Permanent Disability between Current Medicolegal System and Reality (A Retrospective Study in Menoufya Medicolegal Authority, Egypt)

Introduction: Disability is simply the inability to engage in any substantial gainful activity as a result of any physical or mental impairment. Disability, impairment and infirmity are interchangeable terms. It is always difficult and confusing to distinguish between these terms. Disabilities and permanent infirmity have a great impact on most of the societies. They represent a challenging health, social and medicolegal wide world problem. Around 15% of the world's population, or estimated 1 billion people, live with disabilities. According to 2006 Egyptian census, it was estimated that 1.8% of the Egyptian population is living with disabilities and the number increase as 10.7% of the Egyptian population is living with disabilities according to 2017 Egyptian census. Aim of the Work: To assess the validity and effectiveness of laws and tables determining disability percentage and compare between Egyptian permanent infirmity tables and other methods like ICF  Methods: A retrospective study of all cases with permanent infirmity prescribed to Menoufya Medicolegal Authority for 6 months period starting from 1st of July 2015 till the 31th of December.  Results: The total cases of injuries with permanent infirmity were 295 of which 205 were excluded as some of these cases were not considered as disabilities according to the Egyptian permanent infirmity tables e.g. skin distortion, so only 90 cases (30.5%) were enrolled in the study. The highest percent was in age group between 30-45 years old (42.2%) and the least in age group between 15- 30 years old (4.4%). Male cases were the predominant represented (74 cases, 82.2%) blunt instruments were accountable for (55 cases, 61.1%) followed by sharp instruments (18 cases, 20%). Skeletal disabilities were the predominant (48 cases, 53.4%) followed by peripheral nerve affection (13 cases, 14.4%). The cause of disability was mostly due to non-occupational injuries (84 cases, 93.3%), which occurred as a sequence of homicidal manner (68 cases, 81%) while there were no suicidal cases that ended in permanent infirmities. Conclusion: The Egyptian permanent infirmity tables are in need for reupdating and fulfillment of the missing infirmities.  Recommendations: Applying ICF as a tool for disability assessment guarantees amore fair compensation method. A large study on disability assessment in Egypt should be carried out to cover all governorates and include ,not only entities of the Medicolegal Authority but also those of the Health Insurance Organization ,being the other party involved in this critical risk with applying ICF as a tool for infirmity assessment