Disability means any loss or change in a structure or in a psychological, physiological or anatomic function.

This question only applies to persons with a permanent disability. If you have a temporary disability (for example, if you use crutches or a wheel chair because you broke your leg or if you suffer from a partial detachment of the retina which forces you to wear an eye patch), the answer is "No".

Hearing - Complete or significant loss of hearing. This includes individuals with a complete or significant loss of the ability to hear a conversation spoken in a normal voice and who have to resort to sight to communicate; this also includes individuals who, under the above conditions, can hear with the help of a hearing aid.

Visual - Complete or significant loss of sight. This includes persons who are unable to or experience extreme difficulty in performing tasks requiring distance or peripheral vision or in performing fine detail tasks such as reading, writing, distinguishing TV images at a distance of 2 metres, see the time on a wristwatch or recognize faces, even when wearing glasses or contact lenses. Not included are individuals who, wearing glasses or contact lenses are capable of performing the above tasks.

Physical - Disability characterized by the difficulty or impossibility of performing activities requiring control of movement or the ability to manipulate objects. Included in this group are individuals who find it impossible or extremely difficult to walk or handle objects without the aid of an assistant device (for example, a wheel chair, walker, crutches, prostheses and outhouses for the members or trunk). Included in this group are individuals in the conditions referred to above and who suffer from, for example, enclosing sodalities, spinal bifida, poliomyelitis, multiple sclerosis, muscular dystrophy, paramyloidosis (Wohlvill-Corino Andrade syndrome), cranio-encephalic trauma.

Mental - Intellectual and psychological disability. Included in this group are persons suffering from mild, moderate or severe mental retardation or other development problems characterized by a significantly lower-than average intellectual ability, such as autism or Down is syndrome (mongolism). It does not include psychotic or serious, degenerative diseases coming under the general classification of psychiatric disorders.

Cerebral palsy - Brain damage causing paralysis and affecting movement and posture. Individuals with cerebral palsy display limited, uncoordinated and uncontrolled movements, difficulty in maintaining their balance, problems of co-ordination and speech. Individuals suffering from cerebral palsy should be mentioned in this group and not in the group for motor impairment.

Other - Disabilities not included in any of those mentioned above. By way of example, persons suffering from kidney failure, hemophilia, lupus, aphasia, dyslexia, mutism, speech disorders, ostomates, deaf -blind.
If you have more than one disability, state the main one, that is, the one causing you the greatest degree of incapacity.

Note: if the answer is No, you must go to question 9.