Re‐Claiming Disability: Identity,Procedural Justice,and the Disability Determination Process

This research highlights the crucial role of an intimate link between a disabled person's self‐identity and the perceived fairness of legal procedures. In doing so, it brings to the foreground a wholly ignored aspect of procedural justice. Earlier researchers have failed to delve into the role identity politics plays in the relationship between the institutions and the beneficiaries of their services, and the way different members of a group understand and define themselves. This research explores the way people with disabilities in the United States, with different kinds of disability identities, experience and evaluate the procedure of claiming Social Security benefits. The findings suggest that disabled people who identified with the social model of disability (as opposed to the medical‐individual models) hold a critical view of the procedure for retaining benefits. They felt they had no control over it, could not voice their opinions, were mistreated by representatives, and had to present an image that was not necessarily true of their disability. They also saw the procedure as discouraging them from participating fully in the labor market, and consequently integrating better in society, an idea that was not present among disabled people who identify with medical‐individual models. Exposing this relationship between the way people perceive themselves and the way they experience and evaluate legal procedures can contribute to the creation of better policies, while improving communication between the state and members of the disability community, along with other marginalized groups.     

Biopsychosocial Considerations in Unnecessary Work Disability

The current definition and management of medical conditions causing impairment and unnecessary disability in workers’ compensation (WC) systems are suboptimal. Fundamental problems include the failure to recognize and address the unique biopsychosocial diathesis of each individual; the powerful influence of human psychology in the genesis, perpetuation, and refractoriness to treatment of many conditions, including medically unexplained symptoms and chronic pain; the work relevance of even non-work-related conditions; the considerable effects of administrative and clinical iatrogenicity; and the plethora of complex factors potentially affecting the course of conditions treated in WC systems. Once claims are established in WC, administrative and medical management of both identifiable pathologic conditions and unexplained symptoms are fragmented, not based on available scientific evidence, and adherent to a biomedical care approach which is not appropriate for a significant number of cases. These obstacles prevent effective understanding and management of many WC cases and may contribute to eventual recovery failure and unnecessary work disability (UWD). This article explores biopsychosocial factors in WC claimants and elements that may contribute to or ameliorate progression to UWD. The author offers a heuristic diathesis stress model of work-related disability as a framework for general and specific interventions to improve system performance and outcomes for all stakeholders.     

伤残等级重新评定45例分析

目的探讨道路交通事故、工伤及其他意外事故所致人身伤害的伤残等级重新评定结论改变的原因。方法回顾性分析杭州求正司法鉴定所2007年3月—2009年3月受理的伤残等级重新评定案件45例。结果重新鉴定结论较之原鉴定结论有改变的共计12例（26.7%）,结论改变原因分别为错误引用条款、鉴定时机掌握不当、漏鉴或误鉴伤情、人工假体鉴定掌握不当、未能准确分析伤病关系及未能准确适用工伤伤残晋级原则等。结论伤残鉴定应准确把握鉴定时机,正确理解标准条款的内涵,采用合适的医学和法医学技术,并充分了解各种相关规定的要求。     

Mental Disorder, Work Disability and the Law

R.J. Bonnie and J. Monahan, eds., Mental Disorder, Work Disability, and the Law (Chicago: University of Chicago Press, 1997): 321 pp.     

Disability, disparate impact, and class actions

Following Title VII's enactment, group-based employment discrimination actions flourished due to disparate impact theory and the class action device. Courts recognized that subordination that defined a group's social identity was also sufficient legally to bind members together, even when relief had to be issued individually. Woven through these cases was a notion of panethnicity that united inherently unrelated groups into a common identity, for example, Asian Americans. Stringent judicial interpretation subsequently eroded both legal frameworks and it has become increasingly difficult to assert collective employment actions, even against discriminatory practices affecting an entire group. This deconstruction has immensely disadvantaged persons with disabilities. Under the Americans with Disabilities Act (ADA), individual employee claims to accommodate specific impairments, such as whether to install ramps or replace computer screens, have all but eclipsed a coherent theory of disability-based disparate impact law. Moreover, the class action device has been virtually nonexistent in disability discrimination employment cases. The absence of collective action has been especially harmful because the realm of the workplace is precisely where group-based remedies are needed most. Specifically, a crucial but overlooked issue in disability integration is the harder-to-reach embedded norms that require job and policy modifications. The Article argues that pandisability theory serves as an analogue to earlier notions of panethnicity and provides an equally compelling heuristic for determining class identity. It shows that pandisability undergirds ADA public service and public accommodation class actions in which individualized remedy assessments have been accepted as part of group-based challenges to social exclusion. The Article also demonstrates that this broader vision of collective action is consistent with the history underlying the class action device. Taking advantage of the relatively blank slate of writing on group-based disability discrimination, it offers an intrepid vision of the ADA's potential for transforming workplace environments. In advocating for a return to an earlier paradigm of collective action in the disability context, the Article also provides some thoughts on challenging race- and sex-based discrimination. Future workplace policies should plan for "all jobs to include some physical activity" unrelated to job qualifications in order to "dissuade unhealthy people from coming to work at Wal-Mart."     

The Psychological Consultative Examination for Social Security Disability

The Social Security Administration (SSA) provides for federal disability insurance for disabled workers and their families through the Social Security Disability Insurance program and the social safety net for low-income disabled individuals through the Supplemental Security Income program. For the Mental Disorders (12.0) listings in the SSA Blue Book, psychologists provide consultative examinations, a form of medicolegal consultation (Chafetz; The Clinical Neuropsychologist 24:1,045–1,063, 2010). Psychologists also provide consultation directly to the Administrative Law Judges for cases going on appeal, or they might work directly for a Disability Determinations Services facility as an examiner for cases with mental disorders. This article describes the role of the psychologist in the Psychological Consultative Examination and its medicolegal context. Problems with non-credible behavior, particularly malingering, must be accounted for by the psychologist, which ultimately can help SSA with the validity of its decisions.