 This implication has led some to criticize the method of quality-adjustment on the grounds that it produces a kind of “double jeopardy:” people with disabilities are disadvantaged twice-over, first by having the disability itself, second by having their health care needs discounted for that very reason (e.g., Singer et al. 1995; Bognar 2011; John et al. 2017). But there is another way of thinking about QALYs which takes issue with both quality-adjustment and an assumption behind the double-jeopardy criticism. When the “exchange rate” between disabled and non-disabled life-years is calculated, it is primarily or exclusively based the judgments of able-bodied people. This feature is criticizable on two distinct grounds. One is that it disrespects the first-person authority of people with disabilities, who know first-hand what it’s like to have the disability in question (and, if disabled as adults, know also what it’s like not to have the disability). This disrespect for first-person authority is plausibly an example of testimonial injustice, at least insofar as it reflects prejudicial or otherwise biased attitudes on the part of the able-bodied. A second, related criticism is that this approach exaggerates the difference in quality between able-bodied and disabled lives, relative to an approach that appropriately incorporated and weighed the perspectives of people with disabilities. Able-bodied people often overestimate how bad it would be to have a given disability, given popular stereotypes which depict life with disability as tragic, occlusive of life’s major goods, and so on. This is plausibly an example of hermeneutical injustice, insofar as the poor understanding of disabled people’s experiences and identities results from their exclusion from the public sphere. This is only one example; much work remains to be done exploring the implications of epistemic injustice for people with disabilities.