By Fati Mamiashvili in Tbilisi (CRS No. 394 31-May-07)
"Giorgi was ready to give his life for his homeland, but the government has even taken away his pension," said Mzia, the mother of 40-year-old Giorgi Vashadze.
In May, Vashadze, who fought in the wars in Abkhazia and South Ossetia of the early Nineties, was stripped of the "category two" disabled status he was awarded in 1999 because of a long list of ailments including gunshot wounds, concussion, bouts of depression, repeated cardiac seizures and cranial problems.
As a war veteran, he received a monthly benefit of 70 laris (around 40 US dollars) until it was cancelled on May 1.
"My son has an unemployed wife and three young children," said Mzia. "He is unable to work, as he permanently needs to take strong painkillers."
According to Georgia's statistics department, just over 231,000 people were registered as disabled last year. Only those in the more serious first and second categories are entitled to the standard allowance of 38 laris (22 dollars) a month.
The new reform, instituted on May 1, is targeting people who are believed to be claiming category two status fraudulently.
In January, the ministry of health abolished the expert panels that were hitherto responsible for assigning disabled status, and entrusted the decisions to ordinary doctors instead.
A new state agency for regulating medical activity is being set up to monitor the doctors who will now take the decisions, and both hospitals and doctors now face severe fines if they are found to be abusing their authority.
The ministry said the old system was blighted by corruption. "In 2006, we traced down 9,313 violations in which category two invalidity status was awarded following illegal, corrupt deals," said deputy minister of labour, healthcare and social security David Meskhishvili..
One of the men spearheading the changes, Devi Tabidze, who heads the department of labour and social welfare in the Georgian health ministry, told IWPR the system was badly in need of reform.
"I've had my gall-bladder taken out, but I don't look like an invalid, do I?" said Tabidze. "But people like me get themselves qualified as category two invalids. In 2005 and 2006, this irresponsible behaviour cost the budget 15 million laris [nine million dollars]."
"The reform has not affected those with permanent invalidity status," insisted Tabidze. "Under the new rules, 20 conditions are no longer classified as disabling. That means over 10,000 people will lose their benefits."
He said that from now on, not only the medical diagnosis but also the patient's ability to work would be assessed to determine eligibility for disability status.
Many Georgians say the changes are pushing them into penury.
Tamara Sulaberidze, 34, who has a slight mental disability and will never be able to work, has been stripped of her category two status and the 38-lari allowance that goes with it.
None of the six Sulaberidze family members works, and they are already in great financial difficulty. Now they are worried about where they will find the money to buy the medicines Tamara needs.
"How can she work if she can't move around on her own?" asked Tamara's sister, Maya. "She is often aggressive and responds to situations badly."
Maya says she does not believe that health minister Lado Chipiashvili knows about the impact the reforms are having.
"I want to get the minister's email address and tell him about the trouble people are in after they've been stripped of their pensions," she said.
Tamara's case also troubles Giorgi Geleishvili, head of Tbilisi's psycho-neurological clinic. He said her situation alone was sufficient reason to review the change in criteria.
"People suffering from mild mental retardation with pathological behaviour won't ever be able to work, as they will immediately get into conflict with someone," he said. "We paid them the benefits to keep them from starving to death or stealing."
Nato Khonelidze, director of the non-governmental organisation Antistigma agreed, saying the health ministry's recommendations were far too vague.
"The decisions were taken under emergency conditions," she said. "These instructions should be made more transparent to avoid making mistakes when determining disability status."
The new rules also impose stricter rules on people whose conditions do qualify for a disability allowance. For instance, they will now have to pay between 70 and 100 laris for a medical examination to determine their eligibility. The test used to be free.
Anna Kopaliani, who is epileptic, has been told she will only receive disability status if her fits are diagnosed as frequent. This will require her to make regular trips to hospital and pay for tests that she cannot afford.
"I will have to forego the benefit, as each night spent in hospital has to be paid for and an encephalogram costs 35 laris. That is one month's allowance," said Kopaliani.
The abolition of the panels of experts has also drawn criticism. "Many countries carry out medical examinations to determine disability status, but it is always licensed experts, not inexperienced doctors, who do this," complained Nato Khonelidze.
IWPR asked Tabidze whether the government plans to help people deprived of disability status to find jobs. He said that an employment project was being devised jointly with the business sector, adding, "But this is a problem for the future, and it's too early to talk about it right now."
Georgia's business sector does not currently provide the special facilities needed if disabled people are to be employed.
Fati Mamiashvili is a freelance journalist and IWPR contributor in Tbilisi