NELK is a state medical authority in Bulgaria. It reviews complaints and appeals against decisions issued by the Territorial Expert Medical Commissions (TELK).

TELK and NELK determine:

• the existence of disability;

• the degree and type of loss of work capacity.

📌 In Bulgaria, there are 71 TELK commissions, while NELK is one nationwide body.

All medical documents are first submitted through the Regional Medical Archives (RKME) and are then forwarded to NELK if necessary.

Procedure and required documents

The examination starts with your General Practitioner (GP)

The GP:

• determines which tests, examinations, and specialist consultations are required;

• issues a medical referral to TELK.

With the referral, you apply to TELK

• The commission is located according to your place of residence.

• If you disagree with the TELK decision, you may file an appeal to NELK.

If you cannot attend in person (limited mobility)

If, for medical reasons, you:

• cannot move independently;

• are staying at home or in hospital,

➡️ the commission may conduct the examination at home or in hospital.

This requires:

• a medical certificate from the treating physician
  or

• a referral from your GP.

TELK visits patients within its territorial region.
NELK may conduct visits throughout Bulgaria.

Is payment required for documents and examinations?

If you are insured:

• examinations and consultations are free of charge;

• the TELK/NELK decision is issued free of charge.

If you are not insured:

• examinations and consultations are paid by the patient;

• the commission’s decision itself is free of charge.

Timeframes for issuing decisions

You receive the TELK decision:

• on the day of the examination
  or

• by post with delivery confirmation.

Review of documents by TELK or NELK takes up to 3 months from the submission of the complete set of documents.

ℹ️ Specialized commissions (ophthalmology, psychiatry, pulmonology) have been abolished.
Such cases are now reviewed by standard TELK commissions with the participation of relevant medical consultants.

Do you need to collect the decision in person?

Yes.

The TELK or NELK decision may be received:

• personally
  or

• by an authorized representative with a notarized power of attorney.

How to appeal a NELK decision?

NELK decisions may be appealed before the Administrative Court based on:

• permanent address
  or

• current place of residence.

Appeals may be filed by:

• the patient;

• social and insurance institutions;

• state authorities.

The procedure is governed by the Administrative Procedure Code of Bulgaria.

Planned changes to the TELK and NELK system

Future reforms aim to make the system clearer and more accessible:

• For children and pensioners, disability degree will be determined instead of percentage of loss of work capacity.

• Improvement and simplification of the medical assessment process.

• Possible transition of all TELK commissions to a single state administration, similar to NELK, in order to ensure:

  • unified standards;

  • transparent funding;

  • equal working conditions;

  • prevention of corruption and conflicts of interest.