Patient TR: 26966322758, Name-Surname:, Application Date: 07-03-2022

DISABILITY HEALTH COMMITTEE Appendix-1

REPORT FOR ADULTS
NECMETTIN ERBAKAN UNIVERSITY MERAM HOSPITAL

APPLICANT'S

T.R. ID No :
Name ve Surname :
Father’s Name :
Mother’s Name :
Date of Birth and Place of Birth :

Application Date :
Report Date and Report Number:

APPLICATION TYPE
Check
INSTITUTIONAL APPLICATION First Report Objection
Examination

PERSONAL APPLICATION First Report  Objection Renovation

REASON FOR APPLICATION FOR SPECIAL EQUIPMENT VEHICLES AND DISABLED RIGHTS

CLINICAL FINDINGS ABOUT DISABILITY, RADIOLOGICAL EXAMINATIONS, DISABILITY

SYSTEMS
LABORATORY INFORMATION AND DIAGNOSIS RATE %
EAR, NOSE, THROAT DISEASES NORMAL EXAMINATION FINDINGS 0
PHYSICAL MEDICINE AND CAUDA EQUINA SYNDROME (TABLE 4.1) 20
REHABILITATION
RHEUMATOLOGY NORMAL EXAMINATION FINDINGS 0
ORTHOPEDICS AND TRAUMATOLOGY BRAIN SURGERY, NEUROLOGY AND F.T.R. OPINION IS APPROPRIATE 0
L1-L2 INSTRUMENTATION + DISCECTOMY (PREVIOUSLY OPERATED ON THE SAME LEVEL)
BRAIN AND NERVOUS SURGERY 13
TABLE 1.7%11, 2. 13% WITH AN ADDITIONAL 2% BECAUSE OF AN OPERATION)
NEUROMUSCULAR DYS FUNCTION OF THE BLADDER, BLADDER REFLEX ACTIVITY
UROLOGY 40
IS DAMAGED, THERE IS INTERMITTAN DRIPING, NO VOLUNTARY CONTROL

RESULT OF THE HEALTH BOARD REPORT

EAR, NOSE AND THROAT DISEASES: Z00.8 - GENERAL EXAMINATIONS, OTHER

PHYSICAL MEDICINE AND REHABILITATION: G83.4 - CAUDA EQUINA SYNDROME

Rheumatology: Z00.8 - GENERAL EXAMINATIONS, OTHER

Diagnosis / Diagnoses
ORTHOPEDICS AND TRAUMATOLOGY: Z00.8 - GENERAL EXAMINATIONS, OTHER
BRAIN AND BORDER SURGERY: M51.1 - LUMBAR AND OTHER INTERVERTEBRAL DISORDERS, WITH
RADICULOPATHY, G83.4 - CAUDA EQUINA SYNDROME
UROLOGY: N31.9 - NEUROMUSCULAR DYS FUNCTION OF THE BLADDER, UNDEFINED

Person's Disability Rate %

-Number- 58 - in writing - Fifty eight

Report Validity Period %

-Number- 2 Years - in writing - Two years

Dependency Evaluation 1. Independent  2. Partially Dependent 3.Fully Dependent

The Nature of the Jobs That Cannot Be -

Employed

DISABILITY GROUP OF PERSON

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Patient TR: 26966322758, Name-Surname: MEHMET RAUF GULER, Application Date: 07-03-2022
ORTHOPEDIC  MENTAL

VISUAL SPIRITUAL AND EMOTIONAL

HEARING CONTINUOUS (CHRONIC) 

LANGUAGE AND SPEECH UNCLASSIFIED

EXPLANATION
ONLY ON THE MOVEMENT PARTS SPECIAL EQUIPMENT IS REQUIRED TO USE VEHICLE.

EXPLANATIONS ON THE ISSUANCE OF THE REPORT

1.In the section of the nature of the works that cannot be employed according to the disability, only the job fields according to the disability should
be specified in general. For example; "Cannot be employed in work areas that require sight.", "Cannot be employed in jobs requiring constant
standing." should be stated in terms such as.
2. “He/she should constantly use a wheelchair or stretcher.”, “He/she should only use a vehicle with a special device in the moving part”, “There is
no need to use a vehicle with a special device. ” etc. Explanations indicating the particular situation of the person should be specified.
3. Reports prior to this report are invalid for new applications regardless of their duration.

Date of Report: 30.03.2022

202233011285612094647
Inquiry regarding the original of this document can be made at https://erapor.saglik.gov.tr/DogrulamaServisi/ Internet address.

This document has been signed with a secure electronic signature in accordance with the electronic signature law no. 5070.

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