National Disability Rating Colombia: Decree 917 (1999) | Althox
Colombia's legal framework for social security and disability assessment is a cornerstone of its social protection system. Among the most significant regulations is Decree 917 of 1999, which established the Single National Disability Rating Manual. This decree, issued by the Presidency of the Republic, plays a crucial role in determining the loss of earning capacity for all inhabitants, ensuring equitable access to rights and benefits for individuals with disabilities.
This in-depth analysis will delve into the foundational articles (1 to 11) of Decree 917, exploring its scope, key definitions, qualification procedures, and the comprehensive criteria used for disability assessment. Understanding this decree is essential for workers, employers, healthcare providers, and legal professionals navigating the complexities of disability in Colombia.
Table of Contents
- Article 1: Scope of the Manual
- Article 2: Key Definitions of Disability
- Article 3: Date of Declaration of Loss of Working Capacity
- Article 4: Requirements and Procedures for Disability Qualification
- Article 5: Determination of Permanent Partial Disability
- Article 6: Rating the State of Disability by Boards
- Article 7: Qualifying Criteria for Integral Disability
- Article 8: Percentage Distribution of Rating Criteria
- Article 9: General Instructions for Qualifiers
- Understanding the Combination Formula for Deficiencies
- Limitations and Exceptions in Disability Rating
- Conclusion: The Enduring Impact of Decree 917
The foundational Decree 917 of 1999 established Colombia's Single National Disability Rating Manual, a key legal instrument.
Article 1: Scope of the Manual
Article 1 of Decree 917 precisely delineates the application of the Single National Disability Rating Manual. This manual is not limited to a specific sector but extends its reach to all inhabitants of Colombia, encompassing a broad spectrum of individuals and employment types. This universal application underscores the decree's commitment to comprehensive social protection.
Article 1. SCOPE. The Unique Handbook for the disability rating contained in this decree applies to all inhabitants of the country, workers from the public, official, semiofficial, in all its orders, and the private sector in general, to determine loss of earning capacity from all sources, in accordance with the provisions of Articles 38, following and consistent Law 100 of 1993, 46 Decree-Law 1295 of 1994 and the 5th. Law 361/97.
The article clarifies that the manual's purpose is to determine the loss of earning capacity, a critical factor for accessing social security benefits. It explicitly references other key legal instruments, such as Law 100 of 1993 (which established the General Social Security System in Colombia), Decree-Law 1295 of 1994 (related to occupational risks), and Law 361 of 1997 (which promotes the integration of people with disabilities). These references highlight the decree's integration within a larger, interconnected legal framework designed to protect workers and individuals with disabilities.
Article 2: Key Definitions of Disability
To ensure clarity and consistency in its application, Decree 917 provides precise definitions for critical terms. These definitions are fundamental for understanding the criteria used in the disability rating process and for ensuring that assessments are standardized across different cases. Article 2 defines "Disability," "Permanent Partial Disability," "Capacity for Work," and "Regular Job."
ARTICLE 2. DEFINITIONS OF DISABILITY, PERMANENT DISABILITY PARTIAL WORK CAPACITY AND WORK DAILY. For purposes of the application and enforcement of this decree, Adopt the following definitions:
a) Disability: Disability is considered with the person who for any reason, any origin, not caused intentionally, had lost 50% or more of their working capacity.
b) Permanent partial disability, permanent disability is considered partial to the person who for any reason, any origin, present a loss of earning capacity equal to or greater than 5% and below 50%.
c) Capacity for Work: means an individual's work capacity all the skills, abilities, skills and / or potential physical, mental and social, allowing you to perform in a regular job.
d) Regular job: work is understood as usual that office, work or occupation performed by the individual capacity for work, training and / or technical or vocational training, receiving compensation equivalent to salary or income, and which listed the Social Security System.
These definitions are crucial for differentiating between various levels of impairment and their impact on an individual's ability to work. A person is considered to have a disability if they have lost 50% or more of their working capacity, provided it wasn't intentionally caused. Permanent partial disability applies to those with a loss between 5% and 50%. The concept of capacity for work is broad, encompassing physical, mental, and social abilities, while a regular job is defined by its compensation and inclusion in the social security system, reflecting a standard employment relationship.
Article 3: Date of Declaration of Loss of Working Capacity
The precise determination of the date on which the loss of working capacity becomes permanent and final is critical for legal and administrative purposes. Article 3 addresses this, emphasizing the need for robust medical documentation to support the declared date. This ensures that the process is objective and evidence-based.
ARTICLE 3. DATE OF DECLARATION OF THE STRUCTURE OR LOSS OF WORKING CAPACITY. The date on which the individual generates a loss in their ability to work on a permanent and final. For any contingency, this date must be documented with medical records, clinical and diagnostic support, and may be earlier or correspond to the date of qualification. In any case, while the person receiving temporary disability allowance, there is no place to claim the benefits arising from disability.
The article highlights that medical records, clinical reports, and diagnostic aids are indispensable for documenting this date. It also allows for flexibility, stating that the declaration date may precede or coincide with the qualification date. A key provision is that individuals receiving temporary disability allowances cannot claim permanent disability benefits simultaneously, preventing dual compensation for the same period of impairment.
Article 4: Requirements and Procedures for Disability Qualification
The process of qualifying for disability is meticulously outlined in Article 4, which details the requirements and procedures that evaluators must follow. The outcome of this process is a formal opinion, a document that serves as crucial evidence of the expert raters' assessment. This opinion must be comprehensive, transparent, and legally sound.
ARTICLE 4. REQUIREMENTS AND PROCEDURES FOR QUALIFICATION ON THE BASIS OF DISABILITY AND OPINION. For purposes of qualifying disability, the qualifiers will be guided by requirements and procedures in this manual to give an opinion. Should note that this opinion is the document that, as a matter of evidence, contains the concept emit expert raters on the degree of permanent partial disability, disablement or death of a member and be based on:
a) Considerations of factual about the situation is being assessed, which relate the events that led to the accident, illness or death, indicating the circumstances of manner, time and place within which they occurred, and CLINICAL DIAGNOSIS technical-scientific, supported by clinical history, occupational history and diagnostic aids required in accordance with the specificity of the problem.
b) Established a clinical diagnosis, we proceed to determine the loss of working capacity of the individual, through procedures defined in this manual. In any case, this determination must be made by the managers with qualified scientific, technical and ethically, with their respective official academic recognition. In case you need concepts, additional examinations or tests shall be performed and recorded in the terms set out in this manual.
c) Given that a loss of earning capacity, it made the INTEGRAL OF THE DISABILITY RATING, which is recorded in the opinion, in the forms and instructions that for that purpose by the Ministry of Labour and Social Security, which must be registered at least: the origin of illness, accident or death, the degree of loss of earning capacity caused by the accident or illness, the date format of the disability and the reasoning based on diagnostic and other reports additives, such as reporting the accident or the death certificate, if applicable.
d) The opinion must contain mechanisms to allow those concerned to exercise the remedies provided under the current rules, in order to ensure an objective dispute its contents in case of disagreement, both in substance and in terms of procedure.
PARAGRAPH . The normal consequences of aging, alone, with no pathology on aggregate, do not generate failure for the purposes of qualifying for disability in the Social Security System. Should co-exist with such pathology consequences may include within the definition of agreement with the impairment, disability and handicap for.
The opinion must detail factual considerations, including the circumstances of the incident, and a technical-scientific clinical diagnosis supported by medical and occupational histories. The determination of earning capacity loss must be conducted by qualified professionals, adhering to ethical standards. The final opinion must include the origin of the condition, the degree of loss, the disability date, and a reasoned justification. Importantly, the opinion must also provide mechanisms for appeal, ensuring due process. A significant paragraph clarifies that normal aging alone does not qualify for disability unless it coexists with a pathology.
The assessment process involves a careful balance of medical evidence and legal definitions to determine the degree of disability.
Article 5: Determination of Permanent Partial Disability
Article 5 outlines the entities responsible for determining permanent partial disability. This responsibility is primarily shared between Professional Risk Managers (ARPs) and Health Promoting Enterprises (EPS) along with Subsidized Regime Administrators (ARS). These organizations play a pivotal role in the initial assessment of an individual's loss of earning capacity.
ARTICLE 5. DETERMINATION OF PERMANENT PARTIAL DISABILITY. The determination of the statement, evaluation, review, grade and source of permanent partial disability, will be made by:
1. The Professional Risk Managers, in accordance with the provisions of article 42 Decree-Law 1295 of 1994, through their own or contract labor committees. They should evaluate the loss of earning capacity, based on this single qualification Manual Disability, in order to ensure access to the rights that persons affiliated to social security.
2. Health Promoting Enterprises (EPS) and the Subsidised Regime Administrators (ARS) in accordance with the provisions of article 5. Act 361 of 1997, will assess the loss of earning capacity, based on the Single User Rating Disabilities provided in this Decree, in order to ensure access to rights that people have with limitation. For this purpose, these entities must have a multidisciplinary team responsible for such status, in accordance with the regulations for that purpose issued by the Ministry of Health. In case of dispute about the extent and origin of the limitation determined, it will go to the Boards of the disability rating, according to the procedures defined by the standards prevailing in the area.
ARPs are tasked with evaluating earning capacity loss for their affiliates, adhering to the manual. Similarly, EPS and ARS assess individuals with limitations, requiring multidisciplinary teams for this purpose. A crucial safeguard is the provision for disputes: if there's disagreement regarding the extent or origin of the limitation, the case is referred to the Disability Rating Boards, ensuring an impartial review process.
Article 6: Rating the State of Disability by Boards
The Disability Rating Boards serve as the ultimate authority for issuing opinions on the state of disability. Article 6 details the specific cases these boards handle, highlighting their critical role in resolving disputes and making definitive determinations regarding disability status and origin. Their decisions are binding and form the basis for social security benefits.
ARTICLE 6. RATING THE STATE OF DISABILITY. The rating and issue an opinion on the state of disability corresponds to the Disability Rating Board, who will hear the following cases:
a) The rating and review of the loss of earning capacity and permanent partial disability, in case of dispute.
b) The rating of origin, degree, date of structuring and reviewing the state of disability.
c) The classification of the origin of the accident and disease, based on Law 100 of 1993, Decree Law 1295 of 1994 and other regulations, in case of dispute.
d) The classification of the origin of death in case of dispute.
Meetings of the Disability Rating must issue the opinion of the disability which, in all cases accurately reflect the contents of the record of each case reviewed by it and the outcome of the deliberations of the members in charge of branding. Similarly, corresponding to the respective Board member reporting the opinion, who can accept it or appeal it to the competent authorities.
The boards handle disputes regarding earning capacity loss and permanent partial disability, as well as the origin, degree, and structuring date of disability. They also classify the origin of accidents, diseases, and death when disputed, referencing relevant laws like Law 100 of 1993. The opinion issued by the board must accurately reflect the case's record and deliberations, and individuals have the right to accept or appeal the decision to competent authorities.
Article 7: Qualifying Criteria for Integral Disability
A cornerstone of Decree 917 is its comprehensive approach to disability assessment, which considers the biological, psychological, and social dimensions of an individual. Article 7 introduces three key concepts: Deficiency, Disability, and Handicap. These terms, derived from international classifications, provide a holistic framework for evaluating the consequences of illness, accident, or age.
ARTICLE 7. QUALIFYING CRITERIA FOR THE COMPREHENSIVE DISABILITY. For purposes of the integral rating of disability are taken into account the biological functional components, psychological and social human being, understood in terms of the consequences of illness, accident or age, and defined as follows:
a) DEFICIENCY: Deficiency means any loss or abnormality of structure or psychological, physiological or anatomical, which can be temporary or permanent, among which include the existence or occurrence of an anomaly, defect or loss caused by member, organ, tissue or other body structure, as well as proprietary systems of mental function. Represents the manifestation of a pathological condition and in principle reflects disturbances at the organ.
b) DISABILITY: Disability means any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being caused by a deficiency, characterized by excesses or deficiencies in the performance and behavior in a normal or routine activity, which can be temporary or permanent, reversible or irreversible, and progressive or regressive. Represents the objectification of the deficiency and therefore reflects changes to the level of the individual.
c) DISABILITY: Disability means any disadvantage for a given individual, resulting from an impairment or disability that limits or prevents the performance of a role, which is normal for you based on age, sex, factors social, cultural and occupational. It is characterized by the difference between performance and expectations of the individual himself or group to which it belongs. Represents the socialization of impairment and disability as it reflects the cultural, social, economic, environmental and occupational, that for the individual arising from the presence of them and alter their environment.
A Deficiency refers to a loss or abnormality in body structure or function (psychological, physiological, anatomical), representing a disturbance at the organ level. Disability, stemming from a deficiency, is a restriction or lack of ability to perform an activity considered normal for a human being, reflecting changes at the individual level. Finally, a Handicap is a disadvantage for an individual resulting from a deficiency or disability, limiting or preventing the performance of a normal social, cultural, or occupational role, reflecting the societal impact.
The path to recovery and rehabilitation is a complex journey, often requiring comprehensive support and assessment.
Article 8: Percentage Distribution of Rating Criteria
To ensure a standardized and objective integral disability rating, Article 8 assigns specific percentage weights to the three criteria defined in Article 7. This distribution provides a clear framework for evaluators to calculate the total loss of earning capacity, ensuring consistency across different cases.
ARTICLE 8. PERCENTAGE DISTRIBUTION OF THE CRITERIA FOR THE TOTAL OF THE DISABILITY RATING. To perform the integral rating of disability, is given a score to each of the criteria described in the previous article, whose sum equals 100% of the total loss of earning capacity, within the following maximum ranges of scores:
STANDARD RATE (%)
Deficiency: 50
Disabilities: 20
Handicap: 30
Total: 100
PARAGRAPH 1. Where there is no deficiency or its value is zero (0) no disability may be described or disability. Therefore, the loss of earning capacity resulting report with a value of zero (0).
PARAGRAPH 2. In accordance with paragraph 1 of article 34 Decree-Law 1295 of 1994, for qualifying in the case of work accidents and occupational diseases, the existence of previous conditions is not caused to increase the degree of disability or the benefits payable to the worker. Similarly, when there are deficiencies of congenital or acquired before complying with legal minimum ages for work and the individual has been approved occupational and socially, these deficiencies are not taken into account for the classification of the loss of working capacity occupational origin, unless they have been aggravated or have thrown up.
PARAGRAPH 3. Given that a patient suffering from a deficiency improves functional status to receive a prosthesis, reduce a defined proportion of the overall deficit of the segment that receives, as follows:
a) For aesthetic prosthesis subtract 10% of the value of global deficiency found;
b) For functional prosthesis 20% of the overall deficit found, and
c) For cosmetic and functional prostheses 30% of the overall deficit found.
Example : Enucleation of left eye with normal right eye: 15% deficiency. In this case, it is an aesthetic prosthesis and therefore subtracted 10% from 15%. Ie, 1.5%, to a final value of overall deficit of 13.5%.
The maximum scores are 50% for Deficiency, 20% for Disabilities, and 30% for Handicap, totaling 100%. Paragraph 1 stipulates that without a deficiency, no disability or handicap can be described, resulting in zero loss of earning capacity. Paragraph 2 addresses pre-existing conditions, stating they do not increase disability or benefits for work accidents unless aggravated. Paragraph 3 details how prostheses reduce the overall deficit, with specific percentages for aesthetic, functional, and combined prostheses, illustrated with an example of an eye enucleation.
Article 9: General Instructions for Qualifiers
Article 9 provides comprehensive instructions for those responsible for applying the Single National Disability Rating Manual. It emphasizes the manual's role in establishing a uniform and compulsory method for legally determining the loss of working capacity. The timing of the assessment is crucial, typically occurring after definitive diagnosis, treatment completion, and comprehensive rehabilitation, or when further recovery is deemed unlikely.
ARTICLE 9. GENERAL INSTRUCTIONS FOR QUALIFIERS. The "Manual single disability rating of" established based on criteria and components defined in the previous articles, a uniform method compulsory for the legal determination of the loss of working capacity that provides an individual at the time of evaluation. The rating of the loss of working capacity of the individual must be made known once the definitive diagnosis of the disease, treatment is completed and on completion of comprehensive rehabilitation process, or even without finishing the same, there is an unfavorable medical concept recovery or improvement. The Manual consists of three books, namely:
1. The first deals with deficiencies. Consists of fourteen (14) chapters that correspond to the evaluation of damage or partial or total absence of different organ systems. Contains a number of criteria and special tables of values to describe the damage;
2. The second deals with Disabilities, broken down into seven (7) categories, which include the additional level of seriousness, and
3. The Third, defines seven (7) categories of disability.
To determine the values of impairments, disabilities and handicaps should follow the following instructions:
a) For the deficiencies: The degree of deficiency referred to the First Book which relates to organic systems, are expressed as percentage of functional loss (global failure). To facilitate the exercise of the assessor or the Qualifying Board, contains a series of tables of values for organs or systems, which can escape the values for this component. However, in cases that are affected two or more organs or systems, partial values of the respective global deficiencies must be combined using the following formula: 1 A + (50-A) B 100 Where A and B correspond to the different deficiencies. A being the highest value and B the lowest value. This will combine the values for A and B. This is called ® combined sum. If there are more than two values, they must be pre-ordered from highest to lowest value, to proceed to combine on the formula. Example : A = 20% B = 10% Combined sum = 20 + (50 -20) X10 = 23% 100 Given that the value of the limb deficiency may reach 100%, you should use the following formula when they combined limb deficiencies: 1A + (100-A) B 100 It must calculate the overall deficit for each chapter and only then will a combination of global impairment values between chapters to find the final overall deficit. Who legally can or should determine the loss of working capacity of a person, take into account that the deficiency must be demonstrable anatomically, physiologically and psychologically, or in combination. Such abnormalities may be determined by testing a diagnostic aid affiliate, regarding the signs and symptoms. The pathologies that manifest themselves only symptoms, not easily possible to define who qualifies. Thus, decisions on the rates of disability must be supported with the patient's medical history and diagnostic testing aid, complementing clinical criteria. The results obtained with additional diagnostic tests should match the anatomic, physiological and / or mental detectable by such tests, and confirm the signs found during the medical examination. The patient's statements which only consider the description of their discomfort without the support of signs or additional examinations have no value to establish a deficiency. Where applicable, it should support the opinion with the concept of Occupational Health to determine the source of the injury. There are other cases in which, following the specific instructions for each lesion, may be added or limb deficiencies in the evaluation of damage to the brain is selected from the different degrees of deficiency the most value to the overall deficit as final.
b) Disability: the case of determining the value of disability, we proceed to perform an arithmetic sum of all disabilities with which characterize the lesion. The result of this sum corresponds to the final value of disability to be registered.
c) In the Disabilities: for determining the value of disability should assess the patient in each of t...
The manual is structured into three "books": the first covers deficiencies across fourteen chapters, providing tables for functional loss percentages. The second addresses disabilities in seven categories, and the third defines seven categories of handicap. For deficiencies, evaluators use tables to determine functional loss. If multiple organs or systems are affected, a specific combination formula is applied to calculate the overall deficit. The formula for combining two deficiencies (A and B, with A being the highest value) is: `A + (50-A) * B / 100`. For limb deficiencies, where the value can reach 100%, the formula changes to `A + (100-A) * B / 100`.
Understanding the Combination Formula for Deficiencies
The combination formula is critical for accurately assessing individuals with multiple deficiencies. It ensures that the combined impact is not simply an arithmetic sum but a more nuanced calculation that accounts for the interaction between different impairments. The formula prioritizes the highest deficiency, then integrates the others, preventing an overestimation or underestimation of the total functional loss. This mathematical approach adds scientific rigor to the assessment process.
For example, if an individual has a 20% deficiency (A) and a 10% deficiency (B), the combined sum would be calculated as: `20 + (50 - 20) * 10 / 100 = 20 + 30 * 10 / 100 = 20 + 3 = 23%`. This method is applied sequentially if more than two deficiencies are present, always ordering them from highest to lowest. The emphasis on demonstrable anatomical, physiological, or psychological abnormalities, supported by diagnostic aids and medical history, reinforces the objective nature of the assessment. Subjective patient statements without supporting evidence are explicitly stated to have no value in establishing a deficiency.
Limitations and Exceptions in Disability Rating
The decree also addresses specific situations that require careful consideration during the rating process. As mentioned in Article 8, pre-existing conditions or those acquired before legal working age are generally not factored into occupational disability ratings unless they have been aggravated. This prevents individuals from being penalized for conditions unrelated to their work or from conditions they had before entering the workforce, provided they were previously integrated occupationally and socially. The role of occupational health concepts is vital here, especially in determining the origin of an injury.
Furthermore, the manual outlines how to handle complex cases, such as brain damage, where the highest degree of deficiency from different categories is selected to represent the final overall deficit. This pragmatic approach ensures that the most significant impact on an individual's functioning is adequately captured in the final rating. The meticulous instructions for assessing deficiencies, disabilities, and handicaps, including the arithmetic sum for disabilities, underscore the decree's commitment to a thorough and consistent evaluation process.
Conclusion: The Enduring Impact of Decree 917
Decree 917 of 1999 stands as a pivotal legal instrument in Colombia, providing a structured and comprehensive framework for the assessment of disability and loss of earning capacity. By clearly defining key terms, establishing precise procedures, and outlining a multi-dimensional approach to evaluation (Deficiency, Disability, Handicap), the decree ensures fairness and consistency across all cases. Its universal scope, covering all inhabitants and sectors, reflects a strong commitment to social protection and the rights of individuals with limitations. The detailed instructions for qualifiers, including the use of specific formulas and the emphasis on medical evidence, reinforce the scientific and objective nature of the rating process. As an integral part of Colombia's social security system, Decree 917 continues to shape how disability is understood, assessed, and addressed, ensuring that those who experience a loss of working capacity receive the recognition and support they are legally entitled to.
Fuente: Contenido híbrido asistido por IAs y supervisión editorial humana.
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