An individual is permanently and totally disabled when he has a permanent impairment, disease or loss which substantially precludes him from engaging in any locally existent useful occupation within his competence, including homemaking.

The impairment must be verifiable by medical findings and be unlikely to improve throughout the person's lifetime. It may be considered permanent so long as treatment is unavailable, inadvisable, ineffectual, or the individual refuses treatment for reasons acceptable to the agency.

Permanence does not rule out the possibility of vocational rehabilitation or even recovery from the impairment. However, pending the actual physical improvement the classification is proper.

The degree of disability is determined by measuring the effect of the impairment on the individual's ability to function. The impairment must be of major importance and of such degree as to interfere with the individual's faculties, such as senses, reasoning, and mobility. Determining “totality” requires consideration of such factors as the following:

The individual must be “substantially precluded” from carrying out the responsibilities of employment or homemaking regularly or on a predictable basis. In determining this, such factors as the following are important:

1. a. 

   Dependence on help from others in functioning. For example, can he function in spite of his disability only because other persons in or outside the home assist him?

2. b. 

   Energy required to function. For example does, it take him six or seven hours to do what most workers can do in one hour.

Can the individual function in any occupation which produces goods or services for which the public is willing to pay? Activities not considered “useful occupations” are:

1. a. 

   Hobbies or occupational therapy prescribed by a physician for remedial purposes.

2. b. 

   Activity which does not provide a genuine job opportunity, (i.e., if the individual stopped doing it no one would be hired to replace him), and

3. c. 

   The “training” portion of a supervised rehabilitation program.

Homemaking is considered a useful occupation. It involves ability to carry the home management and decision making responsibilities, and providing essential services within the home for at least one person in addition to one's self. (An individual living alone cannot be evaluated for ability to engage in homemaking.)

Important to the successful performance of homemaking are shopping for food and supplies, planning and preparing meals, house cleaning activities, washing and ironing clothes, child care activities and miscellaneous tasks created by the individual's setting, (e.g., carrying water when there is no indoor source of supply, making fires, carrying fuel, etc.)

A homemaker is considered permanently and totally disabled if:

1. a. 

   She can perform all of the essential services but not for the required number of hours that may be involved. For example, she may be able to prepare breakfast after resting all night but is unable to get the other two meals, or

2. b. 

   She cannot perform the service on predictable basis, (e.g., she can shop when there is remission of pain or swelling but it cannot be known when these remissions will occur), or

3. c. 

   she is unable to perform a significant combination of the essential activities.

“Locally Existent Occupation” is one which exists anywhere in D.C. In the sense of the definition it means there is no such work anywhere in D.C. as that which the individual has been found physically able and competent to do. Do not confuse it with the individual's inability to find work within his competence and physical limitations.