Darya Sydorenko: What is wrong with MSEKs, and how to change it?®

Darya Sydorenko: What is wrong with MSEKs, and how to change it?®


Probably, most Ukrainians have heard the story from Kharkiv, where the Ukrainian defender, who almost lost his leg, was refused the necessary disability group. The head of the regional medical and social expert commission advised the combatant to “cut off his leg.” This is a story that became known and made it possible to bring the discussion about the problems of MSEKs to a new level.

However, negligent attitude and arrogance is only the tip of a large iceberg of problems that are characteristic of medical and social expert commissions. Therefore, the short answer to the question of what is wrong with MSEKs is everything.

Starting with how realistically it is for a traumatized person to get into the premises of commissions without help, ending with the completeness of the list of documents that must be presented. But it is impossible to change everything at the same time.

Therefore, the following is about the main problems that people with disabilities face when interacting with medical and social expert commissions. It is important: we are talking about those problems that are quite realistic to eliminate now, by making changes to the current legislation, in particular to the Decree of the Cabinet of Ministers of Ukraine “Issues of medical and social expertise” dated December 3, 2009 No. 1317.

The process of referral for medical and social examination is currently unorganized. According to the current rules, in order to get a medical and social examination, a person must undergo a complete medical examination. But due to the fact that the legislation does not establish a single procedure for such an examination, in practice it can be carried out in different ways: by hospitalization or on an outpatient basis.

If we remove the definition of “full medical examination” and introduce multidisciplinary rehabilitation teams instead of medical advisory commissions, we will get a much more orderly process of passing the examination.

Terms of consideration. Currently, there are conflicting rules about how long a person should be examined. We define a specific and adequate term – 5 days, and significantly simplify the life of all participants in the process.

No digitization. Ukrainian “Diya” is admired by the world. Vaccination certificates appeared easily in our smartphones. But when it comes to the process of interaction with commissions, it all looks like a parallel reality.

Due to the lack of electronic queues and the possibility of submitting documents online, people are forced to waste a lot of extra time. After all, so are the commissions themselves.

It is important to understand that the current legislation allows electronic referral for medical and social examination, but the commissions are not connected to the eHealth system. Also, commissions do not systematically enter data into the Central Disability Data Bank. This makes it impossible to generate complete statistics on persons with disabilities. We integrate data from the Central Bank and eHealth – and get much simpler procedures and a better understanding of the situation regarding the number of people with disabilities.

Limited employment opportunities. In an individual rehabilitation program, a limited range of activities or even individual professions that a person can perform is fixed. It is possible to go another way – to introduce the principle that “what is not forbidden is allowed.” This will greatly increase people’s opportunities to find work.

Lack of transparency in the terms for which disability is established. Currently, the term for which disability is established is 1-3 years. This gives too much power to the members of the commissions to decide for what period to establish disability.

Establishing clear terms of disability for different diseases/groups of diseases will allow a person to clearly understand his rights and reduce corruption risks.

It is also worth mentioning that a large and complex reform of the procedure for obtaining disability is currently underway. It involves the transition to the international classification of functioning, which has been used by many countries for a long time.

The fear that the transition to such a system will reduce the number of persons with disabilities and receiving social benefits is groundless. My colleague Mariana Onufrik, who researches this topic, cites important statistics that support this.

In Ukraine, before the full-scale invasion, 6% of people had a disability. While in the USA, in Australia, that is, in those countries where the ICF was implemented a long time ago, 18% of people have a disability. This does not mean that sicker people are born there or that they are injured more often, just that a person can get a disability based on a much larger number of signs.

But this system will work next year at best. And people with disabilities, like people without disabilities, deserve to be treated with dignity every day.

Therefore, it is necessary to change the quality of work of medical and social expert commissions now.

Therefore, it is necessary to change the quality of work of medical and social expert commissions now. My colleagues from the Princip Human Rights Center for servicemen, the Ukrainian Helsinki Human Rights Union and the public organization “Together Against Corruption” have already addressed the Ministry of Health with relevant proposals.

If they are taken into account and accepted, we will get a quick, clear, objective and simple procedure for obtaining a disability and interaction with MSEKs today.

Daria Sydorenkoexecutive director of the “League of the Strong” public union.

The material was prepared with the support of the International Renaissance Foundation. The material represents the position of the author and does not necessarily reflect the position of the International Renaissance Foundation

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