§33 · 20 tips

Living with a disability

When you or a family member becomes disabled, which complications do you prevent first, which subsidies can you apply for, and what about school, work and guardianship?

Tips from this section that apply in the United States.

After a spinal cord injury, if there is a sudden severe headache and sweating, help the person sit up straight, loosen clothing, and call 120 (China's ambulance number) at the same time

In a person with a spinal cord injury, part of the body's alarm wiring is cut. A full bladder or tight clothing may not be felt at all, yet blood pressure can shoot up. The warning signs are a sudden severe headache and sweating. When that happens, first help the person sit up straight, loosen any tight clothing, and check whether the bladder is full, and call 120 (China's ambulance number) at the same time.

Top value
Evidence B
Buys life

Treat the first ten years after becoming disabled as a high-risk period for suicide, and don't write it off as something “cheer up” will fix

In the first few years after a disability, it is common for the person or their family to fall apart emotionally; it is not a matter of willpower. A long-term follow-up at two spinal cord injury centers in the U.K. found that the suicide rate in this group was 5 times that of the general population. More than 90% of the suicides happened in the first ten years after the injury. For people whose injury was itself a suicide attempt, the risk is higher still.

High value
Evidence A
Buys life

Someone who provides long-term care for a disabled person at home needs someone watching over their own health

A caregiver breaking down is not being overdramatic. A study in the U.S. followed more than 800 older adults for four years. Among those who cared for a disabled spouse and also reported that they were mentally strained, the risk of death was about 60% higher than for people who did not give care. Caregivers who did not feel strained did not show this rise. So what to watch is not the caregiving itself but the long-term strain.

High value
Evidence A
Buys life
Disputed

If you use a wheelchair long term, switch to a pressure-relieving cushion and check the sitting bones and tailbone once a day

An ordinary foam cushion, after long sitting, will break down the skin; once broken, it heals slowly and infects easily. Among nursing-home residents who used pressure-relieving cushions, pressure sores over the sitting bones were clearly fewer, but when the tailbone was counted together with them no difference was seen. The wheelchair itself should also be fitted to the person's size, not just bought as a generic model.

Moderate value
Evidence B
Buys life

Don't buy treatments and devices that claim to “cure paralysis, blindness or deafness”

The Advertising Law (《广告法》) is blunt. Ads for medical services, drugs and medical devices may not guarantee results, may not state a cure rate or effective rate, and may not use people giving personal testimonials. So claims like “stand up in three courses of treatment” or “so many people have recovered” are themselves illegal ads, and there is no need to study the principle they describe. Anything that is not a medical device may not even mention treating disease.

Moderate value
Evidence A
Saves money

Do rehabilitation at a proper facility with a rehabilitation medicine department, and let the therapist set the intensity: harder is not better

Taking the person home to lie down and wait for natural recovery is the most common mistake. After a stroke, organized care by a multidisciplinary team means more people are still alive a year later and still able to live at home. But don't add extra on your own either: practicing earlier, more often and more within 24 hours after a stroke led to worse outcomes at three months. How much to practice, and when, is for the rehabilitation department and the therapist to say.

Moderate value
Evidence A
Buys life
Disputed

If your hearing is getting worse, get hearing aids, and do it so you can hear, not to prevent dementia

The claim that “wearing hearing aids prevents dementia” has not held up so far. A three-year trial of nearly 1000 people showed no difference overall. A difference was seen only in the subgroup whose risk of cognitive decline was higher to begin with. So the reason to get hearing aids is to hear right now, to talk with people, and to hear cars when crossing the road, not to protect your brain decades later.

Moderate value
Evidence A
Buys life
Disputed

Mainland China only 13 tips

These tips describe mainland-China rules and do not apply in the United States; they are here for people living in China.

Admission to a psychiatric hospital is voluntary in principle, and only two situations allow it without the person's consent
A word from family or an employer can't keep a person in a psychiatric hospital. The law recognizes only two situations: the person has already harmed themselves or is in danger of doing so, or has already harmed others or is in danger of doing so. For the first, the guardian's consent is needed before the person can be admitted. If you disagree with the diagnosis, you can ask for a second diagnosis within three days, and after that you can commission an assessment yourself.
Once the disability certificate is issued, go to the county Disabled Persons' Federation and ask about everything you can apply for, all at once
The disability certificate (残疾人证) itself pays no money; it is a key. Behind it are several separate benefits, each of which you have to apply for yourself, and none of which comes to your door automatically. On the first visit to the Disabled Persons' Federation (残联), ask about the items on its list one by one, which saves you running back and forth several times.
If a child under 7 has a disability or autism, apply for rehabilitation assistance at the county Disabled Persons' Federation
The state has built a rehabilitation assistance system for disabled children and children with autism aged 0 to 6, covering surgery, assistive devices and rehabilitation training. Assistance goes first to families in difficulty, and where local finances allow, the age and family-income conditions can be relaxed. This stretch is the window when rehabilitation works best, so don't put it off until school age. The facility must be chosen from the Disabled Persons' Federation's list of designated providers.
You can apply to the government at county level or above for a subsidy for ramps, handrails and bathroom modifications at home
The Barrier-Free Environment Construction Law (《无障碍环境建设法》) has a provision: governments at county level or above should support and guide barrier-free modification of home facilities and should give suitable subsidies to qualifying households with disabled or older members. These projects are generally led by the Disabled Persons' Federation (残联) and run with a yearly quota, so register early. How much is paid and which modifications are covered are set by each locality.
When job hunting, say up front that you hold a disability certificate: hiring you offsets a cost for the company
The share of disabled employees an employer arranges to hire may not be lower than 1.5% of its total staff, with the exact share set by the province. If it falls short, the employer has to pay a disability employment security fund (残疾人就业保障金) based on the shortfall in headcount, with each missing person calculated at the employer's average annual wage for the previous year. So hiring you is not only a kindness, it is real money saved. In the interview, make clear that you hold the certificate, and the employer can work out this sum for itself.
Individual income tax for disabled people can be reduced; call the provincial tax bureau to ask how much
The Individual Income Tax Law (个人所得税法) says the income of disabled people may receive a reduction in income tax. But how much and for how long are left by the law to provincial governments, so it differs from province to province. Some provinces set a yearly reduction limit, and some reduce by a percentage. To find out, call 12366 (China's tax service hotline) to ask the local tax bureau, or look for the reduction item in the Individual Income Tax app.
Guide dogs can be taken into public places and onto public transport, and blind people ride city buses free
The law states that public places and public transport must provide convenience for disabled people who bring guide dogs, hearing dogs or assistance dogs. Blind people ride city buses, subways and ferries free with a valid certificate, and disabled people can bring along the assistive devices they need at no charge. If you are stopped, cite these two points, and if that doesn't work, file a complaint.
Disabled candidates in the college entrance exam (高考) can apply for reasonable accommodations; those using the Braille paper get half again as much exam time
Disabled candidates in the college entrance exam can apply for a Braille paper, a large-print paper, exemption from the foreign-language listening section, a separate exam room, hearing aids and wheelchairs in the room, and extended exam time. These are not given automatically: you must submit a written application by the date set by your province, with a second-generation or later disability certificate attached. If you disagree with the result, you can apply to the provincial department of education for a review.
Schools may not turn away a disabled child who applies to enroll; for those who can't get to school, the education bureau arranges teaching at home
Kindergartens and schools of all kinds may not refuse admission to a disabled child who meets the conditions, and the same goes for regular vocational schools. For a child who needs a dedicated caregiver and can't get to school, the county education bureau arranges teaching at home (送教上门) or remote classes, and the child still has an enrollment record. Admission and transfer are decided by the education bureau after an expert committee's assessment, not by the school alone.
You can take the driver's test even with the right lower limb or both lower limbs missing; the license class is C5
A person whose right lower limb or both lower limbs are missing or can't move, but who can sit steadily on their own and has enough upper-limb ability, can take the test for a small automatic-transmission car for disabled drivers, class code C5. A person missing one palm can also apply. People with vision impairment in one eye or hearing impairment each have vehicle classes they can test for. The medical exam must be done at a specialized hospital designated by the province.
To say an adult “cannot manage their own affairs,” apply to the court for a determination; a family member saying so does not count
Whether an adult has “no civil capacity” or “limited civil capacity” can be decided only by a court. Family members, an employer or the residents' committee (居委会) can't decide on their own. An interested party or a relevant organization has to apply to the court. In the other direction, if intellectual or mental health recovers, an application can also be made for a determination that the person has regained capacity. This procedure is both a restriction and a protection.
An adult's guardian is set in a legal order; if the person under guardianship injures others, the guardian pays
After an adult loses capacity, the guardian is chosen in order: the spouse, then parents and children, then other close relatives, and last any other person or organization willing to serve. If there is a dispute, the residents' committee (居委会), villagers' committee (村委会) or civil affairs department (民政部门) makes the appointment, and anyone who disagrees can go to the court. While still clear-minded, a person can name a future guardian in writing. If the person under guardianship injures others, the guardian pays.
If you are turned down for hiring, not made permanent, or paid less because of a disability, you can sue, but work out the cost of the process first
The law forbids discrimination against disabled people in hiring, regularization, promotion, professional titles, pay and social insurance. You can file a complaint with the responsible authority, or sue in court. But even if you win, the other side does not pay your lawyer's fees. So complain first, apply for legal aid (法律援助) at the same time, and only then consider a lawsuit.