Misguided reforms in a misguided system

As a welcome to the new year, the government has stirred up yet another TELK mess. The reason for this is the changes to the Social Security Code that have crept into the transitional and final provisions of the State Social Security Act for 2012, which increase the degree and scope of administrative criminal liability to which experts from medical commissions who illegally issue/have issued decisions are subject.

It would hardly be surprising if it were people with disabilities who would end up being the ultimate victims of yet another ill-conceived and half-baked reform. Doctors have already threatened to close entire commissions and deliberately lower the coveted disability rates in order to avoid possible subsequent sanctions. Their motives are that the decisions of the TELC are made on the basis of already conducted examinations and diagnoses, which makes it inappropriate to attribute additional responsibility for possible errors in the subsequent assessment of working capacity.

The reasons for the mess, however, remain structural and remain unaddressed. The problems in the system for supporting people with disabilities built in this way are far from being limited to the amount of fines to which members of the TELC are subject in the event of unlawful failure to fulfill their obligations, and the control carried out by the National Social Security Institute. The effective functioning of a system that guarantees the most targeted distribution of public funds presupposes both the availability of qualified personnel and information security, adequate control and effective legislation. All things that the system for supporting people with disabilities in Bulgaria does not have.

The low pay of doctors on expert committees (an average of 580 leva per month), the legally established requirement not to hold another position, and the low attractiveness of the job repel qualified personnel, who prefer to seek employment in the private sector. The increase in administrative pressure and control over the activities of the TELC threatens to lead to a shortage of personnel in the system, which is unlikely to increase its efficiency.

Adequate control is impossible without the necessary information security in the form of a unified system for people with disabilities. The same system that we have been waiting for with bated breath since 2007 and which we may not see before the end of 2012. Although the National Social Security Institute already has its representatives in the commissions, and in Art. 349 of the Social Security Code, administrative fines have been provided for violations of medical expertise, only 3% of the more than 550 thousand decisions of the National Social Security Institute/National Social Security Institute reviewed in the period 2006-2011 have been appealed, and only a third of them (i.e. 1%) have been proven illegal. The people from the National Social Security Institute are clearly shooting in the dark, which is normal, considering the chronic lack of information about individual beneficiaries.

Thus, we finally come to the main point, namely - effective legislation. In addition to the motive of obtaining a secure monthly income of 150-200 leva, the disabled person certified by the TELK receives a number of additional benefits and privileges that arise as a result of the commission's decision. Such are free vignettes when using the republican road system, numerous tax breaks, longer annual leave under an employment contract, additional legal protection on the labor market, the possibility of early retirement and many others.

What can be done to stop the abuses?

Efforts to reform the system should be directed not at limiting the consequences, but at eliminating their causes. The introduction of a social assessment (i.e. an assessment of the individual needs of the person and their opportunities for inclusion in the labor market) and an income criterion as a mandatory part of the certification process will reduce the number of people who are interested in the monthly income and the privileges that their disability status provides. State assistance should be directed precisely to those people with disabilities who need it, and the ultimate goal of the policy for the integration of people with disabilities should be precisely to guarantee their ability to participate equally in public processes.

Another factor that reinforces the importance of social assessment is that not all diseases that carry a disability percentage make a person incapacitated. The concept of a universal and emphatically medical approach to determining the working capacity of individuals often falls victim to its own percentages and formulas, ignoring the individual characteristics and needs of people with disabilities.

The introduction of an individual social assessment, including an income criterion, as a mandatory part of the process of determining work capacity will increase the efficiency of the allocation of public funds and limit the possibilities for abuse.

If this approach to determining work capacity is adopted in future reforms, perhaps in the future we will no longer witness disabled people and their companions armed with TELCs heading to Borovets to ski at a 50% discount.

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*The article was written for the weekly newsletter of the Institute for Market Economics. The original publication can be found here.