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- ‘any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range, considered normal for a human being’ (World Health Organization).
- ‘a form of social oppression resulting from a (socially constructed) environment unsuited to the needs of impaired people’ (Peirson and Thomas, 1995). In emphasizing the socially constructed nature of, at least, part of the disadvantage and discrimination experienced by ‘impaired’ people, definition 2 emphasizes the political dimensions of disability and its remedy
(Russian, invalidnost’), the complete or partial loss of the ability to work either permanently or for a prolonged period as a result of illness or injury. Disability also refers to those persons not yet of pension age with prolonged loss of work ability because of diseases, traumas, or defects of development.
Initial disability (the number of disabled who have been acknowledged as such for the first time in a given year) is considered separately from total disability (the total number of those disabled). Initial disability provides an insight into the dynamics of total disability. For example, in the USSR from 1960 through 1969 initial disability among production and clerical workers was reduced by a factor of almost three. Increase in total disability does not denote unfavorable changes in the population’s state of health, since it may testify to successful treatment of the disabled and to the preservation and prolongation of their lives, which leads to an increase in their number. The level of disability is one of the indexes of the state of health of the population, the quality of medical care, and the effectiveness of treatment, all of which reflect the social and hygienic conditions of the country, the level of development of medical science, and the quality of the organization of public health. The level of disability reveals a population’s requirements for various forms of medical care and determines the dimensions of community and government aid, of work-related services, and of social security and other benefits. Of great significance is the study of the causes of disability. In the USSR a tendency has manifested itself in the structure of disability toward a decrease in the proportion of certain types of ailments as causes of disability (for instance, tuberculosis and mental, eye, and other diseases).
In the USSR disabled persons are divided into three groups, depending on the degree of loss of work ability. The first group consists of persons who have complete permanent or prolonged loss of work ability and who need constant care (help or supervision), including those who may adapt to certain types of work in specially organized individual conditions (such as special shops, home jobs, and work devices). The second group consists of persons who, with complete permanent or prolonged loss of work ability, do not need constant outside help, care, or supervision; it also includes persons for whom all types of work are contraindicated for a prolonged period, because of the possibility of aggravating the course of the disease, and persons with severe chronic diseases with accompanying defects of the support-motor apparatus and significant loss of vision, for whom work is available only in specially created conditions. The third group includes those persons who for health reasons must be transferred to work permitting a lower level of qualifications, because of inability to continue work in a previous occupation (specialization); those who for health reasons require considerable changes in their work conditions, changes leading to a lowered volume of productive activity; persons with functional disturbances and few qualifications and persons who have never worked, so that there is little chance of arranging work; and persons with anatomical defects or deformities that entail disruption of functions and considerable difficulty in performing professional work, regardless of the work to be performed.
In the USSR the extent of loss of work ability (the disability group) is established by medical-labor experts’ commissions. Since with treatment and under the influence of social factors (such as labor by capacity), the degree of loss of ability to work constantly changes, periods have been established for reexamination of the disabled: the first group is reexamined once every two years and the second and third groups once a year. Those disabled by anatomical defects or irreversible chronic diseases at any age and male invalids over 60 and female invalids over 55 are permanently certified. After reexamination, some invalids are returned to work and their disability group is changed. In the RSFSR 2.7 percent of invalids were declared able to work in 1955 after reexamination, 6.7 percent in 1965, and 8 percent in 1970.
Legislation stipulates ten causes for disability: general illness; occupational illness; occupational injury; disability since childhood; disability before the beginning of work activity; wounds (shell shock, injury) received in defending the USSR; wounds (shell shock, injury) received during performance of other duties of military service; illness contracted at the front; illness or injury (wounds, contusion) not connected with the performance of duties of military service; and illness (injury, wounds, contusion) not connected with being at the front. Those disabled because of general illness make up the great majority of disabled. The most important form of help to the disabled is the provision of work and occupational training. Of all disabled, 50 percent work, including 70–80 percent of those in the third group.
In all socialist countries, some arrangement of groups of disabled has been established, the basis of the degree of loss of work ability. For example, in the Czechoslovak Socialist Republic, complete and partial disability are distinguished; in the German Democratic Republic, a person is recognized as disabled if he is incapable of earning one-third of his previous earnings or if he has lost no less than 20 percent of his ability to work as a result of an employment injury. Work is provided for the disabled (using their remaining work capacity), and various privileges are granted to them. In the majority of capitalist countries complete disability is partially insured and partial disability is not insured at all. Measures for retraining the disabled are financed at the expense of the insured (that is, from insurance contributions).
REFERENCESOstwvy vrachebno-lrudovoi ekspertizy. Moscow, 1960.
Fliaster, M. I. Trudovye prva invalidov. Moscow, 1968.
G. N. SOBOLEVSKII
the inability to work for reasons of health, age, or other causes provided for by law. Varying forms of disability are distinguished by degree (whether complete or partial), by prospect for rehabilitation (whether the disability is temporary or permanent) and by the category of labor activity affected (whether general or occupational).
In the USSR disability is determined on the basis of a medical testing of the individual’s loss of working ability by a medical advisory commission or a medical labor commission of experts. Where the impairment is permanent and requires that the patient cease work for a long period or that significant changes be made in working conditions, the patient is declared disabled. Disability is a primary condition for the awarding of pensions, grants, and various privileges related to working conditions, taxes, housing, domestic help, and medical care.