The government has adopted a resolution on replacing the MSEC with a new assessment system

The government has adopted a resolution on replacing the MSEC with a new assessment system
On November 15, the Cabinet of Ministers approved the resolution "On Some Issues of Implementing Human Daily Functioning Assessment," which establishes a new assessment procedure and replaces the process of medical and social examination (MSEC).
This was announced by the press service of the Ministry of Health.
The Ministry of Health reported that the resolution will ensure changes in the system from January 1, 2025.
This includes:
- 
introducing a new assessment concept;
 
- 
simplifying the process for the patient to establish or confirm disability status;
 
- 
accessibility and professionalism of the assessment;
 
- 
digitalization of the process and anti-corruption measures;
 
- 
creating an Assessment Center for appealing decisions.
 
After January 1, 2025, documents for people with a permanent disability status will remain valid. For other people with disabilities whose re-evaluation period falls during the implementation of the new system, the re-evaluation period will be extended by 6 months. All rights, documents, payments, benefits, social services, and deferments are preserved.
New Concept
The system is based on the assessment of a person’s daily functioning by expert teams of doctors at multi-specialty hospitals. This is a comprehensive approach to assessing the impact of injury or illness on daily activities, to quickly determine the individual needs of a person and help them return to an active, dignified life.
Simplification for the Patient
The process of establishing a disability status will become significantly simpler and shorter. There will be no need to go through the medical advisory commission of the institution - the doctor will immediately refer for assessment. For some conditions, the doctor can refer for assessment immediately after a specific diagnosis or intervention, without waiting as before, for 120 days of sick leave. Electronic referrals for additional examinations will be formed by expert team doctors during the assessment, and without compelling reasons, re-examinations cannot occur more than once. The expert team’s decision will be transmitted to the social sphere via the electronic system.
Improving Accessibility and Professionalism of the Assessment
Instead of separate MSEC organizations, where most doctors were not involved in treatment, the assessment will now be conducted by teams of practicing doctors at hospitals. The patient and their doctor will choose one of 300 powerful multi-specialty institutions. The hospitals will be evenly geographically located, and each institution will have multiple teams for each case profile. Whenever possible, cases will be directed to specialized institutions: for example, assessment of neoplasms at an oncology facility, and assessment of mental disorders at a relevant profile institution. In these same hospitals, additional examinations can be conducted under the Medical Guarantee Program.
Digitalization of the Process and Anti-Corruption Measures
A fully electronic system will be implemented instead of a completely paper-based process. Referrals and associated documents, protocols, decisions, and all actions will be recorded in the electronic system.
The composition of teams will not be fixed as it was before. Now an individual expert team will be formed for each case. An administrator at the institution will check in the electronic system the completeness of the case and whether the system correctly identified the specialties of doctors and the review form according to the criteria. Then the system will select a profile team for the case that has the nearest available time to conduct the assessment. The team administrator will not know which team and at what time the case will be assigned, and individual data about doctors and patients will be hidden from each other until the day of the assessment.
The Ministry of Health emphasizes that none of the MSEC heads will be able to join the expert teams.
Assessment Center for Appealing Decisions
Within the framework of the resolution, it is planned to create a Center for Functional Status Assessment of individuals, which will check the validity of team decisions and handle cases aimed at appeals. The center’s team will consist of doctors from different healthcare institutions.
Validity and Continuation of Documents
The resolution also provides that disability is maintained for all individuals who were granted it for life. At the same time, all rights, documents, payments, benefits, social services, and deferments are maintained. Their disability status can only be reviewed at their request or by court decision. For individuals who were granted disability with a re-evaluation term that falls during the implementation of the new system, the disability status will be extended by 6 months, along with the respective payments and guarantees.
For individuals who did not undergo the scheduled re-evaluation during the martial law period, it will be necessary to do so: for men of draft age - by November 1, 2025, for others - by April 1, 2026. Exceptions include individuals in temporarily occupied territories and individuals with severe health conditions as defined in the resolution. Additionally, an assessment before the defined term may occur at the request of the court or law enforcement agencies, including within criminal proceedings.
Next Steps by the Ministry of Health
To implement the new system, it is planned to adopt orders from the Ministry of Health that will help doctors make informed decisions and reduce the number of documents a person receives from the assessment: instead of 12 certificates or extracts in various combinations, there will be one comprehensive document.
The funding of the new teams will be carried out through the NHSU for assessment services according to transparent requirements for team activities.
It is also planned that reference and statistical information about teams, their specialties, locations, queues, and decisions will be publicly available on analytical dashboards.
The current changes do not yet apply to children. Processes related to child disability also require updates to be more convenient and patient-oriented. This is planned as the next step. Currently, for children, the system where the disability status is assigned by the medical advisory commission of the healthcare institution remains in force.
| 
 WAS  | 
 WILL BE  | 
|
| 
 Name  | 
 MSEC - medical and social expert commissions  | 
 Expert teams for assessing the daily functioning of a person  | 
| 
 Result  | 
 1. Disability status 2. Payments, benefits, deferments 3. Rehabilitation aids 4. 12 certificates and extracts in different combinations  | 
 1. Disability status 2. Payments, benefits, deferments 3. Rehabilitation aids 4. One comprehensive document  | 
| 
 Patient Pathway  | 
 1. Person - 2. Attending doctor - 3. Institutional Medical Advisory Commission - 4. MSEC  | 
 1. Person - 2. Attending doctor - 3. Expert team  | 
| 
 Reference Information  | 
 With the doctor and in paper journals  | 
 On public analytical dashboards  | 
| 
 Documents  | 
 All in paper form: case, referral, protocol, decision  | 
 All in electronic system: case, referral, protocol, decision  | 
| 
 Queue  | 
 In paper journals  | 
 In electronic system.  | 
| 
 Location  | 
 Separate MSEC structures and premises  | 
 Teams in powerful multi-specialty hospitals  | 
| 
 Doctors  | 
 Most do not treat, only conduct medical and social examinations. Not all necessary specialties in MSEC staff  | 
 Team of practicing doctors of various specialties - all necessary for reviewing the relevant case  | 
| 
 Number of Doctors  | 
 4 - 10 doctors in total  | 
 10 - 50+ doctors in total - decided by the institution  | 
| 
 Composition of Doctors  | 
 Fixed composition for each patient  | 
 The team selected by random assignment for each case according to the profile of the case No MSEC heads can join expert teams  | 
| 
 Re-examination  | 
 From MSEC, return to attending doctor for electronic referral Can undergo an examination under the Medical Guarantee Program  | 
 The doctor of the expert team issues electronic referrals during the assessment Can undergo examination under the Medical Guarantee Program wherever convenient, including in the hospital where the team is located  | 
| 
 Decision  | 
 One joint decision for the commission, signed by the head  | 
 The position of each doctor and joint decision recorded, signed by each doctor with an electronic signature  | 
| 
 Appeal  | 
 At oblast or central MSEC  | 
 Appeal in electronic and paper form at the central level  | 
| 
 Funding  | 
 Subvention from the state budget and additional funding from local budgets for MSEC existence  | 
 Through the NHSU program for assessment services  | 
| 
 Patient Representative  | 
 Not provided  | 
 Provided  | 
| 
 Recording of Meeting  | 
 Not provided  | 
 The individual or their representative is allowed to make video or audio recordings of the assessment.  | 
Topics: CorruptionMobilizationMinistry of DefenceMinistry of HealthMSEC
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