In Ukraine, seriously disabled people lost part of their payments

This was one of the consequences of the reforms introduced by Law 2620 authored by MP Mykhaylo Papiyev with the support of Committee head Halyna Tretyakova. It envisages the merger of the Social Insurance Fund with the Pension Fund. An explanatory note to the legislative initiative states that these changes will reduce administration costs and improve the quality of social services.

However, people with severe disabilities insist that they have now been spared assistance on which their lives directly depend. They have formed groups on social media and are trying to start communicating with the authorities.

People who suffer a serious injury at work and the consequent 100% loss of working capacity have quite extensive social protection guarantees. The relevant possibilities are laid down in the law "On compulsory state social insurance" (Act). The main condition is to be insured, i.e. to work officially. And also the proof that the accident has occurred in the workplace. In today's environment, this can be difficult to achieve, especially on construction sites or in other private settings.

However, people whose injuries are recognised as the result of an industrial accident are entitled:

• to a one-off compensation;

• to insurance benefits in accordance with their average wage;

• the right to rehabilitation.

And it is the issue of rehabilitation that has changed the most.

Previously, the Social Insurance Fund financed the costs of medical and social assistance, including supplementary food, medicines, special medical, permanent nursing care, domestic services, prosthetic appliances, health rehabilitation, spa treatment, special mobility aids, etc. (Article 42 of the Law).

Following amendments to the law, the new law reads as follows:

Victims are entitled to health care treatment and rehabilitation in health care facilities conducted in accordance with the requirements of the Laws of Ukraine 'On State Financial Guarantees of Health Care for the Population' and 'On Rehabilitation in the Field of Health Care' . Rehabilitation measures in the field of health care include medication within the competence of a physician of physical and rehabilitation medicine, physical therapy, occupational therapy, language and speech therapy, provision of prosthetics, orthotics and other rehabilitation aids indicated in the individual rehabilitation plan.

In other words, previously, people with severe disabilities due to an occupational injury or their families could purchase the necessary medical and hygiene aids, hire medical staff for procedures or care staff on their own.

Now these needs must be met by the relevant institutions - hospitals or palliative care services. However, people with disabiliƟes emphasise that such changes significantly worsen the quality of medical care and, in some cases, actually put survivors on the brink of survival.

According to Anna Bal, wife of a severely injured and totally disabled miner, previous legislation allowed for decent living conditions for such people.

The Social Insurance Fund paid recourse payments, as well as payments for special medical and household care, hygiene products, diapers, catheters, medicines (all related to injuries), medicines, bandages. Disability trolleys, handrails, mattresses, searches, underwear, bedding. There were payments for supplementary food," says Anna.

That is, previously people were reimbursed for treatment and care that they bought or ordered privately. But now there are only recourse payments, which are insufficient to cover even basic needs.

A month we need 90 nappies, 60 diapers - more than 6 thousand hryvnias. And then there are the medicines," says Anna.

According to her, "lying down", that is, people with severe injuries, like her husband, are prescribed massages, injections and many other daily medical and hygiene procedures that people without medical training cannot perform. Families used to employ staff to do this.

Now they are offered a palliative care service, which is already free. And it can only come twice a month," says Anna.

So, for almost half a year now, severely disabled people and their families have been in despair.

The men are crying into the tube. They tell us that they used to be honoured, but now they have been abandoned to their fate," says Anna.

Yuriy Otrishko from Kharkiv Region also talks about a similar situation. He was seriously injured in 1986 while building an oil pipeline.

I was working as a driver, there was an emergency dumping at the loading point. I was covered in the car... I was 25 years old. Now I have a 100% disability for 37 years," Yuriy recalls.

According to him, there are 593 people in Ukraine with similar industrial spine injury. And for them, these changes in legislation are a death sentence.

Such a person needs comprehensive assistance 24 hours a day. We were paid 6,700 UAH for medical care, 3,500 UAH for other assistance, 1,750 UAH for domestic care, that is, to cook food. Now they have taken it all away and equated it to other persons with disabilities. And a spinal patient... you cannot go to the toilet, you have to have enemas, catheters. It is a death sentence," the man is convinced.

Maria Goncharuk from Odessa, who has been in a wheelchair for 38 years, thinks that the Verkhovna Rada passed the bill wrongly.

Tretyakova (Galina Tretyakova, head of the parliamentary committee on social policy and veterans' rights protection - ed.) said that we do and will do everything for the disabled, and lawmakers did not understand and voted for it," the woman said.

Maria has no family, so she is totally dependent on outside help, which she pays for herself.

I fell from the height of a tower crane during construction. I am in need of three types of care for life: special medical care, permanent personal care and domestic care. I am also entitled to accompanied spa treatment, medicines, medical devices, bed and linen, technical means of rehabilitation, mattresses and a trolley. We were reimbursed by the Social Insurance Fund until January 1, 2023. Everything was completely in one office. Now the Fund is merged with the Pension Fund of Ukraine and since the new year they do not provide anything. says Maria.

According to her, their provision has been transferred to the local authorities and to the system of palliative care, which has not been developed yet.

The law stipulates that we should be provided with medicines from the local budget. I called the health department in Odessa... She said: "I sympathize with you. The fact that you were prescribed 90 pampers and 60 nappies a month by the MSEC.... But we were not given any instructions from above and we have no money for this," she says: "The special ambulance has been transferred to the palliative care service, but it is not developed and cannot be physically fulfilled," stresses Maria.

In his turn, Sergiy Bai, who has also faced the consequences of the new legislation, points out that in his region there are three hospitals with mobile palliative care.

Three per region!!! They are 80 km away. Of course, they can't come three times a day. A man comes to me, but he has to pay," says the man.

The essence of the reform is the liquidation of the Social Insurance Fund and the transfer of its powers to the Pension Fund. It was the Social Security Fund that was responsible for administering two insurance systems - temporary disability insurance and industrial accident insurance.

Its budget had a significant deficit. So, the elimination, according to the authors, allows to save money by reducing the administrative staff and to better control expenditures.

The purpose of the draft law is to strengthen the financial sustainability and improve the provision of insurance benefits in the state social insurance system by:

- improving administration in the system of compulsory social insurance of working citizens due to the reduction of administrative management structures;

- introducing a unified fund management system and a unified information system

- strengthening of state control over the use of social insurance funds," the explanatory memorandum states.

But people who have lost their ability to work because of an occupational injury are sceptical about such claims.

Former driver Yurii Otrishko notes that the authorities plan to create separate firms to provide care for the disabled.

There will be firms set up and social workers will come in twice a week," Yuriy said.

However, the ways of financing such institutions are still unknown.

Previously, care costs were given out-of-pocket. But now the money will be given to their intermediaries", says Anna Bal, the miner's wife.

The social portal has sent requests to the authors of the bill, Mykhaylo Papiyev and Halina Tretiakova, asking them to explain the economic feasibility of changing the rights of people injured at work. And also to the National Health Service of Ukraine, which finances palliative care services, as to what kind of medical care such people can receive and whether it can be expanded on an individual basis, if the proposed one is sufficient for them. No answer could be obtained.

At the same time, a representative of the Parliamentary Commissioner for Social and Economic Rights Olena Kolobrodova pointed out in her reply to Sotsportal that the Ombudsman proceedings were initiated in February 2023 because of numerous complaints from people with disabilities.

However, it was limited to enquiries to state authorities, who assured that the service of nursing care and domestic service would be fully covered by the social service "home care" and the service of special medical care by the medical service "mobile palliative care".

The Ministry of Social Policy notes that in this way, the state will ensure the provision of services, as well as the opportunity for the victim and his family to choose at their own discretion: to care for a relative by themselves (with appropriate payment of services), or the state will pay the professional service provider, - said in the response of the Commissioner.

Yulia Cherniavska from Poltava, who has been in a wheelchair for 24 years because she was run over by a petrol truck at an agricultural company, assures us that she has also applied to all the possible authorities.

In reply we hear that our constitutional rights have not been violated. The ministry says that we get everything, but we don't get anything," stresses Iulia.

It should be noted that in the reply of Olena Koloborodova it was said that the Ombudsman has no right to evaluate whether the Law is compliant with the Constitution of Ukraine, because this question is in the competence of the Constitutional Court of Ukraine. It is possible that an appeal to this institution will be a further step for citizens who faced injustice.