Social rehabilitation is a social service designed to support a person with a disability or reduced work capacity in coping with their everyday life. Through social rehabilitation, the person and their family learn how to cope on a day-to-day basis with the special health needs arising from their state of health.

The social rehabilitation service is organised by the Estonian National Social Insurance Board. If the assessment of the need for service reveals that the person is in need of social rehabilitation service, the Estonian National Social Insurance Board shall assume the obligation of the person to pay the fee for the service, i.e. refers them to the service.

Description of the service

The aim of the social rehabilitation service is to teach and develop everyday skills, increase opportunities to participate in social life, support learning, and prepare the groundwork for working. 

The service is active in nature, and the person is able to perform all the activities that need to be done to achieve the goal on their own – for example, exercising or learning to dress using a technical aid. These skills are practised with the help and guidance of a rehabilitation specialist, and in addition, the specialist provides exercises and tasks to be performed at home independently or with the help of a family member/caregiver. As active participation on the part of a person is always a prerequisite for the effectiveness of rehabilitation services, passive procedures – such as massage, treatment bath, salt chamber, cold treatment, etc. – are not included among rehabilitation services.

Social rehabilitation is a complex service, one that is necessary if a person has several problems, the resolution of which is not possible by means of individual services (e.g. support person, rehabilitation, caregiver, or personal assistant), instead requiring the intervention of specialists from multiple specialties, i.e. rehabilitation team intervention.

To achieve the objectives, the following services will be provided, where necessary:

• Occupational therapist service

• Creative therapist service

• Social worker service

• Psychologist service

• Special education teacher service

• Speech and language therapist service

• Physiotherapist service

• Experience advisor service

• Doctor services

• Nurse services

The services are provided both individually and to a family or group, with the exception of the services of a doctor, which is only provided individually. A detailed list of services and a description of their content, can be found here opens in a new tab

The service is time-limited, i.e. it is provided for the time necessary to achieve the set purpose. At the end of the rehabilitation period, the rehabilitation service provider will assess the need to continue the service. If it becomes evident that the service needs to be continued, a new application will need to be submitted to the Estonian National Social Insurance Board, followed by a new assessment of the need for service.

NB!

• The person must actively participate in the social rehabilitation service according to the action plan and rehabilitation plan drawn up by the rehabilitation service provider. If this is not done, the Estonian National Social Insurance Board may refuse to assume the obligation to pay the fee on the basis of clause 21 (1) 3) of the General Part of the Social Code Act.

• Treatment, including rehabilitation, is not considered social rehabilitation. If you need treatment and rehabilitation, see your family physician or other doctor.

• The service provided by a physiotherapist consists of assessing the person’s motor performance skills and the operating environment (e.g. school, home) and recommending adaptations to the environment, preparing and teaching physiotherapeutic programmes to promote independent coping, teaching the use of technical aids, teaching sustainable assistance techniques to family members. The service provided by a physiotherapist does not include passive activities, such as massages, baths, salt therapy chamber, cold therapy, etc.

• The services of a doctor and nurse are consultative in nature and do not include activities related to treatment, such as establishing a diagnosis, preparing a treatment plan, writing a prescription, performing treatment procedures, issuing a referral to a medical specialist or for analyses, etc.

Application

You need to apply for the service. You can find the application form for social rehabilitation service here. 

Before submitting an application, think again about whether the service is still necessary, i.e. whether you or your child have a number of coping restrictions due to the health condition that cannot be alleviated by other measures (e.g. learning support services at school/nursery school, rehabilitation, technical aids, etc.).

The application can be submitted in several different ways. Use the one that suits you:

• on the State Portal eesti.ee opens in a new tab;

• send the digitally signed application, by e-mail, to the following address info@sotsiaalkindlustusamet.ee;

• send a signed paper application, by post, to Paldiski mnt 80, 15092 Tallinn;

• you can also apply at the Estonian National Social Insurance Board’s customer service offices in Estonia. Addresses and opening hours of customer service offices can be found here.

An application for social rehabilitation service does not need to be submitted for a child in need up to the age of 18, who has been identified by the local government entity as being in need of assistance under the Child Protection Act and for whom the entity has assessed the need to refer the child to the social rehabilitation service.

Persons suffering from a primary psychosis are also entitled to the service if the medical institution identifies a need for rehabilitation.

When you have been identified as needing social rehabilitation

Once you have received a referral decision, you have 60 days to make your selection from the received list of providers and register for the service. To do this, contact the service provider of your choice either by phone, e-mail or post, or appear in person and agree on a time to start the service.

When registering, please provide the referral decision number, which is in the format K000... – the service provider can use this number to view the decision details in the information system.

When you go to the service, take the referral decision with you or send it by e-mail.

The validity of the referral decision is up to 2 years, with the start and end dates indicated in the decision. During the period of validity of the decision, there is no need to extend or renew it.

The decision is accompanied by an annex indicating the amount per calendar year for which the services can be used, by service.

We will send you the decision by the method of your choice, which you indicated in the application. We will send you a list of service providers with the referral decision.

What should I do if I have received a negative decision on the options for using the services in the assessment?

The services consultant will approach each person’s situation individually, assessing what the person’s difficulties are, what help they would need and what further recommendations they have. If the services consultant and the person agree during the course of a joint discussion that the person does not need social rehabilitation, then no rehabilitation services will of course be provided. At the same time, the services consultant will not fail to recommend other services and, if necessary, help you to reach them, for example, by consulting with your family physician, local government social worker, etc. This means that if the services consultant has made a negative decision on social rehabilitation, the consultant will still make a number of recommendations on what to do next, and the person will get the help they need by following these recommendations.

If you think that the decision is inappropriate (for example, if you have received a decision refusing a referral), you can lodge a complaint with the Estonian National Social Insurance Board.

You have 30 days after receiving the decision to lodge a complaint.

We will resolve the complaint within 30 days of the date of the complaint. In cases where further investigation of the complaint is needed, we will extend the time limit for reviewing the complaint by up to 30 days. We will send a notice of extension to the person who made the request.

Provision of service

A provider of social rehabilitation services shall provide you with the service in accordance with the referral decision, either as a rehabilitation programme, or on the basis of an action plan or rehabilitation plan. If you receive the service on the basis of a rehabilitation plan, the service provider prepares a plan for you first. You will start receiving services once you have a plan.

You can get the service for the period indicated in the decision. The expiry of a decision on disability or incapacity for work does not terminate the provision of the service; you may receive the service until the expiry of the decision on referral.

For the services provided, the service provider will compile a data set indicating the date, the name and code of the service, the number of hours, the name and speciality of the specialist and the description of the content of the service for each service procedure. You have the right to ask your service provider, at any time, to provide you with the data set in order to review it.

The service invoices must correspond to the data set. No later than before the final invoice is drawn up, the service provider will obtain your confirmation regarding services received.

At the end of the service, the service provider will assess the impact of the service on your coping, i.e. describe the effectiveness of the service. The assessment describes the developments that have taken place as a result of the service, and the factors that have contributed to and hindered the achievement of the objective. The need for further rehabilitation services and other assistance needs will also be evaluated and recommended.

The service provider you contacted, and from whom you agreed to receive the service, will arrange for all the rehabilitation services you need. The provider may, if necessary, involve other social rehabilitation service providers from another rehabilitation institution with which the Estonian National Social Insurance Board has a contract. 

Change of service provider

It is possible to change the service provider if there is a good reason to do so – for example, if you have changed your place of residence. If you need to change the service provider, please inform the provider of the need and provide us with a free form and reasoned application to change the service provider.

Reimbursement of travel and accommodation expenses

Our task is to ensure that the right service is available for the right person. Therefore, in order to use the service budget efficiently, our aim is to provide the service in a rehabilitation facility close to the person’s home.

However, in cases where there is no suitable service provider close to home, it may still be necessary to receive the service from a service provider further away, and in exceptional cases it is reasonable to provide the service with accommodation. When providing rehabilitation service with accommodation, one meal per day, usually breakfast, is included in the price of accommodation. Therefore, you need to take into account that you will need to pay for lunch and dinner yourself.

The accommodation limit per calendar year is:

• up to EUR 120.45 per recipient of the service (up to EUR 24.09 per day);

  • for the user of the service limit for a person of working age with a mental disability, the annual limit for accommodation is EUR 843.15.

• up to EUR 91.54 for the person accompanying a child.

Please note that we do not pay for accommodation only (e.g. if the services are paid for by the person themselves).

The costs of travelling to a rehabilitation service shall be compensated to the recipients of the service who attend the service outside the local government where their home is located. We compensate for travel expenses related to the provision of rehabilitation services in the amount of EUR 0.10 per kilometre travelled, up to a maximum of EUR 41.55 per year. An application must be submitted to compensate for the expenses.

• send the digitally signed application, by e-mail, to the following address info@sotsiaalkindlustusamet.ee;

• send the application signed on paper by post to Paldiski mnt 80, 15092 Tallinn;

• you can also apply at the Estonian National Social Insurance Board’s customer service offices in Estonia. You can find the addresses and opening hours of the customer service offices here.

Source (Sotsiaalkindlustusamet 24.01.2024)