Conclusion of the Medical Commission on the need for permanent outside care: what it is and how to obtain it

The need for “permanent outside care” is confirmed by medical documents, primarily LCC conclusions issued on approved forms. These documents are used to arrange social care services, to obtain a deferment/exemption on family grounds in coordination with the TCC & SP on matters of military law, as well as in court disputes. It is important to understand which exact form to request, how to prepare the medical evidence package, and what to do in case of refusal — that’s covered below.

What “permanent outside care” is and how it differs

The concept of “permanent outside care”

This means prolonged (continuous or systematic) assistance by another person with basic self-care and mobility when an individual’s independence is significantly limited by disease or disorder. In the approved forms, this is described as: “cannot move independently and/or perform self-care and requires a social service of care on a non-professional basis.”

The difference between “outside” and “permanent” care

“Outside” emphasizes that assistance is provided by another person; “permanent” means the need is not episodic but long-term and confirmed by medical criteria and wording in the LCC conclusion or an AEFE (ЕКОПФО) decision.

Legal basis and LCC conclusion forms

Forms 080-4/o, 080-2/o, other forms

Currently, the following are used, among others:

• Form No. 080-4/o — a conclusion on the presence of impaired body functions due to which a terminally ill person cannot move or perform self-care independently and requires a social service of care on a non-professional basis (with completion instructions).
• Form No. 080-2/o — a conclusion on the presence of cognitive impairments in older persons, as a result of which a social service of care on a non-professional basis is required.
• A special form for persons with disabilities in Groups I–II due to a mental disorder — approved by a separate MoH order (used to assign social payments and confirm the need for care).

MoH orders, resolutions, instructions

Key acts include: MoH orders approving forms 080-4/o and 080-2/o and their instructions; the procedure for organizing and operating LCCs; and by-laws on the Assessment of Everyday Functioning (AEFE, ЕКОПФО), which may serve as an alternative or additional confirmation to an LCC conclusion.

Which forms commissions and the TCC recognize

In practice, the TCC & SP accept medical confirmations of the need for care in the form of: an MSEC certificate (if any), an extract from an AEFE decision, an LCC conclusion under form 080-4/o or 080-2/o, as well as the special form for mental disorders. Other “free-form” certificates are usually rejected.

Who can obtain it and the criteria

Medical indicators, functional limitations

The grounds are persistent limitations of vital activity: inability to move/perform self-care independently (for 080-4/o) or established cognitive impairments in older persons (for 080-2/o).

Eligible categories

May apply: individuals with severe chronic diseases, older persons with cognitive impairments, and persons with disabilities in Groups I–II due to a mental disorder (using the special form).

Required wording in the conclusion

Avoid vague phrases like “needs occasional outside help.” The 080-4/o or 080-2/o must reproduce the approved wording about inability to self-care/move and the need for a social service of care; in TCC practice, the absence of clear wording about the need for “permanent outside care” often becomes a reason for refusal.

Documents required for an LCC conclusion

Passport, tax number, medical record

Prepare identity documents, the tax number, an outpatient card/e-records, and discharge summaries from treating facilities.

Diagnoses, physicians’ conclusions, tests

Attach results of specialist consultations, instrumental tests, cognitive assessment scales (for 080-2/o), and a description of self-care limitations (for 080-4/o).

Additional certificates or documents of kinship

For submission to the TCC, it is advisable to have proof of kinship and cohabitation/actual caregiving, and (if available) an extract from an AEFE decision as an alternative to an LCC conclusion.

Procedure for obtaining an LCC conclusion

Contacting a medical facility or doctor

Contact your family or attending physician, who prepares the medical materials and submits them to the LCC.

Referral to the commission, preliminary examinations

The doctor compiles a file: discharge summaries, test results, specialist conclusions; if needed — consultations with a neurologist/psychiatrist/geriatrician.

LCC meeting — examination and assessment

The LCC reviews the materials, may examine the patient, and records functional impairments and their effect on self-care/mobility or cognitive functions.

Decision, recording and issuance of the conclusion

Based on the results, form 080-4/o or 080-2/o (or the special mental-disorders form) is completed. The conclusion is signed by LCC members and certified by the health-care facility’s seal.

Specifics, refusals and nuances

Common reasons for refusal

• The conclusion lacks a clear phrase about inability to self-care/move and the need specifically for a “social service of care on a non-professional basis.”
• A free-form certificate was submitted instead of the approved form (or without mandatory requisites).
• No evidence of actual caregiving or documents of kinship when applying to the TCC.

Insufficiently substantiated conclusion

Prepare a table of symptoms/limitations and link each item to physicians’ conclusions, tests, and activities of daily living (hygiene, cooking, walking, orientation). This helps the LCC clearly formulate the need for permanent care.

How to appeal a refusal or re-apply

Obtain a written refusal with reasons, prepare additional medical evidence, re-submit, or appeal in court. Case law has repeatedly overturned TCC refusals on formal grounds.

Case law and examples

Examples where courts upheld the conclusion

Courts have found TCC refusals unlawful where the applicant provided an 080-4/o with clear wording and the commission refused on formal grounds. In such cases, courts took into account that 080-4/o directly confirms the need for care; the absence of additional “acts” cannot automatically nullify the document.

Cases where courts required clearer wording

There are instances where, due to vague LCC text (“needs assistance”) instead of “cannot perform self-care and requires a social service of care,” the court sided with the TCC. Therefore, request correct wording and a full description of limitations.

Tips and recommendations

How to prepare for the commission

• Collect up-to-date discharge summaries, test results, and specialist consultations.
• Ask the doctor to describe specific limitations (walking, self-care, orientation, memory).
• For older persons — cognitive tests (MMSE/MoCA, etc.) and a neurologist/psychiatrist’s conclusion.

What to check in the conclusion

• Full form requisites, signatures of all LCC members, facility seal.
• Diagnosis and the key phrase about the need for care.
• For 080-2/o — specific mention of cognitive impairments.

Which form to request

• If the person cannot move/perform self-care → request 080-4/o.
• If the main issue is cognitive impairment in older age → request 080-2/o.
• If there is disability in Groups I–II due to a mental disorder → the special profile form.
• If available — consider an AEFE (ЕКОПФО) extract as an alternative or additional document.

FAQ

Which LCC conclusion type fits for a deferment or exemption?

Depending on the condition: 080-4/o, 080-2/o, or the special mental-disorders form. An AEFE extract or confirmation under the rules of Resolution 560 on deferment for caregiving also fits.

Can I obtain a conclusion without disability status?

Yes. For 080-4/o and 080-2/o, disability status is not mandatory: the key is medically confirmed functional/cognitive limitations.

What if the LCC refused?

Request a written refusal, clarify deficiencies, gather additional evidence and re-apply; in case of formal TCC refusals — appeal in court.

Must the phrase “permanent care” be in the conclusion?

Yes, substantive wording is required: the 080-4/o/080-2/o must clearly state inability to self-care/move and the need for a social service of care; otherwise the document may be rejected.

Can the conclusion be changed later?

If the condition worsens or needs clarification, a doctor may resubmit the case to the LCC or initiate an Assessment of Everyday Functioning (AEFE) and obtain an extract from the expert team’s decision.

How we can help

“Pravovyi Lider” offers a free initial consultation: we will briefly review your medical materials, advise which LCC form or AEFE extract to request, and provide step-by-step recommendations on next actions. We then help prepare applications and the document package for the TCC & SP, handle communications and, if needed, represent you in court. You can contact us via the website form — we’ll respond shortly.