“Permanently” refers to a condition which is not likely to improve or which will continue throughout the lifetime of the individual; it may be a condition which is not likely to respond to any known therapeutic procedures, or a condition which is likely to remain static or become worse unless certain therapeutic measures are carried out, where treatment is unavailable, inadvisable, or is refused by the individual on a reasonable basis; “permanently” does not rule out the possibility of vocational rehabilitation or even possible recovery in light of future medical advances or changed prognosis; in this sense the term refers to a condition which continues indefinitely, as distinct from one which is temporary or transient.

Totality of impairment is defined to mean that the individual has a physical and/or functional disability which substantially precludes him from:

1. a. 

   Engaging in a useful occupation existing in the community, such employment to be on a regular and predictable basis.

2. b. 

   Performing the essentials of homemaking for self and at least one other person.

The individual is measured against his usual role as indicated by the pattern in existence at the time of the eligibility determination. If the client has carried both roles—breadwinner and homemaker—he will be measured against his ability to function in his actual role at the time of application.

Totality is primarily determined from the content of the social study report which must reflect such factors as the applicant's age, education, work history, marital history, living conditions, health, and quality of interpersonal relationships.

These will reflect how this disability affects this person as well as providing indicators regarding the person's ability to function in the light of his permanent impairment.

A useful occupation is one which if the individual were not performing on it, would require a replacement. It must constitute the production of goods or services to which the public attaches a money value and for which there must be a demand in the community. The following are examples of activities that would not be considered useful occupations:

1. a. 

   A job that is made for an individual out of sympathy or compassion, or which he is able to perform only because others provide more assistance or supervision than would be characteristic of a bona fide employment situation, or a market for his goods or services is created more on sympathy than intrinsic value received.

2. b. 

   A job that is part of occupational therapy prescribed and supervised by a physician.

3. c. 

   An activity which is in the nature of a hobby and does not provide a bona fide job opportunity from the standpoint of genuine economic demand and remuneration.

4. d. 

   Activity while it is in a part of an active Vocational Rehabilitation program constituting training and supervised by a rehabilitation agency.

An individual does not meet the test of totality with respect to homemaking if he is found able to perform without substantial assistance the essential elements of the following activities in homemaking for at least one person in addition to himself:

1. a. 

   shopping for food and supplies.

2. b. 

   preparing meals and washing dishes.

3. c. 

   washing and ironing clothes.

4. d. 

   decision making and direction of household management and if children are present, general supervision over them.

Exists in the Community—Exists in the community means that work exists in the immediate area. If the kind of work for which the individual has competence does not exist within the community but does exist elsewhere in the state, consideration will be given to the individual's previous living habits. Consideration will also be given to what is medically and socially desirable in the light of the individual's disability. If the individual has previously moved his family about or has maintained himself separately from his family as necessitated by the nature of his employment, he would be expected to follow the same pattern unless his disability were of the type to interfere with such a pattern.