CJRTP

Chinese Journal of Rehabilitation Theory and Practice ›› 2025, Vol. 31 ›› Issue (4): 373-381.doi: 10.3969/j.issn.1006-9771.2025.04.001

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Disability definition, classification, grading and assessment in disability eligibility: an ICF and ICD -11 framework perspective

YANG Yaru1,2, QIU Zhuoying1(), CHEN Di1,3(), LÜ Jun4,5,6, TIAN Yifan1,3, ZHANG Aimin3   

  1. 1. WHO-FIC Collaborating Center in China, Beijing 100068, China
    2. College of Physical Education and Health, East China Normal University, Shanghai 200241, China
    3. Department of Rehabilitation Information Research, China Rehabilitation Science Institute, Beijing 100068, China
    4. School of Public Health, Fudan University, Shanghai 200032, China
    5. China Research Center on Disability, Fudan University, Shanghai 200032, China
    6. National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai 200032, China
  • Received:2025-04-04 Published:2025-04-25 Online:2025-04-25
  • Contact: QIU Zhuoying, E-mail: qiutiger@hotmail.com; CHEN Di, E-mail: cindino80@126.com
  • Supported by:
    The Fundamental Research Funds for Central Public Welfare Research Institutes, conducted by China Rehabilitation Science Institute(2022CZ-1);National Social Science Fund of China (Major)(17ZDA078);National Key Research and Development Program of China(2021YFC2701004);National Natural Science Foundation of China (General)(72274038)

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Abstract:

Objective Utilizing the International Classification of Functioning, Disability and Health (ICF) framework and International Classification of Diseases, the 11th Revision (ICD-11) system, alongside evidence from World Health Organization (WHO) global reports and technical reports from relevant countries, this study systematically examines the definitions, classifications, grading, and assessment methods for visual, hearing, speech, physical, intellectual, and mental (psychiatric) disabilities.
Methods Employing the ICF's biopsychosocial model, classification, and coding system and ICD-11, and referencing WHO global reports and national technical reports, this study systematically investigated the definitions, classifications, grading and assessment approaches for six prevalent disabilities: visual, hearing, speech, physical, intellectual and mental.
Results The ICF and ICD-11model and classification system offered a robust framework for defining, classifying, grading and assessing disabilities. Disability definitions should address body function impairments, activity limitations, participation restrictions and environmental factors. The definitions, classifications and grading of visual, hearing, speech, physical, intellectual and mental disabilities aligned with ICF categories for body functions and structures, activities and participation and categories of ICD-11. Standardized tools like the WHO Disability Assessment Schedule (WHODAS 2.0) effectively measured overall activity and participation levels.
Conclusion Anchored in the ICF and ICD-11 framework, disabilities are defined, classified, graded and assessed across body functions and structure, activities and participation, and environmental factors. WHODAS 2.0 serves as a universal tool for assessing activities and participation, enabling both comprehensive functional evaluations and the conversion of results from other assessment tools. By analyzing WHO global reports and technical documents in some countries within the ICF and ICD-11 classifications framework, this study highlights global advancements in disability definitions, classifications, grading and assessments. Variations in disability statistics stem from differing definitions, diagnostic criteria and assessments. Disability service eligibility criteria should be tailored to the needs of recipients and the capacity of providers.

Key words: International Classification of Functioning, Disability and Health, International Classification of Diseases, the 11th Revision, disability, grading, assessment

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