The Paradox of Vocational Disability

¹ New York, New York

It is part of medical diagnosis when physicians decide a patient has recovered sufficiently to do light work or to do his regular work on part-time. Disability certification at this stage of tuberculosis is well formulated in the paradox "From a vocational viewpoint, totally disabled at the present time but capable of doing selected work." Such certification gives the physician the opportunity to explain the role of rehabilitation to employers, insurance carriers and civic authorities who require disability certificates in order to administer sick-pay and insurance benefits. Employers and administrators have not been sufficiently informed on this important factor for recovery. Physicians must use each case to reiterate that rehabilitation is part of treatment. If a job is made available in which the work, hours and the patient are under medical control, then the patient is able to do useful work and will probably progress rapidly toward completely restored working capacity. If such a job is not provided, he cannot do any work, continues totally disabled and progresses toward completely restored working capacity at a snail's pace. The author cites the case of a hospital worker to illustrate these principles.

Rehabilitation through medically controlled wage-earning work is most successful when done by the employer for whom the patient worked prior to his illness. The employers who have the best facilities and opportunities for rehabilitating their former employees are our hospitals. Special institutions for rehabilitation are valuable especially because they have taught us that the major part of rehabilitation must be accomplished within industry.