“False blind” and guillotines. A typical Italian problem


Italy – “I’d tear your eyes out…” is how a comment in FB reads under the post of an article that is part of the massive media campaign on “False blind people”. This violence was precisely the aim of concentrating the visually impaired in a single large basin, that of fraudsters, and then we will see why. This indignation about social issues was, however, made up of ephemeral elements, the articles posted showed a very poor knowledge of the subject and it was precisely this that led us to ascertain the actual status of the situation of the visually impaired.
The conviction that the journalist knows everything cannot and must not pass, but the ethical obligations of an information professional include knowledge of what is written and the implications that provoke certain news about people’s lives and society in general.
Touched by this ferocity without contradictory, we have gone down to the magma of the problem, going to see what Visual Disability means, how large is the range of cases of people with disabilities and what are the reasons that too often involve them in inappropriate investigations that stamp them as “fraudsters” before the eyes of the world and even worse, before the pronouncement of the judges.

Who are the blind by law?
For the purposes of the law in force on 3 April 2001, no. 138, total blindness is defined:
a)those who are affected by a total lack of sight in both eyes;
b) those who have the mere perception of shadow and light or the movement of the hand in both eyes or in the best eye;
(c) those whose binocular perimeter residue is less than 3 per cent
Partial blinds, on the other hand, are those who:
a)those who have a visual residue not exceeding 1/20 in both eyes or in the best eye, even with any correction;
b)those whose binocular perimeter residue is less than 10 per cent.

We are pleased to interview a doctor who has lived his professional life in close contact with people suffering from diseases that often involve a visual disability. He is Dr. Filippo Cruciani, born in the Marche region and adopted in Rome, former head of the UOC (Complex Operating Unit) Ophthalmology A Policlinico Umberto I – Sapienza University of Rome, with an intense research activity that has distinguished his career and is scientific coordinator at the National Pole for Prevention and Visual Rehabilitation located at the Policlinico A. Gemelli.
A man of great experience as well as great professionalism, Dr. Cruciani lives every day in the field not only the pathology of the patient but also his torments, his fears and prejudices that take away the strength to live.

Dr. Cruciani, in your opinion, how much truth is there about the false visual disability?
“In general, almost all the visually impaired have been affected by a very violent media campaign that has further worsened their lives, all starts from the very little knowledge – unfortunately sometimes found even among those who claim to be experienced – of the difficulties that involves the visual disability. When we talk about vision loss we speak in dichotomous terms: either you see us or you don’t see us; either you are in total darkness or you see us. Nobody can imagine intermediate situations, nobody assumes the grey scale from white to black.
It is difficult to imagine – continues Cruciani – how the visually impaired person sees; if you can see how those with their eyes off can move and orient themselves in the environment, it becomes difficult to imagine how a blind person can see that keeps a glimmer of light. For example, those suffering from severe optical neuropathies report seeing as a beacon pointed in the eyes 24 hours a day with shadows on the sides, which allows you to see nothing but a “hole” of strong light during the day and night, with eyes open and eyes closed: a very annoying situation not to be desired by anyone. Paradoxically, we have noticed that sometimes more people have been rehabilitated who have lost their sight completely, then those who live in the darkest condition of darkness, who have learned to relate differently to the environment through hearing, smell and touch. Rehabilitation becomes more difficult for the blind person who perceives light and movement, whose condition changes according to the moments, situations, environmental conditions, albeit with modest perceptions of shadows.
The disabled person – says Cruciani – hides his disability: among the blind, especially if there is a minimum visual residue are very few who use the white stick, for a sense of shame and the media campaign launched without criteria on the “false blind” has further worsened the situation, so that these disabled people try even more to hide their real condition.

How did this situation come about?
“The cover of the INPS has narrowed down. The National Institute of Social Security has been used, especially in the past, also for social purposes and not only for medical purposes, so at a certain point the problem exploded: you have to save money.
It is difficult from the outside to assess the various disabilities, especially in the face of a person who has not totally lost his vision and has been rehabilitated to make the most of his residue, to orient himself and move with a certain fluency in the environment. The mistake that is normally made by everyone (man in the street, journalist, financier, carabiniere, judge, and – more than once – doctor) is that it refers to the condition of blindness on the basis of commonplaces and not on the basis of the Law that gives a very precise classification of visual impairment. By Law (Law 3 April 2001, no. 138), in fact, the category of absolute blind also includes those who perceive not only light but also things in motion. Moreover, one can be absolutely blind even when the visual field has been totally lost (i.e. the amount of space that can be controlled) but the central vision has been partially preserved (the so-called visus that allows one to recognize an object by staring at it) and vice versa: the central vision has been totally lost and the visual field has been partially preserved.
People don’t understand this, paradoxically it is hard to understand even a few workers and the INPS clung to it in the hope of containing costs and creating a favourable ground for a revision of the Law in a restrictive sense.
The bomb of the media campaign of the “false blind” stems from the typicality of visual disability that lends itself to raising suspicions such as when a blind person walks alone in the street. Almost always, simple anonymous letters are enough to trigger the machine of justice with devastating consequences for the disabled and absurd expenses for the State. Common sense – says the Doctor – would suggest to start with medical checks carried out by competent specialists according to the pathology declared by the disabled person, but instead you spend dizzying sums of money with unnecessary video footage to demonstrate what is most often denied as in the case of the use of the phone by the disabled person with whom he can easily interact with the help of voice synthesis. If he stares at the cell phone as if he were seeing it, it is just a normal reflection that preserves those who were not born blind.
By this I do not mean that there are no scams, unfortunately they happen in all colors, what I mean is that before triggering the judicial mechanisms must be noted through experts at the specialist medical level, whether the disease exists or not and once established the existing disease to what extent it makes the subject invalid. Otherwise it becomes a devastating persecution for the disabled. Even just a person with maculopathy, which does not allow you to read or write but to see only a big black spot on what you are staring at, lives a terrible condition, how can you not recognize a disability?
We need a review of the benefits to be given to people with disabilities. Visual disability is very complex, the absolute blind person must be given accompaniment. The visually impaired medium serious or mild (according to the classification of the existing law) that compares to those who have had a stroke so lives a disabling condition, must be absolutely protected, to date he is not recognized a whole lot of nothing, not even optical and electronic aids, technology that could change the quality of life. In any case – concludes Cruciani – it is absolutely essential that the doctor who assesses the disability or certifies it should be a specialist possibly competent in visual rehabilitation.

 

In a beautiful book, sociologist and journalist Mauro Marcantoni writes: “I look you in the eye, but I can’t see you. I do it to make you feel at ease”. “That’s right – says Valentina, a visually impaired woman with a rare disease. When I find myself in front of a person, I could try to rotate my eye acrobatically to put my interlocutor in that very limited segment of peripheral vision that I have left, to try to see a vague outline. This would not be of much help to me and therefore I prefer to point the eyes at him, so as to make him feel at ease, even if he disappears completely in my scotoma (in medical language, it is understood that area of blindness, within the field of vision). I took a course – continues Valentina – in Public Speaking and posture. Those born blind do not know the attitude of a sighted person. It is estimated that among sighted people 93% of communication is not through voice but through gestures, eyes and body. Whoever becomes blind as an adult preserves the attitudes and expressions of the face he had as a sighted person, knowing its meaning and communicative value, trying to put at ease the interlocutor, so that he does not move away from him. Those who have been blind since birth do not know any of this and obviously have a different attitude.

 

Unfortunately, as Dr. Cruciani explained, this is the case study that lends itself most to being targeted by the ignoble timbre of the “false blind”. While the disabled person seeks all the strength within himself to appear “normal” and face a minimum of everyday life using the magnificent aids that technology offers (think that there are applications that allow you to use a scale or a funnel through the warnings, as well as being able to cross the road independently through the traffic light or read a label through an app of the mobile phone always with voice synthesis), an anonymous letter devastates every effort and the investigators begin to send Carabinieri or Finanzieri (often not prepared for this particular service) to produce videos, make endless ambushes to prove that the blind touches the fruit at the market, looks at the phone and crosses the street independently, without making sure of what is behind all this.

So what would they say about blind people who practice competitive sports and who (not wrongly) arouse the admiration and emotion of those who watch them? What would their comments be on the film of a blind man who, on skis, throws himself into a descent on the snow, or faces an opponent with fencing or “miraculously” hits the ball when he plays baseball (see article lr)? And if they had seen on the Rai channels the program on Felice Tagliaferri (absolute blind), able to make incredible sculptures and even able to recognize the color of the clothes of his son only by touching the fabric …

Unfortunately, ignorance, understood as lack of knowledge, creates monsters and hallucinatory costs for the execution of absurd checks carried out in the worst way and endless and exhausting processes. Rather than paying six months, a year of ambushing, would it not be more logical to give the floor to science and to the irrefutable examinations such as the OCT (Optical Coherence Tomography) that shows the degree of loss of nerve fibres that make up the optic nerve for those suffering from neuropathic eye diseases?

Here are some data. Vincenzo Falabella, national president of the FISH (Federazione Italiana per il Superamento dell’Handicap – Italian Federation for Overcoming Handicap), said in an interview “In less than ten years a crazy campaign of 1,250,000 controls has been conducted in Italy. A wretched planning that has produced costs and damages. Now we also have the numbers certified by the INPS and the Ministry of Labour and Social Policies: with 450,000 checks between 2013 and 2015 the State has recovered 13 million and 600,000 euros (against a cost of 17 billion). This can be seen from the decree of distribution of the Fund for non-self-sufficiency, published in the Official Gazette on 9 February, which allocates a total of 463.6 million euros for 2017: 450 million from the budget law 2016 and 13.6 million “resulting from the activities of verification of the permanence of health requirements against holders of civil disability, blindness, civil deafness, disability and disability carried out by the National Social Security Institute (INPS)”.

In the course of our research we have found how unusual it is, for example, that in the same city, patients have been visited by an INPS Commission that always uses the same ophthalmologist (in the case of the visually impaired) regardless of what they are affected. There are two things: either this ophthalmologist (i.e. without any particular specialisation) is a monster of competence or something unclear is going on which facilitates the blocking of the “Absence of Pathology” box, as if he had the authority to cancel the diagnoses made by competent specialists.

 

We want to do more. We address the Deputy Minister Vincenzo Zoccano, in June 2018 appointed Undersecretary of State for the Presidency of the Council of Ministers with delegated powers to Family and Disability. Perfect for this task, Zoccano is not only a very competent man, so much so that he is even President of the Italian Disability Forum (FID – which includes organizations and federations representing People with Disabilities and families) and member of the National Direction of the Italian Blind and Visually Impaired Union, but he is also personally touched by issues related to disability as blind. “I am well aware of the mechanisms of investigations that are absolutely unsuitable to avoid unnecessary persecution of those with disabilities, but fortunately the INPS is now also realizing the seriousness of the condition that lives the honest disabled person whose dignity and integrity is shredded in the deadly rack of investigations not appropriate especially in terms of medical skills. On the other hand,” continues Zoccano, “the doctors who intervene in the committees are paid two bucks, which is unacceptable to a specialist with a certain experience, and a certain “carat” and even in this it is necessary to intervene by offering the right salaries. Let us bear in mind that the disabled person who comes to the committee to be assessed, is not a culprit, is not a burden on society, on the contrary, the right assessment leads to the rehabilitation of the visually impaired, blind or disabled person in general. What we want,” says the Under-Secretary, “is the rehabilitation of people with disabilities, which is essential for themselves and for society. Inclusion is the goal. Of course scams unfortunately exist and must be identified as soon as possible; it must be said that the fraudster necessarily always has an accomplice. Today there are technological means that facilitate the operations of assessment for both the evaders and for fraudsters who enjoy benefits without having the right – concludes the Deputy Minister – and we are working precisely in this direction: eliminate situations devastating to the disabled “real” and find the thieves of benefits that take resources from those who have a vital need.

What are the benefits of the Law?

Here is an excursus on all the benefits available today in Italy for the blind

Accompanying allowance – absolute civilian blind. The allowance is payable to blind persons regardless of age or income situation. For the year 2018 the amount of the allowance is 915.18 euros and is paid for 12 months.

Pension – absolute civilian blind: The pension is aimed at absolute blind adults with an individual income not exceeding the thresholds provided for annually by law. For the year 2018 the amount of the pension is 305.56 euros for the blind not hospitalized and 282.55 euros for those hospitalized, and is paid for 13 months.

Special allowance – partial civilian blind ‘twenty-seventh anniversary’. The special allowance is an economic benefit, paid on application for partial blinds. For 2018, the amount of the allowance is €209.51 and is paid for 12 months.

Pension – partial civil blind “twenty-sixths”. The pension is an economic benefit, paid in favor of persons recognized as blind partial civilians with a visual residue not exceeding one twentieth in both eyes with any correction. For the year 2018 the amount of the pension is 282.55 euros and is paid for 13 months. The annual personal income limit for 2018 is 16,664.36 euros.

We hope that the INPS will put its hand on its conscience and take all the necessary measures to put an end to this torment that we have realized to the end only by digging into the lives of the blind. Clinging the situation of a visually impaired person by passing him off as a “fraudster” is a crime because it takes away his dignity, cancels any effort for a possible rehabilitation and leads him to close dramatically in the “darkness” of depression. This would be the end for the disabled, but the Society also loses out.

D.R.



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