Leprosy Cured Persons with Disabilities

Leprosy, also known as Hansen’s disease (HD), is a chronic infectious disease caused by a bacteria called Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract and the eyes. Leprosy is known to occur at all ages ranging from early infancy to very old age. About 95% of people who contact M. Leprea do not develop the disease.

Cure of Leprosy

Leprosy is curable with multidrug therapy. Treatment of paucibacillary leprosy is with the medications dapsone, rifampicin, and clofazimine for six months. Treatment for multibacillary leprosy uses the same medications for 12 months. A number of other antibiotics may also be used. These treatments are provided free of charge by the World Health Organization.

In the past 20 years, 16 million people worldwide have been cured of leprosy.

Prevalence of Leprosy

1. At the end of 2016, there were 173,000 leprosy cases globally.
2. The number of new cases in 2016 was 216,000.
3. Most new cases occur in only 14 countries,
4. India accounts for more than half of the new cases.
5. About 200 cases per year are reported in the United States.

Disability in Leprosy Cured Persons

Leprosy cured person means a person who has been cured of leprosy but is suffering from:

1. loss of sensation in hands or feet as well as loss of sensation and paresis in the eye and eye-lid but with no
   manifest deformity;
2. manifest deformity and paresis but having sufficient mobility in their hands and feet to enable them to engage in normal economic activity;
3. extreme physical deformity as well as advanced age which prevents him/her from undertaking any gainful occupation, and the expression “leprosy cured” shall construed accordingly.

India’s RPWD Act 2016 has recognized the leprosy cured persons with disabilities eligible for receiving disability benefits.

Disability Certificate for Leprosy Cured Persons

Leprosy Cured Persons with disabilities can apply for a disability certificate. This document is required for getting disability benefits from the government.

To apply for the disability certificate you should contact a government hospital. A medical board will evaluate your condition and give you certificate accordingly.

How Disability is Calculated for Leprosy Cured Persons

WHO Grading of Disability in Leprosy

• Grade 0
  • Eyes: No eye problem due to leprosy; no evidence of visual loss
  • Hands: No anaesthesia, no visible deformity or damage
  • Feet: No anaesthesia, no visible deformity or damage
• Grade 1
  • Eyes: Eye problem due to leprosy present, but vision not severely affected as a result of these (vision: 6/60 or better; can count fingers at 6 metres).
  • Hands: Anaesthesia present, but no visible deformity or damage
  • Feet: Anaesthesia present, but no visible deformity or damage
• Grade 2
  • Eyes: Severe visual impairment (vision worse than 6/60, inability to count fingers at 6 metres). Also includes lagophthalmos, iridocyclitis and corneal opacities
  • Hands: Visible deformity or damage present (such as cracks/wounds, claw fingers, wrist drop, contractures, amputation etc.)
  • Feet: Visible deformity or damage present (such as cracks/wounds, claw toes, foot drop, contractures, amputation etc.)

EHF (Eyes, Hands, Feet) Grade Score is calculated.

Higher the Score, greater the Disability. Maximum EHF Score possible is 12.

1. EHF Score is 0-1, then % of disability is up to 20%
2. EHF Score is 2-3, then % of disability is 20% to 40%
3. EHF Score is 4-5 then % of disability is 41% to 60%
4. EHF Score is 6-7 then % of disability is 61% to 70%
5. EHF Score is 8-9 then % of disability is 71% to 80%
6. EHF Score is 10-11 then % of disability is 81% to 90%
7. EHF Score is 12 then % of disability is 91 to 100%

NOTE 1: Involvement of dominant upper extremity (mostly right hand), additional 10% weightage is to be given.

NOTE 2: Total permanent physical impairment/disability % will not exceed 100%

NOTE 3: Review may be done after two years, if needed or desired by the affected person, in view of likely worsening of deformities in some persons.