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| ? WHEN IS A PERSON CONSIDERED DISABLED FOR SOCIAL SECURITY DISABILITY? |
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For Social Security Disability purposes, to be considered disabled a person must have an impairment, either medical, psychological, or psychiatric in nature. The disabled person's impairment must also meet the definition of disability which essentially states that the impairment must be severe enough that it keeps the person from working, and earning above a certain amount, for at least twelve months.
In detail, what does this really mean, as far as the Social Security Administration is concerned?
First, a person's medical records must indicate the presence of an impairment, or several impairments, either physical or mental in nature.
Second, the impairment must be severe enough that it prevents a disabled individual from working, or, if they continue to work, prevents the person from earning more than $900.00 each month. This amount is referred to by the social security administration as SGA, or substantial gainful activity. It is important to note that this amount is before taxes.
Third, the impairment must last at least twelve calendar months, or be projected to last that long.
Therefore, applicants for Social Security Disability should realize the following:
1. A claimant may fit the definition of disability and be considered eligible for Social Security Disability on the basis of one impairment, or on the basis of several impairments. But the condition must be severe enough to significantly affect the ability to work. This means the impairment must last at least twelve months, or be expected to last that long. It also means that while "back conditions" usually fall into the severe category, "wrist and ankle sprains" seldom qualify as severe disabling conditions.
2. A disabled individual may be working when they apply for Social Security Disability, and may continue to work even after they have been approved---as long as they do not earn more than the SGA amount. The SGA amount changes periodically, but currently it is $900.00 per month. It is important to remember this is a gross income amount, i.e. before taxes have been deducted.
3. A person earning more than the SGA amount who applies for Social Security Disability or ssi benefits will, essentially, be denied the same day without having their impairments or medical records even considered. This is referred to as a "technical denial".
The specific answer to Question One, however, is this: in the eyes of the Social Security Disability and ssi programs, a person is considered disabled when:
1. They have a severe impairment that has lasted, or will last, twelve months.
2. They are unable to perform work (work they have done in the past) while earning in excess of $900.00 per month.
3. They are unable to perform other types of work, typically work related to their past work (for example, a car mechanic might be expected to switch to motorcycle engine repair if the job duties are similar enough).
When a Claimant passes this litmus test, they are considered disabled and eligible for Social Security Disability or ssi benefits. |
| ? What is disability? |
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Introduction
It might appear surprising that something apparently as obvious as the meaning of disability should excite controversy. Nonetheless, for many years this question has been the subject of passionate debate. These debates are directly addressed in two Disability KaR projects (cited below) and figure in one way or another throughout all the work done under the Programme. The aim of this section is to outline the findings and to consider why the arguments are important for shaping policies and practices concerned with disability issues in developing countries.
Medical understanding
What most often passes for a 'common sense' understanding of disability is that it is what 'is wrong' with someone. So, 'disabilities' would include blindness, deafness, the various conditions that make it difficult or impossible to walk or to speak, mental illnesses and such things as Down's Syndrome and epilepsy.
Those viewing disability through this medical lens concede that it is unfortunate that many disabled people face social exclusion or poverty but these are seen as the result of the natural functional limitations imposed by their 'disabilities'. Furthermore, as the problem is primarily medical, solutions are generally given over to various caring professionals either to cure, rehabilitate or to protect the individual with a disability. In disability and development these processes usually take place within a charitable context.
Social understanding
The international disability movement (as represented by disabled people's organisations - DPOs) has offered a radical alternative to the medical conception of disability by asserting that people are disadvantaged not by their impairments, but as a result of the limitations imposed on them by attitudinal, social, cultural, economic, and environmental barriers to their participation in society.
'As an individual, I don't have any regret but others underestimate me, they
keep reminding me of what I cannot do.' Young man who had polio,
training to be a horticulturalist in India (Ref. A7) |
Rejecting the idea of abnormality, although not the importance of medical intervention or impairment prevention, this 'social model' understanding points to the normality of impairment within any population.
What is not normal, it is argued, is being discriminated against and socially excluded because of having an impairment. This is what is disabling.
Nothing about us without us!
In the Disability KaR paper The social model of disability, human rights and development (Ref. C1) it is argued that by seeing impairment as an ordinary part of life, and disability as the result of discrimination and exclusion, the social model underpins efforts to move disability from the medicalised, 'special needs' ghetto and into the mainstream of development policies and practices.
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'International Development Targets can only be achieved with the engagement of poor people in the decisions and processes which affect their lives. Human rights are a central part of work to achieve the International Development Targets because they provide a means of empowering all people to make effective decisions about their own lives.' DFID, Realising human rights for poor people, 2001
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The social model has also promoted the idea that disabled people should be actors in their own lives, rather than passive recipients of care or charity. This equates almost exactly to current thinking on a human rights-based approach to development, increasingly adopted by government and international development agencies throughout the world. This is explored in the Disability KaR paper, Disability and a human rights approach to development (Ref. C4). The Disability KaR Programme exemplifies this approach. When disabled people were brought in to manage the Programme, active engagement with Southern DPOs increased. This resulted in a quantum shift in the quality and depth of understanding of disability. The research clearly reflects this.
By projecting disabled people into a leading role in defining and controlling their lives, the social model also offers a powerful device for the liberation of those who remain the poorest of the poor in all countries, both developed and developing.
The model is so powerful because it illuminates the fact that the roots of poverty and powerlessness do not to reside in biology but in society. The former is, for most disabled people, immutable; the latter, through collective action, can be transformed. A human rights approach to development offers both the platform for such societal transformation and a way for disabled people to transform their sense of who they are - from stigmatised objects of care to valued subjects of their own lives. For people who are poor and oppressed this is a key starting point of any meaningful process of social and economic development.
Lessons from gender and development
In the Disability KaR paper Mainstreaming disability in development: Lessons from gender mainstreaming (Ref. C3) it is argued that a social-model conception of disability provides a clear parallel with the Gender and Development paradigm in terms of understanding disability as socially constructed, as resulting from barriers to equal access, as well as from the reality of unequal power relationships across the entire spectrum of development work from policy to practice. As with gender, seeing disability in this way is fundamental to devising effective strategies to tackle the disabling consequences of discrimination and social exclusion.
Trying to capture an illusive concept
Although a social-model conception has helped to change the emphasis of development interventions, uncertainty remains when the term 'disability' is used, as it is often applied to 'impairment', rather than the process of becoming disabled. This is due partly to the dogged persistence of stereotypical assumptions about disability and partly to the different realms (i.e. social welfare, health, impairment prevention) in which the concept is applied. Also, because disability is socially constructed, it has been difficult to capture in a way that allows simple cross-cultural comparisons. This has made international agreement on meaning virtually impossible and, therefore, has undermined attempts to collect uniform statistical information.
Recently the World Health Organization devised new guidelines (the ICF - International Classification of Functioning, Disability and Health) in an attempt to both overcome some of the aforesaid difficulties, and to harmonise the competing models outlined above.
The ICF takes into account the complicated interrelationships between health conditions, personal aspects and negative environmental (in the broadest sense) factors that, it claims, determine the extent of disablement in any given situation. Although it has been widely seen as a definition, the ICF is more of a framework for making different assessments of disability for different purposes. The new ICF has been accepted by the World Bank and many other key development organisations and seems set to become the gold standard for understanding and measuring the extent of disability. However, as pointed out in the Disability KaR paper Is disability really on the development agenda? (Ref. C2), critics have argued that the ICF represents little more than medical model thinking clothed in social model language, particularly as many professionals continue to pay little attention to environmental impacts and focus instead on impairments.
Nonetheless, it is claimed in the ICF that it '… provides an appropriate instrument for the implementation of stated international human rights mandates as well as national legislation.' It remains to be seen whether it will be used in a way that is helpful in the practical business of designing mainstream development policies and practices that break with traditional medical approaches, challenge accepted power relations and seek to promote human rights by bringing disabled people into the heart of their societies.
The question raised above is tackled in the Disability KaR report on data and statistics (Ref. D5). Researchers working with DPOs in Southern Africa on assessing the living conditions of disabled people have in previous studies attempted to operationalise the terminology in the ICF and apply a disability concept that is founded on activity limitations and restrictions in social participation. Their research under Disability KaR was aimed at exploring the mechanisms needed to ensure how these findings can be used in the best interests of disabled people.
Conclusions
Despite the existence of the ICF, disability continues to be a deeply contested concept. The variety of cultural settings in which it is defined and the different purposes to which such definitions are put would be enough to insure this is true. Added to this is the fact that disability, widely recognised as being the result of systematic discrimination, raises difficult and often uncomfortable personal, social and political questions.
So what is disability?
Disagreements over the answer to this question will continue. However, all the work done under the Disability KaR Programme has adopted, in one form or another, a social model understanding of disability as a starting point. This is not only consistent with what the international disability movement has been arguing for decades, but also with the stated policies of an increasing number of multi- and bi-lateral development agencies. |
| ? Disability and poverty? |
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3. Disability and poverty
Introduction
For decades the international disability movement has been saying that disability is a cause of poverty, that poverty often leads to disability and that disabled people are among the poorest of the poor in any country. However, it is only recently that a solid platform has been found from which to advance this argument. This has come about through the promotion of the UN's Millennium Development Goals (MDGs), which have prioritised poverty reduction in developing countries, and the establishment by the World Bank and International Monetary Fund of various new aid instruments and procedures, also built ostensibly around reducing poverty.
Unfortunately, those who constructed this platform did so without making disability part of the framework. Disability is not, for example, explicitly mentioned in any of the eight MDGs or the documentation for the new aid instruments or procedures (see Section 3). It has been left to disabled people's organisations (DPOs) and their allies to campaign to get disability onto the development/poverty agenda.
This process is ongoing and has been considerably facilitated by the World Bank, whose former president was an outspoken disability champion. In 2002 a Disability and Development Team was set up at the Bank. Its members have been proactive in supporting research into disability and poverty and finding ways to get DPOs more involved in Poverty Reduction Strategy Papers, one of the main new aid instruments (see Mainstreaming Disability in Development >>). They have also been pushing hard to get the tackling of disability issues recognised as essential for achieving almost all of the MDGs.
'… disabled people are also more likely than other people to live in grinding poverty. More than 1.3 billion people worldwide struggle to exist on less than [US]$1 a day, and the disabled in their countries live at the bottom of the pile.' James D. Wolfensohn, former president of the World Bank, 2002
The links between poverty and disability figured prominently in the Disability Knowledge and Research Programme. They were a priority issue in all of the many reports by the Disability Policy Officer and the subject of one of the Programme's major research projects.
Disability and poverty: trying to capture illusive concepts
Although the various connections between disability and poverty might appear to be relatively straightforward, the Disability KaR paper Disability, poverty and the 'new' development agenda (Ref. C5), has argued that the linkages are in fact deceptively complicated. The hard statistical evidence is also limited and very sketchy. The report poses some fundamental questions about how the two concepts of disability and poverty are understood and what that understanding means in terms of an analysis of their convoluted interrelationship.
The researchers point out that disability and poverty are highly contested political concepts. Furthermore, because different meanings are used, and there is insufficient care taken to recognise this, commentators are often at cross purposes when debating the issues. For example, disability and impairment are frequently conflated: the latter is confused with how a person with an impairment becomes disabled through complex social processes. As discussed in the Disability KaR paper Data and statistics on disability in developing countries (Ref. D5), this definitional problem is compounded by statistical surveys which invariably fail to '… detach the issue of disability prevalence from an impairment-based approach to disability.' Poverty too throws up similar, and in many respects more multifaceted, uncertainties of meaning.
Why are so many disabled people poor? Why are so many poor people disabled?
Bearing in mind the points made above, the Programme's Policy Officer's country reports on Rwanda, Cambodia and India (Refs A4-6) provide excellent case studies of the social factors that make it more likely that poor people will contract impairments and why people with impairments are likely to become or remain poor.
Disabled people struggle to find employment in all three countries. Having a physical impairment makes it difficult to work in the agricultural sector, which dominates in all the economies. Vocational training opportunities are limited, tend to be in urban areas and are not generally linked to gainful employment. Because they are seen as presenting a high risk, disabled people are also usually denied access to micro-credit schemes.
It was found that in Cambodia poor people tend to live near areas that had been mined, are forced to use more risky means of transport, have more dangerous jobs and cannot access health care so that minor illness or injury can become more permanent impairments. Malnutrition, which makes having a whole range of impairments more likely, is also closely associated with being poor.
However, another Disability KaR report from Cambodia, Developing participatory rural appraisal approaches with disabled people (Ref. B3), found that '…the highest disability (impairment) prevalence rate appears to be in the least isolated village with the best social and economic opportunities, which raised questions about the links between poverty and disability.' This mirrors the way that the prevalence of impairment is significantly higher in the more economically privileged countries of the North and highlights how complex the poverty-disability-poverty question really is.
Disability and social exclusion
The prevention of impairment, through mine clearance, inoculation, better health care and/or nutrition, is vital in developing countries, but needs to be clearly distinguished from interventions aimed at combating the social exclusion and denial of human rights that disable people with impairments.
'Rwandan society places little value on disabled people; they are seen as useless and incapable and are stigmatised and discriminated against.' Country-level research - Rwanda country report (Ref. A5)
The reality and extent of the social exclusion of disabled people is brought out starkly in the three country reports mentioned above, as well as the Policy Officer's final report, Disability, poverty and the Millennium Development Goals (Ref. A7).
Conclusion
On this and related topics, the Disability KaR Programme's research has provided ample evidence of the interconnected and multi-layered symbiotic relationship between poverty, impairment and disability. This is succinctly summed up in the report Disability, poverty and the Millennium Development Goals (Ref. A7):
* Disabled people are typically among the very poorest, they experience poverty more intensely and have fewer opportunities to escape poverty than non-disabled people.
* Disabled people are largely invisible, are ignored and excluded from mainstream development.
* Disability cuts across all societies and groups. The poorest and most marginalised are at the greatest risk of disability. Within the poorest and most marginalised, disabled women, disabled ethnic minorities, disabled members of scheduled castes and tribes, and so on will be the most excluded.
* DFID cannot be said to be working effectively to reduce poverty and tackle social exclusion unless it makes specific efforts to address disability issues. |
| ? How to work with people with disability? |
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Everyone has different levels of contact with people with disability. If you have any concerns or questions about working with a person with disability or would like some tips on things to consider, this guide is for you.
If you are working with a person with mental illness, then you may also be interested in:
* Working with people who have a mental illness
Put the person first
The greatest barrier that people with disability experience in relation to employment is community stigma and stereotypes.
When working with a co-worker with disability, it is important to consider their goals, strengths, skills and resources rather than their disability.
When communicating with a person with disability, treat the person with the same respect you would other people. The focus should be on interacting with the person and not their disability. People with disability are usually experts in their own needs, so if you have any questions about what will make them most comfortable, ask them first.
* How to communicate with people with disability
Most importantly relax. A sincere commitment to including people with disability will compensate for most mistakes—a sense of humour should cover the rest!
Disclosure of disability
Disclosure is a choice a person makes about whether to tell another person or organisation information about their disability. There is no legal obligation for a co-worker to disclose information about their disability to you or your employer, unless it is likely to affect their performance or ability to meet the inherent requirements of the job, including their ability to work safely and ensure the safety of others.
If a co-worker has disclosed information about a disability to you or has made a choice to disclose a disability to your employer, it is important that any information about their disability is treated appropriately as it may involve sensitive personal information. For example, you should not discuss the disability related information with other co-workers unless you have been given permission to do so.
For more information on your rights and responsibilities regarding disclosure and privacy:
* Your rights and responsibilities
Starting a job
Starting a job can be an anxious experience for any new employee. For a new co-worker with disability, concerns about acceptance by co-workers can make the start of a job an especially stressful time. When a new co-worker with disability starts a new job in your workplace, ensure that you have a relaxed manner and work environment to assist the new person settle in.
As with other co-workers, providing regular and ongoing feedback on work performance or other work related behaviour will provide direction and increased confidence, and make the settling in period more successful. Providing feedback is also an effective technique to minimise stress at work as stress may affect the person's ability to function.
Disability awareness training
If a co-worker with disability is commencing a new job in your workplace, you may want to attend some disability awareness training. Disability awareness training can help you feel at ease when communicating and working with a new co-worker with disability. It can also help a new co-worker with disability feel supported by you when they commence the new job.
If disability awareness training is not available in your workplace, talk to your employer about organising disability awareness training if appropriate. If this is not possible or practical, JobAccess can help link you to providers in your area:
* Disability awareness training
Auslan training
Auslan is Australian Sign Language. If you work with someone who is Deaf or hard of hearing and communicates using Auslan, you may wish to do some training to help you communicate at work. Your employer may also be eligible for help with Auslan training.
* Auslan training
Social events
Work-related social events are an important part of developing a healthy work environment. Social events do not just refer to the annual Christmas party or the family picnic day, but include things like Friday night drinks and sporting groups.
Just like any other employee, co-workers with disability should be included in these events, with considerations made to ensure that the event facilities are fully accessible to people with disability. For example, parking is available for a co-worker in a wheelchair, ramps or lifts are available rather than stairs only and noise levels are not too high for a co-worker who has difficulty hearing.
Don’t assume that a person cannot or does not want to be involved simply because they have a disability—adjustments can almost always be made so that everyone can be included. |
| ? Disability: What are the different types of impairment? |
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Physical Disabilities
Conditions that result in physical disabilities include spinal cord injury, arthritis, cerebral palsy, acquired brain injury, multiple sclerosis and a number of other conditions of the muscular, nervous and respiratory systems. These conditions tend to result in some degree of restricted activity in mobility and manipulation, such as restricted arm and hand movements and communication.
Intellectual Disabilities
The term 'intellectual disability' refers to a group of conditions caused by various genetic disorders and infections. These conditions result in a limitation or slowness in an individual's general ability to learn and difficulties in communicating and retaining information. As with all disability groups, there are many types of intellectual disability with varying degrees of severity.
Mental Illness
Disabilities labelled as psychiatric or psychological may include schizophrenia, clinical depression, bipolar disorder, eating disorders such as anorexia nervosa, and anxiety disorders. Anxiety and depression are two of the most common psychological disabilities.
Sensory Disabilities
Blindness and Low Vision
There are an estimated 300,000 Australians who are blind or have some kind of vision impairment. While some people have a total absence of vision, about 90 percent of people classified as legally blind have some useable vision. Access requirements of people with vision impairments will therefore vary widely.
Deafness or Hearing Impairment
There are an estimated 30,000 deaf people in Australia who have no useable hearing and whose first language is Auslan (Australian Sign Language). In addition, there are between one and three million Australians with varying degrees of hearing impairment who mainly use oral communication.
Learning Disabilities
Learning disability is the result of neurological disorder which may cause the learner to receive and process some information inaccurately. The most common learning disability is dyslexia. Other learning disabilities are dysgraphia and aphasia. Students with a learning disability may have significant difficulties in perceiving and/or processing auditory, visual or spatial information.
Asperger's Syndrome and Autism
Asperger’s Syndrome is an autistic spectrum disorder caused by a neurological dysfunction which particularly impacts on social functioning. As this is so intrinsic to the way that most teaching and learning takes place, students with autism or Asperger’s Syndrome may find the experience of further education and training daunting despite having the intellectual capacity to study at this level.
Health Conditions
A wide range of medical conditions may impact on students’ learning and their ability to attend lectures and tutorials, complete assignments by due dates, or be assessed in the usual ways. These conditions include epilepsy, asthma, diabetes, kidney disorders, cystic fibrosis, cancer, hepatitis, chronic fatigue syndrome (CFS), and HIV/AIDS. While some of these conditions are lifelong, others such as CFS, may last for periods ranging from a few months to several years.
The Disability Discrimination Act (DDA) identifies and defines the following categories of disability
Physical - affects a person's mobility or dexterity
Intellectual - affects a person's ability to learn
Psychiatric - affects a person's thinking processes
Sensory - affects a person's ability to hear or see
Neurological - results in the loss of some bodily or mental function
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| ? Deafblind? |
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Deafblindness, also referred to as ‘dual sensory loss’, is a condition where a person has both hearing and vision loss.
Deafblindness affects people of all ages in different ways, and no two people who are deafblind are the same.
Many people will not be completely deaf or completely blind, but will have some remaining use of one or both senses. Others may also have additional physical or learning disabilities. |
| ? Polio? |
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Poliomyelitis or polio is an infectious disease caused by a virus.
Due to a national immunisation schedule, polio is no longer prevalent within Australia, however post polio syndrome is still evident, with some of those originally having polio experiencing further symptoms or 'late effects of polio' years or decades after the initial infection occurred. |
| ? Blindness or vision impairment? |
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Complete vision loss or blindness refers to a severe loss or absence of vision. A person is considered legally blind:
- when they cannot see at six metres what someone with normal vision can see at 60 metres
- if their field of vision is less than 20 degrees in diameter (as a person with normal vision can see 180 degrees).
The term 'vision impairment' simply means a person has some degree of sight loss. Most people with vision impairment will have some degree of sight and may use a white cane, guide dog and/or a GPS navigating device to help them with their mobility.
Many diseases of the eyes, diseases of the body, or injury can result in blindness or vision impairment. Blindness or vision impairment may be present at or near birth (congenital) or develop later in life (acquired). |
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