News

9 November 2023

Ombudsman Diana Kovacheva sent an opinion to the Minister of Health Hristo Hinkov and to the Minister of Social Policy Ivanka Shalapatova, in which she warns that five months after the latest changes in the regulatory documents for people with disabilities, their problems with expert medical assessments remain unresolved.

The reason for this opinion of Prof. Kovacheva reflects the numerous complaints and reports received by the Ombudsman’s institution from outraged and desperate citizens about their rights being violated during their expert medical assessment and the resulting impossibility to promptly enjoy the rights and support as disabled people. Most often, people complain that their expert medical assessment by TELK (Territorial Expert Medical Commission) is delayed several months, and until then they have no income to live on. The problem is that they remain without health insurance rights and without access to treatment.

The Ombudsman emphasizes that the Council of Ministers’ Decree on amendments and additions to the Regulation on the structure and organisation of the work of expert medical assessment bodies and of the regional files of expert medical assessments has not been adopted yet. This further hinders improvement of the activities of the expert medical assessment bodies.  

Diana Kovacheva insists that, pending the start of the work of the established interdepartmental working group to prepare the necessary regulatory changes regarding expert medical assessments, in view of its significant delay and the continued violation of the rights of a huge number of vulnerable citizens, additional measures should be taken as a matter of urgency to speed up the process of carrying out expert medical assessments and resume disability pensions until preparation and implementation of the necessary comprehensive reform in the field.

“I would like to note my strong commitment to the problems faced by people with disabilities and their relatives in getting their expert medical assessment decisions and also recall that, in accordance with the powers of the institution, I have made a number of proposals and recommendations to address the problems and ensure the rights of citizens”, writes the Ombudsman.

Diana Kovacheva recalls that, at her suggestion, the National Assembly adopted changes to the Persons with Disabilities Act and the Health Act, as well as that the Council of Ministers adopted amendments to by-laws to basically ensure the rights of people with disabilities in order to prevent interruption of social support in case of delayed re-certification, as well as fairer assessment of their permanently reduced working capacity/type and degree of disability.

However, the Ombudsman warns of a number of problems that remain unresolved and lists some of them.

“Significant delay of expert medical assessment decisions by the Territorial Expert Medical Commissions (TELK), especially in some areas of the country. The delay violates the rights of people with disabilities who have submitted an application-declaration for primary certification, as well as for early re-certification, for example due to deteriorated condition, who until the expert decision is issued and the administrative procedures are completed, are deprived of the opportunity to enjoy the rights of people with disabilities, when they need them most. It should also be noted that not all rights can be enjoyed for a past period,” Prof. Kovacheva points out.

She adds that there is a delay in expert medical assessments by the National Expert Medical Commission (NELK) and, above all, the cases of several consecutive annulments and returns to TELK of expert medical assessment decisions of the same person within one procedure. She emphasizes that as a result of the annulment of an expert medical assessment decision of TELK, until a new one is issued and enters into force, the disability pension, as well as other social rights of citizens are suspended.

She also draws attention to another problem that needs to be resolved, namely the delay in issuing and sending the expert medical assessment decision after the date announced for examination of the administrative procedure. In this context, it is appropriate to provide for a mechanism to ensure that NELK does not have the right to return the file indefinitely for re-examination by TELK.

 “The extended period of entry into force of expert medical assessment decisions, often exceeding one month, during which disabled people are left without their disability pensions. Here it is appropriate to emphasize the positive practice of the structures of the social assistance system to implement expert medical assessment decisions immediately after their issuance, even if they have not entered into force. In this way, it is ensured that citizens with disabilities can receive the support under the Persons with Disabilities Act and the Personal Assistance Act as quickly as possible, overcoming the problems with long deadlines for entry into force of expert medical assessments”, the Ombudsman writes.

The Ombudsman underlines the position she has expressed on several occasions that sending an expert medical assessment decision from the regional expert medical assessment files to the territorial unit of the National Social Security Institute only after having verified that all parties have been informed thereof and that the time limit for appeal under Article 63, paragraph 1 has expired is the cause for the delay of expert medical assessment decisions by the medical commissions to the territorial units of the NSSI, whereas the 14-day time limit for appeal starts to run upon receipt of the expert medical assessment decision, which further extends the time for granting a disability pension and creates conditions for violation of citizens’ rights as a result of this delay.

 “In this regard, I think it is important to discuss the possibility of speeding up the resumption of citizens’ pensions, which could be achieved, on the one hand, by introducing and applying the general principle of sending of the decision issued to the interested parties. On the other hand, by providing the medical commissions with access to information and documentation in the electronic system, relating to the expert medical assessments and certifying the current health status of the persons, the activities of the commissions could be further accelerated. It is good to consider the possibility of introducing the positive practice of the structures of the social assistance system for implementation of expert medical assessment decisions immediately after their issuance and regarding the resumption of the pensions of the affected citizens”, the Ombudsman also recommends.

The other problems with the expert medical assessments mentioned by the Ombudsman in the opinion are available here: https://www.ombudsman.bg/bg/n/ombudsmanat-nastoyava-za-speshni-promeni-v-me-2131