Examples of situations:
Moderate hypertension in a person of sixty or more in whom there is impairment due
to the normal aging processes such as vision, hearing, circulation, etc., is probably
more disabling than in a person of forty or younger. A man of 62 may be eligible if
he has impaired vision and hearing with a moderate hypertension becoming progressively
worse, because of the aging process. He would be unable to continue his usual work
as a carpenter, and is not qualified for any light work, or another useful occupation existing in
his community.
An individual is 55 years of age, lives in a rural area, and has always made his living
doing heavy manual labor. He now has developed a heart condition which is sufficiently
severe to prevent him from doing heavy manual labor. He has only a second grade education;
he has no special training or skills. His community offers no employment opportunities
in light work for a person of his competence. Since he has a permanent impairment
(serious heart condition) and no special skills or training to equip him for another
job in his community; and since his community has no jobs for a person with his impairment, skills and
training, he can be considered as being permanently and totally disabled.
The next illustration is an example of a condition that substantially precludes useful
occupation within the person's competence and training. A tubercular whose condition is arrested and who must, due to lack of training, return
to a laborious type of work where he exposes himself to excessive fatigue, dust or
fumes, heat or cold and dampness, may be considered as still incapacitated until he
can be trained to do something else or by job placement qualified to work in a less
hazardous environment, and at work which is not likely to cause a reactivation of
his tuberculosis.
A client who has had major surgery such as an operation on a lung, stomach, back,
etc., may or may not have disability after convalescence. He is, of course, totally
disabled for the period of surgery and convalescence. Convalescence varies depending
on such factors as the duration of a disease process before surgery, the age and general
condition of the patient, the magnitude of the surgical procedure, and complications
following surgery. The determination of disability after the usual surgical convalescence
is an individual problem which is affected by many factors. Most persons can return
to their usual occupation with little, if any, restriction. However, physical factors
which may affect the length of convalescence, other factors such as attitude toward
surgery, the present motivation of the individual, the type work done, etc., affect
the extent of disability. No rule can be laid down stating that a client is or is
not disabled because of a past history of gastrectomy (removal of part of the stomach),
lobectomy (removal of part of the lung), etc. Each case must be evaluated in terms
of all available medical and social information.
When a person has had major surgery, he shall be considered as totally and permanently
disabled if he is physically unable to return to his usual occupation in the foreseeable
future and until by retraining, job placement, or both, he can be placed in some work
compatible with his physical incapacity.
A client with leprosy or uncontrolled epilepsy is considered totally and permanently
disabled.