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Will the new Bill improve the life 0f disabled people?

Amendments to the Law on the Rights of Persons with Disabilities have been discussed in society and the Milli Majlis for a long time. Aydin Khalilov, head of the “Independent Life” Development and Support Center Public Union, answered ASTNA`s questions on the amendments intended to be made to the legislation.

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– Aydin bey, what do theamendmentsintended to be made to legislation mainly envisage?

– I think and believe that amendments are for the better. The information on the website regarding the amendments to the Law on the Rights of Persons with Disabilitiesis as follows:

“3.3-1. If a person’s disability is re-determined as a result of a reassessment of disability within 6 months after the expiration of the disabilityperiod, the person shall be considered a person with a disability, including the time elapsed.”

This means that after the end of the disability period (within 6 months), if the person’s disability is confirmed, he or she will be able to receive the severance benefit for these 6 months. I think people with disabilities and their families will like it.

As far as I know, other amendments are also positive. The terms “cripple”, “handicapped”, “person with a limited physical condition” will be removed from all official documents, and the term “person with a disability” will be used instead (in accordance with the UN Convention), and a more detailed explanation of the term “reasonable adaptation” and other such changes are envisaged.

– The main discussions on the amendment to the law are related to the assessment of a person’s disability and the determination of percentages for determining disability. What is the reason for the difference of opinion?

– We can see a lot of dissatisfaction and misunderstanding in social networks and the media regarding the assessment of a person’s disability status and the determination of percentages for determining disability. However, I think the reason is that society, especially people with disabilities, has little information about this. It would be good if the MLSPP provides a detailed explanation. However, this has long been applied in international practice. Let me give you an example, this incident happened recently and, in fact, 3 citizens lost their legs below the knee. If I am not mistaken, all three were assigned a group 3 disability. However, the 1st person underwent an ankle amputationprovided that the heel bone remainsin place (with or without a special prosthesis, he can walk freely by wearing shoes), the 2nd person underwent an amputation1-2 cm above the ankle, and the 3rd person underwent an amputation5 cm below the knee. Now tell me, is this a fair approach? All three are in group 3 and receive the same benefits. This is unfair. The functions of life are also different. The first personcan walk without the prosthesis. The secondperson cannot walk without a prosthesis; however, when he has a prosthesis, he has almost no problems with walking, even if he loses his functions below the knee. However, the third person is considered to have completely lost function below the knee, and even during certain movements (running, lifting heavy loads), the prosthesis can come off the foot and can be life-threatening. True, this is a rough comparison. However, this clearly shows that group 1-2-3 is an old method of assessing disability.

– According to the amendment to the law, there will no longer be disability indicators like groups I, II, and III. The degree of disability will be determined by the degree of loss of body function, i.e. as a percentage. Loss of 30-60 percent of the body’s function will be considered group III, loss of 60-80 percent as group II, and loss of 80-100 percent as group I. How right is this decision?

– The assessment of a new person’s disability according to a certain degree of disability will depend on his or her ability to serve, act independently, direct, communicate, control behavior, learn, and work. The best international practices in this field were analyzed, the experiences of Russia, Austria, Great Britain, the United States, and Germany were studied, and the European Union’s “physical and mental disability rating” document was studied. In these countries, as well as in a number of countries around the world, the International Classification of Diseases (ICD) and the International Classification of Functioning (ICF), which are standard diagnostic tools of the World Health Organization (WHO), are widely used for epidemiology, health management, and clinical purposes. The new draft “Criteria for Determining Disability” also includes the WHO’scriteria for the distribution of diseases on the basis of the ICD, a comprehensive and detailed description of stable disorders of the human body, the assessment of stable disorders of the human body in the range of 10-100% and, consequently, includes criteria for determining disability based on the degree of limitation of the 7 main categories of human life activities, such as self-care, free movement, choice of direction, communication, behavioral control, learning, work skillson the basis of the ICF.

The application of the new criteria will ensure a more objective determination of disability. Such that according to the previous criteria, persons with disabilities were assigned groups I, II, and III, and there was no difference between patients with the severe condition under group I, who needed the care of someone else, and patients who were completely dependent on the permanent care of someone else. The new criteria will allow a more objective assessment of the severity of the disease, the form of the course, the activity of the process, the frequency of exacerbations, the scope of the organs in which the pathological process occurs. The criteria will allow for a more objective assessment, taking into account the degree of restriction of the main categories of life activities. Thus, a clear decision will be made about the dysfunction of the human body.

– Payment of a labor pension to a person with a disability will be suspended from the day the disability period expires. What is the duration of disability? Why are disability indicators checked periodically for all categories? There are some disabilities that cannot change for life? Why, without taking this into account, do all people with disabilities are subject toa period related to the expiration of the disability period? And why are they forced to live without a pension for several months?

– At present, according to the regulations (Article 2), there is a list of certain diseases (and their complications) belonging to each group (persons over 18 years of age). Diseases of children are in Article 3. The disability periodis specified in Article 4. I would like to mention it here as it is.

Periodsfor determining disability and health limitations;

4.1. In special cases where there is a first-degree disability and a medical prescription, the second-degree and third-degree disability is determined indefinitely.

4.2. Second-degree and third-degree disability is determined for a period of 5 (five) years. If the second-degree disability is determined for 10 (ten) years without interruption and the third-degree disability is determined for 15 (fifteen) years without interruption, the disability is determined indefinitely.

4.3. Regardless of the degree of disability, disability is granted to persons who have reached the age limit for the right to receive a labor pension or social benefits for the age established by the laws of the Republic of Azerbaijan on Labor Pensions and on Social Benefits.

4.4. In the cases specified in Paragraphs 3.1.1 – 3.1.22 of this Regulation, the health limit of children under 18 years of age shall not exceed 18 years for a period of 3 (three) years, and in other cases, up to 18 years. Limited health opportunities for children 6 (six) months or less before the age of 18 are determined until the age of 18.

So, let me summarize in response to your question about the period. So, according to this Regulation, some diseases are temporary because they are treatable and have no complications. That is, every time the period expires, the citizen must undergo a medical examination and submit documents about his/her condition to the Medical-Social Expertise and Rehabilitation Subsystem (MSERS) through the polyclinic. On the basis of these documents, MSERSissues an opinion – whether or not the disability is assigned to this citizen, and if so, at what percentage. If it is not assigned, the reason is indicated. Let me remindyou that the amendments made to the Regulations on Medical and Social Expert Commissions(MSEC) by Resolution No. 446 of the Cabinet of Ministers of the Republic of Azerbaijan dated November 11, 2016, ensure the transparent implementation of the disability assessment process on the basis of electronic technologies and complete elimination official-citizen contacts in this area. Thus, the information received from the Ministry of Health on the registration of the referral for the assessment of disability will be included in the register of referrals to the MSECin real-time and then immediately transferred to the MSERS. After receiving the referral, MSERSwill anonymize all the information that allows identifying the health facility (polyclinic, Central Hospital) that issued the referral, the persons who confirmed it, as well as the person to whom the referral belongs, i.e. the citizen whose disability is to be assessed. After that, the system will send the referral electronically to the MSECfor the assessment of disability. However, in this case, the referral may not be sent to the MSECin the area where the issuing health facility locates or the person whose disability status is to be assessed resides. Then, theMSECwill decide whether or not a disability has been determined based on the condition of the illness, based solely on the information in the referral, without knowing which health facility provided the referral and to whom. In conclusion, I must emphasize that the relevant body of the Ministry of Health (polyclinic, Central Hospital) receives the documents of citizens and sends them to MSERSvia the Internet, and not to the MSEC, which operates under the MLSPP. However, we see that the relevant body of the Ministry of Health (polyclinic, Central Hospital) is responsible for notifying citizens about the expiration of the disability period and uploading documents to the system in the correct form.

As for forcing them to live without a pension for several months, as I mentioned above – according to the new amendments (their 2ndreading has happened in the Milli Majlis, so they will be passed), if the period of determination of disability (of course, if the disability is confirmed) takes even 6 months (even if the period of confirmation of disability is extended for 6 months and the person remains without a pension for 6 months), once the disability is determined, the person will be reimbursed the pension cut during this 6-month waiting and investigation period.

– The biggest dissatisfactionis related to the recent cuts in pensions ofpersons with disabilities. There are many complaints. Although people are disabled, sometimes some institutions do not want to recognize them as disabled and cut their pensions. What are these mistakes related to?

– As you know, to date, the assessment of disability or the assignment of disability groups have been regulated by the Regulations on the criteria for determining disability and limited health conditions approved by Resolution No. 413 of the Cabinet of Ministers of the Republic of Azerbaijan dated December 30, 2015. According to this Regulation,personsfrom disability groups that are determined due to certain diseases must periodically confirm their disability through a commission. That is, this procedure is necessary to examine and observe the degree of improvement and aggravation of the condition of persons with disabilities or the complete elimination of the problems of these persons. As a result of this examination, the disability is either revokedor kept unchanged, or the percentage ofdisability is increased or reduced. It depends on the condition of the person.

– How would you like these issues to be resolvedby yourself? That is, how can it be done that pensions are not assignedon false disability documents and that persons with disabilities do not suffer from such issues?

– Look, I think our people with disabilities are also at fault. First of all, if they know that their disability is for a certain period of time, they should go and get the necessary medical examinations before that period. When the time comes, they should submit it to the relevant body of the Ministry of Health (polyclinic, Central Hospital) so that relevant bodies get acquainted with the documents and say whether they are correct, for having time to deliver the missing documents and sending the correct documents in time. Otherwise, they face the problems you mentioned. That is, at the end of the disability period, MSERS electronic system automatically terminates pension. The citizen begins to move when there is no money on the bank card. But more time is needed to rectify this situation. The way out so that they do not suffer:

• The citizen must prepare all documents in time.

• The relevant body of the Ministry of Health (polyclinic, Central Hospital) must notify the citizen in advance by SMS and any other means.

However, I would like to note that people with fake disabilities have also obtained fake medical certificates and acquired this disability group. Therefore, the procedure to investigate this issue takes a long time, and persons with disabilities are really suffering. But there is no other way. In case of doubtful facts, they are sent for re-examination. For example: How can a person be diagnosed with Hemophilia, Thalassemia, Tuberculosis, Cardiovascular, or Diabetes? You cannot see it when you look at the face of the person. Of course, they have to undergo a medical examination to find out who is right and who is wrong.

I want to touch on another issue. Nowhere in the world are disability pensions high. This is only a partial compensation provided by the state for the loss of a citizen’s vital functions. However, in developed countries, apart from pensions, a very perfect social policy has been formed. These include free medicines, medical services, rehabilitation services, auxiliary equipment, resort-sanatorium services, social housing, utilities, public transport, social workers at home, accessible environment, accessible transport, inclusive education, sports, art, theater, employment. That is, people with disabilities do not only support themselves and their families with their benefits. They are given the opportunity to work. Unfortunately, such conditions have not yet been created in Azerbaijan.

True, you can say that Azerbaijan provides these services to people with disabilities. But let’s compare…

Source: Turan News Agency