ABSTRACT
WHO-ICF defines impairment, limitation of activities, participation restriction, and environmental factors. No methodology exists for evaluation of disability integrating impairment, limitation of activities, participation restriction, environmental and personal factors. Hence, the author proposed to advance “integrated evaluation of disability.” It assesses impairment of functions and/or structures. It evaluates limitation of activities in the individual’s personal demands, for example, self-care, restriction of participation in educational/vocational pursuits. It also assesses participation restriction namely social demands, for example, parental/family roles, social and community activities, and his/her role as a citizen, and so on. It also evaluates environmental factors such as availability and access to medical management, and rehabilitation services, architectural barriers; and behavior of the person towards his/her disability. Integrated evaluation of disability institutes clinical methods/tools to evaluate impairment of function/structure. It applies activity-participation-skill-assessment scale to assess limitation of activity and participation restriction. It uses environmental and personal factors measurement scale to measure environmental barriers and/or support, the behavior of the person towards his/her disability and earning capacity. It applies the formula A + [B(100 – A)/100] to combine impairment of functions/structures to achieve a ceiling level of 100%; and combines impairment, limitation of activities, participation restriction, environmental, and personal factors to derive whole person disability. “Integrated Evaluation of Disability” conducted a pilot study using clinical models and developed a ready reckoner impairment table for about 300 clinical conditions with multiple clinical presentations hyperlinked to excel worksheet. In addition, software program integrated with this book would enable the physicians practising disability evaluation to save time for computing whole person disability.
