{"id":25255,"date":"2016-04-18T07:21:44","date_gmt":"2016-04-18T05:21:44","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=25255"},"modified":"2016-04-18T07:22:46","modified_gmt":"2016-04-18T05:22:46","slug":"mam-roztrousenou-sklerozu-mam-sanci-na-priznani-invalidniho-duchodu","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=25255","title":{"rendered":"M\u00e1m roztrou\u0161enou skler\u00f3zu. M\u00e1m \u0161anci na p\u0159izn\u00e1n\u00ed invalidn\u00edho d\u016fchodu?"},"content":{"rendered":"

Dotaz:<\/strong>
\n pot\u00fdk\u00e1m se s novou diagn\u00f3zou-roztrou\u0161en\u00e1 skler\u00f3za. I po l\u00e9\u010db\u011b Solumedrolem a doma Medrolem jsem \u00fapln\u011b na odpis. Sna\u017e\u00edm se o pozitiva, zdrav\u011b j\u00edst, cvi\u010dit, ale p\u0159etrv\u00e1v\u00e1 velik\u00e1 \u00fanava, jsem schopna fungovat denn\u011b 2-3 hodiny. Bol\u00ed m\u011b v noci cel\u00e9 t\u011blo, prav\u00e1 \u010d\u00e1st t\u011bla je hor\u0161\u00ed. M\u00e1m z\u00e1vrat\u011b. Neum\u00edm si p\u0159edstavit, \u017ee bych pracovala, i kdy\u017e se t\u011b\u0161\u00edm mezi lidi, ale nyn\u00ed jsem r\u00e1da, \u017ee jsem r\u00e1da. P\u0159\u00edznaky jsem m\u011bla zhruba p\u016fl roku p\u0159edem. \u010cek\u00e1m na l\u00e9\u010dbu. Cht\u011bla bych si po\u017e\u00e1dat o invalidn\u00ed d\u016fchod na do\u010dasn\u00fd \u010das. Nev\u00edm dle \u010deho komise hodnot\u00ed, kolik mus\u00edm m\u00edt EDSS. Zda jsou schopni objektivn\u011b posoudit stav, kdy \u010dlov\u011bk je fakt na padrt\u02c7, a to doslova. T\u0159ese se mi snad cel\u00e9 t\u011blo, zvl\u00e1\u0161t\u011b po aktivit\u011b, z \u00fanavy, pak se nedok\u00e1\u017eu ani podepsat, naj\u00edst, vypad\u00e1v\u00e1 mi v\u0161e z ruky. U\u017e mi nen\u00ed dvacet a na druhou stranu v\u011b\u0159\u00edm v lep\u0161\u00ed z\u00edt\u0159ky a n\u00e1vrat mezi lidi.<\/strong>
\n
\nOdpov\u011b\u010f:<\/strong>
\nJednozna\u010dn\u011b lze doporu\u010dit, abyste si o invalidn\u00ed d\u016fchod po\u017e\u00e1dala. Nen\u00ed ani pot\u0159eba si \u017e\u00e1dat na do\u010dasn\u00fd \u010das, je toti\u017e velice pravd\u011bpodobn\u00e9, \u017ee kdy\u017e by V\u00e1m byl p\u0159izn\u00e1n, tak si L\u00e9ka\u0159sk\u00e1 posudkov\u00e1 slu\u017eba \u010cSSZ automaticky vy\u017e\u00e1d\u00e1 jeho p\u0159ezkoum\u00e1n\u00ed v ur\u010dit\u00fdch \u010dasov\u00fdch \u00fasec\u00edch, z pravidla po jednom roce. Zlep\u0161\u00ed-li se tedy V\u00e1\u0161 zdravotn\u00ed stav, LPS V\u00e1m jej u\u017e nep\u0159izn\u00e1.
\nKrom\u011b invalidn\u00edho d\u016fchodu si tak\u00e9 m\u016f\u017eete po\u017e\u00e1dat o p\u0159\u00edsp\u011bvek na p\u00e9\u010di, jist\u011b byste mohla m\u00edt na jeden ze \u010dty\u0159 stup\u0148\u016f n\u00e1rok. O p\u0159\u00edsp\u011bvek na p\u00e9\u010di si m\u016f\u017eete za\u017e\u00e1dat na sv\u00e9 pobo\u010dce \u00da\u0159adu pr\u00e1ce.<\/p>\n

V\u00edce informac\u00ed o p\u0159\u00edsp\u011bvku na p\u00e9\u010di naleznete zde:
\nP\u0159\u00edsp\u011bvek na p\u00e9\u010di: Podle \u010deho se p\u0159id\u011bluje?<\/a><\/p>\n

O tom, zda V\u00e1m bude p\u0159izn\u00e1n invalidn\u00ed d\u016fchod rozhoduje LPS \u010cSSZ p\u0159edev\u0161\u00edm na z\u00e1klad\u011b l\u00e9ka\u0159sk\u00e9 zpr\u00e1vy, kterou si vy\u017e\u00e1d\u00e1 od Va\u0161eho o\u0161et\u0159uj\u00edc\u00edho l\u00e9ka\u0159e. Je dobr\u00e9, kdy\u017e krom\u011b z\u00e1kladn\u00edho vy\u0161et\u0159en\u00ed V\u00e1\u0161 l\u00e9ka\u0159 p\u0159ilo\u017e\u00ed je\u0161t\u011b zpr\u00e1vu z n\u011bjak\u00e9ho odborn\u00e9ho vy\u0161et\u0159en\u00ed, kter\u00e1 bude detailn\u011b popisovat V\u00e1\u0161 zdravotn\u00ed stav.<\/p>\n

„Poji\u0161t\u011bnec je invalidn\u00ed, jestli\u017ee z d\u016fvodu dlouhodob\u011b nep\u0159\u00edzniv\u00e9ho zdravotn\u00edho stavu nastal pokles jeho pracovn\u00ed schopnosti nejm\u00e9n\u011b o 35 %.
\nJestli\u017ee pracovn\u00ed schopnost poji\u0161t\u011bnce poklesla
\na. nejm\u00e9n\u011b o 35 %, av\u0161ak nejv\u00edce o 49 %, jedn\u00e1 se o invaliditu prvn\u00edho stupn\u011b,
\nb. nejm\u00e9n\u011b o 50 %, av\u0161ak nejv\u00edce o 69 %, jedn\u00e1 se o invaliditu druh\u00e9ho stupn\u011b,
\nc. nejm\u00e9n\u011b o 70 %, jedn\u00e1 se o invaliditu t\u0159et\u00edho stupn\u011b.“<\/p>\n

Pro \u00faplnost uv\u00e1d\u00edm i procentu\u00e1ln\u00ed m\u00edry poklesu pracovn\u00ed schopnosti u RS, tak jak jsou uvedeny v p\u0159\u00edloze k vyhl\u00e1\u0161ce \u010d. 359\/2009 Sb.
\n„Demyeliniza\u010dn\u00ed posti\u017een\u00ed, roztrou\u0161en\u00e1 skler\u00f3za mozkom\u00ed\u0161n\u00ed, jin\u00e1 degenerativn\u00ed posti\u017een\u00ed CNS<\/p>\n

Posudkov\u00e9 hledisko:
\nP\u0159i stanoven\u00ed m\u00edry poklesu pracovn\u00ed schopnosti je t\u0159eba zhodnotit stav funk\u010dn\u00edch syst\u00e9m\u016f \u2013 pyramidov\u00e9ho, moze\u010dkov\u00e9ho, senzitivn\u00edho, zrakov\u00e9ho, kmenov\u00e9ho, funkci sfinkter\u016f, schopnost ch\u016fze, st\u00e1n\u00ed, dopad zji\u0161t\u011bn\u00fdch skute\u010dnost\u00ed na celkovou v\u00fdkonnost. K hodnocen\u00ed pokro\u010dilosti roztrou\u0161en\u00e9 skler\u00f3zy mozkom\u00ed\u0161n\u00ed se pou\u017e\u00edv\u00e1 Kurtzkeho \u0161k\u00e1la EDSS. Samotn\u00fd n\u00e1lez CT, MRI bez klinick\u00e9ho korel\u00e1tu a funk\u010dn\u00edho posti\u017een\u00ed nem\u00e1 dopad na pracovn\u00ed schopnost.
\n6a
\nminim\u00e1ln\u00ed funk\u010dn\u00ed posti\u017een\u00ed,
\nbez hrub\u0161\u00ed poruchy funkce nebo mal\u00fd neurologick\u00fd n\u00e1lez, celkov\u00e1 v\u00fdkonnost a pohyblivost dot\u010dena minim\u00e1ln\u011b, lehk\u00e1 slabost nebo spasticita, lehk\u00e1 monopar\u00e9za, m\u00edrn\u00e9 poruchy ch\u016fze a sn\u00ed\u017een\u00ed dosahu ch\u016fze, okohybn\u00e9 poruchy, n\u011bkter\u00e9 denn\u00ed aktivity vykon\u00e1v\u00e1ny s obt\u00ed\u017eemi, EDSS 2-3
\n10%
\n6b
\nlehk\u00e9 funk\u010dn\u00ed posti\u017een\u00ed,
\ncelkov\u00e1 v\u00fdkonnost omezena, pohyblivost zachov\u00e1na, ch\u016fze se sn\u00ed\u017een\u00fdm dosahem (cca 500m), vyj\u00e1d\u0159eny z\u00e1kladn\u00ed p\u0159\u00edznaky nebo kombinace v\u00edce leh\u010d\u00edch p\u0159\u00edznak\u016f (nap\u0159. lehk\u00e9 par\u00e9zy dvou kon\u010detin, lehk\u00e9 sfinkterov\u00e9 obt\u00ed\u017ee, okohybn\u00e9 poruchy), n\u011bkter\u00e9 denn\u00ed aktivity vykon\u00e1v\u00e1ny s obt\u00ed\u017eemi nebo vykon\u00e1v\u00e1ny s vyu\u017eit\u00edm kompenza\u010dn\u00edch mechanism\u016f a prost\u0159edk\u016f, EDSS 4
\n25-35%
\n6c
\nst\u0159edn\u011b t\u011b\u017ek\u00e9 funk\u010dn\u00ed posti\u017een\u00ed,
\npokles celkov\u00e9 v\u00fdkonnosti p\u0159i b\u011b\u017en\u00e9m zat\u00ed\u017een\u00ed, st\u0159edn\u011b t\u011b\u017ek\u00e1 porucha motoriky, ch\u016fze na krat\u0161\u00ed vzd\u00e1lenost (cca 300 m), v\u00fdrazn\u00e9 sfinkterov\u00e9 poruchy, podle rozsahu symptomatologie a funk\u010dn\u00edho posti\u017een\u00ed, n\u011bkter\u00e9 denn\u00ed aktivity omezeny, EDSS 5-6
\n50%
\n6d
\nt\u011b\u017ek\u00e9 funk\u010dn\u00ed posti\u017een\u00ed,
\npodstatn\u00e9 omezen\u00ed celkov\u00e9 v\u00fdkonnosti a pohyblivosti (ch\u016fze 100 m, funk\u010dn\u011b v\u00fdznamn\u00e1 spasticita na dvou kon\u010detin\u00e1ch, ataxie, afektivn\u00ed nebo kognitivn\u00ed poruchy), n\u011bkter\u00e9 denn\u00ed aktivity podstatn\u011b omezeny
\n60%
\n6e
\nzvl\u00e1\u0161\u0165 t\u011b\u017ek\u00e9 funk\u010dn\u00ed posti\u017een\u00ed,
\nt\u011b\u017ek\u00fd pokles celkov\u00e9 v\u00fdkonnosti p\u0159i lehk\u00e9m zat\u00ed\u017een\u00ed, t\u011b\u017ek\u00e9 poruchy motoriky (na \u00farovni t\u011b\u017ek\u00fdch par\u00e9z kon\u010detin), pohyblivost velmi obt\u00ed\u017en\u00e1, p\u0159esuny na velmi kr\u00e1tk\u00e9 vzd\u00e1lenosti pop\u0159. odk\u00e1zanost na invalidn\u00ed voz\u00edk, z\u00e1va\u017en\u00e1 afektivn\u00ed nebo kognitivn\u00ed porucha, denn\u00ed aktivity t\u011b\u017ece omezeny, EDSS v\u00edce ne\u017e 7
\n70-80%“<\/p>\n

Ji\u0159\u00ed Marek
\ninvArena<\/p>\n","protected":false},"excerpt":{"rendered":"

Dotaz: pot\u00fdk\u00e1m se s novou diagn\u00f3zou-roztrou\u0161en\u00e1 skler\u00f3za. I po l\u00e9\u010db\u011b Solumedrolem a doma Medrolem jsem \u00fapln\u011b na odpis. Sna\u017e\u00edm se o pozitiva, zdrav\u011b j\u00edst, cvi\u010dit, […]<\/a><\/p>\n<\/div>","protected":false},"author":3,"featured_media":1457,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-25255","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25255","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25255"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25255\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/1457"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25255"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25255"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25255"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}