It is possible to change the quality of work of medical and social expert commissions and simplify the procedure for obtaining a disability today. Experts from the public sector are convinced of this. Therefore, the League of the Strong NGO, together with the Principle Human Rights Centre for Military Personnel, the Ukrainian Helsinki Human Rights Union and the Together Against Corruption NGO, have submitted relevant proposals to the Ministry of Health. They concern the standardisation of the examination period, modernisation of the work of the MSEC, digitalisation of medical and social expertise, elimination of corruption factors in the work of the commissions and bringing the acts in line with current legislation.
“We have jointly analysed the draft resolution of the Cabinet of Ministers of Ukraine ‘On Amendments to the Regulation on the Procedure, Conditions and Criteria for Establishing Disability’. In general, we support the need to streamline the list of documents required to pass the medical and social expert commission. However, we understand that other changes to government decisions are also needed. That is why we have developed proposals aimed at improving people’s access to medical and social expertise, modernising the activities of medical and social expert commissions and bringing certain regulatory acts of the Cabinet of Ministers of Ukraine in line with the law,” explains Daria Sydorenko, Executive Director of the League of the Strong.
What changes are proposed to be made?
- Eliminate the term “full medical examination” to avoid unequal application – instead, introduce examination of persons by multidisciplinary teams exclusively in the area of the disease.
- Improve the procedure for referral to a medical and social expert commission (MSEC) – instead of medical advisory commissions, create multidisciplinary rehabilitation teams.
- Abolish the widespread practice of hospitalisation as evidence of a full medical examination – this creates unnecessary burden and costs. The decision on the need for hospitalisation should be made by a multidisciplinary team of healthcare professionals. Outpatient examinations should be equivalent in practice.
- Set a time limit for the MSEC to conduct the examination – 5 working days from the date of receipt of the referral.
- Provide for clear terms for which disability is established for different diseases or conditions.
- Ensure the requirements of the current legislation regarding the composition of the MSEC in terms of rehabilitation specialists
- To abolish the division of the MSEC into general and specialised profiles, keeping only the administrative division by territory.
- Digitalise the process by integrating the work of the MSEC with the eHealth system
- Improve the quality of examinations and ensure flexibility in providing recommendations in individual rehabilitation programmes. The rehabilitation programme should be developed on the basis of recommendations from multidisciplinary rehabilitation teams.
- Introduce the principle that “what is not forbidden is allowed” in the list of activities and certain professions that a person can perform.
How will this affect the process for people?
- Clear process of referral to the medical and social expert commission
This can be achieved by introducing an assessment of the person by a multidisciplinary rehabilitation team. This will also allow a person to avoid having to prove the existence of certain functional limitations on their own.
- Speed up the process of passing the commission
Determining a clear timeframe for the medical and social expert commission’s examination and eliminating misunderstandings in the current regulation will help people pass medical and social expertise faster. According to the proposals, this period is 5 working days.
- Simplified process thanks to digitalisation
The introduction of digital technologies will mean a simplified and faster process of medical and social expertise. Digital systems will make the exchange of documents between hospitals and commissions more efficient. The introduction of electronic queues will make the process of registering for an examination more convenient and transparent. A person will also be able to check the status and compliance with the examination deadlines, which will help to obtain the necessary information faster and reduce the waiting time for the results of the medical and social examination.
- Liability of MSEC members for unreasonable decisions.
At present, MSEC members do not bear any tangible responsibility for illegal and unjustified decisions, in particular for unreasonable establishment and refusal to establish/extend/confirm disability, determination of disability group and percentage of disability.
The ability of MSEC members to make arbitrary decisions should be limited to an exhaustive list of gross violations, for which MSEC members are deprived of membership in commissions at all levels and the right to perform functions in the field of disability determination.
- Awareness and realistic possibility of appealing against MSEC decisions
People with disabilities cannot be restricted in their right to medical information about themselves, as well as to appeal against the decisions of the MSEC. For these reasons, we believe it is necessary to abolish the ban on issuing extracts from the MSEC examination report to a person. Without this document, the person is aware of the decision, but does not have comprehensive information about its reasons and reasoning, which makes it difficult to appeal.
- Expanding employment opportunities
Introducing the principle that what is not prohibited is allowed will increase a person’s chances of finding a job. After all, they will enjoy the employment benefits provided for by law and, at the same time, will be able to perform work on an equal footing with other employees.
- Real opportunities for rehabilitation
Instead of a “blank sheet” of rehabilitation, there should be high-quality recommendations for rehabilitation and rehabilitation aids. They should be developed according to the needs of the individual as part of a health compensation strategy based on the recommendations of multidisciplinary rehabilitation teams.
- Clear rules of the game in terms of the period for which disability is established
It is about providing clear terms for different nosologies and conditions for which disability is established. Thanks to these changes, people will be able to know exactly how long a disability is established for in accordance with their illness or injury.
The analytical work to develop the proposals was carried out by the League of the Strong with the support of the International Renaissance Foundation. The document represents the position of the authors of the appeal and does not necessarily reflect the position of the International Renaissance Foundation.
