Thursday, June 28, 2012

A Closer Look at Defining Disability

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By: James Crew, Programs Intern

There are many different ways with which to approach a definition of disability. My awareness of these differing definitions and their implications comes from my work as the programs intern at the Greater Carolinas Chapter and my personal experience(s) attempting to navigate the relationship between Multiple Sclerosis and Social Security Disability Insurance (SSDI). With that in mind, perhaps the most accessible definition is found using the statistical approach.  This is the “formula” used when calculating national and global statistics of “disabled persons.”  For example, when we hear a television or radio program say “according to:” this is the definition being used.

This definition tells us that one out of ten Americans report having a disability.  This figure represents non-institutionalized individuals of all genders, all races and ethnicities, with all education levels in the United States (ACS, 2009).  In order to determine these figures, the American Community Survey (ACS) uses these six questions: 
1. Is this person deaf or does he/she have serious difficult hearing?
2. Is this person blind or does he/she have difficulty seeing even when wearing                          glasses?
3. Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions?
4. Does this person have serious difficultly walking or climbing stairs?
5. Does this person have difficulty dressing or bathing?
6. Because of a physical, mental, or emotional condition, does this person have difficulty doing errands alone such as visiting a doctor’s office or shopping?
Using this formula, a person is coded as having disability/disabled if they answer “yes” for one or more of these six categories.  The social security administration uses a similar series of questions, along with a medical examination, to decide whether individuals are considered disabled.  Their formula says that 8,100,000 individuals in the US (3% of the total population) are disabled.
These figures give an understanding of the quantity of disability in the US, but do they allow us to clearly define what disability is?  In the framework of a socio-political definition: no.  This perspective requires that we broaden our point of view to include the full experience of individuals who were counted as “disabled” using the formula(s) above.
The socio-political perspective requires that disability be approached as a social construct. Essentially, this means that the significance and experience of disabilities/impairments are shaped by how the able-bodied majority views individuals with disability.  This is usually a definition that is based on what the individual can or cannot do. It is this false dichotomy that resonates through society and structures much of the SSDI system, which does not bode well for those individuals whose disabilities and lifestyle do not fit into the cookie-cutter mold of “disabled.”

In practice, this closed view results in a surprising number of denied benefits.

A Social Security Disability denial occurs over 65% of the time with initial claims and up to 85% at the reconsideration appeal level. The later stage denials at the hearing level through Federal court may vary from 15% to over 80%. The Social Security Disability denial and award statistics change in relation to individual states, hearing offices, judges and disability claim adjudicators.

Conversely, the socio-political definition encourages a definition that moves closer to an understanding of disability.  This perspective suggests that in order to fully understand/define disability, we need to consider the ways in which society in general imposes restrictions.  These restrictions are often imposed on the same tasks that are used to define an individual as disabled. 
Perhaps what is needed to more fully integrate a working definition of disability into our lives is to move away from defining a person by what they “can’t do.” When we can step away from this specific marker for disability and begin to search for definitions that include the full experience of what it is to suffer disability, hopefully we can move towards a more truthful appreciation of the experience. 
What are your thoughts on this matter? We encourage you to share your stories, opinions, and questions in the comments section. 

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