How the severity of a physical impairment determines the support level
The inclusion allowance is a cash benefit for persons with disabilities intended to help them overcome barriers that may prevent their full and effective participation in society on an equal basis with others. For physical impairments, the degree of impairment of functional ability is determined, among other things, by the Barthel Index.
What the Barthel Index is
The Barthel Index (BI) is a standardised scale for assessing a person’s functional independence in the basic activities of daily living. Ten activities are scored: feeding, bathing, grooming, dressing, bowel and bladder control, toilet use, transfers (for example from bed to chair), mobility, and climbing stairs. The total score ranges from 0 to 100: the lower the score, the more dependent the person is on the help of others, and the higher the score, the more functionally independent they are. The index is used in rehabilitation and in expert assessment to measure the degree of independence and the need for assistance.
The Barthel Index in the List of Impairments (List II)
For adults with a physical impairment, the List of the Type and Severity of Disability links the Barthel Index range to the degree of impairment of functional ability:
- Degree I - Barthel Index 91-99 (mildest impairment, requiring minor assistance)
- Degree II - Barthel Index 61-90
- Degree III - Barthel Index 36-60
- Degree IV - Barthel Index 0-35 (most severe impairment, dependence on the help of others)
Condition for recognition of the right
An adult with a physical impairment is granted the right depending on the degree of severity of the disability: the highest amounts (support levels 1 to 3) require the third or fourth degree, while the lower amounts (levels 4 and 5) require the second or third degree. It follows that Degree I (Barthel Index 91-99) does not, on the basis of a physical impairment alone, give rise to a right to the inclusion allowance.
Linking the degree of impairment to the support level and amount
The amount of the allowance is expressed as a percentage of the base amount, and the support level is determined according to the List of Impairments. For adults with a physical impairment, the relationship is as follows:
| Degree of impairment / Barthel | Support level | Amount (% of base) | Monthly* |
|---|---|---|---|
| Degree IV · BI 0-20 | Level 1 | 600 % | EUR 720 |
| Degree IV · BI 21-35 | Level 2 | 400 % | EUR 480 |
| Degree III · BI 36-60 | Level 3 | 360 % | EUR 432 |
| Degree II · BI 61-90 | Level 4 | 135 % | EUR 162 |
| Degree I · BI 91-99 | - | - | no entitlement |
*Calculated on a base amount of EUR 120.00 (decision of the Government of the Republic of Croatia); the highest amount (level 1) is EUR 720.00 per month.
As a rule, a lower Barthel Index means a higher degree of impairment, a higher support level, and a larger allowance. The table above applies to a physical impairment as the sole basis in adults. For children, for cases involving an additional difficulty, and for other types of impairment (sight, hearing, intellectual, mental, chronic illness, and others), the Act prescribes separate criteria for classification into support levels.
Who determines the degree and who decides
The Barthel Index and the degree of impairment are determined by the findings and opinion of the Institute for Expert Evaluation, Professional Rehabilitation and Employment of Persons with Disabilities, while the right itself and the support level are decided by a decision of the Croatian Institute for Social Work. Before submitting an application for the inclusion allowance, you may request that the Barthel Index be assessed by a specialist in physical medicine and rehabilitation, a specialist in orthopaedics, or a specialist in neurology.
If you believe that too low a degree of impairment or an incorrect support level has been determined in your case, our office is available to analyse the findings and opinion, to prepare objections and appeals against the decision, and to represent you in the procedure for exercising the right to the inclusion allowance.