Disability Evaluation
What are Disability Evaluations?
Disability is a mental or physical impairment that considerably limits an individual’s ability to function in day-to-day activities of life. Disability/impairment can occur as a result of injury, illness, or disease. There are many types of disabilities that can affect an individual, including:
- Movement
- Vision
- Hearing
- Thinking
- Learning
- Communicating
- Remembering
- Mental health
Disability evaluation refers to an examination performed by a certified physician, such as a family physician, to assess the level of an individual’s disability and how it impacts their employment, insurance benefits, and the ability to access required accommodations. Disability evaluations are required for short-term work restrictions following an illness or injury and for more complex cases involving workers' compensation, personal/private disability insurance claims, Family and Medical Leave Act, Social Security Disability Insurance, and Supplemental Security Income.
What are the Dimensions that Disability Involves?
In general, disability has 3 dimensions:
- Impairment in an individual’s body function or structure, or mental functioning; examples of impairments include loss of vision, loss of a limb, or memory loss
- Activity limitations, including difficulty walking, hearing, seeing, or problem-solving
- Participation restrictions in day-to-day activities, such as working, participating in social and recreational activities, and securing health care and preventive services
Disability can be:
- Connected to conditions that are congenital (present at birth) and may impact functions later in life, including mobility, vision, hearing, behavior, cognition (memory, learning, and understanding), and other areas.
- Related to developmental conditions that become clear during childhood (for instance, ADHD or attention-deficit/hyperactivity disorder and autism spectrum disorder).
- Associated with an injury (for instance, spinal cord injury or traumatic brain injury).
- Connected to a longstanding disease (for instance, diabetes) that can cause a disability, such as nerve damage, vision loss, or limb loss.
- Progressive (for instance, muscular dystrophy), static (for instance, limb loss), or intermittent (for instance, some forms of multiple sclerosis).
What Does Disability Evaluation Involve?
Physicians, especially physiatrists, are acknowledged as experts in the evaluation of disability and making assessments with respect to the extent of losses, appropriateness of work activities, and necessity of benefits and services for patients. Using a stepwise approach based on awareness of the social, psychological, and biological elements of disability assessment may facilitate this evaluation.
- Step 1 establishes the role of the physician in the process of disability evaluation and the context of the request.
- In step 2, the physician assesses impairments and establishes a diagnosis based on findings from an examination and validated diagnostic tools.
- In Step 3, the physician identifies specific participation restrictions by assessing the patient's ability to perform specific movements or activities and reviewing the employment environment and tasks.
- Steps 4 and 5 ensure proper documentation, billing, and coding.
In complex cases, consultants such as physical therapists and psychiatrists may help by providing insight into an individual’s physical and mental impairments, activity restrictions, and response to treatment.
Summary
Disability evaluation is often referred to as an independent psychiatric examination that can be requested by government institutions, insurance agencies, employers, or either party in litigation. The purpose of such reports is to assist them in deciding the course of action such as providing healthcare benefits or arranging damages and workplace accommodations.
