Medical experts solely assessed disability from the perspective of health impairment in the assessment scheme applied prior to 2008; however, preserved capacities and abilities that can still be used, which are relevant in terms of employability, were completely disregarded. The majority of persons with changed working capacity were forced into life-long social inactivity as a result of this incorrect approach. 

Complex assessment introduced on 1 January to promote the complex rehabilitation of persons with changed working capacity is different to the old procedure in terms of its fundamental approach. Instead of concentrating on health impairment, the new assessment system focuses on preserved capacities, mapping abilities that can still be used and issuing an opinion on the chances of successful employment rehabilitation. Besides the medical expert, social and employment rehabilitation experts also assess eligibility for benefits, chances for employment rehabilitation or obstacles inhibiting this during the course of the complex assessment procedure. 

The introduction of complex assessment in 2008 only established the opportunity to issue competency-based expert opinions in theory – the standard set of rules elaborated in detail and incorporated in legislation was missing, on the basis of which experts would have been able to carry out their activity in a controllable and accountable manner in the following. Ministry of National Resources Decree 7/2012 filled this void. This decree sets forth the detailed set of rules to be applied within the framework of the complex assessment procedure, the scope of tasks of social and employment rehabilitation experts and the criteria to be applied for issuing opinions.  

A group of experts comprised of medical professors, medical expert witnesses and clinical experts defined the professional and standard evaluation criteria for determining the state of health of persons with changed working capacity. These experts put together tables categorising the degree of health impairment by disease group (percentage). By applying this set of criteria defined as a result of the sound professional work undertaken, the objectivity of this medical recommendation became unqueriable.

The medical expert assesses and summarises the degree of health impairment by organ and disease category, determines the preserved state of health of the claimant and issues an opinion on self-sufficiency on the grounds of medical findings, discharge summary records, laboratory test results, as well as by examining the current state of the individual. The medical expert classifies health impairments certified by findings and medical opinions based on the tables set out in the legislation referred to. These tables define the percentage value of the various degrees of impairment caused by diseases. With the help of these tables, it is possible to precisely determine the percentage rate of partial impairments based on findings, namely, ECG, laboratory and respiration tests. Using these results, the medical expert applies a formula to determine overall impairment and preserved capacity. The total degree of impairment cannot exceed 99%. 

If the preserved state of health of the claimant exceeds 60%, this individual is not eligible for any benefit granted to persons with changed working capacity. The medical expert recommends rehabilitation if this value is between 31-60% and health-related circumstances do not prevent the employment of the given individual. Such individuals may work 20 hours a week on a part-time basis concurrently to receiving a rehabilitation benefit. The rehabilitation benefit is suspended if employment exceeds the above-specified number of hours. In every case, the medical expert also states what factors may inhibit employment and what health circumstances need to be considered during the course of employment rehabilitation in the opinion issued by the given competent expert. 

Individuals whose preserved capacities fail to reach 30% are exclusively eligible for disability benefit, i.e., can by no means be recommended for rehabilitation. The legislation referred to ensures the opportunity for restricted income-earning activity in the case of individuals receiving disability benefits. Benefits are suspended if the income earned during three consecutive months exceeds 150% of the current minimum wage. 

During the course of the interview, the social expert assesses whether any social need or circumstance prevents employment rehabilitation, and if there are any that do, can these be eliminated by social rehabilitation. The social expert applies a wide range of evaluation criteria, such as: communication skills, motivation, lifestyle and problem-solving ability or factors potentially inhibiting emotional and family ties, life circumstances, as well as mobility.

The employment rehabilitation expert evaluates the employment and educational history of the claimant from the perspective of the potential to rehabilitate the individual; collects information on the fields of interests and lifestyle of the claimant, or possibly characteristics of their disadvantaged situation, mobility capacity. When making a decision, this expert takes account of current employment opportunities and perspectives accessible in the proximity of the claimant, as well as employment benefits available. The assessment and the evaluation cover the assessment of work load, the possible need of special employment conditions, as well as the entire career and the claimant’s attitude towards regular work. 

The unnecessarily complicated system for persons with changed working capacity was reduced to two types of benefits in 2012. Any claimant who cannot be reintegrated into the world of labour through re-training or lengthy rehabilitation, or whose social circumstances inhibit regular employment is eligible to receive disability benefit. However, any claimant that has a good chance of fully reintegrating into society will receive rehabilitation benefit. The rehabilitation benefit is provided for a maximum period of 3 years. During this period, the individual receiving this benefit takes part in custom-tailored trainings, skill development trainings and constantly keeps in contact with a counsellor with whom the claimant evaluates employment opportunities. The transformed subsidy system offered to companies employing persons with changed working capacity applied from 2013 will also help integrate individuals returning to the open labour market.