Assessment of daily functioning as a mandatory step in establishing disability following shelling and mine/blast injuries

In this article, we answer questions about undergoing the assessment of a person’s daily functioning for the first time after sustaining health damage as a result of shelling or a mine/blast injury, and for the second time, in order to change the cause of disability for the purpose of obtaining the status of a person with a disability as a result of war.

Since 1 January 2025 the MSEC procedure (Medical and Social Expert Commissions) has been replaced by the assessment of a person’s daily functioning. However, documents previously issued by MSECs remain valid for the period specified in them.

Has the approach to the criteria for establishing disability changed

Yes. The key factor in establishing disability is now not the diagnosis itself or the severity of the injury, but its impact on the person’s functioning — whether the person is able to work, move around, take care of themselves, orient themselves, and perform other everyday activities. Based on the results of the assessment of daily functioning, disability Group I, II or III may be established depending on the loss of working capacity, limitations in daily functioning, and the patient’s needs:

1. Group III (40–65% loss of working capacity): moderate limitation; the person may continue working with reduced qualifications or a reduced workload;
2. Group II (66–84% loss of working capacity): significant limitation; the person requires assistance or assistive devices but does not need constant care;
3. Group I — subgroups A and B (85–100% loss of working capacity): severe limitation, full dependence on others or the need for constant supervision.

Who should refer a person for an assessment of daily functioning

As a rule, the referral is prepared by the attending physician after the necessary diagnostic, treatment, and rehabilitation measures have been completed. This may be a doctor working at either a public or private healthcare facility. To issue the referral, the doctor must be registered in Ukraine’s Electronic Health Care System (EHCS), where the electronic referral is created.

A family doctor may issue the referral in exceptional circumstances if the patient is in a de-occupied territory or an area of hostilities where access to specialised doctors is limited, as well as where the patient has already collected the full package of required medical documents and no additional consultations with specialised doctors are needed.

Can I choose the expert team

Yes. The healthcare facility with the relevant Expert Team for Assessing Daily Functioning is selected jointly by the patient and the doctor. The list of healthcare facilities and the profiles of expert teams are available on the dashboard on the website of the Ministry of Health of Ukraine.

How can the assessment be conducted

There are four forms of assessment: in-person, remote, document-based (in absentia), and on-site. These forms make it possible to take into account each person’s circumstances — their health condition, completeness of the available documents, and ability to attend the assessment in person. For example, remote assessment is available to Ukrainian citizens who are abroad. For more information on undergoing the assessment while abroad, please see the Guide of the Ministry of Health of Ukraine.

The form of assessment is specified in the referral and must correspond to objective criteria. It may be changed if the person’s health condition changes or new documents become available.

Is it true that I can have a representative with me during the assessment

Yes. During the assessment, a patient has the right to invite a representative if they need support or additional advice.

The doctor who issued the referral or an authorised representative whose authority is duly confirmed may be present during the assessment (for example, a lawyer, another authorised representative, an involved doctor, a rehabilitation professional, a social worker, etc.).

More information about representation during the assessment of daily functioning is available in this material of the Ministry of Health.

How long does consideration of the case take

The Expert Team for Assessing Daily Functioning should consider the case within 30 calendar days from the date on which the healthcare facility accepts the electronic referral, although in practice the process may take longer. The process includes several stages:

1. preliminary review: the administrator of the healthcare facility reviews the documents within 5 days of receiving them and registers them in the system;
2. consideration of the case: the Expert Team considers the case on the date of the scheduled meeting, according to the queue;
3. additional examinations: if additional examinations are required, the patient is informed accordingly. The 30-day period is suspended and resumes no later than 30 days after the additional examinations have been completed.

The Case Status Check service for the assessment of daily functioning allows you to track changes in the status of your case.

What document confirms the establishment of a disability group

Following the assessment, the patient receives an extract from the Expert Team’s decision.

If disability is established, the extract is accompanied by recommendations concerning rehabilitation, treatment, employment, assistive devices, and other forms of support. These recommendations form part of the individual rehabilitation programme.

As a rule, the applicant receives the extract from the decision by post, while the relevant information is automatically transferred to the Electronic Health Care System (EHCS) and the Unified Information System of the Social Sphere. The document is also available to the patient through the Electronic Cabinet of a Person with a Disability.

Can the Expert Team’s decision be appealed

Yes. If a person disagrees with the disability group, duration, cause of disability, or a refusal to establish disability, the decision may be appealed within 40 calendar days from the date the extract was sent, either through the out-of-court procedure or before an administrative court by filing a claim.

Under the out-of-court procedure, the complaint is considered by the Centre for Functionality Assessment (the Centre), which may be contacted:

1. by email: [email protected];
2. by post: 1-A Feodosiia Makarevskoho Lane, Dnipro, 49005, Ukraine.

For a judicial appeal, it is advisable to seek legal assistance.

Does the cause of disability specified in the Expert Team’s decision matter

Yes, if the person intends to apply for one-off compensation and annual assistance for persons affected by explosive ordnance in accordance with Resolution No. 1020 of the Cabinet of Ministers of Ukraine dated 29 September 2021.

For the Expert Team to have grounds to specify a cause of disability related to an injury caused by explosive ordnance — wounds or other health damage caused by explosive ordnance — the package of documents prepared for referral for assessment must include an extract from the Unified Register of Pre-Trial Investigations (URPI), the state information system containing records of criminal offences, with information about the criminal proceedings, the circumstances in which the health damage was sustained, and the injured person. Otherwise, the cause of disability is recorded as “general disease”.

Can a person obtain the status of a person with a disability as a result of war if the cause is stated as “wounds or other health damage caused by explosive ordnance”

No. To obtain this status, the extract from the Expert Team’s decision must specify the cause of disability as “Wounds or other health damage sustained during the Anti-Terrorist Operation or measures to counter the military aggression of the Russian Federation.” Other wording, even if similar, cannot serve as a legal basis for obtaining the status.

How can the cause of disability be changed

For the cause of disability specified in the extract from the Expert Team’s decision to reflect the actual circumstances and serve as a basis for obtaining the status of a person with a disability as a result of war, the person must undergo the assessment procedure again. The referral must include the decision of the Interagency Commission under the Ministry of Veterans Affairs of Ukraine, adopted in accordance with the relevant Procedure and Regulations.

To do this, the person must contact the doctor who issued the previous referral for the assessment of daily functioning, provide the original decision of the Interagency Commission under the Ministry of Veterans Affairs, and have a new electronic referral created under the criterion “need to change the cause of disability.”

How is the new assessment conducted and how is the extract issued

As a rule, an assessment for the purpose of changing the cause of disability is conducted within five working days from the date of the applicant’s request, in a document-based form without the person’s direct participation, on the basis of the decision of the Interagency Commission establishing the fact that the affected person sustained health damage caused by explosive ordnance, as well as the documents attached to the referral and available in the Electronic Health Care System.

Please note! The date on which the cause of disability is changed is the date of referral of the person with a disability for an assessment for the purpose of changing the cause of disability.

If you need an individual consultation or legal assistance on issues related to the consequences of the war, you can choose a lawyer and book an online consultation via this link.

This information material was developed within a project implemented by the NGO "STEP" in cooperation with the Danish Refugee Council (DRC) with funding from the European Union. However, the views and opinions expressed are those of the author alone and do not necessarily reflect the views of the European Union or DRC.