Granting Social Rights: Medical and Medico-Social Approaches in French Disability Policies. A study of the Evaluation of Applications in Two Maisons Départementales des Personnes Handicapées
The debates around a biomedical or social definition of disability find an echo in the assessment of disability by the French Maisons Départementales des Personnes Handicapées. The constraints they face lead them to favor an assessment that is either medical or multidisciplinary and environmental, as shown by the analysis of the applications for recognition as a disabled worker. This assessment work is characterized by the tension between a principle of individualization of care and a principle of equivalence of treatment. Two types of resolution of this tension can be distinguished: a biomedical resolution, stressing on the diagnosis, and a medico-social resolution, based on the work of multidisciplinary teams. Conflicts between these two approaches may arise when determining an official “disability rate”. These differences in approach may overlap with professional and generational differences (between doctors and social workers, between agents who worked in the former bodies / recently recruited agents).