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Role of doctors in the application process
Many Kela benefits are awarded in respect of illness or disability (including certain reimbursements for medical expenses, sickness allowances, rehabilitation, and disability benefits and pensions). The eligibility criteria for the individual benefits are set forth in law.
Kela enlists the services of medical advisors – specialists in insurance medicine who assess the applicant's health status, functional capacity and ability to work, and need for rehabilitation or treatment. Medical advisors provide an expert opinion from an insurance medicine perspective about whether eligibility criteria are met.
They do not award or deny a benefit. That decision is made by a qualified Kela staff member. The decision reviews all of the relevant criteria and considers to what extent they are satisfied in each case.
Medical advisors provide an expert statement on the following types of application:
- Sickness Allowance and Partial Sickness Allowance
- Disability Allowance for persons under 16 years of age
- Disability Allowance for persons aged 16 years or over
- Pensioners' Care Allowance
- vocational rehabilitation for persons with functional impairment
- intensive medical rehabilitation
- medical rehabilitation provided on a discretionary basis
- Rehabilitation Allowance for young persons
- reimbursements for medicine expenses
- reimbursements for medical care expenses
- Special Care Allowance
- Special Maternity Allowance
- Disability Pension and Rehabilitation Subsidy