The paradox of disability.

نویسنده

E W Johnson

چکیده

But other definitions are sharper, e.g. impairment is a physiologic or anatomic dysfunction which is easily measured identically from person to person. Disability, then, becomes the result of that impairment on the individual with all of the personal characteristics including age, co-morbid conditions, education, experience, etc. Handicap adds the environment to the mix. This involves the job market, physical environment, the local prejudices, and other obstacles. Before including the term disability in any authoritative paper, it must be defined. In its most commonly used context! disability is a synonym for lost function. Unfortunately, this can be perceived much differently by the injured worker than by the employer a circumstance which inevitably leads to conflict. Even more egregious is the variation in evaluations by physicians. Some years ago, I organized a 1-day seminar for specialists to assess disability for a state agency. I asked four different medical experts to evaluate the same patient a low back injury of 6 months duration. One participant came up with 'no impairment', another with '20%', yet another with '40%', and the final appraisal suggested that the injured person deserved permanent total disability! In the post-session discussion, an attendee pointed out that this described patient if a professional football player could play linebacker for the Chicago Bears but if examined by another expert would be in 'intensive care' awaiting exodus. Why are these appraisals so disparate? My punditic responses:

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