Analysis of the Medical Expertise System in Bulgaria: Structural Deficits, Financial Sustainability and Strategic Path towards the ICF Model

Petko Salchev

Economic Thought journal, 2026, issue 2, 244-274

Abstract: This article examines the state of and challenges facing the system for medical expertise determining permanent disability in Bulgaria (the TELC system). Despite recent steps towards fairer calculation of percentages, the introduction of lifetime TELC status for more diseases, digitalisation and the elimination of delays with legislative changes from 2023–2024, the system continues to suffer from serious structural deficits rooted in the strictly medical approach to disability assessment. The article analyses the increasing number of disability decisions and their impact on the long-term financial sustainability of the funds of the National Social Security Institute (NSSI). Special attention is paid to the discrepancy between medical diagnoses and real functional possibilities for integration into the labour market. The author argues that the strategic modernisation of the system requires a paradigm shift from a medical model to the WHO International Classification of Functioning, Disability and Health (ICF) framework. The results show that adopting a biopsychosocial approach would not only increase social justice but would also optimise public spending by more accurately targeting support and rehabilitation services.

JEL-codes: H55 I18 J14 (search for similar items in EconPapers)
Date: 2026
References: Add references at CitEc
Citations:

Downloads: (external link)
https://etj.iki.bas.bg/storage/app/uploads/public/ ... bbea039056703731.pdf

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:bas:econth:y:2026:i:2:p:244-274

Access Statistics for this article

More articles in Economic Thought journal from Bulgarian Academy of Sciences - Economic Research Institute Contact information at EDIRC.
Bibliographic data for series maintained by Diana Dimitrova ().