Appealing the Disability Health Board Report and the Legal Process

What is a Disability Health Board Report?

A disability health board report is an official health board document that indicates a person's disability status, disability group, disability rate, degree of disability, and in some cases, special needs or dependency status. This report is a fundamental document for benefiting from disability pensions, home care assistance, special education, employment, tax reductions, excise tax exemptions, transportation discounts, social support, care services, and certain rights in the health sector. The Ministry of Family and Social Services' current frequently asked questions page also states that the disability health board report is a fundamental document for benefiting from disability rights and is used in areas such as social assistance, education, employment, health, tax reductions, and exemptions.

A disability health board report is not merely a medical assessment. The report's outcome can directly affect a person's working life, social assistance rights, educational opportunities, vehicle purchases, retirement process, care services, applications to public institutions, and daily life. Therefore, an incomplete determination of the disability rate, incorrect designation of the disability group, or erroneous use of terms such as "severely disabled," "fully dependent," "partially dependent," "special needs," or "temporary-permanent" in the report can lead to serious loss of rights.

Different legislation applies to disability health board reports for adults and children. For individuals over 18 years of age, the Regulation on Disability Assessment for Adults applies. The purpose of this Regulation is to regulate the procedures and principles regarding the issuance, validity, evaluation of adult disability health board reports, and the determination of authorized health institutions that can issue these reports. For children under 18 years of age, the Regulation on Special Needs Assessment for Children applies, and the report issued for children is known in practice ÇÖZGER .

Why Appeal Against a Disability Health Board Report?

An appeal against a disability health board report is made if the individual believes that the medical or legal conclusions stated in the report do not reflect their true situation. The most common reason for appeal is the underestimation of the disability percentage. For example, the percentage calculation may be incomplete despite the individual having multiple illnesses or functional impairments. Certain medical specialties may have been excluded from the assessment, existing diagnoses may not have been included in the report, or the Balthazard calculation may have been performed incorrectly.

The second major reason for objection is the incorrect classification of disability categories in the report. Misclassification of areas such as mental-emotional, intellectual, orthopedic, visual, hearing, chronic illness, speech and language, specific learning disabilities, pervasive developmental disorders, or similar conditions can affect a person's applications for education, employment, and social support.

The third reason relates to whether the report is issued for a limited or permanent period. A person's disability may be medically determined to be permanent, yet the report may be issued for a limited period. Conversely, a limited-term report may be normal in a situation where the disability can change with treatment. According to the Adult Disability Regulation, reports can be issued for a limited or permanent period; in the case of a limited-term report, if less than six months remain before its expiration, a new report may be issued upon the request of the disabled individual.

The fourth reason is the absence of specific phrases in the report that affect access to social rights. For example, phrases such as "fully dependent," "partially dependent," "requires special conditions," "can use a specially adapted vehicle," "can/cannot drive," "areas of work in which the individual cannot be employed," and "severely disabled" can be decisive in the exercise of specific rights. Not every phrase needs to be included in every report; however, if the individual's actual health condition necessitates these phrases, an incomplete report may result in a loss of rights.

Who can appeal the Disability Health Board Report?

The disabled individual, their guardian, or the institution requesting the report may appeal the adult disability health board report. Article 12 of the Regulation on Disability Assessment for Adults explicitly stipulates that appeals against these reports shall be made to the Provincial Health Directorate by the disabled individual, their guardian, or the institution requesting the report.

Regarding children, the caregiver or the institution requesting the report may object to the Child Special Needs Assessment (ÇÖZGER) report. Article 12 of the Regulation on Child Special Needs Assessment states that objections to personal reports must be made within thirty days of the date of delivery to the relevant party, and objections not made within this period will not be considered.

It is important to note that the objection to the Provincial Health Directorate . The Ministry of Family and Social Services' current information also states that objections to disability reports can be made to the Provincial Health Directorate of the place of residence or the province where the report was issued, within thirty days of receiving the report or seeing it on the e-Government portal.

What is the time limit for appealing a disability report?

The deadline for appealing individual disability health board reports is 30 days. This period begins from the date the report is delivered to the individual or becomes visible via e-Government. The Ministry of Family and Social Services states that appeals against disability health board reports can be made within thirty days of the date the report is received or becomes visible via e-Government.

Article 12 of the Regulation on Disability Assessment for Adults stipulates that individual appeals against reports must be made within thirty days of the date of delivery to the applicant, and appeals not made within this period will not be considered. For institutional appeals, a reasoned written application is required, and there is no time limit.

Therefore, if the report yields a low approval rating or contains a deficiency that results in a loss of rights, individuals should not act on the assumption that they can reapply later. A report that is not appealed within the specified time frame may become final, and a certain waiting period may be required before applying for a new report concerning the same area of ​​need. According to the regulation, a new application for a report that has become final due to a referral hospital decision or due to a lack of timely appeal will be accepted no earlier than six months later, concerning the same area of ​​need.

Where and How to File an Appeal?

Appeals against disability health board reports must be submitted to the Provincial Health Directorate of the applicant's place of residence or the province where the report was issued. The appeal must clearly state the aspects of the report that are deemed incorrect. Instead of simply stating "I appeal the report," the appeal should concretely explain why the disability rating is low, which diagnoses were not evaluated, which specialist examinations were incomplete, which statements are incorrect or incomplete, and which social rights are affected.

The application should include a copy of the medical report, a photocopy of the ID card, a power of attorney (if applicable), previous medical reports, discharge summaries, surgical notes, MRI, CT scans, X-rays, laboratory results, medication reports, psychiatric follow-up records, physical therapy documents, vision/hearing test results, special education reports, and relevant expert opinions. In particular, if there is a disease or functional impairment that is considered to have been inadequately assessed in the report, submitting relevant documents will increase the seriousness of the appeal.

The Provincial Health Directorate refers the individual to the nearest authorized alternative health institution upon application. If the previous report was obtained from a different health institution and the individual is being monitored at a health institution where they are under continuous care, referral to that health institution is also possible in accordance with the Regulation.

Second Hospital Report and Referee Hospital Process

Upon appeal, the individual is referred to a second authorized healthcare institution. This second hospital conducts a new assessment and issues a new disability health board report. If the decisions in the first report and the second report are consistent, the report becomes final. For example, if the disability rate is 35% in the first report and is the same in the second report, or has the same legal consequence, the process can be finalized.

However, if there is a difference between the initial report and the second report issued upon appeal, and the individual wishes to continue their appeal, the Provincial Health Directorate will refer them to the nearest arbitration hospital. According to the Adult Regulations, if the report results differ and the appeal continues, the directorate will refer the individual to the nearest arbitration hospital; the decision given by the arbitration hospital is final.

The same system has been adopted for ÇÖZGER reports as well. If an objection is raised against the child's report, the child is sent by the Provincial Health Directorate to the nearest authorized alternative health institution. If the first and second reports are in the same direction, the report becomes final; if the results differ and the objection continues, the child is referred to an arbitration hospital, and the arbitration hospital's decision is considered final.

Here, the phrase "the arbitration hospital decision is final" means that the administrative appeal process has ended. However, this statement should not be broadly interpreted as meaning that the judicial path is completely closed in every case. If an administrative action has been taken based on the arbitration report—for example, if a disability identity card, VAT exemption, home care assistance, tax reduction, disability pension, right to education, or right to employment has been denied—then administrative courts or relevant appeal paths should be evaluated separately for that specific action.

What can be done against a referee hospital report?

The expert hospital report and the health board report are final in terms of the appeal process. Therefore, it may not be possible to initiate a new report process by repeatedly applying to the Provincial Health Directorate on the same issue. The regulation stipulates that a new report application for the same area of ​​need will be accepted at the earliest six months after a report that has been finalized by an expert hospital decision or due to a lack of timely appeal.

However, a person is not entirely helpless in every situation without waiting six months. If a new and significant change has occurred in their health condition, a new illness has emerged, they have undergone surgery, their illness has progressed, their functional loss has increased, or the medical data on which the report is based is clearly incomplete, a request for reassessment may arise depending on the specific circumstances. The Adult Disability Regulation stipulates that if the disability status changes, the relevant specialist physician may refer the case to the board for reassessment without any time limit.

If a person's social rights are denied based on a referral hospital report, the subject of the lawsuit is often not only the report itself, but also the administrative action based on the report. For example, if home care assistance is denied due to a disability rating, the action of the Family and Social Services administration is examined separately; if a tax reduction is denied, the action of the tax administration is examined separately; if a special consumption tax exemption is denied, the tax/registration action is examined separately; and if a disability pension is denied, the relevant social assistance action is examined separately.

What should be done if the reporting rate is low?

If the disability rating on your report is lower than expected, the first step is to carefully examine the report. You should check which medical specialties conducted the assessment, which diagnoses were included, which department determined the disability rating, how the total rating was calculated if there were multiple conditions, the meaning of "permanent" and "temporary" disabilities, and whether any specific sections affecting social rights have been filled out.

The second step is to gather any missing medical documents. For example, if there is an orthopedic disability, current physical therapy, orthopedics, neurology, and imaging records should be added; if there is a visual impairment, eye examination reports and measurements; if there is a hearing impairment, audiometry tests; if there is a psychiatric disorder, follow-up records, medication reports, and hospitalization summaries should be added; and if there is a chronic illness, follow-up records from the relevant departments should be included in the file.

The third step is to appeal to the Provincial Health Directorate within 30 days. The appeal should be prepared with as much medical and legal justification as possible. Instead of simply stating "The percentage given is too low," concrete objections such as "Disease X was not included in the report," "Specialty Y evaluation was not performed," "A temporary report was issued despite continuous treatment," or "Dependency status was not assessed" will be more effective.

Objection to the ÇÖZGER Report

For children under 18, a Special Needs Assessment Report (ÇÖZGER) is issued instead of a disability health board report. The ÇÖZGER uses the child's level of special needs as the basis, rather than a classic percentage rate. Therefore, when appealing a child's report, instead of focusing on the percentages used in adult reports, the focus should be on whether the child's level of special needs has been accurately determined, and whether developmental, intellectual, physical, mental, auditory, visual, or chronic disease areas have been correctly assessed.

According to the Regulation on Special Needs Assessment for Children, reports are issued for a limited or permanent period. If the child's special needs change, a reassessment can be made without a time limit, upon the request of the caregiver and the recommendation of the relevant specialist physician to the board. In the case of limited-term reports, if less than six months remain until the expiration date, a new report can be issued upon the request of the caregiver.

Personal objections to the ÇÖZGER report must be submitted to the Provincial Health Directorate within thirty days of the date the report is delivered to the relevant party. Upon objection, the child is sent to a different authorized health institution; if the first and second reports are consistent, the report becomes final; if there are discrepancies and the objection continues, a referral hospital process is initiated.

Reports of Children Who Have Reached the Age of 18

Disability assessment reports issued for children should be reviewed for adult disability assessment purposes upon reaching the age of 18. The Child Regulations stipulate that disability reports, both permanent and temporary, issued under the Disability Assessment and Reduction Program (ÇÖZGER) framework, will become invalid upon the date the individuals reach the age of 18, with the exception of reports related to terrorism, accidents, and injuries.

The Adult Disability Regulation stipulates that those whose disability reports have become invalid due to reaching the age of 18 within the framework of the Disability Assessment and Recognition Regulation provisions may apply for a reassessment of their disability status within three months of reaching the age of 18; and that adult disability health board reports issued within this scope will be considered valid from the date of reaching the age of 18, with certain exceptions.

Therefore, the transition to 18 years of age is important for individuals with a child report. Families should plan the new adult report process as their child approaches 18 to avoid interruptions in social assistance, education, care, health, and employment rights.

Continuous Reporting, Periodic Reporting, and Acquired Rights

The wording "permanent" or "temporary" on disability reports can directly affect a person's rights. A permanent report may be issued in cases where the disability is expected to remain constant or worsen. A temporary report, on the other hand, may be issued in cases where the disability may change depending on treatment, rehabilitation, or the course of the illness.

The Adult Disability Regulation states that the percentages of total body function loss determined by permanent medical board reports issued for disabled individuals over the age of 18 before the regulation came into effect are valid, and that there are provisions regarding acquired rights in terms of maintaining employment, education, social support, and assistance services provided based on these percentages.

Nevertheless, in practice, issues may arise regarding the validity of old reports, institutions requesting new reports, the termination of rights, or a reduction in rates according to the provisions of the new Regulation. In such cases, the date of the report, whether it is continuous or not, the right for which it was used, the reason for the relevant institution requesting a new report, and the status of acquired rights should be evaluated separately.

What lawsuits can be filed if rights are lost due to a disability report?

Since disability health board reports are fundamental documents for exercising many administrative and social rights, errors in the report often lead to other administrative actions. For example, disability pensions may not be granted, home care assistance may be rejected, special consumption tax exemptions may be denied, tax reductions may not be applied, a disability identity card may not be issued, and applications for special education or employment may be rejected.

In such cases, the legal avenue is not limited to appealing the medical board report. After the appeal process is exhausted, or after a right is denied based on the report, an annulment lawsuit, a full judicial review lawsuit, or special appeal procedures stipulated in the relevant legislation may be considered against the relevant administrative action. In administrative courts, annulment lawsuits are filed against administrative actions that are unlawful in terms of authority, form, reason, subject matter, and purpose; full judicial review lawsuits, on the other hand, are filed by those whose personal rights have been directly violated due to administrative actions and procedures.

If the individual has suffered financial harm due to an erroneous assessment in the report—for example, due to the termination of social assistance, inability to utilize tax advantages, failure to access care services, or delayed access to a right—compensation for financial damages may be considered, depending on the specific circumstances. However, when determining a legal strategy, the defendant administration, time limits, competent court, and the subject matter of the lawsuit must be carefully identified.

Evidence in Disability Health Board Report Cases

In appeals against disability reports or in lawsuits based on these reports, the most important evidence is medical records. Not only the current report, but also previous reports, treatment history, surgical documents, discharge summaries, medication records, imaging results, laboratory values, functional tests, psychiatric follow-ups, rehabilitation records, and expert opinions should be submitted to the file.

Especially in chronic and persistent illnesses, a single examination can be misleading. Long-term follow-up records are important in areas such as diabetes, kidney failure, heart disease, neurological diseases, rheumatological diseases, psychiatric diseases, cancer, vision or hearing loss, or orthopedic dysfunction.

The application should also specify which social benefit the report will be used for. For home care assistance, dependency and daily living activities are considered separately; for VAT exemption, vehicle use and special equipment; for employment, working capacity and unsuitable jobs; and for education, special needs. Therefore, the application should explain not only the percentage but also the legal implications of the report.

What should be considered when writing an appeal petition?

An appeal against a disability health board report must be clear, concrete, and supported by documentation. The appeal should include the date of the report, the hospital that issued it, the report number, the determined disability percentage or level of special needs, the parts being appealed, and the reasons for the appeal.

The following points are particularly important in the petition: illnesses not considered, incomplete specialist examinations, incorrect disability rating calculation, wrong disability group designation, temporary/permanent disability error, incorrect determination of dependency status, missing specific phrases, contradictions with previous reports, current medical documents, and the nature of the loss of rights.

The appeal letter should avoid overly general statements. Instead of saying "the report is unfair," more effective explanations include phrases like "the report did not assess the existing orthopedic functional loss," "neurology follow-up documents were not included in the board's evaluation despite being available," and "developmental reports affecting the child's level of special needs were not taken into consideration.".

Conclusion: The Appeal Process Against the Disability Health Board Report Can Prevent Loss of Rights

A disability health board report is a crucial document for exercising many social, economic, educational, and legal rights. Underestimating the disability percentage, incorrectly stating the disability group, incomplete assessment of dependency status, erroneous wording regarding temporary or permanent disability, or failing to include information that would allow access to special rights can all lead to serious loss of rights.

In adult disability reports, the disabled individual, their guardian, or the institution requesting the report may appeal to the Provincial Health Directorate; in child reports, the caregiver or the institution requesting the report may appeal. The individual appeal period is generally 30 days from the date the report is submitted or appears on e-Government. Upon appeal, the individual is sent to a different authorized health institution; if the reports are consistent, the report becomes final; if there are differences and the appeal continues, an arbitration hospital process is initiated. The arbitration hospital's decision is considered final in terms of the administrative report appeal process.

The most important point in this process is that the appeal is made within the time limit and with justification. All of the person's medical documents should be collected, the specialties that were not properly assessed should be identified, it should be explained which social rights are affected by the report, and if necessary, legal avenues should be explored against administrative actions that cause a loss of rights based on the report.

The process of appealing a disability report should not be solely aimed at increasing the disability rating, but rather at ensuring that the individual's true health status is legally recognized accurately. A strong appeal is successful only when it presents a combination of evidence including medical records, relevant legislation, claims of loss of rights, and concrete grounds for appeal.