Cancellation of the ‘Limitedly Fit’ Status Is Necessary, but Will Create Risks at the Front: What a Military Lawyer and a Combat Doctor Say

Ukraine has abolished the status of “limitedly fit” for serving in the army, arguing that it is necessary to reduce corruption risks and introduce a clearer system for determining one’s fitness for military service.

From now on, many of those who had the status of limited fitness, according to the updated list of diseases, are fit to serve even in combat units. But despite the acute shortage of people at the front, replenishing units with soldiers who have health problems can only do harm. 

Zaborona’s editor Svitlana Hudkova asked a military lawyer and a combat doctor what they think about the decision of the Defense Ministry and its consequences.

No more ‘limitedly fit’

On May 4, 2024, the law on ensuring the rights of the military to social protection came into force. It abolishes the status of “limitedly fit for military service”. From now on, men aged 18–60 who previously had this status must undergo a military medical examination again. They have nine months to do so, i.e. until February 4, 2025.

After the second MME, the servicemen and women liable for military service will be recognized as fit or unfit, divided into the following categories:

Fit

• fully fit;
• fit for service in military support units, Territorial centers of recruitment, higher military educational institutions, training centers, institutions, medical units, logistics, communications, operational support, security units; but unfit for service in airborne assault troops, marines, special operations forces, special purpose units;
• fit for performing specific tasks.

Unfit

• temporarily unfit, requiring treatment, leave, or dismissal;
• unfit, with re-evaluation in 6–12 months;
• unfit for military service with exclusion from the military register.

People with HIV, hepatitis, and tuberculosis will serve

The Ministry of Defense has approved a list of diseases according to which a person can be declared fit or unfit for service (see full list). Zaborona focused on the diseases that still make conscripts fit to serve at the front and in the rear.

Those fit for military service can be diagnosed with:

• residual changes after cured tuberculosis of various localizations;
• chronic viral hepatitis with minor dysfunction;
• HIV-related diseases and asymptomatic HIV carriage;
• neoplasms in the phase of long-term stable remission after specific treatment; blood diseases that progress slowly or do not progress;
• diseases of the endocrine system, eating disorders, and metabolic disorders with minor dysfunctions; neurotic mild mental disorders in recovery;
• inflammatory diseases of the central nervous system with minor dysfunctions;
• hypertension of the first stage;
• liver diseases with minor dysfunctions;
• gastric ulcer and duodenal ulcer with minor dysfunction;
• osteoarthritis and other joint disorders with minor dysfunction, etc.

Those fit for rear service can be diagnosed with:

• clinically cured tuberculosis;
• chronic viral hepatitis with moderate dysfunction;
• HIV-related diseases with immune sub-compensation;
• cancer of the lower lip, skin cancer; a condition after radical surgical treatment of the primary tumor;
• benign tumors with moderate dysfunction;
• blood diseases that progress slowly with moderate dysfunction and frequent exacerbations, etc.

Fit and unfit for service

Lawyers generally positively assess the abolition of the “limitedly fit” category and the subsequent elimination of corruption risks during the MME. In particular, the order of the Ministry of Defense eliminates an individual assessment by a doctor.

“Previously, the board of doctors of the military medical commission could decide at its own discretion on the fitness or limited fitness of a person with a certain diagnosis. But for some reason, of two people with the same diagnoses in their MMC certificates, one could be fit, and the other limitedly fit. That is, this element of an individual assessment contained a corruption component and was not fair. From now on, a person will either be fit or not,” explains military lawyer Anastasiya Volodenkova.

If a person disagrees with the decision of the military medical commission on fitness or unfitness for service, with a clear list of diagnoses, it will also be easier for lawyers to determine and prove whether the decision of the commission was legitimate.

Among the positive innovations, the lawyer emphasizes the possibility of undergoing a control MME in another medical institution in case of appealing the decision of the previous medical institution.

Volodenkova also notes that along with the abolition of the limited fitness status, the Ministry of Defense still left out an intermediate position. “That’s the subcategory ‘fit for service in military support units, Territorial centers of recruitment, higher education institutions, training centers, institutions, medical units, logistics, communications, operational support, and security units.’ Here, again, we have clear diagnoses. It’s not like before, when those limitedly fit for service ended up serving in the Special Forces for some reason,” the expert adds.

With the elimination of this category, those who were previously limitedly fit are now exclusively fit or unfit. Volodenkova believes it is important that soldiers with amputations or severe contusions, who were previously recognized as limitedly fit, are now unfit and can resign from service.

At the same time, conscripts with a wider range of illnesses will now be fit for service. Unfortunately, this will have a serious impact on the combat capability of the units, says military medic Ruslan Dobrovolsky.

“There are soldiers among us who are unable to perform military tasks in full due to old injuries. And because the medical service has to provide assistance to the entire battalion, it actually reduces its combat capability,” he said in a comment to Zaborona.

But due to the catastrophic shortage of people, they have to continue serving as long as they are able in their health condition. And it is clear that, along with reducing corruption risks, the changes introduced by the Ministry of Defense are intended to increase the number of soldiers, but in fact, such replenishment will not be of high quality.

“We spent four months in Chasiv Yar, where we had to walk through ditches with water and cross swamps in winter,” says the soldier. “Even the physically fit could barely make a couple of kilometers, not to mention someone who’s sick. Sick people at the front can pose a threat to themselves and others. If something happens to a person on a mission, in the very least they will become a burden to their comrades. And if they take wrong actions, it can endanger the lives of others.”

Mobilization plan

The doctor is convinced that the mobilization plan should be implemented not by recruiting patients, but by motivating people with payments and social guarantees, which is not yet being done.

“Everything is good on TV, they say that payments will be raised. We were also supposed to be paid 100 thousand hryvnias for performing tasks in the combat zone, in Chasiv Yar. But we were paid the standard 30 thousand, because, as it turned out, we were three kilometers from the front line, and this is no longer considered a combat zone. Although artillery is still firing at you there, as well as the gliding bombs. And while officials in Kyiv are paying themselves millions in salaries, those who are defending them, risking their own lives, are paid a minimum. This is the injustice that pushes people away from joining the army. If this were corrected, if people felt that the state would take care of them both at the front and afterward, it could motivate them,” says military medic Ruslan Dobrovolsky.