How the state provides prosthetics for amputations

People who will be returning from the front will need support, social guarantees and rehabilitation.

One of the most common combat injuries is amputation. Defenders and protectors who have experienced amputation will have a long road to recovery. It is important that they are accompanied every step of the way by qualified specialists who, in addition to medical care, will also provide information support. Already today there is a great need for timely and reliable information, because not all veterans and lawyers. veterans who need prosthetics know about the technical possibilities of different prostheses, the state policy on free prosthetics and compensation for the purchase of rehabilitation equipment at their own expense. We have prepared an informative material in which we tell you what to pay attention to when choosing a prosthetic company, how to apply for free prosthetics and share useful contacts.

Pre-prosthetic rehabilitation begins in the hospital. Wound care, bandaging, exercises to prevent contracture and range of motion: all of this creates the optimum conditions for further prosthetic rehabilitation.

Prosthetics usually take place in two stages: first, a temporary prosthesis is selected and later a permanent, customised prosthesis is made. A temporary prosthesis may be recommended by the medical centre to control the size of the residual limb - the part of the limb left after amputation. It may not be very aesthetically pleasing or mobile. These properties should be paid attention to when making a permanent personal prosthesis. In Ukraine now operates more than 50 prosthetic enterprises in different regions. Not all enterprises provide the same amount of services. Some can make only upper limb prostheses, others - both upper and lower limbs. The following points should be considered when choosing a prosthetics company:

1. Talk to people who have had a similar injury and have been living with it for some time. They can recommend a company and a prosthetist based on their own experience.
2. Focus on the transport accessibility of the company. The prosthesis needs to be serviced regularly by specialists, so it should be convenient for you to get to the facility.
3. Find out about the qualifications of the prosthetist. His work experience should be at least 3 years. And he should have made dentures for at least 20 patients in the last 2 (data from the brochure "If you have been injured and lost an end" https://protezinua.com/poraneni/").
4. Ask specialists for certification from the manufacturer of the components they will use for your prosthesis.

Today the technologies of prosthetic limbs in Ukraine are not inferior to foreign ones. Our specialists use the same components as specialists from the States or Europe. And the state policy is aimed at ensuring that all those who need prostheses are provided with them at public expense. Payment for the service is made through the Fund for Social Protection of Persons with Disabilities. The selection, adaptation of the prosthesis and further training on how to interact with the prosthesis are also free of charge. The state has certain payment standards. Therefore, if the prosthesis and further maintenance prove to be more expensive, a co-financing system can be used. For example, co-financing through charitable foundations and organisations.

A person with a disability can receive the following auxiliary rehabilitation devices (ARD) at public expense:

• prosthetic and orthopaedic devices, including orthopaedic footwear;
• special means for self-service and care;
• mobility aids;
• aids for personal mobility, transfer and lifting;
• furniture and equipment;
• special aids for orientation, communication and information exchange.

To receive a prosthetic device with public funds, gather the following documents:

• application for provision with a prosthetic device;
• a passport of a citizen of Ukraine or a relevant certificate;
• a document with data on the registration number of the taxpayer's registration card;
• decision of the VLK on the necessity to provide a prosthetic device;
• an extract from the order of the commander of the military unit or a certificate on the circumstances of the injury issued by the commander of the military unit.

In order to receive the necessary means of rehabilitation for certain categories of the population, including persons with disabilities as a result of war, it is necessary to go through several stages:

Stage 1. Submission of an application.

The application for the provision of DZR, complete with a full package of documents, must be submitted to the centre for the provision of administrative services (CNAP) or to the social protection authorities (OSZN), or through the electronic office of the person with a disability.

Step 2: Be sure to familiarise yourself with the information materials.

The staff of the CNAP/SOSPN should familiarise you with the content of information materials and useful sources, such as

• a list of businesses that people can contact regarding the provision of MCT (https://protezinua.com/pidpryemstva/" target="_blank") );
• a catalogue of REMs(http://wheelchairs.protez.eu/Wheelchairs /CatalogTZR/Content);
• the mechanism for providing an REM and receiving compensation for self-purchased means " rel="nofollow noopener">https://zakon.rada.gov.ua/laws/show/321-2012-%D0%BF#Text);
• information on the compatibility of REMs(https:/ /zakon.rada.gov.ua/laws/show/z0429-21#Text);
• information on the operation of the electronic cabinet(https://ek-cbi.msp .gov.ua/).

If the application is submitted through the electronic cabinet, the applicant must familiarise himself/herself with all the information.

Step 3: Receiving notification of the decision.

The Fund for Social Protection of Persons with Disabilities sends a notification of the decision and forms an electronic referral through the CNAP, telecommunication means, electronic cabinet of the person or through the Unified State Web Portal of e-services on the need to provide missing documents.

Step 4: Appeal to the enterprise.

It is necessary to apply to the selected enterprise with a statement of intent to provide an FMI. The application must be submitted in person or through the electronic office. From the moment of application you have 14 days to change the selected enterprise if necessary.

Step 5: Selection, ordering and fitting of the FMCT.

The company helps you with the selection of rehabilitation equipment and forms orders for its manufacture. You must check the order and sign it. After trying on the finished individual rehabilitation device (if it fits you), you re-sign the order and the work acceptance certificate.

Step 6. Receipt of the DLR.

When you receive the finished DZR, you should be provided with the instruction manual and warranty service coupon.

Getting an amputation as an adult is especially difficult. You will need more time to heal and adjust. To make this process easier, enlist the support of others. This can be relatives, friends, doctors, psychologists, people with similar experiences. We, in turn, share contacts of friendly organisations that support veterans.

For consultation on selection of a prosthetic company you can contact the specialists of the Prosthetics in Ukraine project by phone +380 50 177 68 39 or by e-mail info@protezinua.com.

If you need support in adjusting to civilian life or need to talk to others who share your experiences, you can contact Veteran Hub on +380 67 348 28 68.

You can also find out more about stump care, exercises for physical rehabilitation after amputation and pain management in the materials of the NGOIngenius.

The material was prepared by the organisation Accessible.UA within the framework of the project conducted thanks to the Veterans Reintegration Programme implemented by IREX with the support of the US Department of State.