RSM 2, Attachment 400-1: Disability: Identification of Impairment & Cause and Disability Priority

Updated: 02/14

1. Disability Descriptions for VR and IL Program

Disabilities are described in terms of the impairment and the cause. The following information may assist staff in considering the range of impairments and causes which may be entered into AWARE™ disability browse. See **Disability Coding in AWARE™** for guidance and web-based resources to assist with identifying ICD codes and descriptions for disability reporting in AWARE™.

2. Impairments

Impairments are divided between sensory/communication impairments, physical impairments, and mental impairments, as follows.

1. No Impairment (not applicable for primary or secondary disabilities)

2. Sensory/Communicative Impairments

• Blindness
• Other Visual Impairments
• Deafness, Primary Communication Visual
• Deafness, Primary Communication Auditory
• Hearing Loss, Primary Communication Visual
• Hearing Loss, Primary Communication Auditory
• Other Hearing Impairments (e.g., Tinnitus, Meniere’s Disease, hyperacusis, etc.)
• Deaf-Blindness
• Communication Impairments (expressive/receptive)

3. Physical Impairments

• Mobility Orthopedic/Neurological Impairments
• Manipulation/Dexterity Orthopedic/Neurological Impairments
• Both Mobility and Manipulation/Dexterity Orthopedic/Neurological Impairments
• Other Orthopedic Impairments (e.g., limited range of motion)
• Respiratory Impairments
• General Physical Debilitation (fatigue, weakness, pain, etc.)
• Other Physical Impairments (not listed above)

4. Mental Impairments

• Cognitive Impairments (impairments involving learning, thinking, processing information and concentrating)
• Psychosocial Impairments (interpersonal and behavioral impairments, difficulty coping)
• Other Mental Impairments

3. Cause/Source of Impairment

Following are descriptions of the cause or source of the impairment and indicate the range of causes which may be considered when entering disability information in AWARE™.

• Cause unknown
• Accident/Injury (other than TBI or SCI)
• Alcohol Abuse or Dependence
• Amputations
• Anxiety Disorder
• Arthritis and Rheumatism
• Asthma and other Allergies
• Attention-Deficit Hyperactivity Disorder (ADHD)
• Autism
• Blood Disorders
• Cancer
• Cardiac and other Conditions of the Circulatory system
• Cerebral Palsy
• Congenital Condition or Birth Injury
• Cystic Fibrosis
• Depressive and other Mood Disorders
• Diabetes Mellitus
• Digestive Disorders
• Drug Abuse or Dependence (other than alcohol)
• Eating Disorder (e.g., anorexia, bulimia, or compulsive overeating)
• End-Stage Renal Disease and other Genitourinary System Disorders
• Epilepsy
• HIV and AIDS
• Immune Deficiencies excluding HIV/AIDS
• Intellectual Disability
• Mental Illness (not listed elsewhere)
• Multiple Sclerosis
• Muscular Dystrophy
• Parkinson’s Disease and other Neurological Disorders
• Personality Disorders
• Physical Disorders/Conditions (not listed elsewhere)
• Polio
• Respiratory Disorders other than Cystic Fibrosis or Asthma
• Schizophrenia and other Psychotic Disorders
• Specific Learning Disabilities
• Spinal Cord Injury (SCI)
• Stroke
• Traumatic Brain Injury (TBI)

4. Guidance: Sensory/Communicative Impairments

The following information was provided by the Rehabilitation Services Administration to clarify descriptions of impairments to be used for identifying individuals with sensory/communicative disabilities.

Code and Description:

• Deafness, Primary Communication Visual

• Receptive Communication – depend on vision for all communication reception. This may involve use of American Sign Language, a signed English variation, speechreading and/or a combination of these. Some individuals may not use a common sign system, but depend upon gesture and demonstration.
• Expressive Communication – may use American Sign Language, a variation of signed English, oral speech, gesture or demonstration.
• May rely on Sign Language or oral interpreters to facilitate communication.
• Depend upon visual-based telecommunication.

• Deafness, Primary Communication Auditory

• Receptive Communication – primarily depend on use of residual hearing with hearing aid(s) and/or cochlear implant(s). May require some visual supplementation.
• Expressive Communication – primarily oral speech.
• May rely on Sign Language and/or oral interpreters to facilitate communication in situations that involve more than one other person.
• May use auditory or visual telecommunication with appropriate amplification/adaptation.

• Hearing Loss, Primary Communication Visual

• Receptive Communication – despite the degree of hearing loss, cannot depend on hearing alone or without amplification for understanding speech. Requires visual information to supplement auditory input.
• Expressive Communication – primarily oral speech.
• May use auditory or visual telecommunication with appropriate amplification/adaptation.

• Hearing Loss, Primary Communication Auditory

• Receptive Communication – can depend upon use of hearing alone (with or without amplification) to understand speech in one-to-one communication.
• Expressive Communication – primarily use spoken language.
• Generally use auditory-based telecommunication with or without additional amplification.

• Deaf-Blindness

The term “individual who is deaf-blind” means:

1. Any individual:

1. Who has a central visual acuity of 20/200 or less in the better eye with corrective lenses, or a field defect such that the peripheral diameter of visual field subtends an angular distance no greater than 20 degrees, or a progressive visual loss having a prognosis leading to one or both of these conditions;

2. Who has a chronic hearing impairment so severe that most speech cannot be understood with optimum amplification, or a progressive hearing loss having a prognosis leading to this condition; and

3. For whom the combination of impairments described in clauses (1) and (2) cause extreme difficulty in attaining independence in daily life activities, achieving psychological adjustment, or obtaining a vocation;

2. Any individual who despite the inability to be measured accurately for hearing and vision loss due to cognitive or behavioral constraints, or both, can be determined through functional performance assessment to have severe hearing and visual disabilities that cause extreme difficulty in attaining independence in daily life activities, achieving psychological adjustment, or obtaining vocational objectives.

• Communicative Impairments (expressive/receptive)

  Speech and Language impairments for the most part come in combination with other impairments such as cerebral palsy, TBI, stroke, mental retardation, multiple sclerosis, deafness, etc., requiring significant intervention in addition to those provided relative to identified major disabling conditions. It is essential that communicative disabilities be recognized and attended to as either the major or secondary disability and appropriate interventions such as the use of augmentative and alternative communication (AAC) systems be implemented.​