Disability registration in Ukraine: has the new system improved?
Kyiv • UNN
In Ukraine, medical and social expert commissions have been abolished and replaced by expert commissions for assessing a person's daily functioning. The new system, which was supposed to be more transparent, in practice faces problems with appealing decisions, as they are considered by only one hospital in Dnipro.
After the liquidation of medical and social expert commissions in Ukraine, they were replaced by expert commissions for assessing the daily functioning of a person, which determine the need to extend temporary disability or establish disability. The Ministry of Health claimed that the new system would provide "a new standard of transparency, fairness, and focus on the needs of each person." However, in practice, most citizens face the problem of appealing the decisions of the new teams, as they are considered by one hospital in Dnipro, where all applications from different parts of Ukraine "go." UNN tells how to obtain disability in 2025, what is needed for this, and how to appeal a decision not to establish disability.
How to apply for a disability group: step-by-step instructions
After a series of high-profile corruption scandals, it was decided to liquidate the medical and social expert commissions in Ukraine, which had been operating in Ukraine since 1992. It was the MSECs that conducted medical and social expertise for individuals applying for disability, referred by a medical and preventive health care institution after diagnostic, therapeutic, and rehabilitation measures.
That is, it was the MSEC that decided whether a person had grounds for establishing a disability group or not.
As already noted, after corruption scandals, the Verkhovna Rada adopted a bill on the liquidation of medical and social expert commissions from January 1, 2025.
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MSECs were replaced by expert commissions for assessing the daily functioning of a person.
The assessment of individuals referred for expert commission due to prolonged temporary disability is carried out to determine the need to extend temporary disability or establish disability.
The assessment is organized in a healthcare institution where a list of doctors and rehabilitation specialists authorized to conduct the assessment has been approved. The list of doctors will be agreed upon with the Ministry of Health.
The assessment is carried out by expert teams, whose composition is formed individually for each case.
The members of these commissions include doctors who:
- practice medicine or provide rehabilitation care in the healthcare sector;
- meet other requirements established by law.
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What documents are needed to apply for a disability group
The assessment of people is carried out based on an electronic referral, which is generated by:
- the attending physician after conducting the necessary diagnostic, therapeutic, and rehabilitation measures;
- the head of the military medical commission.
In the absence of technical capability to use the electronic system, the referral will be made using paper documents.
Some patient cases will be sent to different hospitals. In particular, cases of patients suffering from tuberculosis are sent for consideration by expert teams created on the basis of regional phthisiopulmonology centers/super-cluster healthcare institutions in the phthisiopulmonology direction.
Cases of patients suffering from mental and behavioral disorders are sent for consideration by expert teams created on the basis of super-cluster healthcare institutions in the psychiatric direction.
Cases of patients suffering from neoplasms are sent for consideration by expert teams created on the basis of super-cluster healthcare institutions in the oncological direction.
The electronic referral must contain the following information:
- information about the person being referred for assessment (surname, first name, patronymic; gender; identification code; date of birth; address of residence; information about the presence or absence of disability; phone number);
- medical history;
- the person's condition at the time of referral for assessment;
- diagnosis at the time of referral for assessment; grounds for referral for assessment;
- information about the referring physician.
Copies of the following documents must be attached to the electronic referral:
- passport and identification code;
- military ID or temporary military service certificate, or conscription certificate;
- medical documents related to the disease or health condition, according to which the person was referred for assessment.
After the healthcare institution receives the electronic referral, it is reviewed by the administrator. Several individuals may be authorized in the healthcare institution to perform administrator functions.
After receiving the referral, the administrator checks it for completeness of the provided information; determines the necessary list of specialties of doctors and/or rehabilitation specialists of the expert team, and also determines the possible form of consideration by the expert team - in person, in absentia, using telemedicine methods and tools, or at the person's place of residence/treatment).
After the administrator accepts the electronic referral for consideration, information about the form, date, and time of consideration is sent to the person's email (if available), and will also be displayed in the electronic system for the referring physician.
In the electronic system, the doctor will not see the composition of the expert team. The administrator can return the referral if there are errors in the information, necessary documents are missing, or the quality of document copies is poor, making it impossible to review them.
How to get a disability group
Until the day of the case review, members of the expert team do not have access to the case in the electronic system. The person referred for assessment does not have access to the personal composition of the expert team that will conduct the assessment.
The case review must be completed no later than 30 calendar days from the date of the electronic referral. Decisions are made by the expert team on the day of the case review, except in cases where additional examination is required.
During the review, members of the expert team examine all provided documents, as well as relevant medical records confirming the person's health status, contained in the electronic healthcare system.
Decisions are made collegially by a majority vote of the expert team members. In case of an equal distribution of votes, the presiding officer in this case has the casting vote.
The expert team's review is recorded in a corresponding protocol, which is signed in the electronic system by each team member by applying a qualified electronic signature.
The expert team's review protocol must contain the following information:
- date and place of the review;
- form of the review;
- surname, first name, and patronymic (if any) of each expert team member conducting the assessment, with an indication of who is presiding;
- surname, first name, and patronymic (if any) of the person being assessed;
- surname, first name, and patronymic (if any) of other persons present at the review;
- method of participation of each person in the review;
- list of decisions to be made according to the referral;
- results of the person's examination in case of an in-person or on-site review;
- brief description of each person's speeches during the review regarding each point of the decisions being made;
- opinion of each expert team member regarding the final decision to be made based on the assessment results;
- information regarding the voting of expert team members based on the assessment results;
- decision made by the expert team based on the assessment results, which also includes the motivational part.
The reasoned position of an expert team member who disagrees with the expert team's decision must be stated in the expert team's review protocol.
An assessment can be conducted remotely if the person has malignant neoplasms of stages III-IV, blood and hematopoietic organ diseases, cerebrovascular diseases complicated by hemiplegia, paraplegia, or tetraplegia, with limb absence, as well as liver diseases, congenital malformations.
Based on the assessment results, the expert team may make a decision that will establish:
- the degree of limitation of the person's vital activity;
- determination of the need to extend temporary disability;
- disability, fixing the causes and time of its onset in accordance with the documents confirming this;
- the degree of loss of professional working capacity (in percentages);
- the need for constant care.
After the assessment, adoption, and signing in the electronic system, an extract with the decision is sent to the person's email, as well as recommendations that are part of the individual rehabilitation program for a person with a disability (if disability is established). An extract from the adopted decision is also displayed in the electronic system for the referring physician.
Also, the decision on establishing disability or the degree of loss of working capacity will be sent to the TCC and SP.
For which diseases is a disability group given?
The basis for recognizing a person as a person with a disability is the presence of the following mandatory conditions:
- persistent impairments of body functions – the disease lasts at least 12 months, or is expected to last at least 12 months or lead to the person's death, and there are minimal chances of significant improvement even with the best available treatment;
- limitation of vital activity – the person has a moderate (1st degree), pronounced (2nd degree), or significant (3rd degree) limitation of the ability to self-care, move, orient, control their behavior, communicate, learn, perform work activities;
- necessity of social protection measures — the person needs support in daily life, namely, receiving rehabilitation services, palliative care, provision of technical and other rehabilitation aids, provision of medicines for outpatient use and/or medical devices for outpatient and home use.
The disability group will be established depending on the degree of disorder of organ and body system functions and the limitation of vital activity, and will be divided into:
- first (I), which is divided into subgroups A and B depending on the degree of health loss of persons with disabilities and the extent of the need for constant external care, assistance, or supervision;
- second (II);
- third (III).
The first disability group is established if a person has a significant degree (3rd degree) of limitation of one or more criteria of human vital activity. Group I includes persons with the most severe health condition, who are completely unable to self-care, require constant external supervision, care, or assistance, are completely dependent on other persons in performing vital social and domestic functions, or who are partially capable of performing individual elements of self-care.
Subgroup A of Group I disability includes persons with an exceptionally high degree of health loss, which leads to the need for constant external supervision, care, or assistance from other persons and actual inability to self-care.
Subgroup B of Group I disability includes persons with a high degree of health loss, which leads to significant dependence on other persons in performing vital social and domestic functions and partial inability to perform individual elements of self-care.
The second disability group is established if a person has a pronounced degree (2nd degree) of limitation of one or more criteria of human vital activity. Group II disability may also include persons who have two or more diseases leading to disability, consequences of injury or congenital defects and their combinations, which in total cause a pronounced (2nd degree) limitation of the person's vital activity and working capacity.
The third disability group is established for persons with a moderate degree (1st degree) of limitation of one or more criteria of human vital activity, caused by disease, consequences of injuries, or congenital defects.
Disability is established for the following periods:
- for persons with anatomical defects, other irreversible impairments of organ and body system functions – indefinitely;
- for persons undergoing re-examination and having Group 1 disability for 5 years – indefinitely;
- for persons with oncological and oncohematological diseases with an unfavorable prognosis – for 5 years;
- for persons with chronic diseases with a severe course – for 5 years;
- for persons who are first established with Group 3 disability – 1 year;
- for persons who are first established with Group 2 disability – 2 years;
- for persons undergoing re-examination, disability is established for a period of 1-3 years.
The annexes to the resolution indicate a list of anatomical defects and diseases for which a disability group is established without a re-examination period. In particular, the list contains 88 diseases. The list of diseases can be found at the link.
Disability will also be established for 5 years if a person has the following diseases:
- respiratory organs, severe course with chronic respiratory failure of stage 3;
- circulatory system, chronic heart failure of stages IIB-III;
- chronic kidney disease of stages 4-5;
- HIV infection;
- type 1 or 2 diabetes mellitus;
- systemic lupus erythematosus with kidney damage;
- Alzheimer's disease;
- multiple sclerosis.
Appealing decisions
Decisions of expert teams regarding assessment results can be appealed. The complaint must be submitted by the person in paper form to the Center for Assessing the Functional State of Individuals, or in electronic form through the electronic system by contacting the complainant's doctor.
It should be noted that previously, Ukrainians could submit an appeal against an MSEC decision to the same MSEC where they were denied disability.
After the liquidation of the MSECs, the functions of the central MSEC are performed by the Ukrainian State Research Institute of Medical and Social Problems of Disability in Dnipro, and accordingly, all appeals "go" there.
That is, complaints are considered by only one hospital in Ukraine.
According to government resolution No. 1338, a complaint can be submitted within 40 calendar days.
No later than the next working day from the date of receipt of the complaint, the authorized person of the Center for Assessing the Functional State of a Person initiates the appeal process in the electronic system.
The consideration of the complaint by the expert team of the Assessment Center must be completed no later than 30 calendar days from the date of its receipt.
UNN interlocutors say that in practice, this works quite differently.
"I filed a complaint back in April. According to the government resolution, the medical facility in Dnipro should have considered this complaint within 30 days, but I am still waiting. At first, no one at the hospital answered the phone at all, then the operators said: 'What can we do, we have 20,000 cases, please wait,'"
The words of our interlocutor are also confirmed by numerous comments under posts on Facebook on the page of the State Institution "Ukrainian State Research Institute of Medical and Social Problems of Disability of the Ministry of Health of Ukraine."
In a comment to UNN, MP Oksana Dmitrieva, a member of the Verkhovna Rada Committee on National Health, Medical Care, and Medical Insurance, said that "she, as a People's Deputy of Ukraine, has not yet received such appeals."
"At the same time, the topic is indeed important. If the number of such cases is growing and the deadlines for considering appeals are being delayed, this requires discussion at the Committee level with the participation of the Ministry of Health and the Ministry of Social Policy. These departments were the initiators of the changes, so it is important to understand how the system works in practice and whether it creates additional barriers for people," she said.