Disability is a universally difficult concept to define and assess for social assistance and social insurance purposes and these benefits have proven difficult to administer internationally because of ambiguities present in the process of determining the employability of people with physical impairments. In post-apartheid South Africa, disability grants (DGs) have proved especially difficult to regulate because of the added complexities of high levels of structural unemployment and poverty, an HIV epidemic and a social security system which does not cater adequately for all groups in need of support. The paper identifies three periods in the state's attempts to improve DG administration through legislative and regulatory measures since 1990: 1) a period of extending access and overcoming administrative barriers, supported by a socio-economic rights discourse; 2) a period of growth and generous access, resulting in growing concern about over-generosity and fiscal sustainability; 3) a period of action or 'rationalisation' in which the state places new limits on access to the grants, leading to decline in the number of social grant recipients. Common to all three periods are numerous and ongoing problems in the disability assessment process. These exist because disability is a complex, multi-dimensional concept, which is difficult and expensive to properly assess, especially in a context of high demand and significant resource limitations within the healthcare system
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