The MSEC Reform Has Turned into New Difficulties for Military Personnel and People with Disabilities — Case Reviews Are Delayed for Months

After the launch of the medical and social examination reform, Ukrainians expected that digitalization and new rules would simplify the process of passing military medical commissions and the procedure for establishing disability. However, in practice, people continue to face months-long waiting times, lack of necessary documents, formal conclusions, and difficulties in appealing decisions.

These problems are especially acute for those liable for military service, wounded military personnel, and civilians with disabilities who are forced to go through a complicated bureaucratic path to confirm their health status. These issues were analyzed by the National Association of Advocates of Ukraine during a discussion on the operation of the ECOPFO and MMC systems.

MSEC and ECOPFO Reform: What Problems Were Identified

The reform of medical and social examination and military medical commissions did not eliminate a number of practical problems faced by those liable for military service, servicemen, and civilians with disabilities. The main difficulties include failure to issue documents, a formal approach to assessing health status, delays in procedures, and the complexity of proving actual limitations in daily life.

This follows from the analysis of the practice of expert teams assessing a person's daily functioning (ECOPFO) and military medical commissions (MMC), as well as the consequences of the medical and social examination reform.

It was noted that after the adoption of Law No. 4170-IX dated December 19, 2024, and Cabinet of Ministers Resolution No. 1338 dated November 15, 2024, the system for assessing a person's functioning underwent significant changes. At the same time, the NAAU drew attention to the fact that in practice questions remain regarding the quality of decisions, speed of procedures, and effectiveness of interaction between authorities and medical institutions.

MMC and Mobilization: Why People Cannot Obtain Documents

Special attention was paid to the work of MMC during mobilization and service. According to discussion participants, one common problem is that those liable for military service are not issued MMC certificates during the commission, although documents are generated in electronic format. Because of this, individuals do not have a document on hand that can be promptly appealed, and lawyers are forced to request materials through the Territorial Recruitment and Social Support Centers.

The issue of using medical data from the Unified Health Care System was also raised. Participants noted that MMC members have access to electronic medical records, but in practice they do not always take into account existing diseases or properly assess the degree of functional impairments. Examples were given where information about diseases was present in the electronic system but was not reflected in the MMC conclusions.

ECOPFO After the Reform: Why Decisions Are Difficult to Appeal

The specifics of ECOPFO decisions were discussed separately. Experts emphasized that after the reform, not the diagnosis itself is assessed, but the impact of the disease on a person's daily life — the ability to self-care, move, work, study, and communicate. If these limitations are not recorded in the primary medical documentation, this may be grounds for refusal to establish a disability group or causal connection.

Among the problems mentioned was insufficient reasoning in ECOPFO decisions. According to participants, in many cases decisions look like short tabular documents without detailed explanations of the reasons for refusal or the logic of assessment. This complicates both administrative and judicial appeals.

People with Disabilities Face Delays in Procedures

Attention was also drawn to the difficulties faced by civilians with disabilities. These included delays due to the technical unreadiness of some medical institutions for digitalization, difficulties with issuing referrals, and prolonged procedures for obtaining rehabilitation technical aids.

As examples, lawyers cited cases where individuals could not get referrals for assessment for months due to errors in the electronic system or when the procedure to replace crutches with a wheelchair took about a year. Difficulties were also reported in using medical documents issued abroad, even with an official translation.

The NAAU emphasized that people with disabilities need not only regulatory regulation but also a clear and understandable algorithm for completing all procedures — from application to receiving the final decision.

The Need to Improve the ECOPFO System

The association noted that the ECOPFO system remains imperfect, and some doctors perceive the new mechanisms as an additional technical burden. At the same time, further reform should take into account the real problems of patients, medical workers, and lawyers that arise during the practical application of the new rules.

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