Between 29 – 31 October in Brasilia, the Ministry of Human Rights (MDH), through the National Secretariat for the Rights of Persons with Disabilities (SNDPD), and the European Union, through the Sector Dialogues Support Facility, brought together representatives from different countries in Latin America and Europe, as well as Brazilian experts, to present their disability assessment models already in line with the concept of the United Nations Convention on the Rights of Persons with Disabilities (CDPD).
The meeting culminated in the signing of the Charter of Brasilia. This document establishes, among other things, that biopsychosocial disability assessments should involve multiple professionals and be interdisciplinary whenever necessary for the participation of persons with disabilities in public policies and affirmative actions. They should also consider body structures and functions, social, environmental psychological and personal factors, limitations to perform activities, and social participation restrictions.
According to the Charter, fostering international cooperation is essential for building human rights-based instruments and systems for disability assessment. For that matter, Brazilian and international specialists in the seminar gave their contribution by presenting different assessment models that have been adopted in their respective countries.
Matt Russel of the Department of Labour and Welfare of the United Kingdom stressed the UK government is committed to ensuring a society of inclusion and participation of all, as reflected in the Equality Act, which came into force in 2010 to protect people from discrimination in the labour market and in society in general.
"The Equality Act defines disability as a physical or mental impairment that has a substantial and long-term adverse effect on the person's ability to carry out normal day-to-day activities. The social welfare system plays a crucial role in assisting persons with disabilities, who can have access to employment and housing benefits, universal credit and allowances for personal independence," explained Russell.
According to him, the United Kingdom has two types of disability assessment. The Work Capability Assessment (WCA) assesses the person's ability to engage in some kind of paid activity. The goal is not to check what a person cannot do, but rather what he/she can do. The WCA is a requirement to receive the employment and support allowance. To get the other benefits, the person needs to go through a second type of assessment, which analyses how his/her physical condition or illness impacts day-to-day activities. "Our assessment process is designed to ensure that people have personalized access to benefits or support to work when they can."
In Denmark, disability assessment, as well as social welfare, is decentralized. Mie Henriee Eriksen of the Department of Persons with Disabilities - Ministry for Children and Social Affairs, explained that their legal framework is national. The Social Services Act provides a series of benefits for persons with disabilities, with the purpose of enabling them to manage their daily lives and improve their quality of life. On the other hand, it is up to the local authorities to evaluate individual people and decide what kind of benefits they are entitled to.
"The decision of the local authority should be based on a professional assessment of the disabled person’s situation; on the conclusion about the need for support and the recommendation of the type of benefit; and on arguments based on information and observations that came up during the assessment process. The citizen's perspective should also be evident in the decision,” says Mie.
The decentralization of disability assessments is also characteristic of France, according to a comparative study between Brazil, Spain and France presented by experts José Nogueira and Marcelo Riberto, with the support of the Sector Dialogues Facility.
The French government has used social and biopsychosocial models of disability as a paradigm in the design of public policies, focusing on human rights, inclusion, activation and employment. The Secretariat of State for Persons with Disabilities operates directly under the Office of the Prime Minister of France, and there is also a coordination of interministerial policies, with focal points in each Ministry.
The national support coverage is decentralized into "Department Houses". Multidisciplinary Assessment teams (doctors, nurses, psychologists and social workers) make a home visit to better evaluate the living conditions of the disabled person and thus determine his/her permanent disability rating (from 0 to 100%). From 50% up, it is possible to have access to the majority of social programs in France. The entire assessment process and service is structured by the Assessment Guide on Compensation Needs (GEVA), a methodological tool with several components designed to facilitate the analysis of evaluators in all dimensions which are relevant to a particular person.
Likewise, in Spain, disability assessment occurs in decentralized centres in the autonomous communities, under the supervision of IMSERSO (Institute for Elderly People and Social Services), which standardizes national assessment criteria, procedures and instruments. As in other European countries, Spain uses the social and biopsychosocial model of disability as a paradigm in the design of public policies (employment and inclusion in general).
In Brazil, the process of transitioning from a purely medical model of disability to a biopsychosocial model, established by the Convention and corroborated by the LBI, is ongoing and should be completed by the end of this year. The aim of this international seminar was precisely to exchange experience with countries that have already changed their legislation or are in the process of moving from the purely medical model of disability assessment (CID) to a more comprehensive definition of disability (CIF) of a physical, sensory, mental and intellectual nature in interaction with environmental barriers, in line with what the Convention establishes.
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