Disabled persons may range from those who are completely invalid (as demonstrated
by the fact that they are bed-fast, chair-fast, or require considerable help in locomotion)
to persons who are feasible sujects for vocational rehabilitation. Persons with paraplegic,
hemiplegia, or serious othopedic crippling conditions could be considered completely
invalid. Another group, although partially ambulant, are quite limited in activity;
these might include persons with moderately severe coronary disease with poor prognosis,
far advanced cancer patients, etc.
Medical, psychological, social, educational and occupational factors are very important
in determining whether or not a disability is a complete occupational handicap for
a specific individual. Two persons with the same permanent disability may, because
of variations in education, vocational experience or skills, emotional stability,
and native intelligence and adaptability, show entirely different reactions to the
disability and to the problem of continuing a useful occupation. It is essential,
therefore, that such factors be evaluated and considered in determining whether the
applicant is permanently and totally disabled as defined.
In many cases, no decision as to total disability can be made without such social
data as will describe the individual's education and work history, the activities
required of him in his home or in his job, living and working conditions, interests,
native capacities and extent to which he has adjusted to the loss he has sustained.
The nature of the social data must provide a base to make it possible to relate the
medical findings to the types of activity the individual is competent to perform.
As an example of the effect of a permanent disability, consider the permanent loss
of use of an arm. An unskilled, semi-literate laborer, age 55, would be completely
handicapped for return to his former occupation of manual labor. Because of his lack
of education and his age, the possibility of his adjustment to any other type of work
is very slight and probably he should be considered totally disabled. An attorney
with the same disability, however, would not be handicapped for his regular occupation
but could continue the practice of law. Therefore, he would not be considered eligible
for AABD(D) on the basis of loss of an arm.
A bed-fast or chair-fast individual might become wholly or partially self-supporting
if his intelligence and education made it possible for him to operate a small business