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BOX 1.2 Definitions

Compensability: Qualifying under the law for payment for medical expenses and/ or loss of earning capacity because of partial or total loss of function or capacity (impairment) as the result of an injury or illness.

Disability: A social definition indicating inability or limitation in performing socially defined activities and roles expected of individuals within a social and physical environment. Examples are inability to perform a job or inability to swim recreationally (Institute of Medicine, 1997:6).

Disease: An objective pathologic condition, involving interruption or interference with normal body structures or function (adapted from the definition of “pathology” in Institute of Medicine, 1997:5).

Disorder: Is variously defined as an alteration in an individual's usual sense of wellness or ability to function. A disorder may or may not interfere with usual activities of daily living or work activities. A disorder may or may not be associated with well-recognized anatomic, physiologic, or psychiatric pathology.

Exposure: Proximity or contact with a putative risk factor in such a manner that an injury, disease, or illness may occur (from Last, 1988). The concept carries with it the dose of the causative risk factor.

Illness: A clinical definition indicating the subjective state of the person who feels aware of not being well (from M.W. Susser, cited in Last, 1988). This subjective experience may or may not be associated with objective signs of disease.

Impairment: A functional definition indicating a loss and/or abnormality of mental, emotional, physiological, biomechanical, or anatomical structure or function. This includes, for example, losses or abnormalities due to pain and/or gait abnormality or at the extreme, invalidism, and may refer to organs and organ systems function or to the intact individual. (derived from Institute of Medicine, 1997:6).

Injury: Any damage to the individual (anatomic, physiologic, or psychiatric) resulting from exposure to thermal, mechanical, electrical, or chemical energy or other stessors or from absence of such essentials as heat or oxygen (adapted from National Committee for Injury Prevention and Control, 1989).

Outcome: All the possible results that may stem from exposure to a causal factor or from preventive or therapeutic interventions: all identified changes in health status arising as a consequence of the management of a health problem. (from Last, 1988).

Work: The act of expending human labor or effort, usually for financial remuneration, to create a product or to produce goods or services. The expenditure of effort to create, transform, or process goods, services, or intellectual models.

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