Figure 1presents a model of how to differentiate between the terms. The terms impairment, disability, and handicap are not interchangeable. It should not include an opinion as to whether the claimant is disabled under the meaning of the law. For adults, the report should include a description, based on the physician's own findings, of the individual's ability to do basic work-related activities. The consultative examination report should be complete enough to enable an independent reviewer to determine the nature, severity, and duration of the impairment and, in adults, the claimant's ability to perform basic work-related functions.Ĭonclusions in the consultative examination report must be consistent with the objective clinical findings found on examination and the claimant's history, symptoms, laboratory study results, and response to treatment. In the disability evaluation of low back pain, physicians should use validated questionnaires, such as the Oswestry Low Back Pain Disability Questionnaire and the Roland Morris Disability Questionnaire. SORT: KEY RECOMMENDATIONS FOR PRACTICE Clinical recommendation Disability leads to substantial personal, physical, social, emotional, and economic hardships for the patient, caregiver, and the entire family. Patients with a disability often lack health insurance, and experience health disparities and barriers to appropriate care. 8 – 10 The most common limitations are the inability to walk three city blocks or to climb a flight of stairs. 8, 9 Back or spine problems, arthritis, and heart conditions are the most common health problems resulting in disability. 7 Blacks and Hispanics are most affected, 8 and older patients comprise the largest group of persons with disabilities. 6 The economic impact of lost time and wages exceeds $171 billion per year. ![]() 5 In December 2012, more than 8.8 million disabled workers received disability benefits (an average of $1,130 per month). 4 In 1960, approximately 559,000 persons received Social Security benefits (about $80 per month). ![]() 3 Approximately 2.5 million new disability applications are made to the Social Security Administration each year. 2 More than 3.6 million veterans have a service-related disability. 1 Of the 56.7 million disabled Americans, 38.3 million adults and 2.6 million children have a severe disability. More than 1 billion persons worldwide have a disability, according to the World Health Organization. Family physicians can perform the initial evaluation, consult appropriate subspecialists, complete the necessary paperwork, and answer questions from the patient, employer, or disability agency. Department of Veterans Affairs provides disability benefits for veterans, and private disability insurance may be provided by the employer or purchased by the employee. ![]() Social Security Disability Insurance and workers' compensation are the two largest disability programs in the United States. Impairment, disability, and handicap are key terms that physicians must understand to properly evaluate patients and make appropriate recommendations. Disability impacts family members and caregivers, as well as patients. Patients with a disability experience health disparities and barriers to appropriate health care. Common limitations include the inability to walk three city blocks or to climb a flight of stairs. Conditions that most often lead to disability include arthritis, back or spine problems, and heart conditions. Blacks and Hispanics are among the groups with the highest disability rates, as well as older patients. ![]() In the United States, more than 56 million American workers have some form of disability of these, more than 38 million persons have a severe disability. According to the World Health Organization, more than 1 billion persons worldwide have a disability.
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