TELK/NELK

The National Expert Medical Commission (NELC)

NELC is an independent legal entity, secondary allocator of budget credits to the Ministry of Health. NELC is the body before which expert decisions issued by Territorial Expert Medical Committees (TELC) are appealed, which certify persons as permanently incapacitated/ type and degree of disability. The medical files are submitted to NELC through the Regional Records for Medical Examinations (RCME). There are 71 TELCs in the country, NELC is only one.

Procedure and Documents

The expertise of permanently reduced working capacity is carried out by TELK and NELK. The preparation of disabled people to appear before the commissions of TELK is carried out by their personal physician. He determines the necessary medical documents, examinations, consultations and tests, which are needed by the relevant person, in addition, he is given a medical referral for TELC.

What should I do if I'm not mobile enough and can't get to TELK?

People who, due to medical reasons, are not able to appear in TELC or NELC, are examined on the spot in their home or in the hospital where they are accommodated. For this purpose, they must have a medical a certificate from their attending physician or a referral from their personal physician. In order to carry out the task of examining inpatients, TELC conducts home visits on a regional basis, that is, within the relevant area, and NELC conducts home visits throughout the country.

Are fees due for preparation of documents for certification by TELC/NELC?

Persons with health insurance do not pay for the examinations and consultations appointed by the personal physician or the specialist for the purposes of the medical examination.
Persons without health insurance must pay the cost of the examinations and consultations carried out for the purposes of the medical examination.
No fees are due upon receipt of a TELK/NELK Expert Decision.

In what terms are the documents received from the commissions?

The expert decisions of the TELC are received on the day of the examination or by mail with a return receipt. The examination of the persons appearing at the TELC/NELC is carried out within three months of receiving the medical documentation in the commissions. By Resolution no. 179 of 27.06.2014, the specialized OCs for eye, mental and lung diseases have been abolished, as of 08.07.2014. Persons with such diseases are examined by OCs in the presence of consultants who are specialists in the relevant diseases.

Do you have to get the Expert Decision in person?

TELK/NELK's expert decision is obtained in person or by a person authorized by a notarized power of attorney.

What are the options for appealing decisions?

Appeals and objections by interested persons and bodies (certificates, insurers, NSI, the Agency for Social Assistance, the Agency for People with Disabilities and the bodies of the medical examination of working capacity) against the decisions of the NELC are made to the administrative court in whose district the permanent or current address of the applicant is located according to the Administrative Procedure Code.

In what direction will the functions of TELK and NELK change?

In order to ensure better access to TELC and NELC, legislative changes in the following direction are currently being considered:

• In the case of people of incapacitated age - children and pensioners, the percentage of permanently reduced ability to work should not be determined as before, but the % degree of disability.
• Optimization of the methodology for performing the medical examination and the order for its implementation.
• The issue of the transfer of TELK to a single administrative subordination similar to NELK, which will allow for uniform standards of financing, administrative management, labor remuneration, material technical and information provision, staff training will be put to discussion and mechanisms for revealing conflicts of interest and corruption schemes.

Certification procedure before TELK

Medical examination includes examination of temporary incapacity for work, examination of permanently reduced working capacity of persons of working age, as well as of persons who have acquired the right to a pension for length of service and age under Article 68 of the Social Insurance Code/ KSO/ who exercise labor activity and have been assigned the type and degree of disability, the type and degree of disability for children up to 16 years of age and persons who have acquired the right to a pension for insurance service and age according to Art. 68 KSO and confirmation or rejection of the occupational nature of diseases
The procedure in the Territorial expert medical /TELK/ starts after the personal physician/dentist/, and for the persons who do not have a personal doctor - the treating doctor/dentist/, refers the patient to the TELK with medical direction according to the model according to appendix No. 8, when it assumes that it is available:

• Permanently reduced working capacity/type and degree of disability not preceded by temporary incapacity.
• Type and degree of disability.
• Change of the date of disability, the period of disability, the contraindications of work or the causal relationship (new - SG No. 84 of 2019, in force from 01.01.2020)
• Necessity of re-certification due to deteriorated or improved condition (new - SG No. 84 of 2019, effective from 01.01.2020)
• Necessity of re-certification on other occasions provided for in normative acts (new - SG No. 84 of 2019, effective from 01.01.2020).

In cases where consultations and examinations were carried out for a specific disease in the last twelve months, preceding the appearance at TELK, and their results are available in the person's medical documentation, to the direction of the personal physician (dentist medicine), and for persons who do not have a personal physician - the attending physician (dentist), applies certified copies of the same, without having to re-appoint and perform them.
It is desirable not to submit original medical documents, as they are added to each person's medical expert file and are not returnable.
After issuing the referral and carrying out additional tests (if necessary), the person can visit the Regional Card File of the Medical Expertise at a permanent or current address, where he fills out an application - declaration according to the model and indicates the reason for his appearance Individuals also have the option to submit their application-declarations electronically in the Information Database at https://ibd.mh.government.bg/.
TELK certifies and re-certifies the persons within a 3-month period from the receipt of the documents by them. Decisions are delivered to the persons or to persons authorized by them, or to their legal representatives against a signature with a letter with a notice of delivery or electronically under the conditions and in accordance with the Law on Electronic Government.
TELCs also certify persons on the occasion of temporary incapacity. The Medical Advisory Committees (PCCs) refer persons to TELCs no later than 7 days before the expiration of the leave according to the last sick leave. The medical protocol of the PCC for the continuation of the temporary incapacity is submitted to RKME no later than 3 days after its issuance. In case of temporary incapacity, the period for certification is 15 days from the date of receipt of the documents in TELK. The term of temporary incapacity can be up to two months from the end of the temporary incapacity according to the last sick leave, unless a shorter term is specified in the expert decision.

Information on TELK/NELK's own expert decisions on permanently reduced working capacity/type and degree of disability

According to Art. 2, Para. 4 of the Law on Electronic Government, NELC is the central data administrator (CDA) for people with disabilities in the Information Database (IDB) under Art. 108a of the Health Law .
Citizens can access information about TELK/NELK's own expert decisions on permanently reduced working capacity/type and degree of disability in the IBD, through the following electronic channels:

• Through the profile of a person with a disability in the web-portal of the Agency for People with Disabilities (AHU) at https://ahu.mlsp.government.bg/hu/prof/index/

The check is carried out in the information system of the AHU through the System for secure electronic delivery (SSEV) of the Ministry of Electronic Government (MEU) - button Profile of a person with disabilities, where all expert decisions from the IBD are displayed.

• Through 'Individual References' in the individual's own profile in the Secure Electronic Address Delivery System https://edelivery.egov.bg/

The check is carried out in the IBD through the information system for the exchange of reference and authentication information (RegiX) maintained by the Ministry of Internal Affairs, by means of the SSEV button - Reference for an individual.
When making a reference for an individual in SSEV, the check must be carried out separately in the two systems of the IBD:

• The information system for the control of medical expertise (ISKME);
• The Unified Information System of Medical Expertise (EISME).

The following queries are supported in the IDB:

• Refer to all expert decisions of a person;
• Reference to the last expert decision of a person