The disability benefits application process has been overhauled to prevent abuse in response to a massive benefits racket that was unearthed this time last year.

At the same time, it will open eligibility to people with so-called invisible disabilities such as fibromyalgia, ME and autism, who so far had no access to benefits. 

The government announced Wednesday the entire application process will migrate online and the current medical panel will be replaced by a board of professionals from various fields.

The new board will evaluate all disabilities using a new WHO-approved model, which means that invisible disabilities and other disabilities that were previously deemed ineligible for the benefit may now become eligible.

The new system will launch on September 2, and will also govern the application process of all disability benefits offered by the state.

"This is truly a win-win situation," Social Policy Minister Michael Falzon said in a press conference.

"With this reform, we are implementing all the recommendations of the probe [led by retired judge Antonio Mizzi] while improving the service and making it accessible to more people."

Racket that cost taxpayers €6 million

The benefits racket scandal largely unfolded around this time last year, when Times of Malta revealed hundreds of people were fraudulently receiving disability benefits they were not entitled to.

Evidence indicates popular family doctor and ex-Labour MP Silvio Grixti provided fake medical documents to help people receive monthly payments averaging €450 for disabilities they did not suffer from.

Further investigations revealed the racket ran even deeper and took a life of its own when other individuals began faking medical documents for scores of people, with some applicants claiming they were asked to pay kickbacks in return for a lifetime guarantee of benefits.

Since then hundreds of applicants have been arrested, arraigned and are paying back their ill-gotten gains. Grixti and four others were charged in court with playing a key role in the racket that is believed to have cost taxpayers as much as €6 million.

Falzon would not say what an internal investigation found on doctors who sat on the medical boards that approved fraudulent applications. Photo: Jonathan Borg

'End-to-end digital'

On Wednesday the government said the new scheme implements the recommendations of an independent probe led by retired judge Antonio Mizzi who was appointed to investigate the system in the wake of the scandal.

The Social Security Department's director general of compliance - George Cremona - explained the revamped online application will become "end-to-end digital" and every doctor or medical professional must submit the application on behalf of the patient through their e-ID, which ensures medical tests and certificates are truly originating from the doctor who signs them.

Patients must seek a medical evaluation from a doctor. The doctor will prepare a medical report and submit it electronically using their e-ID.

"Upon receipt, the Social Security Department will verify the application against the medical registry; once verified, both the doctor and patient will receive official confirmation," Cremona said.

"The application will then be forwarded to the inter-professional board's secretary, who will schedule an interview with the patient. During the interview, the board will assess each disability using a new model to determine eligibility."

Mark Musu, Permanent Secretary at the Social Policy Ministry. Photo: Jonathan Borg

Permanent Secretary Mark Musu said the new system will widen eligibility for more people with disability, using an internationally recognised evaluation model known as the ICF.

The International Classification of Functioning (ICF) is a framework developed by the World Health Organization (WHO) to describe the consequences of health conditions, including disabilities. It provides a standardised language and classification system for health, disability, and related concepts.

The framework will help the board to objectively rate each case to determine whether the patient deserves the benefit, which means some disabilities - often invisible ones - that were so far deemed ineligible, may now become eligible.

This may offer a ray of hope to the significant number of racket fraudsters who were not eligible for the disabilities they applied for but truly do suffer from other disabilities that happen not to be included in the list of eligible disabilities.

Musu said the reform also fulfills one of the government's 2022 electoral pledges.

The inter-professional board will consist of:

• A medical doctor to confirm the diagnosis
• A professional with knowledge of the assessment of the components of the ICF
• A social worker
• An occupational therapist,
• An expert from the department responsible for the payment of disability assistance and
• A person with a disability, on the advice of the CEO of Sapport.

The new board members are professionals who applied following a public expression of interest.

Musu said every professional who applied was accepted - given they had the necessary qualifications - and enough professionals applied for the government to be able to set up two boards that will work in rotation.

Minister Falzon said that for the sake of fairness and transparency, the board was not appointed.

"It was a public call and every professional who showed interest was welcomed on board," he said.

What about the doctors on the previous boards?

Falzon would not say, however, what action was taken on the medical board doctors who approved the fraudulent applications.

There was an independent internal investigation, he said, but would not say what came out of it and insisted that the important thing was that the system had been changed.

"The recommendations were taken on board," he said.

"I'm not in a position to discuss what happened to medical professionals. From our end, whatever is recommended that we improve, we will improve."

Junior Minister Julia Farrugia Portelli said this was a beautiful and positive day. Photo: Jonathan Borg

'Beautiful, positive day' 

Disability minister Julia Farrugia Portelli said the reform will assist people who suffer from disabilities that were often overlooked because they are invisible or affect the patients for a few hours or days during the week.

"This is a beautiful, positive day that is opening a window of care and love," she said.

"With this reform, we can evaluate people as whole individuals, not just on paper."