Handling Disability Certificates: Definition and Grading of Various Types of Disabilities

1. Visual disability

Definition

It refers to those who have visual impairment or narrowed vision in both eyes due to various reasons, and who cannot restore their visual function through various drugs, surgeries and other treatments (or who are temporarily unable to restore their visual function through the above treatments), thus affecting their daily life and social participation.

Grading

Level 1: No light perception - <0.02; or visual field radius <5 degrees.
Level 2: 0.02 - <0.05; or field of view radius <10 degrees.
Level 3: 0.05 - <0.1.
Level 4: 0.1 - <0.3.

2. Hearing disability

Definition

It refers to the permanent hearing impairment of varying degrees in both ears due to various reasons. The person cannot or cannot hear the surrounding environment sounds and speech sounds, which affects daily life and social participation.

Grading

Level 1: Extremely severe damage to the structure and function of the auditory system, with an average hearing loss of ≥91 dB HL in the better ear.
Level 2: The structure and function of the auditory system are severely damaged, with an average hearing loss in the better ear between 81 - 90 dB HL.
Level 3: Moderate to severe damage to the structure and function of the auditory system, with an average hearing loss in the better ear between 61 - 80 dB HL.
Level 4: Moderate damage to the structure and function of the auditory system, with average hearing loss in the better ear between 41 - 60 dB HL.

3. Speech disability

Definition

Refers to varying degrees of speech impairment due to various reasons (those who cannot be cured after more than one year of treatment or whose disease duration exceeds two years), who are unable or difficult to carry out normal speech communication activities (under 3 years of age are not classified as disabled).

Grading

Level 1: No speech function or speech intelligibility ≤10%.
Level 2: Have certain vocal and speech abilities. Speech intelligibility ranges from 11% - 25%.
Level 3: Some verbal communication is possible. Speech intelligibility ranges from 26% - 45%.
Level 4: Can carry out simple conversations, but has difficulty expressing in longer sentences or articles. Speech intelligibility ranges from 46% - 65%.

4. Physical Disability

Definition

Structure and function damage of the human movement system results in the loss of limbs or paralysis (paralysis), deformity, etc. of the limbs and trunk, resulting in varying degrees of loss of human movement functions and restriction of activities or participation.

Grading

Level 1: Unable to independently perform activities of daily living. Quadriplegia: severe loss of motor function of the limbs; paraplegia: complete loss of motor function of both lower limbs; hemiplegia: complete loss of motor function of one limb.
Level 2: Basically unable to independently perform activities of daily living. Amputations of limbs at different locations or congenital missing limbs; amputation of a single upper limb and both lower legs; amputation of both upper arms and single thigh.
Level 3: Ability to partially carry out activities of daily living independently. Amputation or missing limbs of both lower legs; amputation of a single limb at the forearm, thigh and upper part, etc.
Level 4: Basically able to carry out activities of daily living independently. Single calf amputation or missing limb; strong (stiff) spine; hunchback deformity greater than 70 degrees, etc.

5. Intellectual disability

Definition

Refers to a person’s intelligence being significantly lower than the average level and showing adaptive behavioral disorders. Intellectual disability includes: mental retardation caused by various reasons during the period of intellectual development; after intellectual development matures, intellectual impairment caused by various reasons and dementia caused by obvious decline of intelligence in old age.

Grading

Level 1: Extremely severe. IQ (intelligence quotient) is <20, adaptive behavior is extremely poor, and his face is obviously dull.
Level 2: Severe. The IQ is between 20 and 34, the adaptive behavior is poor, and the ability to take care of oneself is difficult to achieve even after training.
Level 3: Moderate. IQ is between 35 and 49, adaptive behavior is incomplete, practical skills are incomplete, and life can be partially taken care of independently.
Level 4: Mild. IQ is between 50 and 69, adaptive behavior is lower than the average level, and has considerable practical skills, such as being able to take care of oneself, and can undertake general housework or work, but lacks skills and creativity.

6. Mental Disability

Definition

Refers to various types of mental disorders that have not been cured for more than one year and have cognitive, emotional and behavioral impairments that affect their daily life and social participation.

Grading

Level 1: WHO-DASⅡ value ≥116 points, severe impairment of adaptive behavior; completely unable to take care of oneself, neglecting one's own physical and psychological basic needs.
Level 2: WHO-DASⅡ value is between 106 and 115 points, severe adaptive behavior disorder; unable to take care of themselves for most of the life, basically not interacting with others, only briefly interacting with caregivers.
Level 3: WHO-DASⅡ value is between 96 and 105 points, moderate impairment of adaptive behavior; able to take care of oneself partially, able to have simple conversations with others, and able to express one's simple needs.
Level 4: WHO-DASⅡ value is between 52 and 95 points, mild disorder in adaptive behavior; basic self-care in daily life, but self-care ability is worse than the average person, and personal hygiene is sometimes neglected.

7. Multiple disabilities

Definition

Multiple disabilities refer to the simultaneous existence of two or more disabilities. For example, a person may have a physical disability that affects his or her mobility, and an intellectual disability that may affect his or her cognitive and learning abilities; or a person may have a hearing disability that causes hearing impairment, or a speech disability that causes difficulty in language communication. These disabilities may interact with each other, further increasing an individual's difficulties in daily life, study, work, and social interactions.

Grading

The grading of multiple disabilities is usually more complex and generally takes into account the various types of disabilities involved and their degrees. First, each disability is assessed and graded separately, and then its overall functional limitations and impact on daily life and social participation are comprehensively judged. For example, if a person has both a second-level physical disability and a third-level intellectual disability, then when assessing his or her multiple disability levels, the comprehensive impact of the combination of these two disabilities on his or her independent life, social interaction, etc. needs to be considered. A professional assessment team usually uses a variety of observations, tests, and assessments to determine the level of multiple disabilities.