Defining Disability

There are varying definitions of the term disability, depending on the context in which it is used. These contexts can range from legal proceedings and legislative perspectives to international agreements, corporate policies and union provisions. The definitions are relative – and still evolving.

In simple terms, disability is anything that impairs a person’s ability to perform day-to-day activities. Some disabilities, that is, they result from the genetic material a person inherits. They may also be acquired through accidents on and off the job, illnesses or chronic conditions. Some disabilities are visible, while other such as depression and other forms of mental illness are invisible. They may be temporary (as with a leg or arm fracture) or permanent.

The World Health Organization defines disability as follows:

Disability is an umbrella term for impairments, activity limitations and participation restrictions. It denotes the negative aspects of the interaction between an individual (with a health condition) and that individual’s contextual factors (environmental and personal factors).

The World Health Organization, in its International Classification of Functioning (ICF), Disability and Health publication, takes the notion of disability a step further by integrating both the medical and social aspects of disability.

The medical model view disability as a problem of the person, directly caused by disease, trauma or other health condition, which requires medical care provided in the form of individual treatment by professionals. Management of the disability is aimed at cure or the individual’s  adjustment and behaviour change. Medical care is viewed as the main issues, and at the political level, the principal response is that of modifying or reforming health care policy.

The social model of disability, on the other hand, sees the issue mainly as a socially created problem, and basically as a matter of the full integration of individuals into society. Disability is not an attribute of an individual, but rather a complex collection of conditions, many of which are created by the social environment. Hence the management of the condition requires social action, and it is the collective responsibility of society at large to make the environmental modifications necessary for the full participation of persons with disabilities in all areas of social life. The issues is therefore an attitudinal or ideological one requiring social change, which at the political level becomes a question of human rights. For this model disability is a political issue.

The ICF is based on an integration of these two opposing models. In order to capture the integration of the various perspectives of functioning, a “biopsychosocial” approach is used. Thus, ICF attempts to achieve a synthesis, in order to provide a coherent view of different perspectives of health from a biological, individual and social perspective.

It is important to remember that persons with disabilities are not a homogeneous group. Their limitations may be physical, sensory, intellectual, mental or social. The disability may have been present from birth or acquired at any point throughout their lives. The impact of the disability may be slight, with minimal effect on a person’s ability to work and take part in society or major, requiring considerable support and assistance. Even two individuals with very similar conditions or injuries, may experience considerable differences in recovery time and impact on their activities. Their education/training and working conditions may also affect the extent to which their ability to return to the job is impaired. Hence, disability management processes focus on the individual.

If I had one piece of advice for anyone engaged in disability management it would be to focus on the individual and not the disability. By doing so you will be able to identify individual strengths upon which to build a successful RTW program … A focus on the individual will result in creating an environment that will allow the person to exploit his or her individual strengths.  – Hon. David Vickers, Chair, Regulation and Compliance Commission, International Disability Management Standards Council