Ministry of Health of Ukraine explained, as decided by the expert team to assess the daily functioning of the person who replaced the MSEC.
The decision of the Expert Team for the Assessment of Daily Functioning of a Person (EKOPFO) is a document that is adopted after analyzing the person's health status, the degree of functional impairment and their needs. It is the result of a comprehensive assessment and includes conclusions and recommendations aimed at providing the necessary support.
The decision-making process by the expert team consists of several stages that ensure thoroughness and objectivity of the assessment.
Queueing a case
Upon receipt of the case, the administrator of the healthcare facility:
- Checks documents for completeness and compliance.
If it is appropriate, the case is added to the queue for consideration by the expert team. - Returns the case for revision if deficiencies are identified (incomplete information, lack of supporting documents, low quality copies).
- Notifies the person of the form, date and time of the case hearing.
Evaluation by an expert team
Assessment by an expert team is a key stage that provides a comprehensive analysis of a person's health status, functional capabilities, and needs.
1. Document analysis: the expert team gains access to the case on the day of the assessment.
2. Examination of the patient (if necessary): the expert team can examine the patient and, if necessary, refer him for additional medical examination.
3. Focus on functionality: during the evaluation, the expert team pays special attention to:
- The degree of dysfunction of organs and body systems.
- The impact of these disorders on the ability to perform daily activities.
- The presence of needs for rehabilitation, social support or other services.
4. Individual approach to assessment
- Each case is considered separately.
- The composition of the expert team is formed according to the person's diagnosis.
- If necessary, doctors with narrow specializations are involved.
This process provides a complete overview of a person's health status and functional needs, allowing for objective decision-making and recommendations for further support.
Decision-making
The decision-making process by the expert team involves a clear and structured procedure aimed at ensuring objectivity, transparency, and accuracy.
- Case review
On the day of the case review, the expert team receives access to all the necessary information about the person referred for evaluation. Doctors carefully study the provided documents and materials, which contain medical reports, examination results, and additional data.
- Collegiality of decision-making
The decision of the expert team is made jointly by all its members. During the discussion, each doctor has an equal right to vote, which ensures collegiality and consideration of the opinion of each specialist. If the votes are divided equally, the final decision is made by the presiding doctor whose specialty corresponds to the profile of the case.
- Formation and signing of the protocol
All evaluation results, including conclusions and decisions made, are recorded in the expert team’s review protocol. The document is signed by each team member using an electronic signature, which gives the protocol official status and legal force.
- Ordering additional examinations
The expert team may order additional medical examinations to clarify the person's health status. For this purpose, the presiding physician generates an electronic referral in the electronic health care system.
A person may be referred for additional examinations only once. The exception is cases when the results of such an examination reveal new conditions, diagnoses, or disorders of the structure and functions of the body that were not specified in the medical documentation attached to the referral.
Types of decisions made
The expert team makes decisions based on the person's needs. The main ones include:
- Establishing or not establishing disability, determining its cause, time of onset and duration.
- Extension of temporary disability.
- Determining the degree of loss of professional ability to work (in percentage).
- Determining the need for special means of transportation (car, electric scooter) and contraindications to their use.
- Determining the volume and types of rehabilitation aids: technical rehabilitation equipment and medical devices.
- Establishing a causal connection between death and an occupational disease in order to provide payments and benefits to family members of the deceased (if necessary).
- Recommendations that are part of the individual rehabilitation program for a person with a disability (IRP):
- Medical component: rehabilitation in the field of healthcare, provision of rehabilitation aids, medical products, sanatorium and resort treatment.
- Social component: social and domestic rehabilitation, applying to authorized bodies to receive social services, state assistance or pension.
- Labor component: workplace arrangement, professional rehabilitation, retraining or career guidance.
- Educational component: psychological and pedagogical rehabilitation, referral to inclusive resource centers for a comprehensive assessment of development.
Decision-making deadlines
The expert team is required to make a decision within 30 calendar days from the date the case is placed in the queue. If the person is referred for additional examination, the 30-day review period begins on the date of completion of this examination.
Getting a solution
The decision is entered into the electronic system for assessing the person's daily functioning, and the patient can access it in a convenient way:
- Immediately during the assessment
- To the email address specified when submitting documents, or by letter
After the expert team's decision is made, the implementation of its recommendations and the envisaged support measures begins.
Appealing the decision
In case of disagreement with the decision of the expert team, the patient has the right to appeal it. A clear mechanism is provided for this. The complaint can be filed with the Center for the Assessment of the Functional State of the Person.
The deadline for filing a complaint is 40 calendar days from the date of sending an extract from the decision to the complainant (his authorized representative).
Possible situations and algorithms for solving them
- Patient did not show up for assessment
If the patient does not appear for an in-person or remote hearing, the reason for the absence must be clarified (by contacting the patient or their representative). In case of valid reasons, the assessment may be postponed.
- Force majeure circumstances
Force majeure circumstances are situations that make it impossible to conduct a case review due to extraordinary and irresistible force under the existing conditions (for example, shelling, etc.). In such cases:
- The schedule of expert team meetings is updated, and the queue for considering cases is adjusted according to circumstances.
- Conflict of interest
A conflict of interest arises when a doctor's public duties conflict with his private interests.
What is NOT a conflict of interest:
- If the doctor has consulted with the patient in the past and was not their treating physician.
- If the doctor had the status of a treating physician, but did not participate in establishing the diagnosis with which the patient came for evaluation.
If a conflict of interest is identified, the doctor is obliged to notify the administrator, and his participation in the case is terminated.
- Expression of disagreement during the signing of the protocol
Members of the expert team may leave a comment in the minutes if they disagree with the decision made.
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