Law, the contributor’s non-occupational disability shall be established if the conditions for establishment of disability in its insurance meaning provided for in paragraph (6) of the said Article are met. The Medical Board shall determine the starting date of disability to take effect on and from the date of satisfaction of all statutory and medical conditions such as the termination of the employment covered under the Law of the contributor or the reduction of his wage to less than one third.
2. The Primary Medical Board shall not determine the state of permanent disability of the injured person as long as he is hospitalized for treatment. It shall determine the state of permanent disability, if any, after the required treatment is completed and the condition is stabilized and he is discharged from the treating center.
3. As an exception of the provisions of paragraph (2), if the treatment center or the office physician discovers that the physical condition of the non-Saudi injured person does not permit him to resume his employment and that he must leave the hospital to his home country directly, the Medical Board may examine him while he is in the treating center. If the Board is satisfied that his condition is stabilized, it may issue its decision before he is discharged from the treating medical center, in which case, the Office shall coordinate with the employer and arrange for his travel to his home country, so that his cash benefit will be paid to him in due course prior to his departure. His receipt of such benefit shall be considered a final settlement of all his entitlements due from the Organization. The Governor shall set out the required arrangements and controls to ensure that the Organization does not pay any medical expenses or additional allowances beyond the time it has fixed for the travel of the injured person.
ARTICLE (8)
The Medical Board may issue its decision on the establishment of the state of non-occupational disability even after the contributor attains sixty years of age in the following two cases:
1. If the case had been presented to the Board before the contributor attained age sixty and the procedures had taken some time until he reached such age.
2. If the case had been presented to the Board for the first time on the date the contributor attained age sixty or thereafter and the Board had been certain that the disability state was established before the contributor reached such age.
ARTICLE (9)
1. If the symptoms of the occupational disease appeared after the termination of the employment covered under the Law, the case shall be presented to the Medical Board to determine the relation of the disease with the occupation he was exercising before he left employment, without prejudice to the provisions of the Schedule of the Occupational Diseases.
2. For the purposes of considering a disease an occupational disease, the Medical Board shall take into account that the occupation which caused such disease to the contributor was one of the causative occupations shown opposite to the respective diseases in the Schedule of the Occupational Diseases.