The Dynamics of Disability Measuring and Monitoring Disability for Social Security Programs (2002) / Chapter Skim
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3. Conceptual Issues in Defining Work Disability
3. Conceptual Issues in Defining Work Disability
Pages 53-64
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From page 53... ...
disability programs the inability to engage in any substantial gainful activity because of physical or mental impairments that are medically determinable. However, in orals to place the concept of work disability in perspective, first, definitions of disability are examined in a wider context.
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From page 54... ...
; and variations from other authors in many different contexts (Patrick and Peach, 1989; Verbrugge and lette, 1994~. While each of these models suggests a theoretical definition of disability, none offers a detailed operational definition, although the extensive classification system of the ICE permits multiple coding for individuals.
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From page 55... ...
In the Social Security disability programs, the benefits are quite valuable, whereas the resources devoted to screening applicants are limited in relationship to the demand for benefits. As the statutory definition makes clear, a person is considered "work disabled" based on the existence of a medical impairment or injury that precludes substantial gainful activity (SGA)
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From page 56... ...
In addition to benefit programs, the other main purpose of disability definitions that is most relevant to this report is in the field of surveys that have their own space and time constraints. The broad conceptual definitions are necessarily shortened, and particular portions emphasized, as survey personnel seek to fit their questions into the prescribed few lines or few minutes of time.
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From page 57... ...
, disability is the expression of a physical or a mental limitation in a social context. En striking contrast to He SSA's definition of work disability as inability to work as a consequence of a physical or mental impairment, Nagi specifically views the concept of disability as representing the gap between a person's capabilities and the demands created by the social and physical environment (Nag)
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From page 58... ...
Within the dimension of disability however, they categorized subdimensions of social roles that can be considered under Nagi's concept of disability. Some of the most commonly applied dimensions include activities of daily living, instrumental activities of daily living, paid and unpaid role activities, social activities, and leisure activities.
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From page 59... ...
The onset of a specific health condition- for example, a stroke or a back injury may or may not lead to actual limitation in performing the work role a work disability. The development of work disability will depend, in part, on the extent to which the health condition limits the individual's ability to perform specific tasks that are part of one's occupation, and alternatively, the degree of work disability may depend on external factors, for example, workplace attitudes, such as flexible working hours, that may restrict employment opportunities for persons with specific heal~hrelated limitations.
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From page 60... ...
More recent disablement formulations or elaborations of earlier models have explicitly acknowledged that the disablement process is far more complex (IOM, 1991, 1997b; Verbrugge and Jette, 1994; Badley, 1995; WHO, 1997, 2001; Fougeyrollas, 1998~. These more recent studies note that a given disablement process may lead to further downward spiraling consequences.
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From page 61... ...
Establishing whether a person is capable of performing past relevant work or any type of substantial gainful activity in the national economy is part of the disability decision process. SSA has been using the Department of Labor's (DOL's)
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While each of these models suggests a theoretical definition of disability, none offers a detailed operational definition. All definitions agree, however, in viewing disability as an intersection between the indig l
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Recommendation 3-1: The committee recommends that the Social Security Administration develop systematic approaches to incorporate economic, social, and physical environmental factors in the disability determination process by conducting research on q
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From page 64... ...
As this chapter has shown' a full understanding of work disability needs to take into account the individual's circumstances and me social and physical environment of the workplace. The research challenge is to apply the insights provided by the current models of disability to come to a common understanding of work disability concepts, and to understand the dynamics of the pathway between health conditions and work disability.
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