The public union “The League of the Strong” suggests making changes to the laws that can affect the work of medical and social expert commissions in a short period of time. Daria Sydorenko, executive director of the “The League of the Strong”, mentioned this during the press conference “Reforming the MSEC: Do we need to wait 5 years?”
As clarified by Daria Sydorenko, a large and complex reform of the disability assessment procedure is currently underway. However, there is a need to make decisions that will facilitate this process here and now. This includes making changes to the Resolution of the Cabinet of Ministers of Ukraine “Issues of Medical and Social Expertise” No. 1317 of December 3, 2009.
“We have analyzed the legislation and propose three key changes. The first one concerns the abolition of the division into specialized and general commissions, which will bring such commissions physically closer to people who may need their services. The second problem is that there is no quality rehabilitation program. And we believe that the commissions must have an expert in charge of the rehabilitation component. With poor quality rehabilitation, people do not receive the necessary assistive technologies, and this, in turn, negatively affects employment issues, because people cannot return to work and an active lifestyle. And the third key change is that the assessment of loss of functionality should be determined by specialists of a multidisciplinary rehabilitation team according to the ICF. And this is very important, because in this case people will not have to prove whether they have a limb or not,” said Daria Sydorenko, executive director of “The League of the Strong”.
According to Masi Nayyem, co-founder of the NGO “Human Rights Center for Military Personnel ‘Principle'”, a service man and lawyer, in the autumn, “Principle” conducted a study based on the MSEC monitoring by military personnel and veterans. According to him, the fact that 39% of the participants in the monitoring began to appeal decisions after the MSEC or planned to do so is a good indication of the work of the MSEC.
“What should be done now? We need to start digitalizing all processes – from the electronic queue to the introduction of the Electronic Healthcare System and full-fledged electronic document management. This would allow the servicemen not to collect papers on their own for months, having problems at every step. Additionally, we need to work on improving the interaction of various authorities faced by the militaries and veterans, taking into account the entire condition of the patient during the MSEC, professional training and ethics of doctors and MSEC staff, and creating a barrier-free environment and real improvement of service,” said Masi Nayyem.
Dmytro Lufer, Advisor to the Prime Minister and former Deputy Minister of Health, spoke in more detail about the major reform of the disability assessment procedure.
“The new system should start working in 2025. The five years are a transition period. For people who need these services in 2025, only the new system will exist. For those who will need confirmation, there will be only a new system. And only those who will have a lifetime status at that time will have 5 years to switch to the new system. This is done so that it does not turn out that in one year we have to transfer all people who already have the status to the new system. This will overload both the system and people,” explained Dmytro Lufer.
The specificity of this reform is that it involves the transition to an international classification of functioning. As explained by Marianna Onufryk, head of the board of the NGO “Family for Persons with Disabilities”, it has been used in many countries for a long time. Fears that the transition to such a system will reduce the number of people with disabilities who receive social benefits are unfounded.
“The International Classification of Functioning provides a much broader list of limitations that a person can face in our society. We can compare using simple numbers. In Ukraine, before the full-scale invasion, 6% of people had disabilities. Whereas in the United States and Australia, countries that have implemented the ICF years ago, 18% of people have disabilities. This does not mean that people are born sicker there or are more likely to be injured, but the spectrum is much wider. That is, a person can be disabled on a much larger number of grounds,” Marianna Onufryk noted.
Rodion Trystan, a veteran and lawyer at the Veteran Hub support line, shared his experience of interacting with medical and social expert commissions.
“My history of interaction with expert commissions began much earlier, in 2005. I had certain illnesses that required me to undergo the MSEC as a child. I can say that nothing has changed in 10 years, when I passed the commission again in 2015-2016. The first thing a person encounters when he or she comes to the commission is the attitude that the staff has descended from heaven. It’s a very correct position to conduct training for employees, but I don’t know how you can teach people to be human. At the same time, while for a civilian, a supercilious attitude is half the problem, for a person who has been through combat operations and suffered health losses, it is a difficult barrier,” Rodion Trystan said.
In order to change these urgent problems, “The League of the Strong” is working on a letter proposing changes to the Cabinet of Ministers’ Resolution. Soon, in cooperation with other civil society organizations, it will be sent for consideration.
The press conference was held with the support of the International Renaissance Foundation. The material represents the position of the authors and does not necessarily reflect the position of the International Renaissance Foundation.
The International Renaissance Foundation is one of the largest charitable foundations in Ukraine, which since 1990 has been helping to develop an open society in Ukraine based on democratic values. Since then, the Foundation has supported about 20,000 projects worth more than $350 million.