Assessment of Everyday Functioning (AEF)

When a person is told they need to apply for disability, determine their degree of capacity loss, or establish the need for long-term care, it is always a cause for concern. This is especially true for military personnel recovering from injuries or complex illnesses. Many questions arise: what documents are needed, who should issue the referral, what will be assessed, and whether the experts will truly understand the patient's actual condition and daily limitations. Mechnikov Hospital has surgical and general Functioning Assessment Teams. Our task is to evaluate—professionally, objectively, and with empathy—how a person's health condition affects their daily life and to prepare a medical report.

Expert Opinion

"The modern system of Assessment of Everyday Functioning is moving away from a formal, 'diagnosis-based' approach toward evaluating how a person actually lives, moves, works, and cares for themselves. It is crucial for us to understand what the patient can do independently and where they require assistance, accommodations, or specialized assistive devices. A well-prepared AEF referral safeguards the patient's interests. It allows Functioning Assessment Teams to make decisions based on structured information about a person's functional capabilities, rather than 'by eye.' Our task, as Functioning Assessment Teams, is to carefully gather this data, relying on the clinical picture, examinations, documentation, and an honest dialogue with the patient."

Patient Pathway: Step by Step
The first and key point: the referral for an AEF is issued by the patient's attending physician. They evaluate the patient's condition, the course of the disease, the duration of disability, and the presence of functional limitations. Generally, the pathway looks like this:

The doctor assesses the condition, analyzes existing tests, treatment duration, and dynamics. If there are grounds for an AEF, they generate an electronic referral

The plan for additional examinations is determined by the specialists who established the primary diagnosis. This may include laboratory tests, MRI, CT scans, X-rays, ECG, ultrasound, and other studies required specifically for your case.

Attached to the electronic referral are hospital discharge summaries, consultation reports, recent examination results, certificates from military medical commissions, reports on injuries or occupational diseases, etc.

The Functioning Assessment Team analyzes the submitted documents, evaluates the individual's everyday functioning, summarizes the data, and formulates the AEF medical report. The time required to prepare these documents depends on the complexity of the clinical case and the doctors' workload. In complex situations—especially when there are multiple severe diagnoses or prior documentation is incomplete—the process may take longer, as a full set of medical data needs to be gathered.

Advantages of Undergoing an AEF at Mechnikov Hospital
The participation of our hospital's Functioning Assessment Teams in the AEF system has several significant advantages:
Combining Clinical Experience and Expertise

The Functioning Assessment Teams are composed of doctors who deal with severe clinical cases on a daily basis. They have a deep understanding of what the patient's condition looks like in real life, not just "on paper."

Multidisciplinary Approach

The teams include specialists from various fields. This allows for the consideration of specific characteristics in polytrauma, chronic illnesses, neurological disorders, cardiological problems, and more.

Operating Within the Current Regulatory Framework

We work in accordance with the Resolution of the Cabinet of Ministers of Ukraine and official criteria, guaranteeing the accuracy and legitimacy of the resulting reports.

Focus on the Patient's Real Everyday Life

The medical report is based not only on diagnoses but also on an assessment of how the person lives, moves, works, and what types of daily assistance they require.

AEF for Military Personnel

The AEF service at our facility is particularly critical for military personnel who have sustained wounds or severe injuries. We have extensive experience working with this category of patients and deeply understand their needs.

What is AEF in Simple Terms?

The Assessment of Everyday Functioning is not just a formality or "another medical board." It is a modern approach that helps answer a key question: how does a disease, injury, or wound affect a person's ability to live a normal life?

During an AEF, Functioning Assessment Teams analyze not only the diagnosis but also how a person:

  • moves around;
  • performs self-care;
  • communicates;
  • works;
  • interacts with their environment.

In other words, it is an evaluation of not only the medical condition but also the actual limitations in everyday activities. This is why a properly conducted AEF is so important for military personnel, people with chronic diseases, and those recovering from severe injuries or surgeries.

How the AEF Process is Organized at Mechnikov Hospital

The facility has two Functioning Assessment Teams:

  1. Surgical Profile Team.
  2. General Profile Team.

This process is coordinated by the Patient Expertise Department. The Functioning Assessment Teams hold their meetings on the ground floor of the Urology Building. The teams consist of 21 doctors from various specialties. This multidisciplinary composition allows for the thorough consideration of surgical, neurological, therapeutic, and other conditions.

The main goal of our work is to conduct a high-quality Assessment of Everyday Functioning and prepare a medical report that is comprehensive, objective regarding the patient's condition, and tailored to their needs.

Who Most Frequently Undergoes an AEF?

Most often, preparation for an AEF at our hospital is conducted for military personnel. These are patients with:

  • consequences of wounds and concussions;
  • amputations;
  • severe musculoskeletal injuries;
  • neurological disorders;
  • polytrauma and multiple-level functional limitations.

However, an AEF may also be required for civilian patients with chronic or irreversible conditions that significantly limit their ability to work, move, or perform self-care.

When Might an AEF Be Necessary?

An Assessment of Everyday Functioning is most often needed when:

  • an illness is long-lasting (12 months or more) or is expected to have a protracted course;
  • the condition is stable or irreversible;
  • temporary disability lasts continuously for 120 days, or intermittently for up to 150 days within a year;
  • the patient has tuberculosis with a prolonged period of incapacity;
  • a person has undergone complex surgeries or medical interventions;
  • it is necessary to determine the degree of occupational capacity loss;
  • the cause of disability needs to be changed, or rehabilitation recommendations need to be clarified;
  • there are questions regarding the need for constant care, social services, or provision of assistive technological devices for rehabilitation.

A separate set of reasons concerns military personnel, individuals with occupational injuries or diseases, and cases where it is necessary to establish a causal link between an illness, injury, or death and the conditions of service or employment.

Regulatory Framework

The work of the Functioning Assessment Teams at Mechnikov Hospital is carried out in accordance with current legislation. The key document is the Resolution of the Cabinet of Ministers of Ukraine dated November 15, 2024, No. 1338, "Certain Issues of Introducing the Assessment of Everyday Functioning."

The most important thing for the patient to know is this: we act within the officially approved procedure, and all reports are formulated according to established criteria. This guarantees that the AEF results will be accurate and fully correspond to the patient's condition.

Examinations Prior to the AEF

The list of required examinations is determined individually. Generally, it may include:

  • laboratory tests;
  • instrumental diagnostics (MRI, CT, X-ray, ECG, ultrasound);
  • specialized examination methods depending on the disease profile;
  • follow-up consultations with medical specialists.

In some cases, even having documents from other medical facilities does not rule out the need for repeat examinations if the available information is insufficient to make a well-founded decision.

Documents Required from the Patient

The full list of documents may look complicated, but it can be broken down into a few categories:

  • identity documents (passport, taxpayer identification number, IDP certificate if applicable, military registration documents for service members);
  • medical records related to the primary diagnosis: hospital discharge summaries, outpatient records, consultation reports, and examination results from the past year;
  • documents regarding occupational injuries or diseases (investigation reports, conclusions of occupational pathology commissions),if applicable;
  • decisions of military medical commissions or other documents concerning military service, injuries, and wounds;
  • documents confirming prolonged temporary disability (medical certificates, sick leave records).

The most common issue that delays the process is the lack of some original documents or having medical records scattered rather than gathered in one place. That is why we advise you to systematically organize everything related to your treatment, examinations, and commission decisions in advance.

Facilities for Patients with Reduced Mobility

The AEF process involves a particularly high number of patients with reduced mobility. The hospital provides facilities to make it easier for them to attend examinations and Functioning Assessment Team meetings:

  • an accessible ramp;
  • a staff call button;
  • designated parking spaces for people with disabilities;
  • unassisted access to the room where AEF meetings are held;
  • a comfortable waiting area.

In addition to medical specialists, psychologists and social workers may assist patients in complex cases. Their involvement is crucial when a person is undergoing not only medical but also significant psychological and social life changes.

Recommendations for Patients and Their Families

To ensure the preparation for an AEF goes as smoothly as possible, we recommend:

  • gathering all medical documents related to the primary illness or injury in advance;
  • keeping all discharge summaries, old medical reports, and test results, as they may be needed;
  • informing the doctor not only about diagnoses but also about what exactly has become difficult in everyday life: self-care, mobility, work, or communication;
  • paying close attention to temporary disability periods, and keeping sick leave certificates and other supporting documents safe;
  • relying on official explanations from your doctor rather than rumors and "myths" about the medical and social expert boards.

The most important thing to remember is that the AEF is designed to reflect your condition as accurately as possible, not to "make life harder." The more comprehensive and honest the information provided, the more accurate the final medical report will be.

How to Start the Process

Our hospital does not have a separate, direct appointment system for an AEF. The first step is always the same: consult your attending physician.

If you or your loved one has been advised to undergo an AEF, discuss this with your treating doctor. They will explain whether there are grounds for an Assessment of Everyday Functioning at this time, what additional examinations are needed, and how the electronic referral will be generated.

Do not postpone this conversation if the condition remains severe for a long time, there are significant limitations in everyday life, or if the doctor has already mentioned the need to prepare paperwork. We are here to professionally assess your everyday functioning, help present your condition in a structured manner, and provide a high-quality medical evaluation for a fair decision.