Determining Work Capacity
For people experiencing disability the first step in the journey towards meaningful work involves administrative procedures of assessing disability and determining work capacity. These assessments constitute the ‘gateway’ to work for people with impairmen
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For many people who experience disability one of the first steps towards meaningful work involves undergoing an administrative determination (or evaluation), often by a panel of physicians, of the extent of their capacity to fulfil the requirements of a job. A person who has acquired impairments, either through injury or through the onset of a disease or other health condition, may in many local jurisdictions be able to benefit from a worker’s compensation scheme, a public social protection or social security provision, or some form of private insurance that sets out the terms and conditions for ‘return to work’. To avoid confusion, the term ‘impairment’ will be used here to refer to decrements in functioning across domains of basic body functions and structures, as well as the resulting limitations in an individual’s intrinsic capacity to perform actions. Impairments are limitations caused by the intrinsic biological and psychological state of individuals. In contrast, the term ‘disability’ will be used to identify decrements in the actual achievement of participation in major life activities—family, home and community life, education and employment, social and political participation, among others—in the way, and to the degree, that the individual wishes. Disability so understood is the result of physical, human-built, attitudinal and social
J. E. Bickenbach (*) Faculty of Humanities and Social Sciences, University of Lucerne, Luzern, Switzerland e-mail: [email protected] © The Author(s) 2020 S. L. Fielden et al. (eds.), The Palgrave Handbook of Disability at Work, https://doi.org/10.1007/978-3-030-42966-9_4
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environmental barriers that limit participation by a person with impairments (cf. Stucki et al. 2017; World Health Organization [WHO] 2001). If the individual has a congenital sensory, cognitive or developmental impairment, she or he may benefit from relevant employment supports and services to enter the workforce. In all these examples, at some point the person will undergo both a preliminary (often purely medical) assessment of disability followed by a determination of their ‘capacity to work’. Most commonly, disability assessment is linked to social security benefits, but it also is the opening step in a series of processes that determine eligibility for a wide range of entitlements—from social pensions and income support, to social assistance in cash and in kind, as well as to specific services such as vocational rehabilitation services, home care and the provision of assistive devices and technology. When disability assessment is the first step towards a work capacity determination the process is primarily a legal and administrative matter, governed by the eligibility requirements under legislation or the contractual provisions of the insurance policy. But increasingly disability assessment and the determination of capacity to work have been seen as human rights issues (WHO/ World Bank 2015). If the assessment procedure violates standards of procedural fairness,
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