--- title: "Doctors refuse to process disability status: patient rights and action algorithm in case of failure of the new system" description: "Doctors are massively refusing to issue referrals for the new ECOFPO disability system. Lawyer Rustam Nuriev explains how to force a medical professional to fulfill their duty: from calling the police to changing doctors. We analyze the action algorithm in case of bureaucratic sabotage. 🏥📉" date: 2026-07-29T14:50:00.000Z lang: en url: https://xab.info/en/posts/doctors-refuse-to-process-disability-patient-rights-and-action-algorithm tags: [rustam-nurieff, ekopf, msk, minzdrav-ukraine, disability-benefits] publisher: "XAB.info" --- # Doctors refuse to process disability status: patient rights and action algorithm in case of failure of the new system ![Doctors discussing documents in a hospital corridor: the issue of disability certification refusal](https://xab.info/media/2026/07/29/vrachi-otkazyvayutsya-oformlyat-invalidnost-prava-patsientov/vrachi-otkazyvayutsya-oformlyat-invalidnost-prava-patsientov-1.webp) The launch of the Daily Living Functionality Assessment system (ECOFPO), which replaced the Medical and Social Expert Commission (MSEC), has revealed systemic problems at the stage of interaction between patients and medical staff. The main obstacle has become the unwillingness or inability of doctors to issue the necessary electronic referrals. Rustam Nuriev, a lawyer from the "Actum" association, explained to RBC-Ukraine how to act in case of refusal and who bears responsibility for bureaucratic delays. ### Change of roles: why the doctor became the key link The new procedure has radically changed the logic of obtaining disability status. If previously the patient independently collected documents and applied to the commission, now the entire burden of forming the package lies with the medical worker. According to the regulations, the family or attending physician is obliged to: - Assess the sufficiency of the medical documents provided by the patient. - Prescribe additional examinations if necessary. - Form a complete package of documents. - Issue an electronic referral and submit it to the ECOFPO expert team. The patient's task is reduced to providing existing medical records. It is the doctor who must initiate the process, but not make the decision on assigning disability status — this is the prerogative of the expert commission. ### Reasons for refusal: from ignorance to sabotage In practice, it is the stage of issuing a referral that has become the "bottleneck". According to the lawyer, problems arise for two reasons. First, some medical workers simply do not know how to technically correctly complete documents in the new system. Second, there are cases of conscious refusal by doctors to perform their duties. The elderly turned out to be the most vulnerable layer, as they do not understand the new digital procedures and are completely dependent on the competence of their family doctor. The situation is exacerbated by the fact that some medical workers, following unwritten recommendations from management, refuse referrals to people capable of moving independently, even if they need a certificate to arrange a deferment from mobilization or social services. ### Action algorithm in case of refusal If the doctor refuses to issue a referral, the patient should not accept the situation. Rustam Nuriev offers a clear action plan to protect their rights: - **Appeal to management.** First of all, it is necessary to demand the presence of the head of the department and find out the official reasons for the refusal. - **Recording the fact.** If the dialogue does not help, the police should be called to record the refusal to provide medical services. - **Official complaint.** After recording the fact, it is necessary to file a complaint with the Ministry of Health of Ukraine. It is important to ensure that the appeal is officially registered. The Ministry of Health is obliged to determine the body for considering the complaint, control the process and provide an official response. At the same time, the doctor who refused to process the documents bears responsibility towards the patient, even if he acted on the instructions of the institution's management. ### Alternative paths and nuances for military personnel In case of a principled refusal or incorrect attitude from the current family doctor, the patient has the right to conclude a declaration with another specialist. This allows changing the attending physician and continuing the document processing procedure. For military personnel, the procedure has its own features. The referral to ECOFPO must be issued during the passage of the military-medical commission (MMC). If the military registration and enlistment office refuses to issue it, such cases are also subject to recording and appeal. In practice, the fastest option for the military is often to appeal to a civilian family doctor during leave, as he is also authorized to issue the necessary documents. ### Prospects for reform Despite the difficulties at the start, the situation is gradually stabilizing. Doctors are gaining experience working with the new system, and patients are more actively using the ECOFPO mechanisms. Nevertheless, cases of groundless refusals remain a relevant problem, requiring vigilance on the part of citizens and control on the part of supervisory authorities.