“Za Istinata” is republishing a report by Emilia Dimitrova from Sevlievo-online.
More than 20% of the population of Gabrovo region receives monthly financial support for people with disabilities, according to an analysis by the Institute for Market Economics (IME). This is one of the highest shares in Bulgaria, comparable only with the situation in Silistra, Vratsa, Vidin and Kardzhali.
Behind this figure lies not only a medical assessment, but access to an entire system of pensions, benefits and preferential schemes – from disability pensions and personal assistance to free road-vignette exemptions and tax relief.
The IME analysis shows that this system has expanded rapidly in recent years, and not evenly across the country. In some parts of Bulgaria, beneficiaries of disability support account for just 7–8 per thousand people, while in others the figure is three to four times higher.
Gabrovo is among the regions where the system has the most visible impact – not so much because its population is necessarily less healthy, but because of a combination of ageing, limited labour-market opportunities and expanding support mechanisms.
A system growing faster than the people who depend on it
Census data from 2021 show that around 655,000 people in Bulgaria, or approximately one in ten, had a decision issued by a medical expert commission assessing disability. The actual number is likely to be higher because more than 190,000 people did not answer the relevant census question, according to the IME analysis.
Every year, expert commissions issue around 270,000 new decisions. The most common diagnoses are related to cardiovascular diseases and complications from diabetes.
The strongest trend, however, is not among the people but in spending.
The number of disability pensioners increased by only 4% between 2019 and 2024, from around 509,000 to 528,000. Over the same period, however, spending on disability pensions increased by 165%, from €0.9 billion to €2.3 billion a year.
In other words, the system is expanding less because there are more people with disabilities than because the amounts being paid out have risen sharply.
The average disability pension for general illness more than doubled, from €137 to €329 a month.
The Personal Assistance Act has also expanded rapidly. The number of users rose from 15,000 when the scheme was introduced in 2019 to more than 94,000 in 2025, while the budget increased from €9.6 million to €642 million over the same period.
This has made personal assistance one of the largest expenditure items in Bulgaria’s disability policies.
Yet labour-market integration remains a major weakness.
Only between 4% of disability pension recipients in different regions – in Gabrovo the figure is 4%, compared with 7% in Sliven – have taken part in subsidised employment programmes over the past six years.
Nearly 60% of those participants were employed in just 10 types of positions, most often as cleaners, general workers or technical assistants.
The employment gap between people with and without disabilities in Bulgaria is more than 33 percentage points. In the best-performing EU countries, it is below 15 percentage points.
Where people live matters
Where a person lives is a strong factor in whether they receive a disability pension.
In 2024, the number of beneficiaries ranged from just seven per thousand people in Burgas to 30 per thousand in Silistra – a difference of more than four times.
The highest rates are found primarily in northern Bulgaria and the northwest, while lower rates are recorded along the Black Sea coast and in the southwestern parts of the country.
Demographics, particularly population ageing, explain part of the picture, but not all of it.
The authors note that regions with similarly ageing populations have substantially different disability rates. A stronger correlation exists with unemployment and the condition of the local labour market.
Gabrovo in the national picture
In 2024, Gabrovo ranked third in Bulgaria in the number of disability pension recipients relative to its population, with 22 per thousand people. It was behind Silistra, with 30 per thousand, and Vratsa, with 27, and slightly ahead of Razgrad, with 20.
The national average was around 7–9 per thousand.
Gabrovo is also one of Bulgaria’s oldest regions in demographic terms, alongside Vidin, Smolyan and Silistra.
The analysis explicitly points out, however, that these four regions have “huge differences” in the share of people with disabilities despite their similar age structures. This shifts attention towards economic rather than purely demographic factors.
Gabrovo is one of only five regions in Bulgaria – together with Silistra, Vratsa, Kardzhali and Vidin – where more than one-fifth of the population receives monthly financial support under the People with Disabilities Act.
At municipal level, the analysis specifically identifies the “area around Gabrovo” as one of several clearly defined clusters with a high share of people receiving support, alongside Silistra region, northwestern Bulgaria and the areas around Kardzhali and Kyustendil.
Gabrovo and Sevlievo municipalities are also among those with the highest relative numbers of free annual road-vignette exemptions for people with disabilities – between 70 and 80 per thousand residents. That places them among the leading municipalities in Bulgaria on this indicator, alongside Alfatar, Mezdra, Vratsa, Krivodol, Roman, Troyan and Kovachevtsi.
A weak spot in active labour-market policies
This is perhaps the sharpest contrast.
While Gabrovo ranks among the “heavy” regions in terms of dependence on disability support, it is at the bottom when it comes to participation in active labour-market policies.
Only 1.1% of disability pension recipients in the region took part in the National Employment and Training Programme for People with Permanent Disabilities over the six-year period from 2019 to 2024.
That is one of the lowest shares in the country, comparable only with Kardzhali at 0.9% and far below the leaders, such as Sliven at 7.4% and Montana at 6%.
In short, Gabrovo is a region with a high concentration of disability pensions, a high share of people receiving support under the People with Disabilities Act and a significant number of beneficiaries of preferential schemes – but with almost no active policy aimed at bringing people with disabilities back into the labour market.
The authors of the analysis do not claim that the higher disability rates in regions such as Gabrovo are the result of abuse of the system.
Their conclusion is rather that where economic opportunities are limited and the population is older, the system of medical assessment and social transfers ends up performing functions that extend beyond a purely medical assessment of a person’s health.
The IME therefore recommends better coordination between institutions such as the National Social Security Institute, the Social Assistance Agency and the Employment Agency; a stronger focus on active labour-market policies; and more regular monitoring of the fiscal impact of rapidly expanding mechanisms such as personal assistance.
Put simply, the recommendation is to combine adequate support for people with genuine limitations with much stronger efforts to integrate them into working life and the economy, rather than relying primarily on pensions and benefits.
