Definition and Overview

Disability evaluation is the assessment of the disability, especially its extent and impact on the quality of life of the person, in order for relevant stakeholders such as the government and physicians to provide assistance or interventions, whenever necessary.

Disability should not be confused with impairment. Impairment is described as the significant deviation or loss of function, whether it is physical or mental. Disability, meanwhile, refers to the effect of such impairment of a person. This simply means that impairment doesn’t always result in disability. Many people with impairments can function normally.

To be assessed as disabled, the impairment must be so profound that it significantly limits the movements and senses of a person. It must also significantly reduce the quality of life or increases the risk of mortality when compared to the general population. The disability may also be classified as either long term or short term, as well as temporary or permanent, or partial and total.

Disability may also be sudden, such as when a person meets an accident that results in a very serious injury, or chronic or degenerative diseases (e.g., Alzheimer’s disease). People with disabilities may require consistent and continuing services to allow them to receive the right treatment, access to good doctors, and better chances of improving life quality, among others.

Who Should Undergo and Expected Results

A person who is believed or has been diagnosed with impairment should undergo a disability evaluation or assessment. The impairment is not limited to the physical function of a person but also includes psychological, mental, or social, as in the case of people who have mental disorders such as depression or schizophrenia.

People who have been diagnosed with a chronic disease or have gone through a significant injury such as a fracture or a brain injury should also seek disability evaluation. These conditions may progress over time, or the side effects of treatment may continue to be pronounced long after the medical intervention is completed, which may decrease the quality of life or increase the risk of mortality.

Disability evaluation is also necessary for those who want to take advantage of the different services offered by healthcare facilities such as hospitals and rehabilitation centers, as well as government programs including Social Security. The evaluation will be one of the bases for determining whether the person is entitled to a claim and how much can be claimed. As the government has various disability programs, the evaluation can also be helpful in matching the person with the most appropriate intervention or service.

An evaluation doesn’t need to always result in a disability finding. However, it can also be used to monitor the condition of the person, whether he’s improving, or the condition is worsening. Only licensed health care professionals and health care personnel recognized or appointed by the government with adequate training will be allowed to conduct a disability evaluation.

Specifically, those who are performing the evaluation under Social Security should have a deep understanding of the different disability programs of Social Security Administration, particularly those disabilities that are within the listing of impairments.

How Does the Procedure Work?

There are different guidelines used in evaluating disability depending on the program. For example, under the Social Security Administration, the health care professional will base the assessment on medical evidence, which may be provided by the claimant or the person with disability, hospitals, clinics, and other healthcare facilities. In the case of children, school records may also be obtained. Attending physicians will also give the agency the required medical documents.

The agency may also accept medical evidence from other sources such as the testimonies of caregivers, employers, colleagues at work, social workers, parents, and experts in the field who may not have directly worked on the person with impairment.

Medical reports of the person may include laboratory findings, clinical results, and medical history. Since the main goal is to determine the extent of the impact of the impairment in the person’s life, the claimant may also be required to submit a statement telling how the impairment affects his daily activities or overall function.

In terms of making a Social Security claim, the process includes:

  • The person with impairment submits an application to obtain a disability benefit, which can be accomplished online, by mail, or by telephone.

  • The application is then verified for eligibility by the field office. If it qualifies, the application is forwarded to the Disability Determination Services, which then performs the evaluation using medical evidence. It is also responsible for seeking more proof of the person’s disability if the documents provided by the claimant are insufficient. These include a consultative examination, wherein the patient may be referred to an independent expert (a physician or a health care professional) who will perform the consultation.

  • If the claimant is assessed to be disabled, the application is returned to the Social Security Administration, who then undertakes the necessary action including paying the appropriate benefits.

In terms of assessing a child’s disability, the procedure may include:

The parent or the school requests for the assessment based on the IDEA (Individuals with Disabilities Education Act). If it’s the school that requests the evaluation, it should provide a prior written notice to the parent, and the parent must give consent. The evaluation should be conducted within the next 60 days after the parents’ consent. Under IDEA, the child may be evaluated in terms of academic performance, health, hearing, vision, social status, emotional well-being, motor abilities, and communicative status.

Possible Risks and Complications

The evaluation process can be time-consuming and stressful. Further, the outcomes of the evaluation may not always be favorable. This simply means that a person who’s trying to claim a benefit from Social Security may not get it, especially if he doesn’t fit the pre-determined criteria or definition of disability. Nevertheless, these types of programs usually provide adequate time for appeal or resubmission of the application in the future.

Reference:

  • Council for Disability Awareness: "Preparing for Disability: Financial Impact," "CDA 2010 Consumer Disability Awareness Survey: Disability Divide," "Chances of Disability," " CDA Research and White Papers."
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