ETAIDF and MMC: where the system fails

The new system for assessing a person’s daily functioning and the practice of undergoing medical-legal examinations have already raised numerous questions — ranging from unclear procedures to difficulties in appealing decisions. These issues were examined by advocates during the roundtable discussion «Problematic issues of the ETAIDF and MMC», organized by the UNBA Committee on the protection of the rights of persons with disabilities and the All-Ukrainian public organization «Human rights union of persons with disabilities».

The chairman of the Committee and the public organization Oleksandr Voznyuk outlined the range of issues brought up for discussion: how the new system works in practice, whether the reform has achieved its goals, to what extent the tasks set by the President for central executive bodies have been fulfilled, and how new regulatory acts should regulate the approaches of expert teams assessing a person’s daily functioning (ETAIDF) and military medical commissions (MMC).

A member of the Committee’s Council Ivanna Kostrakevych analyzed case studies of conscripts and military personnel undergoing MMCs. She noted that the conclusions of the MMC directly impact the realization of human rights, as they determine fitness for military service, the possibility of continuing service, the need for treatment or rehabilitation, as well as the causal link between an illness or injury and the performance of military duties or the defense of the homeland. According to her, the most problems during the Medical Examination Commission process arise precisely in the commissions at the TCCs, where violations of current legislation are most frequently recorded.

Deputy chairman of the Committee Svitlana Bryntseva confirmed that one of the most sensitive issues during martial law is the interaction of persons with disabilities with the TCCs. Typical problems cited included the disregard of documents confirming disability, repeated referrals for medical examinations or MMC without proper grounds, the lack of a unified approach to verifying such documents, as well as the inaccessibility of certain procedures for people with severe forms of disability. Regarding the ETAIDF, the discussion focused on the lack of clarity in assessment criteria, differing interpretations of findings by expert teams, insufficient public awareness of the procedure itself, and the difficulty of accessing medical records.

S. Bryntseva also addressed judicial practice. She noted that the most common grounds for appeal in disputes regarding the ETAIDF and the Medical Examination Commission are superficial medical examinations, the disregard of existing medical documents, the absence of reasoned conclusions from the commissions, and a formalistic approach to assessing a person’s condition. Courts generally emphasize the need for a comprehensive medical examination, consideration of all documents, and proper justification of decisions. Among systemic issues, the speaker cited the insufficient regulation of the ETAIDF procedure, the lack of clear coordination between the TCC, medical institutions, and expert teams, as well as the weakness of the pre-trial mechanism for appealing MMC decisions.

A member of the Committee’s Council Oleg Romanishin focused on administrative appeals of ETAIDF decisions through the lens of legal practice and the protection of the rights of individuals undergoing the disability determination process. He noted that the conclusions of expert teams directly impact the realization of social rights, particularly the establishment of disability status, receipt of social benefits, rehabilitation, and other state guarantees. At the same time, administrative appeals remain the only mechanism for reviewing such decisions on their merits, as courts typically do not assess the medical criteria of a disease or injury.

Separately, the speaker emphasized that the new assessment system is based not only on the diagnosis, but primarily on the degree of impairment of a person’s vital functions — the ability to care for oneself, move about, communicate, and engage in work activities. Therefore, an effective appeal of ETAIDF decisions requires not only legal arguments but also a thorough analysis of medical documents and their comparison with the criteria for functional limitations. According to him, in practice, appeals are filed not only against decisions establishing a disability group but also against specific elements of the expert opinion: the percentage of loss of working capacity, the duration of disability, the need for external care, and the causal link between the illness and military service or the defense of the homeland. It is precisely these conclusions that often determine the amount of social benefits and guarantees.

Participants were also presented with practical challenges in the administrative appeal process, including insufficient reasoning in expert panel decisions, lengthy complaint review periods, and the absence of a multi-level system for reviewing decisions. It was emphasized that effective protection of rights in such cases is possible only through interdisciplinary cooperation between advocates and doctors, since cases involving the determination of disability are not merely about documents, but primarily about people’s life circumstances and fates.