By JAKE SORIANO
JULIET Lara has dystonia, a chronic neurological illness that affects her muscle movement.
“Nanginginig yung katawan ko pag hindi ako nakakainom ng gamot (My body shakes when I fail to drink my medicine),” she said.
Even though dystonia impairs her ability to perform everyday activities, Juliet cannot secure a person with disability (PWD) ID for it, as chronic illnesses are not among the categories that make one eligible for the said program.
She remembers being told, when she applied, to put mental disability instead on the form.
“Sabi ko wala naman akong ano sa utak (But I told them that what I have is not a mental disability),” Lara recalls.
In the end, she was able to obtain her card that states she has an orthopedic disability.
Her experience is not uncommon, according to a 2014 study commissioned by the Department of Health (DOH) with assistance from the Western Pacific Regional Office of the World Health Organization (WPRO).
In reviewing the efficacy of the current PWD ID card system in the Philippines, the paper found that the present methods to determine disability are “inconsistent with the definition of disability contained in national and international legislation.”
“Determination is based upon impairment categories without consideration of how impairments impact upon functional ability,” the paper said.
The inclusion of chronic illness in the PWD ID is “an important question,” according to the study, given the rise of diseases of such nature that will “likely confront…governments in the provision of social protection for persons with disabilities.”
The study recommended the inclusion of chronic health conditions in the PWD ID “to the extent that they lead to impairments and limitation in functioning.”
Standardize how disability is determined
Because a medical approach still guides how disabilities are settled on in the Philippines, inconsistencies and inefficiencies in determining who are eligible for a PWD ID occur.
In the paper, these can be mended if the objective of the program is clearly defined as one that helps alleviate poverty and that is targeted to “all persons that experience functional limitation.”
The study found that eligibility processes varied greatly in two local government units (LGU) – one urban and one rural – where research was conducted.
In urban Quezon City, PWD ID applicants with apparent disabilities were assessed by visual inspection while those with non-apparent disabilities were asked to provide a medical abstract. The LGU representative tasked to assess the said abstract, not being a doctor, reported difficulty in doing the task.
In rural barangay Baras in the province of Rizal, meanwhile, all applicants were referred to the rural health unit for assessment. The role of the LGU was restricted to issuing the PWD ID only.
In both cases, medical categories of disability were observed to take precedence over the impact of these on how a person with these disabilities can participate in society.
The limitations observed in both LGUs can be remedied, the study said, by clarifying the responsibility of those involved in determining disability.
“Local government units should be responsible for the overall administration of the disability determination process. This includes the implementation of functional assessments and ultimate determination of disability status. Medical practitioners should be responsible for assessing the extent to which health conditions leads to impairment,” the paper said.
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The paper recommended the following steps in the application process:
- Applicants obtain a PWD Registration Form (PWD-RF) from the LGU
- Applicants fill in personal details of the form
- Applicants present at Regional Health Unit or a licensed medical practitioner for assessment of their medical condition
- Health practitioner assesses the medical condition and associated impairment, and completes the PWD-RF by ticking the main impairment type category of the applicant
- Applicants return the completed PWD-RF to the LGU
- LGU checks and verifies the data and confirms the impairment of the applicant, conducts the functional assessment test, and determines disability status
- LGU takes a photo of person classified with a disability
- LGU submits PWD-RF and accompanying documents to the City or Municipal Social Welfare Office for entry into the national PWD database
- LGU issues the ID card to the PWD
Source: The PWD ID card: An Options Paper for the Philippines
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Working towards a more inclusive PWD ID
Social assistance is particularly important not only for PWDs but also for their families because they are vulnerable to chronic poverty and social exclusion.
“Households with disabled members are characterized by low human capital resulting in reduced earning capacity of the disabled family member and their primary career,” noted the DOH-commissioned study.
“PWDs are consistently reported as more likely to be unemployed or underemployed. Among working PWDs, the majority work in the informal sector which is characterized by low and unstable income.”
As the country’s flagship program designed for the social protection of PWDs, the PWD ID provides among others discounts on basic goods and services.
“Malaking tulong, lalo na sa gamot (It helps a lot, especially when it comes to medicines),” said Juliet of her PWD ID.
She is among the 300,000 persons as of June 2014 to have been provided a PWD ID card by their local governments.
The National Council on Disability Affairs (NCDA) said it continues to work for improvements to the program.
“On improving the coverage, we hope that the VAT [value added tax] exemption will also be approved by the Senate to avail the full 20 percent discount,” said NCDA Acting Executive Director Carmen Zubiaga,
Currently, the PWD ID card remains subject to 12 percent VAT, which minimizes the net discount its holders receive.
The NCDA, said Zubiaga further, also wants to emphasize on “discounts on rehabilitation services and assistive devices.”
