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Defining disability: A complex issue

This document provides a review of, and framework for understanding, disability definitions in key Government of Canada initiatives. Overall, the report illustrates and seeks to clarify the complex and multi-dimensional nature of the concept of disability found in policy, programs and benefits. It highlights the fact that confusion exists between definitions, eligibility criteria and program objectives. The paper concludes that a single harmonized definition of disability across the Government of Canada may not be desirable or achievable and that the scope of solutions to address the broader issues identified go beyond definitions. In reaching these conclusions, the paper illustrates the various tensions between the concept of disability, program design and the horizontal nature of disability programs. The report is divided into four main sections. Part one describes the evolution of the key disability conceptual models of disability–medical, functional limitation and social and human rights models–as well as the main disability data sources based on these models. Part two is the most detailed section of the report. It provides an inventory of key Government of Canada laws, programs and tax measures that target persons with disabilities in four areas: antidiscrimination legislation; activities of daily living and assistance in the home; income, and employment and learning. The review highlights the varying treatments of disability in each of these four categories, confirming that no single definition of disability exists at the federal level. Instead, disability definitions are found both explicitly and implicitly in legislative statutes and eligibility criteria. The report demonstrates the interaction and influence of these sometimes competing perspectives on disability definitions, objectives and eligibility. In part three, the report provides a summary of the key issues related to defining disability across the Government of Canada, including: the complexity of disability definitions because of the evolving perception of the meaning of disability; the horizontal nature and shared responsibility of disability; the confusion between disability definitions, program objectives and their eligibility criteria (for example, some programs focus on employability and others on income replacement and some programs determine disability through self identification while others require detailed information from medical specialists); and, finally, the need for improved communication and awareness. The report demonstrates that these issues are not easily disentangled and continue to challenge policy responses.Part four highlights key government actions and next steps to address the major issues. The report’s conclusion stresses the need to bring more coherence to disability-related programs. Despite the challenges associated with disability definitions, the Government of Canada has undertaken a number of activities aimed at increasing the understanding, awareness and accessibility of programs, services and benefits for Canadians with disabilities. Specific commitments include improving the horizontal management of disability programs, increasing consultation with all partners, streamlining the application and assessment processes, and improving communication products for Canadians. In addition to describing programs, the report provides some examples of concerns related to definitions raised by witnesses appearing before various Parliamentary committees between 2001 and 2003. A preliminary study of provincial disability definitions conducted by a consultant on behalf of HRDC, and international definitions are also included as annexes. Finally, a table that summarizes the key initiatives reviewed is included in Annex D. By providing a database of information on key Government of Canada disability initiatives, this report is only a first step in our goal to provide a more coherent picture of our disability policies and programs. Improving our understanding of the interaction between the different concepts of disability through further research and consultation will assist the Government of Canada in its disability policy and program design. To deal with the broader issues will require further discussion and collaboration among and within governments to explore areas where consistent approaches could lead to improved programs and services for people with disabilities.