A new definition of disability

When an employee goes out on disability, it?s often hard to know when that person?s capable of coming back to work.

'Right now it?s simply based on clinicians? gut opinions,' says Daniel J. Conti, PhD, vice president and director of the employee-assistance program at the financial services corporation First Chicago NBD. 'We need a better way of measuring people?s functional ability, a standardized way of talking about how far away from optimal functioning somebody is.'

The World Health Organization (WHO) is trying to meet that need. In 1980, WHO published its International Classification of Impairments, Disabilities, and Handicaps (ICIDH) in an attempt to classify the consequences of disease. In light of changes in the way disability is understood, WHO recently revised the document with a team that included APA, scientists, health-care professionals, government officials, people with disabilities and others from around the world. The draft is currently being field-tested.

Now called the International Classification of Impairments, Activities, and Participation, or ICIDH-2, the publication offers a standardized system for discussing psychological and physical disability and functioning in situations ranging from individual assessment to service delivery to social policy development.

For APA, the system represents a convenient way of measuring things like the cost-offsets realized by integrating psychological services into disability management, says Russ Newman, PhD, JD, executive director for professional practice at APA. For psychologists in general, he says, the system offers a way of making classifications without having to slap labels on people.

'We?ve had the Diagnostic and Statistical Manual-IV foisted upon us in this country,' says Newman. 'We hope to get more psychologists involved in using the ICIDH-2 when it?s ready.'

?Rebecca A. Clay