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DisabilityAka: Impairment, Sick Leave

Definitions
1. Impairment (Objective Physiologic Deficit)
  1. Anatomic or Physiologic Deficit
  2. Example: Lumbar Disc Herniation
2. Disability (Subjective Functional Deficit)
  1. Activities limited by Impairment
  2. Example: Difficulty waiting tables
Epidemiology
1. Americans with ongoing disabling condition: 49 million
2. Disability preventing work or school in U.S.: 9 million
Groups with disproportionately greater Disability
1. Minority ethnic group
2. Elderly
3. Low socioeconomic group
4. Children living in poverty
5. Female headed households
Risk Factors suggesting prolonged recovery
1. Behaviors
  1. Disability out of proportion to diagnosis
  2. Exaggerated pain behavior or history of Somatization
2. Family factors
  1. Dysfunctional family
  2. Family History of prolonged Disability
3. Comorbid conditions
  1. Substance Abuse
  2. Major Depression
4. Workplace Difficulties
  1. Occupational dissatisfaction
  2. Difficulties with coworkers
  3. Financial or legal hardships
Evaluation
1. See Disability Evaluation
Management
1. See Disability Management
2. See Assistive Technology
3. See Letter of Medical Necessity
4. See Disability Referral
References

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This page was written by Scott Moses, MD, and was last revised 1/27/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.