Manual Single National Disability Rating to Colombia - Decree 917 of 1999 (Part II of II) - CHAPTER XIV 14. Hematopoietic System 14.1 General

MANUAL SINGLE NATIONAL DISABILITY
(PART II OF II)

CHAPTER XIV
14. Hematopoietic System

14.1 General

This chapter contains the criteria for evaluating impairment caused by alterations in the hematopoietic system.

14.1.1 Rating:

a) Anemia

b) Erythrocytosis

c) Changes of leukocytes

d) Changes of the reticuloendothelial system

e) Bleeding disorders or coagulation

f) Changes of platelets

14.2 ANEMIA

Chronicity is indicated by a persistence of the condition of at least 3 months and with a hematocrit below 30% and requires at least a weekly transfusion.

14.2.1 Evaluation

Laboratory reports must match the values ​​obtained in more than one test, conducted over a period of 3 months prior to evaluation.

TABLE No. 14.2.1 Global related deficiency anemia

Symptomatology level in peripheral blood hemoglobin, g/100 ml of blood

Transfusion need global deficiency (%)

• No 11 or more in adult females None 0
• No 12 or more adult males None 0
• None to minimal 9-11 No 3
• Minimal to moderate 7 to 9 Average of 1 unit or less cada6 weeks. 10
• Moderate 7 Average of 1 unit or more every two semanas20
• Moderate to severe 5-7 Average of 1 or less every 2 weeks 30
• Severe 5 Average of 1 or more every 2 weeks 40
• Less severe than 5 1 or more every two weeks 50

14.3 erythrocytosis14.3.1 Criteria for the Evaluation of Permanent Impairment Related erythrocytosis:

TABLE No. 14.1. Global deficiency erythrocytosis.

Class Description of criteria Global Deficit (%)

I • The hemoglobin level is high, but remains at a level below 18 g/100 ml blood at sea level, with infrequent or no treatment. 5.0

II · need an intermittent treatment with phlebotomy myelosuppressive month to keep the level of peripheral blood hemoglobin less than 18 g/100 ml of blood at sea level. 20.0

III · myelosuppressive therapy is required with phlebotomy every two weeks or less to maintain the level of peripheral blood hemoglobin less than 20 g/100 ml of blood at sea level. 40.0

14.4 CHANGES OF LEUKOCYTES

For greater clarity in the exposition and to facilitate the search of the percentage of impairment is not included in this chapter leukemia in its different types or varieties which are described in the chapter that corresponds to malignant neoplasm.

14.4.1 Criteria for evaluating the impairment caused by disorders of leukocytes

TABLE No. 14.2. Global deficiency disorders of leukocytes

Class Description of criteria Global Deficit (%)

I • There are symptoms and signs of abnormality in leukocytes; Do not need any treatment or only needed sporadically; • And, you can perform all or most activities of daily living. 3.0

II • There are symptoms and signs of abnormality in leukocytes, and, • Although continuous treatment is necessary, can continue with most activities of daily living 10.0

III • There are symptoms and signs of abnormality in leukocytes · need continuous treatment; • And, there is interference in carrying out activities of daily living, occasionally requiring the assistance of others. 20.0

IV • There are symptoms and signs of abnormality in leukocytes · need continuous treatment; • And, they have difficulty performing everyday tasks, requiring continued assistance of others. 35.0

NOTE:

In general, all chronic granulocytopenia ANC repeatedly under 2,000 per mm3 and recurrent systemic bacterial infections, duly certified for at least 3 times within 5 months prior to filing for disability qualification under the class IV deficiency 35%.

14.5 ALTERATIONS the reticuloendothelial system.

Splenectomy or failure in the development of this body before 5 years of age may be associated with changes in other organ systems. Any failure on these grounds should be assessed according to the affected system. If splenectomy is traumatic origin is given a 10% overall deficit. Abnormalities of the thymus with hyperfunction should be assessed in the chapters on the aftermath, his overactive benign or malignant tumors or absence of the thymus only be assessed in relation to the difficulties of the individual to develop their activities.

14.5.1 Criteria for the evaluation of reticuloendothelial system deficiency

TABLE No. 14.3. Global deficiency disorders of the reticuloendothelial system. Class Description of criteria Global Deficit (%)

I • There are symptoms or signs of reticuloendothelial disease; • And, you can perform activities of daily living with little or no difficulty. 5.0

II • There are symptoms and signs of reticuloendothelial disease; • And, can perform most daily tasks with little help from others. 20.0

III • There are symptoms and signs of reticuloendothelial disease. · Need continuous treatment; • And, you can not perform activities of daily living. 30.0

14.6 bleeding disorders or coagulation

Since people with bleeding disorders should avoid activities that may cause trauma, there will be an overall deficit of 5.0%. Any complications or complications, should be evaluated individually according to the criteria in the standards, regardless of the cause. The percentage value assigned to the complication, must then be combined with that calculated for the disorder.

Hemophilia 14.6.1

Given that there is a deficiency of clotting factors and therefore the hemophilia should avoid activities that might cause injury, is taken as a criterion to assign a percentage of overall deficit of 17.0%. Deficiencies caused by the disease were evaluated in the relevant chapters.

14.7 ALTERATION OF PLATELET

Since platelets have impaired people need to avoid activities that could cause trauma and constant need for hemostasis, an individual who has an established disorder in platelets, have a deficiency of 10%. The complications that may arise as a result of disorder in platelets, such as bleeding or thrombosis should be evaluated according to the criteria for the assessment of impairment of the affected system and then combined with the value determined for the disorder platelets.

Article 13th. - Book Two: OF DISABILITY

1. General:

This book complements the First and Third, to achieve the rating of disability within the principle of comprehensiveness. It is therefore necessary that the doctors of the Functional Assessment Committees and the Boards of the Disability Rating, understand very clearly what the impact of a deficiency in the operation causes physio-psycho-social of a person or a worker.

2. Definition of disability:

In Health experience, a disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. Their top rating in the sum total of disability is 20%.

3. Nature of the disability:

The disability is characterized by excesses or deficiencies in performance and behavior in a normal routine activity, which can be temporary or permanent reversible or irreversible and progressive or regressive. Disabilities may arise as a direct result of the deficiency, or a response of the individual himself, especially the psychological, physical disability sensory or otherwise. Disability represents the objectification of a deficiency and as such, reflects changes at the level of the individual.

4. General Criteria for the classification of disability.

To qualify for disability must be taken into account the following criteria:

4.1. Concept of integrity: to award the disability is considered the human being as an open system composed of three subsystems.

a) Subsystem will: Government, singles, motivates and initiates execution. The will determine the "why we do what we do."

b) Habituation Subsystem: Organize what we do in patterns (habits and routines) whereas when we do.

c) subsystem performance: "It is that with what you have to do" and includes structures used to produce occupational performance.

4.2. The damage occurred in any of these subsystems leads to a particular disability is qualified.

4.3. To qualify for disability of occupational performance, human processes regarding occupational (work, recreation, leisure and self care) must take into account not only the main executing agency for such activities as such, but also the systems, organs and functions that support, provide feedback and take part in the execution of the activity evaluated.

4.4. Each of the disabilities other than disabilities of the situation has a different severity depending on the type of pathology as follows:

TABLE No. 1. Severity rating

STANDARD RATE

0.0 nondisabled

0.1 Difficulties in implementing

0.2 Implementation aided

Assisted implementation dependent, increased. 0.3

In awarding the score should be used for the previous table in each of the disabilities, taking into account not exceed the maximum value assigned to each category of disability.

5. Classification of disability

For a better understanding and ease of type of disability can be an individual, they have been divided into categories, each category in turn has a maximum score qualifying under the weight of each category is within the normal performance of an individual. The following table condenses the categorization and individual scores for qualifying.

TABLE No. 2. Classification of disabilities

Relationship categories and their individual maximum scores for qualification

MAXIMUM PERCENTAGE ASSIGNED Category

• Behavioral disabilities 3.0
• 3.0 Communication Disabilities
• Personal care disabilities. 3.0
• Disabilities of locomotion 3.0
• Disabilities of the disposition of the body 3.0
• 3.0 dexterity disabilities
• 2.0 Disability status
• TOTAL SCORE 20.0

TABLE No. 3. List of disability categories and double digit scores. Indivi Category SCORING TYPE OF DISABILITY. Sum Total

1. 3.0 BEHAVIORAL DISABILITIES

Disability Awareness (10-16) 2.1

• 10 Disability Awareness 0.3 I
• 11 Disability in relation to the location in time and space 0.3
• 12 Other disability 0.3 Identification
• Disability 
• 13 0.3 Personal Safety
• 14 Disability in relation to the conduct situational 0.3
• 15 Disability in the acquisition of knowledge 0.3
• 16 Other educational disability 0.3
• Disabilities relations (17 - 19): 0.9
• 17 0.3 Disability of family role
• 18 0.3 Disability of occupational role
• 19 0.3 Disability of the social role

2. 3.0 COMMUNICATION DISABILITIES

Speech disability (20-22) 0.9

• Disability 20 0.3 understanding speech
• 21 0.3 Disability talk
• 22 Another disability talk 0.3
• Disability hearing (23 - 24) 0.6
• Disability 23 0.3 hearing speech
• 24 0.3 Another hearing disability
• Disabilities to see (25-27) 0.9
• 25 Disability visual tasks together 0.3
• 26 Disability for detailed visual tasks 0.3
• 27 Other disability to view and similar activities 0.3
• Other communication disabilities (28-29) 0.6
• 28 0.3 Disability type
• 29 Another 0.3 communication disability

3. 3.0 PERSONAL CARE DISABILITIES

Disabilities excretion (30-32) 0.9

• 30 0.3 Difficulty controlled excretory
• 31 0.3 Difficulty uncontrolled excretory
• 32 Disability to move and make use of sanitary or other elements for excretion. 0.3
• Disabilities personal hygiene 0.6
• Disability 33 0.3 bath
• 34 Other personal care disability 0.3
• Fixed Disabilities (35-36) 0.6
• 35 Disabilities to put clothes 0.3
• 36 Another 0.3 fixed disability
• Disabilities for feeding and other personal care (37-39) 0.9
• 37 Disability in food preparations 0.3
• 38 Another 0.3 feed disabled
• 39 Other personal care disability 0.3

4. 3.0 DISABILITIES MOVEMENT

Disabilities of ambulation (40-45) 1.8

• 40 0.3 Disability walk
• 41 0.3 Disability save slopes
• 42 0.3 Disability stairs
• 43 Another disabilities to climb 0.3
• Disability to run 0.3 44
• 45 Another 0.3 ambulation disability
• Disabilities from leaving (46 -47) 0.6
• 46 Disability to change positions in bed or chair. 0.3
• Disability 47 0.3 transport use
• Other disability in locomotion (48-49) 0.6
• Up 48 0.3 Disability
• 49 Another 0.3 locomotion disability

5. DISABILITIES OF THE DISPOSITION OF THE BODY 3.0

Domestic Disabilities (50-51) 0.6

• 50 Disability to provide subsistence 0.3
• 51 Disability 0.3 housework
• Disabilities body movement (1952-1957) 1.8
• Disability 52 0.3 pick
• Disabilities to reach 0.3 53
• 54 Another disability of arm function 0.3
• 55 0.3 Disability kneel
• Disability 56 0.3 Crouch
• 57 Another body movement disabilities 0.3
• Other disabilities in the provision of the body (58-59) 0.6
• 58 Impaired postural 0.3
• 59 Another provision of the disability of the body 0.3

6. 3.0 SKILL DISABILITIES

Disabilities in daily life (60-61) 0.6

• 60 Disability regular 0.3 environment
• 61 Another disability of daily life 0.3
• Disabilities manual activity (62-66) 1.5
• Disability 62 fingers to handle 0.3
• Disability to grab 63 0.3
• Disability 64 0.3 hold
• 65 Disability hand use 0.3
• 66 Other disability manual activity 0.3
• Other dexterity disabilities (67-69) 0.9
• Disability 67 0.3 foot control
• 68 Another Body Control disabilities 0.3
• 69 Another 0.3 dexterity disability

7. 2.0 DISABILITY STATUS

Disabilities dependency and resistance (70-71) 0.4

• Unit 70 0.2 circumstantial
• 71 0.2 Disability in the resistance
• Environmental Disabilities (1972-1977) 1.4
• 72 Disability relating to tolerance of temperature 0.2
• 73 Disability relating to tolerance of other climatic 0.2
• 74 Disability relating to tolerance to noise 0.2
• 75 Disability relating to tolerance of 0.2 Lighting
• 76 Disability relating to tolerance to stress at work 0.3
• 77 Disability relating to tolerance of other environmental factors 0.3
• Other disability status (78) 0.2
• Another 78 0.2 Status disabled

CHAPTER I

BEHAVIORAL DISABILITIES

Refers to the restriction or lack of the ability of individuals to behave, both in daily life activities and in relation to others, either because of problems of consciousness, loss of motivation or learning difficulties. Excludes: Communication Disabilities (2)

DISABILITIES AWARENESS (10-16)

Awareness refers to having knowledge.

10 AD DISABILITY AWARENESS OF SELF

Includes: disturbance of the ability to develop or maintain a mental representation of self-identity of the subject or body (body schema) and its continuity over time, and behavioral disturbance resulting from the interference with conscience or sense of identity and confusion (inappropriate interpretation and response to external events, which is expressed by means of agitation, restlessness and noise). This disability is scored when present on a temporary or permanent.

10.1 Disability in the orientation of the body schema

Includes: disturbance of the mental representation of the subject's body, such as inability to differentiate right and left, experiences "phantom limb" and other similar phenomena.

10.2 In personal appearance

Includes: Souci for shaving or hair care status and bring dirty clothes. Dress and makeup in a careless manner, physical appearance very strange or inconsistent with the circumstances and the socio - cultural.

10.3 Other disturbance of the presentation of self

Includes: disturbance of the ability to offer a favorable image in social situations, such as not paying attention to social support routines (eg, waving, partying, thank, apologize, apologize, and reciprocity of all it) and lack of "presence" (eg, total lack of originality or excessive conformity in behavior). Excludes: Intentional Behavior unconventional (not a disability).

11 AD DISABILITY IN RELATION TO THE LOCATION IN TIME AND SPACE

Includes: disturbance of the subject's ability to properly identify external objects, events and himself in relation to the dimensions of time and space. This disability is qualified even if this temporarily.

DISABILITY IDENTIFICATION AD 12

Includes: disturbance of the ability to correctly identify objects and people.

This disability is qualified even if this temporarily.

12.1 Conduct out of context

Inappropriate conduct to the place, time, degree of maturity at the prevailing circumstances.

13 SECURITY DISABILITY PERSONAL AD

Includes: disturbance of the ability to avoid risks to the integrity of the body of the subject as being at risk of injury, being unable to react to protect themselves from any risk.

13.1 tendency to cause injury

Includes: Risk of suicide or self-inflicted injury or injury from loss of sensitivity.

13.2 Disability to ensure personal safety in special situations.

Includes: To be in danger in special situations such as those related to travel, transport and leisure, including sport. Excludes: Disability occupational role (18)

13.3 Conduct irresponsible or potentially dangerous to the subject himself

Includes: Leave the gas on or off the fire, throwing burning matches on carpet

13.4 Loss

Another 13.5 madness.

14 AD DISABILITY IN RELATION TO THE CONDUCT SITUATIONAL

Includes: disturbance of the ability to record and understand the relationships between objects and people in daily life situations. Excludes: personal safety Disability in special situations (13.2)

14.1 Disability understand situations

Includes: disturbance of the ability to perceive, record and understand the relationships between things and people.

14.2 Disability in interpreting situations

Includes: False interpretation of the relationships between people, things and their meaning.

14.3 Disability to address the situation

Includes: disturbance of the ability to perform in specific situations, such as those made outside of the house or in the presence of certain animals or other objects. Excludes: Disability behavior in critical situations (18.7)

15 AD DISABILITY IN THE ACQUISITION OF KNOWLEDGE

Includes: general disturbance of the ability to learn, as can be caused by deficiencies of intellect or ability to learn new skills.

16 OTHER DISABILITIES OF CHARACTER EDUCATION

Includes: Another disabilities to take advantage of educational opportunities due to the disruption of specific individual skills to acquire, process and retain new information. Excludes: due to communication disabilities (2) and other disabilities (3-7) Includes: Decline in mental function.

DISABILITIES OF RELATIONS (17-19)

17 AD DISABILITY FAMILY ROLE

17.1 Disability in participation in household activities.

Includes: Impaired ability to develop common activities such as regular meals together, doing household chores, going out together to visit, play games and watch TV and conducted during these activities, as well as the difficulty and lack of interest in decision making household matters, such as decisions relating to the children and money.

17.2 Disability in the marital role emotional.

Includes: disturbance of the affective relationship continued with their regular partner and communication (well, talking about the children, news and events of everyday life), ability to show affection and warmth (but excluding regular outbursts of anger or culturally irritability) and generate the feeling of being a source of support for the other spouse.

17.3 Disability marital role

This disability may exist because of a physical or mental. Includes: Disruption of sex with regular partner (including the practice of sexual intercourse and whether the subject and your partner are satisfactory sexual intercourse)

17.4 Disability parental role.

This disability may exist because of a physical or mental. Includes: disturbance of the ability to assume and perform the tasks of caring for children that correspond to the position of the subject at home (well, feed, into bed or take to school, so that relates to young children, and addressing the needs of children, in the case of older children) and to express interest in children (well, play with them, read a story and interested in the problems of children or homework)

17.5 Other family role disability.

AD 18 DISABILITY OF OCCUPATIONAL ROLE

Includes: disturbance of the ability to organize and participate in occupational activities, leisure or recreational routine.

Excludes: Disabilities of the situation (70-78)

18.1 Disability in motivation.

Includes: Interference with the ability to work under a severe deficiency of momentum.

18.2 Disability in cooperation.

Includes: Inability to cooperate with others and to "give and take" in social interaction.

18.3 Disability in the work routine

Includes: disturbance of other aspects of adaptation to the routine work (such as going to work regularly and on time, and observe the rules).

18.4 Disability for managing daily routines.

Includes: disturbance of the ability to organize activities according to a temporal sequence, and difficulty making decisions on issues of everyday life.

18.5 Other disability in the performance of work

Includes: Other difficulties in the conduct and results of the work.

18.6 Disability in recreational activities.

Includes: Lack of interest in leisure activities (such as watching television, listening to the radio, read newspapers or books, play games and have hobbies) and events of local and global levels (including efforts to obtain information).

18.7 Disability behavior in critical situations.

Includes: unsatisfactory or inappropriate responses to events (illness, accident or other incidents affecting a family member or others), emergency (like fire) and other experiences that would normally require a quick decision and action.

18. 8 Another occupational role disability.

Includes: For subjects who do not work, the disturbance of interest in getting a job or return to the old position, and the steps taken to achieve this goal. Excludes: Other social role disability (19.2)

19 AD DISABILITY SOCIAL ROLE.

This disability can occur as a result of mental or physical disability in the latter case, people may lose interest in social interaction. Includes: impairment of interpersonal relationships outside the home (friends, coworkers and the general community). Excludes: Disability occupational role (18).

19.1 Disability social interaction.

Includes: Conduct of the subject that involves difficulties in social interaction, either by excess or defect (withdrawal, irritability defendant or other frictions arising in social situations outside the home.) Excludes: Disability Awareness I (10) and identification (11-12)

19.2 Indifference to social norms accepted.

Includes: Conduct that is embarrassing (such as making suggestions or sexual innuendo, or not contained in the genital scratching or noisy farts release), disrespectful (such as singing, making silly jokes or impertinent remarks or showing too much familiarity) or histrionic (as express feelings in an exaggerated way, dramatic) Excludes: Intentional conduct or when it is proper behavior is itself a cultural context, not being a disability. .

19.3 antisocial behavior.

Includes: Severely maladjusted, psychopathic and delinquent

19.4 Other social role disability

Includes: Another behavioral disturbance in excess or defect that presents control problems (such as aggressiveness, destructiveness, hyperactivity and extreme attempt to get attention or extreme passivity).