Establishment of special needs

Special needs are established in accordance with the Description of the procedure for the establishment of a special need for a permanent nursing, of a special need for a permanent care (assistance), of special needs for the compensation of costs of acquisition a passenger car and its technical adaptation approved by the Order of the Minister of Social Security and Labour of the Republic of Lithuania and of the Minister of Health of the Republic of Lithuania without taking into consideration the age of the individual, a degree of disability or working capacity.

The individuals listed below have the right to the establishment of special needs:

• the citizens of the Republic of Lithuania;
• the citizens of another Member State of the European Union or of the country party to the Agreement on the European Economic Area and their family members who have been issued with the documents confirming their right to reside in the Republic of Lithuania;
• individuals who, in accordance with the regulations of the European Union for coordinating social security schemes, are subject to the Law of the Republic of Lithuania on Social Integration;
• foreigners holding a long-term European residence permit of the Republic of Lithuania, and foreigners granted asylum in the Republic of Lithuania.

The following special needs may be established for individuals:

The need for a permanent nursing:

• a special first degree need for a permanent nursing;
• a special second degree need for a permanent nursing. 

The need for a permanent care (assistance):

• a special first degree need for a permanent care (assistance);
• a special second degree need for a permanent care (assistance).

How special needs are established?

Special needs are established through a complex assessment of a basic level of functioning (i.e. a medical criterion according to the state of the health of the individual: diseases, injuries, pathological conditions and the related functional impairments, and opportunities for self-reliance in daily activities.

In cases where special needs for working-age individuals and for individuals of retirement age are being established, a questionnaire for the assessment of the individual's performance and ability to participate is required to be completed at the Disability and Working Capacity Assessment Office (DWCAO). The points of the questionnaire completed are treated as a personal self-reliance coefficient. The number of points that is obtained by multiplying a basic level of functioning by a self-reliance coefficient is treated as a degree of a special need for a permanent nursing or of a special need for a permanent care (assistance).

The questionnaires for the assessment of the individual's performance and ability to participate that are designed for children of 4 years through to 18 years of age are adapted for different age groups, and there is no requirement to complete the questionnaires for children under 4 years of age.

The need for the compensation of costs of acquisition a special passenger car and its technical adaptation is established for individuals with a very severe movement disorder according to the established criteria.

A special second degree need for a permanent nursing or a special first or second degree need for a permanent care (assistance) can be also established for an individual in combination with a special need for the compensation of costs of acquisition of a passenger car and its technical adaptation if functional impairments of the individual meet the criteria for establishing these needs.

Special needs are established:

• in participation of the individual in the territorial division of the DWCAO. In the situation where a forecasted basic level of functioning of the individual is no more than 20 points and because of functional impairments the individual is unable to arrive to the DWCAO, the individual shall be examined either at home or in the hospital, or in the social care institution where the individual lives; 
• in absence of the individual when his / her special needs are assessed repeatedly, and the necessary documents provided for the purpose of establishing special needs do not give rise to doubts that a forecasted basic level of functioning of the individual is 10 points and the level of his / her self-reliance has not changed, and because of functional impairment the individual is unable to arrive to the territorial division of the DWCAO.

If an individual whose special needs are being assessed fails to arrive to the DWCAO without justified reasons when is invited to attend in or refuses to participate in the procedure of assessment of special needs, the special needs of such individual are not assessed.

Special needs are also not assessed when the DWCAO applies to the Personal Healthcare Facility that employs the physician who has issued a referral to the DWCAO for the purpose of establishing special needs or to other facilities or institutions for additional medical documents (information), and the Personal Healthcare Facility that employs the physician who has issued a referral to the DWCAO for the purpose of establishing special needs or other facilities or institutions inform that the individual without a justified reason refuses from additional examination.

Deadlines for establishing special needs

The following deadlines apply for the establishment of special needs for a permanent nursing and for a permanent care (assistance):

• for a period of 6 months when a special need for a permanent nursing, a special need for a permanent care (assistance) and a degree of special needs are assessed for the first time, and the change in the state of the health of the individual or in his / her self-reliance in daily activities is forecasted within the next six months;
• for a period of one year when a special need for a permanent nursing, a special need for a permanent care (assistance) are assessed for the first time and/or the change in the state of the health of the individual or in his / her self-reliance in daily activities is forecasted within the next 12 months;
• for a period of 2 years when the change in the state of the health of the individual or in his / her self-reliance in daily activities is forecasted within the next 24 months;
• for an indefinite period of time when the change in the state of the health of the individual or in his / her self-reliance in daily activities is not forecasted and/or the health disorders of the individual are permanent, constant by their nature.

The following deadlines apply for the establishment of a special need for the compensation of costs of acquisition of a passenger car and its technical adaptation:

• for a period of 6 years when a special need for the compensation of costs of acquisition of a passenger car and its technical adaptation is established and the change in the state of the health of the individual is forecasted within the next 72 months;
• for an indefinite period of time when the change in the state of the health of the individual or in his / her self-reliance in daily activities is not forecasted and/or the health disorders of the individual are permanent, constant by their nature.

Special needs are assessed repeatedly:

• short before the established maturity deadline of special needs;
• in case of change in the state of the health of the individual or in his / her self-reliance;
• when the individual or the institution paying the targeted compensations disagree with the decision of the territorial division of the DWCAO;
• if the inspection of the decisions adopted by the DWCAO reveal that the decision has been adopted unreasonably;
• when the decision of the Dispute Commission under the Ministry of Social Security and Labour is being implemented.