Section 33·20 items·9 October 2026

Living With a Disability

three on-the-spot steps for autonomic dysreflexia, the suicide window in the ten years after becoming disabled, the voluntary principle for psychiatric hospitalization and its two exceptions, caregivers' own risk of death, pressure-relief wheelchair cushions, scams promising a cure, the six benefits to ask about in full after getting the certificate, long-term care insurance is not only for older people, rehabilitation assistance for ages 0 to 6, subsidies for home accessibility modifications, quota-based employment and the disability employment security fund, individual income tax reductions, guide dogs and free rides, reasonable accommodations for the college entrance exam, schools may not refuse admission and teaching delivered at home, the C5 driving license, how to choose a rehabilitation facility, hearing aids, determination of legal capacity and guardianship. Outcome type: mortality/money/time/personal freedom.

A 17B 3C 0

Lifespan 6Time and energy 1Money 9Personal freedom 43 contested

This section is about life after a disability has already happened. How to prevent disability is covered in Section 1 and Section 13, and is not repeated here.

The four outcome types are counted separately and are not converted into one another. The items on acute emergencies and complications are counted in mortality. The items on subsidies, benefits and lawsuits are counted in money. The items on going to school and handling paperwork are counted in time. The items on psychiatric hospitalization, legal capacity and guardianship are counted in personal freedom.

The World Health Organization's fact sheet gives three figures. About 1.3 billion people worldwide have a significant functional impairment, 16% of the world's population, roughly one in every six people. Some people with disabilities die up to 20 years earlier than people without disabilities. People with disabilities have twice the risk of depression, asthma, diabetes, stroke, obesity or poor oral health. A large part of these gaps is caused not by the disability itself but by not being able to see a doctor, go to school, find work or get out of the house. That is why, of the items in this section, half are about the body and half are about procedures and rights.

Five topics are already covered elsewhere; here they are only pointed to, not repeated. How to get a disability certificate, and how the seven categories and grades one to four are assessed: see Section 24, Item 10 (disability certificate). How long to wait before a disability assessment is done: see Section 24, Item 9 (disability assessment). How to claim the two disability subsidies: see Section 7, Item 8 (the two subsidies). How a work-capacity assessment and disability grade for a work injury translate into money: see Section 19, Item 14 (work-capacity assessment). How to apply for long-term care insurance for severe loss of function: see Section 17, Item 7 (long-term care insurance). That item is in the section “When There Are Older People in the Family,” but this benefit has no age threshold; young people can claim it just the same.

For most items in this section, the beneficiaries are you yourself and your family, the top two tiers. Where other people are involved, this is written separately in the Notes.

The items in this section are grouped by theme below; the numbers in parentheses are item numbers.

Body and rehabilitation: sudden severe headache after a spinal cord injury (Item 1), switching to a pressure-relief wheelchair cushion (Item 5), don't buy treatments that claim to cure paralysis (Item 6), do rehabilitation at a proper facility (Item 16), get hearing aids when your hearing declines (Item 17).

Benefits and subsidies: ask the disabled persons' federation (残联) about all your benefits in one go (Item 7), apply for rehabilitation assistance for a child with a disability (Item 8), apply for subsidies for ramps, handrails and bathroom modifications (Item 9), individual income tax reduction (Item 11).

Finding work and defending your rights: tell employers up front, when job hunting, that you hold a disability certificate (Item 10), you can sue if you are refused a job because of a disability (Item 20).

School and getting around: take a guide dog into public places (Item 12), apply for reasonable accommodations in the gaokao (Item 13), schools may not turn away children with disabilities (Item 14), you can get a driver's license even without both legs (Item 15).

Mental health and caregivers: suicide risk in the first ten years after becoming disabled (Item 2), caregivers looking after their own health (Item 4).

Mental disorders and guardianship: psychiatric hospitalization is voluntary in principle (Item 3), determining legal capacity requires an application to a court (Item 18), guardians are set by a statutory order (Item 19).

Sources are reproduced exactly as they appear in the Chinese original, including Chinese titles of laws and quoted statutory text. Original Chinese text of this section at upstream commit bb25081, on GitHub.

Items in this section (20)

BItem 1After a spinal cord injury, if there is a sudden severe headache and sweating, first help the person sit upright and loosen their clothing, and at the same time call 120 (ambulance)
AItem 2The first ten years after becoming disabled are a high-risk period for suicide; don't treat it as something “just look on the bright side” can fix
AItem 3Psychiatric hospitalization is voluntary in principle; only in two situations can it happen without the person's own consent
AItem 4The person who looks after a family member with a disability long-term needs someone keeping an eye on their own health
BItem 5If you use a wheelchair long-term, switch to a pressure-relief cushion and check your sitting bones and tailbone once a day
AItem 6Don't buy treatments or devices that claim to “cure paralysis, blindness or deafness”
AItem 7Once your disability certificate is issued, go to the county disabled persons' federation and ask about everything you can apply for, all in one go
AItem 8If your child is under 7 and has a disability or autism, apply to the county disabled persons' federation for rehabilitation assistance
BItem 9For ramps, handrails and bathroom modifications at home, you can apply for a subsidy from the government at or above the county level
AItem 10When job hunting, tell employers up front that you hold a disability certificate; hiring you lets the company offset a sum of money
AItem 11People with disabilities can get a reduction in individual income tax; call the provincial tax bureau to ask how much
AItem 12Guide dogs may be taken into public places and onto public transport, and blind people ride city public transport for free
AItem 13People with disabilities taking the gaokao (national college entrance exam) can apply for reasonable accommodations; with a Braille paper, the exam time is extended by half
AItem 14When a child with a disability applies to enroll, the school may not refuse; for a child who cannot get to school, the education bureau arranges for teachers to come to the home
AItem 15Even if you have lost your right leg or both legs, you can still get a driver's license; the vehicle class is called C5
AItem 16Do rehabilitation at a proper facility with a rehabilitation medicine department, and follow the therapist on intensity; harder is not better
AItem 17When your hearing declines, get hearing aids; the reason to get them is to hear, not to prevent dementia
AItem 18To say an adult “can't manage their own affairs,” you must apply to a court for a determination; family members' say-so doesn't count
AItem 19An adult's guardian is set by a statutory order; if the person under guardianship harms someone, the guardian pays compensation
AItem 20If you are refused a job, denied regular status or paid less because of a disability, you can sue, but first work out the cost of the process

Section 33, Item 1·Outcome Lifespan

After a spinal cord injury, if there is a sudden severe headache and sweating, first help the person sit upright and loosen their clothing, and at the same time call 120 (ambulance)

Value for cost Very high

In plain terms

In a person with a spinal cord injury, a stretch of the body's alarm wiring has been cut. With a full bladder or tight clothing, the person may feel nothing, yet their blood pressure can shoot up sharply. The signal is a sudden severe headache and sweating. At that point, first help the person sit upright, loosen any tight clothing and check whether their bladder is full, and at the same time call 120.

Cost: No money. Three actions, done in a few dozen seconds. No money Done in passing No willpower Benefit size large
Benefit: This kind of episode is called autonomic dysreflexia. A systematic review searched four databases, Medline, CINAHL, EMBASE and PsycINFO, and included 31 studies, 6 of them randomized controlled trials. The review states that non-drug management during an episode consists of three steps: placing the patient in an upright position, loosening tight clothing, and removing the triggering stimulus. These three steps rest on clinical consensus and physiological data, which is level 5 evidence. Blood-pressure-lowering drugs are used only when blood pressure stays elevated; among them, prazosin has level 1 evidence, and nifedipine and prostaglandin E2 have level 2 evidence. The review also states that strategies to prevent episodes mainly target two common kinds of trigger, the genitourinary system and surgery, and are mostly supported only by level 4 and level 5 evidence
Evidence grade: B
Notes: It is graded B because there are no randomized controlled trials behind those three on-the-spot actions, only consensus and physiological reasoning. The review itself says that most of these measures are supported only by non-controlled studies. The medication part is the doctor's job; do not give blood-pressure drugs yourself at home. Laying the person flat makes blood pressure go higher, so help them sit upright. Family members and care workers need to know these three steps too. Don't treat it as an ordinary headache and just try to ride it out.
Sources: Krassioukov A, Warburton DE, Teasell R, Eng JJ; Spinal Cord Injury Rehabilitation Evidence Research Team (2009). A systematic review of the management of autonomic dysreflexia after spinal cord injury. Archives of Physical Medicine and Rehabilitation, 90(4):682-695. https://doi.org/10.1016/j.apmr.2008.10.017

Section 33, Item 2·Outcome Lifespan

The first ten years after becoming disabled are a high-risk period for suicide; don't treat it as something “just look on the bright side” can fix

Value for cost High

In plain terms

In the first few years after a disability, it is common for you or a family member to break down emotionally; it is not a question of willpower. Long-term follow-up at two spinal cord injury centers in the UK found that the suicide rate in this group was five times that of the general population. More than nine in ten of the suicides happened in the first ten years after the injury. People whose injury was itself caused by a suicide attempt have a higher risk still.

Cost: No money. Make one phone call, or book one doctor's appointment. No money Done in passing Some willpower Benefit size large
Benefit: The study followed 2304 patients with traumatic spinal cord injury who were newly admitted from 1991 to 2010, survived the first year after the injury and had a neurological deficit at discharge, with follow-up to the end of 2014. For 63 of them (2.7%), the cause of the injury was itself a suicide attempt. By the end of follow-up, 533 people had died; 4.2% of them died by suicide, and 91% of the suicides happened in the first ten years after the injury. The age-standardized suicide mortality was 62.5 per 100,000 per year (95% CI 36.4–88.6, confidence interval), five times the 2014 suicide rate in the general population of England and Wales (12.2 per 100,000). For those injured in a suicide attempt, compared with other causes of injury, the odds ratio for death was 4.32 (P<0.001) and the odds ratio for suicide was 9.46 (P<0.001)
Evidence grade: A
Notes: This study looked only at spinal cord injury; applying it to other causes of disability, such as blindness, amputation or burns, is an extrapolation. What it does show is the time window: the risk does not pass once you are discharged; keep watch for ten years. If you need someone to talk to, call the 12356 mental-health hotline; see Section 29, Item 11 (12356). Don't stockpile sleeping pills or pesticides at home; see Section 1, Item 25 (suicidal thoughts). If grief and low mood are still stuck in the same place after six months, book an appointment with psychiatry or clinical psychology; see Section 29, Item 8 (grief after six months).
Sources: Savic G, DeVivo MJ, Frankel HL, Jamous MA, Soni BM, Charlifue S (2018). Suicide and traumatic spinal cord injury - a cohort study. Spinal Cord, 56(1):2-6. https://doi.org/10.1038/sc.2017.98

Section 33, Item 3·Outcome Personal freedom

Psychiatric hospitalization is voluntary in principle; only in two situations can it happen without the person's own consent

Value for cost Very high

In plain terms

A word from family members or an employer is not enough to keep a person in a psychiatric hospital as an inpatient. The law recognizes only two situations: the person has already harmed themselves or is at risk of doing so; the person has already endangered others or is at risk of doing so. In the first situation, the person can be admitted only with the guardian's consent. Those who dispute the diagnosis can ask for a second diagnosis within three days, and after that can still commission an assessment on their own.

Cost: No money. Remember the two situations, so you can state them when you need to. No money Done in passing No willpower Benefit size large
Benefit: Article 30 of the Mental Health Law (精神卫生法) states that “inpatient treatment of mental disorders follows the principle of voluntariness.” Inpatient treatment should be given only when the diagnosis and the assessment of the condition show that the person is a patient with a severe mental disorder and one of the following situations applies. First, “has already engaged in conduct harming themselves, or is at risk of harming themselves.” Second, “has already engaged in conduct endangering the safety of others, or is at risk of endangering the safety of others.” Article 31: in the first situation, the medical institution gives inpatient treatment only with the guardian's consent; if the guardian does not consent, it may not be given. Article 32: in the second situation, if the patient or the guardian objects, they may request a second diagnosis; the request must be made within three days of receiving the diagnosis, and the second diagnosis is made by two licensed psychiatrists other than the doctor who made the initial diagnosis; if they still object to the second diagnosis, they may on their own commission a legally qualified assessment institution to carry out a medical assessment of mental disorder. Article 35: if the second diagnosis or the assessment report shows that the person cannot be confirmed as a patient with a severe mental disorder, or that the patient does not need inpatient treatment, the medical institution may not give them inpatient treatment. Article 78: anyone who knowingly sends a person without a mental disorder to a medical institution for treatment as a patient with a mental disorder bears liability for compensation according to law (nationwide, in effect from May 1, 2013, amended in 2018)
Evidence grade: A
Notes: Conversely, it is not the case that no one can be taken to a doctor. Article 28 provides that where a person suspected of having a mental disorder has already engaged in conduct harming themselves or endangering the safety of others, or is at risk of doing so, their close relatives, their workplace and the local public security authorities (police) shall immediately take measures to stop it and take the person to a medical institution for a mental-disorder diagnosis. A medical institution to which a person is brought for diagnosis may not refuse to make a diagnosis. So “being taken for a diagnosis” and “being kept as an inpatient” are two separate doors: the first is low, the second is high. Article 75 lists the liabilities of medical institutions: applying restraint or seclusion in violation of the rules, or diagnosing a person without a mental disorder as having one, is punished with disciplinary sanctions, up to revocation of the practicing certificate. For what to do when someone around you has an urge to hurt people, see Section 8.
Sources: 中华人民共和国精神卫生法（2018 年修正，第三十条、第三十一条、第三十二条、第三十五条、第七十八条）. https://flk.npc.gov.cn/detail?id=2c909fdd678bf17901678bf7448a066d

Section 33, Item 4·Outcome Lifespan

The person who looks after a family member with a disability long-term needs someone keeping an eye on their own health

Contested Value for cost High

In plain terms

A caregiver wearing out is not being overly sensitive. A US study followed more than eight hundred older people for four years. Those who were caring for a spouse with a disability while reporting that they themselves felt mentally strained had a risk of death about 60% higher than people who were not caregivers. Caregivers who did not feel strained showed no such increase. So what needs watching is not caregiving itself but the long-term strain.

Cost: No money. Hand off part of the caregiving work, and go get a checkup yourself. No money Done in passing Some willpower Benefit size large
Benefit: The study was a prospective population-based cohort, run from 1993 to 1998 with an average follow-up of 4.5 years, in four communities in the US. There were 392 caregivers and 427 non-caregivers, aged 66 to 96, all living with their spouse. Within four years, 103 people (12.6%) died. After adjusting for sociodemographic factors, existing illnesses and subclinical cardiovascular disease, those who were caregiving while reporting mental or emotional strain had a risk of death 63% higher than non-caregiver controls (RR 1.63, 95% CI 1.00–2.65, confidence interval). Neither those caregiving without reporting strain (RR 1.08, 95% CI 0.61–1.90) nor those whose spouse had a disability but who were not caregivers themselves (RR 1.37, 95% CI 0.73–2.58) had elevated mortality after adjustment
Evidence grade: A
Notes: Contested: the lower bound of this study's confidence interval sits right at 1.00, so the possibility of “no difference” has not been fully ruled out. The population was older Americans living with their spouse, and the person cared for was an older spouse with a disability; applying it to people caring for a young family member with a disability is an extrapolation. What it does show is the direction: the strained group is at higher risk. Hand off whatever caregiving work you can; ask the local disabled persons' federation and civil affairs bureau about residential care and day care services. Caregivers should not stop the medicine for their own chronic illnesses; see Section 16, Item 1 (take medicine for the full course as prescribed). The beneficiary of this item is you yourself.
Sources: Schulz R, Beach SR (1999). Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA, 282(23):2215-2219. https://doi.org/10.1001/jama.282.23.2215

Section 33, Item 5·Outcome Lifespan

If you use a wheelchair long-term, switch to a pressure-relief cushion and check your sitting bones and tailbone once a day

Value for cost Standard

In plain terms

An ordinary foam cushion, sat on for a long time, can wear the skin through; once broken, it heals slowly and easily gets infected. Older people in nursing homes who used pressure-relief cushions had clearly fewer pressure sores over the sitting bones, but when the tailbone was counted too, no difference was seen. The wheelchair itself should also be fitted to the person's size; don't just buy a one-size-fits-all model and leave it at that.

Cost: A pressure-relief cushion costs from a few hundred to over a thousand yuan. Checking once a day takes one minute. A little money Done in passing Some willpower Benefit size medium
Benefit: This randomized clinical trial was run in 12 nursing homes and, from 2004 to 2008, recruited 232 residents aged 65 or over who sat in a wheelchair 6 hours or more a day and had a Braden score of 18 or below. Everyone was first fitted with a properly sized wheelchair, then randomly assigned to one of two groups. One group used skin-protection cushions (air, viscous fluid plus foam, or gel plus foam); the other used 7.6 cm thick segmented foam cushions. Follow-up lasted 6 months or until a pressure sore developed. For pressure sores over the ischial tuberosities, there were 8 cases (6.7%) in the segmented foam group and 1 case (0.9%) in the skin-protection cushion group, P=0.04. Counting pressure sores over the ischial and sacrococcygeal areas together, there were 21 cases (17.6%) in the segmented foam group and 12 cases (10.6%) in the skin-protection cushion group, P=0.14; no difference was shown
Evidence grade: B
Notes: It is graded B for two reasons. First, the sample was only 232 people, the P value of 0.04 for the primary endpoint only just cleared the threshold, and the secondary endpoint showed no difference. Second, the population was very old nursing home residents; applying it to young wheelchair users is an extrapolation. In the trial everyone was first fitted with a properly sized wheelchair, so “fit” and “cushion” worked together; don't change only the cushion. For pressure-sore prevention for people who are bedridden long-term, with air mattresses and regular turning, see Section 17, Item 8 (pressure sores). For how to apply for the subsidy for providing basic assistive devices, see Item 7 of this section (ask the county disabled persons' federation about everything).
Sources: Brienza D, Kelsey S, Karg P, et al. (2010). A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions. Journal of the American Geriatrics Society, 58(12):2308-2314. https://doi.org/10.1111/j.1532-5415.2010.03168.x

Section 33, Item 6·Outcome Money

Don't buy treatments or devices that claim to “cure paralysis, blindness or deafness”

Value for cost Standard

In plain terms

The Advertising Law (广告法) leaves no wiggle room. Advertisements for medical services, drugs and medical devices may not guarantee results, may not state cure rates or effectiveness rates, and may not have people give personal testimonials. So phrases like “standing up after three courses of treatment” or “so many people have already recovered” are illegal advertising in themselves; there is no need to look further into the principle they claim. Things that are not medical devices are not even allowed to mention treating illness.

Cost: No money; it saves money. The hard part is that family members are holding on to hope and can't be talked out of it. No money Done in passing Some willpower Benefit size medium
Benefit: Article 16 of the Advertising Law provides that advertisements for medical services, drugs and medical devices may not contain the following: “(1) assertions or guarantees about efficacy or safety; (2) statements of cure rates or effectiveness rates; (3) comparisons with the efficacy and safety of other drugs or medical devices, or with other medical institutions; (4) recommendations or testimonials by advertising endorsers.” Article 17 provides that, apart from advertisements for medical services, drugs and medical devices, “all other advertisements are prohibited from referring to disease-treatment functions, and may not use medical terminology or terms that make the goods promoted easy to confuse with drugs or medical devices.” Article 4 provides that advertisements may not contain false or misleading content and may not deceive or mislead consumers, and that the advertiser is responsible for the truthfulness of the advertisement's content (nationwide, amended in 2021)
Evidence grade: A
Notes: There is only one way to judge: see whether it dares to make absolute claims. The rehabilitation department of a legitimate hospital will not promise you that you will stand up after so many courses of treatment. When you come across this kind of promotion, report it to 12315 or the local market regulation authorities. The sales pitch for health supplements follows the same playbook; see Section 6, Item 10 (health supplements). If you have already bought something and want your money back, follow the procedures for online shopping and prepaid consumption; see Section 5, Item 29 (online shopping goes by the platform's rules). The beneficiaries of this item are you and your family.
Sources: 中华人民共和国广告法（2021 年修正，第四条、第十六条、第十七条）. https://flk.npc.gov.cn/detail?id=ff8081817ab231eb017abd6bd860052d

Section 33, Item 7·Outcome Money

Once your disability certificate is issued, go to the county disabled persons' federation and ask about everything you can apply for, all in one go

Value for cost Standard

In plain terms

The disability certificate itself doesn't pay any money; it is a key. Behind it come several separate benefits, each of which you have to apply for yourself; none will come to your door automatically. On your first visit to the disabled persons' federation, go through the items on the list one by one; it saves more trouble than going back and forth several times.

Cost: No money. One trip to the county disabled persons' federation, a morning of asking. After that you will have to go to more than one department. No money A few hours No willpower Benefit size medium
Benefit: The certificate opens the way to at least six benefits, each with its own legal basis. First, the living subsidy for people with disabilities in financial difficulty and the nursing-care subsidy for people with severe disabilities; see Section 7, Item 8 (the two subsidies). Second, rehabilitation assistance for children with disabilities; see Item 8 of this section (rehabilitation assistance). Third, the subsidy for providing basic assistive devices, based on Article 26 of the Regulations on Disability Prevention and Rehabilitation of Persons with Disabilities (残疾预防和残疾人康复条例). Fourth, the subsidy for accessibility modifications in the home; see Item 9 of this section (ramp, handrail and bathroom modifications). Fifth, quota employment and employment services; see Item 10 of this section (say up front that you hold a certificate). Sixth, individual income tax reduction; see Item 11 of this section (income tax reduction). Article 26 of the Regulations on Disability Prevention and Rehabilitation of Persons with Disabilities also states that the state provides basic rehabilitation services to poor people with disabilities in urban and rural areas and to people with severe disabilities by carrying out key rehabilitation projects, and “gives subsidies for the provision of basic assistive devices in accordance with relevant state regulations.” Article 20 provides that the relevant departments of people's governments at or above the county level and disabled persons' federations shall use community resources, set up rehabilitation sites or purchase services, and carry out community rehabilitation work such as rehabilitation guidance, training in activities of daily living, rehabilitation nursing, provision of assistive devices, information and consultation, and referral (nationwide, in effect from July 1, 2017)
Evidence grade: A
Notes: For the procedure for getting the certificate itself, see Section 24, Item 10 (disability certificate). Most subsidy standards and specific rules are set at the provincial level, and the same benefit can differ several-fold between two provinces. When you ask, write down the name of each item, and at home look up the original document again by that name on the local disabled persons' federation's official website and on government websites; don't rely only on what you are told verbally at the counter. Don't count on one round of asking covering everything; go back and ask again a year later, because policies change.
Sources: 国务院 (2017). 残疾预防和残疾人康复条例（第二十条、第二十六条）. https://www.gov.cn/zhengce/zhengceku/2017-02/27/content_5171308.htm

Section 33, Item 8·Outcome Money

If your child is under 7 and has a disability or autism, apply to the county disabled persons' federation for rehabilitation assistance

Value for cost High

In plain terms

The state has set up a rehabilitation assistance system for children aged 0 to 6 with disabilities and children with autism, covering surgery, assistive devices and rehabilitation training. Families in financial difficulty are covered first; where local finances allow, the age range and the family financial conditions may be relaxed. This period is the window when rehabilitation works best; don't put it off until it's time to start school. The facility has to be chosen from the disabled persons' federation's list of designated facilities.

Cost: No money. Submit one application at the county disabled persons' federation, then choose one of the designated facilities. No money A few hours No willpower Benefit size large
Benefit: The Opinions of the State Council on Establishing a Rehabilitation Assistance System for Children with Disabilities (国务院关于建立残疾儿童康复救助制度的意见) state that those eligible for assistance are qualifying children aged 0–6 with visual, hearing, speech, physical, intellectual and other disabilities, and children with autism. This includes children with disabilities in families receiving the urban or rural minimum living allowance (dibao) and in households registered as poor, children with disabilities taken in and raised by child welfare institutions, orphans with disabilities, children with disabilities covered by extreme-poverty support, and children with disabilities in other families in financial difficulty. The specific rules for determining other families in financial difficulty are set by local people's governments at or above the county level. The document also states that “areas where conditions permit may expand the age range for rehabilitation assistance for children with disabilities, and may also relax the restrictions on the family financial conditions of those assisted.” Funding standards are set by category by local people's governments at or above the county level, based on local financial capacity, the number of people covered, the category of disability and so on, with a dynamic adjustment mechanism. The higher-level legal basis is Article 26 of the Regulations on Disability Prevention and Rehabilitation of Persons with Disabilities (残疾预防和残疾人康复条例): the state establishes a rehabilitation assistance system for children with disabilities, “gradually enabling children aged 0–6 with visual, hearing, speech, physical, intellectual and other disabilities and children with autism to receive services such as surgery, provision of assistive devices and rehabilitation training free of charge” (nationwide, from 2018)
Evidence grade: A
Notes: Assistance standards are set by each province; first check the local disabled persons' federation's official website for the “implementation rules for rehabilitation assistance for children with disabilities” (残疾儿童康复救助实施办法). The list of designated facilities is also held by the disabled persons' federation. The document requires disabled persons' federations, together with the relevant departments, to strengthen oversight of the entry and exit of designated rehabilitation facilities, set up regular inspection and comprehensive evaluation mechanisms, and set up a blacklist system. At a facility not on the list, you pay the full cost yourself, and if something goes wrong it is hard to hold anyone accountable. The beneficiary of this item is your child, which is the second tier. Treat facilities that promise a “guaranteed cure” as in Item 6 of this section (cures for paralysis).
Sources: 国务院 (2018). 关于建立残疾儿童康复救助制度的意见（国发〔2018〕20 号）. https://www.gov.cn/zhengce/zhengceku/2018-07/10/content_5305296.htm；国务院 (2017). 残疾预防和残疾人康复条例（第二十六条）. https://www.gov.cn/zhengce/zhengceku/2017-02/27/content_5171308.htm

Section 33, Item 9·Outcome Money

For ramps, handrails and bathroom modifications at home, you can apply for a subsidy from the government at or above the county level

Value for cost Standard

In plain terms

The Barrier-Free Environment Construction Law (无障碍环境建设法) contains a provision: governments at or above the county level shall support and guide accessibility modifications in homes, and shall give appropriate subsidies to eligible families of people with disabilities and older people. These projects are usually led by the disabled persons' federation and run on annual quotas, so register early. How much is subsidized and which modifications are covered is decided locally.

Cost: Applying costs nothing. The modifications themselves are mostly subsidized, though you may still have to pay part yourself. You will have to go to the disabled persons' federation and the subdistrict office. No money A few hours No willpower Benefit size medium
Benefit: Article 19 of the Barrier-Free Environment Construction Law: “People's governments at or above the county level shall support and guide accessibility modifications in homes. Appropriate subsidies shall be given to eligible families of persons with disabilities and older persons.” Article 18 provides that, for existing residential buildings, residential areas, public buildings, public places, transport facilities, urban and rural roads and the like that do not meet the engineering construction standards for accessibility facilities, people's governments at or above the county level shall draw up targeted accessibility modification plans based on actual conditions and organize their implementation. Article 62 provides that any organization or individual has the right to put forward opinions and suggestions to the competent government departments on strengthening and improving barrier-free environment construction, and to complain about or report conduct that violates this law; a competent department that receives a complaint or report “shall handle it promptly and give a reply.” Article 63 provides that, for conduct violating this law that harms the public interest, the people's procuratorate may issue a procuratorial recommendation or bring a public interest lawsuit (nationwide, in effect from September 1, 2023)
Evidence grade: B
Notes: It is graded B because the law says only “shall give appropriate subsidies” and leaves how much, and who counts as eligible, entirely to local governments; there is no uniform national figure. First check the local disabled persons' federation's official website for “accessibility modifications for families of people with severe disabilities in financial difficulty” (困难重度残疾人家庭无障碍改造). Places are mostly allocated annually, so join the queue early. Installing elevators in residential compounds and renovating stairwells is a different procedure, handled by the housing and urban-rural development department. If accessibility facilities in public places are not up to standard, complain to the competent department under Article 62; it has to give you a reply.
Sources: 中华人民共和国无障碍环境建设法（第十八条、第十九条、第六十二条、第六十三条）. https://flk.npc.gov.cn/detail?id=ff80818188d7430b0189018493370940

Section 33, Item 10·Outcome Money

When job hunting, tell employers up front that you hold a disability certificate; hiring you lets the company offset a sum of money

Value for cost Standard

In plain terms

The share of people with disabilities an employer employs may not be lower than 1.5% of its total workforce; the specific share is set by the province. Employers that fall short must pay the employment security fund for persons with disabilities for the shortfall in headcount, with each person counted at the employer's average annual wage for the previous year. So hiring you is not just a kindness; it saves real money. Make it clear in the interview that you hold a certificate, and the employer can do the math itself.

Cost: No money. One extra sentence in the interview. The hard part is saying it. No money Done in passing Some willpower Benefit size medium
Benefit: Article 8 of the Regulations on the Employment of Persons with Disabilities (残疾人就业条例): “The proportion of persons with disabilities employed by an employer shall not be lower than 1.5% of its total number of employees on the payroll. The specific proportion shall be set by the people's governments of provinces, autonomous regions and municipalities directly under the central government according to the actual conditions of their regions.” Article 9: employers that do not reach the proportion set by the provincial people's government where they are located shall pay the employment security fund for persons with disabilities. Article 8 of the Measures for the Administration of the Collection and Use of the Employment Security Fund for Persons with Disabilities (残疾人就业保障金征收使用管理办法) gives the formula: “Annual amount of the security fund payable = (number of employees on the employer's payroll in the previous year × the proportion for employing persons with disabilities set by the people's government of the province, autonomous region or municipality directly under the central government where the employer is located - number of persons with disabilities actually employed by the employer in the previous year) × average annual wage of the employer's employees in the previous year.” Article 16: for 3 years from the date of business registration, small and micro enterprises that have not reached the required proportion for employing persons with disabilities and have 20 or fewer employees on the payroll (20 included) are exempt from the security fund. Article 36 of the Law on the Protection of Persons with Disabilities (残疾人保障法) provides that the state gives tax preferences according to law to employers that meet or exceed the required proportion for employing persons with disabilities, or that employ persons with disabilities in concentrated form (nationwide; the Regulations on the Employment of Persons with Disabilities in effect from May 1, 2007)
Evidence grade: A
Notes: For small and micro enterprises within three years of registration and with 20 people or fewer, this argument doesn't hold; don't count on it. The reduction and exemption policies for the security fund have kept being adjusted over the years; for specifics, go by that year's announcement from the Ministry of Finance. Also, quota employment requires real employment. Being on the payroll in name only, drawing a salary so the employer can use you to offset the security fund, is fraud, and you will be drawn into it too. For recognition as a person with employment difficulties and the social insurance subsidy, see Section 7, Item 12 (people with employment difficulties). For vocational training subsidies, see Section 7, Item 13 (vocational training subsidies). The beneficiary of this item is you yourself.
Sources: 国务院 (2007). 残疾人就业条例（第八条、第九条）. https://www.gov.cn/zhengce/zhengceku/2008-03/28/content_6646.htm；财政部、国家税务总局、中国残联 (2015). 残疾人就业保障金征收使用管理办法（财税〔2015〕72 号，第六条、第八条、第十六条）. http://www.gov.cn/zhengce/zhengceku/2015-09/15/content_5650063.htm；中华人民共和国残疾人保障法（第三十六条）. https://flk.npc.gov.cn/detail?id=ff8080816f135f46016f1d134c88132b

Section 33, Item 11·Outcome Money

People with disabilities can get a reduction in individual income tax; call the provincial tax bureau to ask how much

Value for cost Standard

In plain terms

The Individual Income Tax Law (个人所得税法) states that individual income tax on the income of people with disabilities may be reduced. But how much and for how long, the law leaves to provincial governments to decide, so it differs from province to province. Some provinces set an annual reduction cap; others reduce by a percentage. The way to find out is to call 12366 and ask the local tax bureau, or look for the reduction item in the Individual Income Tax app.

Cost: No money. Tick one box when filing, or submit one set of record-filing materials. No money Done in passing No willpower Benefit size small
Benefit: Article 5 of the Individual Income Tax Law: “In any of the following situations, individual income tax may be reduced; the specific extent and period shall be set by the people's governments of provinces, autonomous regions and municipalities directly under the central government and reported to the standing committee of the people's congress at the same level for the record: (1) income of persons with disabilities, elderly persons living alone without family support, and family members of martyrs; (2) suffering serious losses due to natural disasters.” Article 36 of the Law on the Protection of Persons with Disabilities (残疾人保障法) further provides that the state gives tax preferences according to law to persons with disabilities engaged in self-employed businesses, and exempts them from administrative and institutional fees (nationwide; the Individual Income Tax Law in effect from January 1, 2019)
Evidence grade: A
Notes: The benefit size is rated “small” because the law itself gives no figure; in most provinces the reduction is on the order of a few hundred to a few thousand yuan a year. It isn't much money, but once arranged it keeps working for a long time, so it is worth the trip. For how much your own province reduces, only the local tax bureau's announcement counts; comparison tables passed around online are perpetually out of date. If you run a small shop yourself, administrative and institutional fees are waived under Article 36 of the Law on the Protection of Persons with Disabilities; bring it up yourself when you apply for your business license.
Sources: 中华人民共和国个人所得税法（2018 年修正，第五条）. https://flk.npc.gov.cn/detail?id=2c909fdd678bf17901678bf724bd0609；中华人民共和国残疾人保障法（第三十六条）. https://flk.npc.gov.cn/detail?id=ff8080816f135f46016f1d134c88132b

Section 33, Item 12·Outcome Money

Guide dogs may be taken into public places and onto public transport, and blind people ride city public transport for free

Value for cost Standard

In plain terms

The law states that public places and public transport must make things convenient for people with disabilities who bring guide dogs, hearing dogs or assistance dogs. Blind people ride city buses, subways and ferries for free with valid documents, and people with disabilities may carry the assistive devices they need with them free of charge. When you are stopped, state these two provisions; if that doesn't work, file a complaint.

Cost: No money. When you are stopped, you have to speak up and cite the law, and there may be a standoff for a while. No money Done in passing Some willpower Benefit size medium
Benefit: Article 46 of the Barrier-Free Environment Construction Law (无障碍环境建设法): “Operating and management units of public places, and operating units of transport facilities and public transport vehicles, shall provide convenience for persons with disabilities bringing guide dogs, hearing dogs, assistance dogs and other service dogs.” Article 35 provides that government service hotlines and emergency call systems for police assistance, fire emergencies, traffic accidents, medical emergencies and so on shall gradually acquire accessibility functions such as voice, large print, Braille and one-touch calling. Article 62 provides that any organization or individual has the right to complain about or report conduct that violates this law, and the competent department shall handle it promptly and give a reply. Article 50 of the Law on the Protection of Persons with Disabilities (残疾人保障法): “Blind persons holding valid documents ride free of charge on city buses, trolleybuses, subways, ferries and other public transport. Reading materials for the blind are mailed free of charge.” The same article also provides that people's governments at or above the county level shall give persons with disabilities convenience and preferential treatment in using public transport, and that persons with disabilities may carry the assistive devices they need with them free of charge (nationwide; the Barrier-Free Environment Construction Law in effect from September 1, 2023)
Evidence grade: A
Notes: The law says “provide convenience” and attaches no penalty, so in an on-the-spot standoff the other side may not give way right away. A screenshot of the provision saved on your phone works better than memorizing the article number. If it can't be resolved on the spot, complain under Article 62; the competent department has to reply. Railways and civil aviation have their own rules; call customer service to confirm before you travel. The “valid documents” accepted for free rides are not exactly the same everywhere; ask the local disabled persons' federation which one is accepted.
Sources: 中华人民共和国无障碍环境建设法（第三十五条、第四十六条、第六十二条）. https://flk.npc.gov.cn/detail?id=ff80818188d7430b0189018493370940；中华人民共和国残疾人保障法（第五十条）. https://flk.npc.gov.cn/detail?id=ff8080816f135f46016f1d134c88132b

Section 33, Item 13·Outcome Time and energy

People with disabilities taking the gaokao (national college entrance exam) can apply for reasonable accommodations; with a Braille paper, the exam time is extended by half

Value for cost Standard

In plain terms

Candidates with disabilities taking the gaokao can apply for a Braille paper or a large-print paper, exemption from the foreign-language listening test, a separate exam room, and bringing hearing aids and wheelchairs into the exam room, and the exam time can also be extended. None of this is given automatically: you have to submit a written application within the time set by the province, with a second-generation or later disability certificate attached. If you disagree with the result, you can apply to the provincial education department for a review.

Cost: No money. You have to submit one written application within the time set by the province, and also confirm in person on site. No money A few hours No willpower Benefit size medium
Benefit: Article 5 of the Provisions on the Administration of Persons with Disabilities Taking the National Unified Examination for Admission to Regular Institutions of Higher Education (残疾人参加普通高等学校招生全国统一考试管理规定) lists twelve reasonable accommodations. They include providing candidates with visual disabilities with Braille papers in the current Braille system, large-print papers or ordinary papers; exempting candidates with hearing disabilities from the foreign-language listening test; allowing candidates with visual disabilities to bring assistive devices such as Braille pens, Braille slates, Braille typewriters without storage, electronic magnifiers without storage, white canes and optical magnifiers; allowing candidates with hearing disabilities to bring hearing aids and cochlear implants; and allowing candidates with limited mobility to use wheelchairs and walkers, with those who have special needs allowed to bring their own special desks and chairs. The amount of extra time is set out in Article 5, point (6): “For candidates with visual disabilities using Braille papers, the exam time is extended by 50% over the total time set for that subject; for candidates with visual disabilities using large-print or ordinary papers, and for candidates who have particular difficulty writing, such as those who cannot write normally with their upper limbs because of cerebral palsy or other conditions or who have no upper limbs, the exam time is extended by 30% over the total time set for that subject.” In addition there are priority entry to the exam site and exam room, a separate standardized exam room, and assigned guiding and assisting staff and sign language interpreters. Article 7 sets out the application procedure: the candidate submits a formal written application at the time and place and in the manner set by the provincial education examination authority, and provides their own second-generation or later disability certificate; an expert panel confirms on site and makes a comprehensive assessment, and the provincial education examination authority issues a “Notification” (告知书). Article 8 provides that a candidate who disagrees with the Notification may submit a written request for review to the provincial education administrative department. Article 9 provides that, for those exempted from foreign-language listening, the foreign-language score is calculated as “written score × total foreign-language score / total score of the written part.” Article 18 provides that persons with disabilities taking other national education examinations who need reasonable accommodations may apply these Provisions by reference (nationwide, issued and in effect from April 7, 2017)
Evidence grade: A
Notes: The application period is set by each province and written into that year's gaokao registration rules; miss it and it's gone. So in the first semester of the final year of high school, go to the provincial education examination authority's official website to confirm the dates. Article 18 also provides that for national education exams such as the graduate school entrance exam and the adult college entrance exam, you can apply by reference too. For the rule that schools may not refuse admission during the school years, see Item 14 of this section (schools may not refuse admission). The beneficiary of this item is you yourself or your child.
Sources: 教育部、中国残联 (2017). 残疾人参加普通高等学校招生全国统一考试管理规定（教学〔2017〕4 号，第五条、第七条、第八条、第九条、第十八条）. http://www.gov.cn/zhengce/zhengceku/2017-04/12/content_5650060.htm

Section 33, Item 14·Outcome Money

When a child with a disability applies to enroll, the school may not refuse; for a child who cannot get to school, the education bureau arranges for teachers to come to the home

Value for cost Standard

In plain terms

Kindergartens and schools of all kinds may not refuse an eligible child with a disability who applies to enroll, and the same goes for regular vocational schools. If a child needs dedicated care and cannot get to school, the county education bureau arranges for teaching at home or remote classes, and the child is still enrolled on the student register. Admission and transfers are decided by the education bureau after an assessment by an expert committee, not by the school on its own.

Cost: No money. You have to submit one application and may have to go through one assessment. When the school stalls, you have to go up to the education bureau. No money A few hours Some willpower Benefit size medium
Benefit: Article 7 of the Regulations on the Education of Persons with Disabilities (残疾人教育条例): “Preschool education institutions, schools at all levels and of all types, and other educational institutions shall provide education for persons with disabilities in accordance with these Regulations and relevant state laws and regulations; they shall not refuse to admit persons with disabilities who meet the conditions set by laws and regulations and apply for admission.” Article 29: “Regular vocational schools shall not refuse to admit persons with disabilities who meet the admission standards set by the state, and regular vocational training institutions shall actively admit persons with disabilities.” The Regulations also provide that, where school-age children and adolescents with disabilities need dedicated care and cannot attend school, the education administrative department of the county-level people's government makes overall arrangements to provide compulsory education through teaching at home, distance education or other means, and includes them in student register management. Article 20 provides that the education administrative department of the county-level people's government shall, together with the health administrative department, the civil affairs department and the disabled persons' federation, set up an expert committee on the education of persons with disabilities, made up of experts in education, psychology, rehabilitation, social work and other fields, which assesses the child's physical condition, capacity to receive education and capacity to adapt to school study and life, and makes recommendations on admission and transfer; the assessment results are the child's private information, and the units and staff concerned have a duty of confidentiality. Article 23 provides that students with disabilities studying in regular classes at regular schools may follow the curriculum plans, curriculum standards and textbooks of regular compulsory education, but the learning requirements for them may be appropriately flexible. Article 52 provides that persons with disabilities taking national education examinations who need necessary support and reasonable accommodations may submit an application (nationwide, in effect from May 1, 2017)
Evidence grade: A
Notes: A school saying verbally “we don't have the conditions for this here” doesn't count. Have it give a written reply, and take that written reply to the county-level education bureau. The assessment is done by the expert committee commissioned by the education bureau. The line in Article 23 that “learning requirements may be appropriately flexible” is very useful; you can cite it when a school uses grades as a reason to push the child out. For how to keep evidence if a child is bullied at school, and which procedure the school must follow, see Section 30, Item 3 (school bullying). For reasonable accommodations in the gaokao, see Item 13 of this section (reasonable accommodations). The beneficiary of this item is your child.
Sources: 国务院 (2017). 残疾人教育条例（第七条、第二十条、第二十三条、第二十九条、第五十二条）. https://www.gov.cn/zhengce/zhengceku/2017-02/23/content_5170264.htm

Section 33, Item 15·Outcome Personal freedom

Even if you have lost your right leg or both legs, you can still get a driver's license; the vehicle class is called C5

Value for cost Standard

In plain terms

People who have lost the right leg or both legs, or cannot move them, but can sit steadily on their own and whose arms meet the requirements, can take the license for small automatic cars specially for people with disabilities, code C5. People missing one palm can also apply. People with impaired vision in one eye and people with hearing impairments each have vehicle classes they can test for. The physical exam must be done at a specialized hospital designated by the province.

Cost: Tuition is about the same as for an ordinary driver's license, several thousand yuan in most places. The car has to be modified for hand controls. A physical exam every three years. Real money Time every day Some willpower Benefit size medium
Benefit: Annex 1 of the Provisions on the Application for and Use of Motor Vehicle Driving Licenses (机动车驾驶证申领和使用规定) sets out the physical requirements in great detail. Point 8: “Those whose right lower limb or both lower limbs are missing or have lost motor function but who can sit up independently, and whose upper limbs meet point 5 of this paragraph, may apply for a motor vehicle driving license for the vehicle class of small automatic passenger vehicles specially for persons with disabilities. Those missing one palm, whose other hand has an intact thumb and two other intact fingers, whose upper limbs and fingers have normal motor function, and whose lower limbs meet point 6 of this paragraph, may apply for a motor vehicle driving license for the vehicle class of small automatic passenger vehicles specially for persons with disabilities.” Point 6: those with only the left lower limb missing or without motor function, but with a normal right lower limb, may apply for the small automatic car class. On vision: those with “visual impairment in one eye, whose better eye's uncorrected or corrected vision reaches 5.0 or above on the logarithmic visual acuity chart, and whose horizontal visual field reaches 150 degrees” may apply for the vehicle classes of small car, small automatic car, low-speed truck, three-wheeled vehicle, and small automatic passenger vehicle specially for persons with disabilities. On hearing: those with a hearing impairment who can tell the direction of a sound source when wearing a hearing aid may apply for the small car and small automatic car classes, and shall wear the hearing aid when driving. Article 85 provides that the proof of physical condition submitted when applying for a driving license for small automatic passenger vehicles specially for persons with disabilities shall be issued by a specialized medical institution designated by the provincial health administrative department. Holders of this vehicle class shall have a physical exam every three years and submit proof of physical condition within thirty days after the end of the scoring cycle. Article 78 provides that, when driving, the special sign for motor vehicles of persons with disabilities shall be displayed on the vehicle body as required (nationwide, as amended by Ministry of Public Security Order No. 172, in effect from January 1, 2025)
Evidence grade: A
Notes: The threshold is much lower for motorized wheelchairs for people with disabilities. Article 119 of the Road Traffic Safety Law (道路交通安全法) classifies them as non-motor vehicles, so no driver's license is needed; Article 58 provides that a motorized wheelchair for people with disabilities traveling in a non-motor-vehicle lane may not exceed a top speed of 15 km per hour. A C5 car needs a hand-operated accelerator and brake installed; the modification has to be done by a qualified manufacturer, and afterwards you register the change at the vehicle administration office. If you do not submit proof of physical condition within one year after the end of three scoring cycles, the driver's license will be canceled.
Sources: 公安部令第 172 号. 机动车驾驶证申领和使用规定（第七十八条、第八十五条、附件 1）. https://www.gov.cn/gongbao/2025/issue_11866/202502/content_7004031.html

Section 33, Item 16·Outcome Lifespan

Do rehabilitation at a proper facility with a rehabilitation medicine department, and follow the therapist on intensity; harder is not better

Contested Value for cost Standard

In plain terms

Bringing the person home to lie in bed and wait to recover naturally is the most common mistake. After a stroke, organized care by a multidisciplinary team means more people are still alive, and still living at home, a year later. But don't push harder on your own either: after a stroke, training earlier, more often and more within 24 hours actually led to worse outcomes three months later. How much to train and when: follow the rehabilitation department and the therapist.

Cost: Inpatient rehabilitation costs a few hundred yuan a day; the self-paid portion varies by place. Time is counted in months. You have to practice every day, and it is tedious. Real money Time every day Lots of willpower Benefit size large
Benefit: A Cochrane systematic review included 29 trials with 5902 participants, comparing organized inpatient stroke unit care with other forms of care. At final follow-up (median 1 year), the odds ratio for a poor outcome (death, disability or needing institutional care) was 0.77 (95% CI 0.69–0.87, confidence interval), the odds ratio for death was 0.76 (95% CI 0.66–0.88), and the odds ratio for death or dependency was 0.75 (95% CI 0.66–0.85), with moderate-quality evidence. In absolute numbers, for every 100 people receiving stroke unit care, 2 more survive, 6 more are living at home and 6 more are independent. On the other hand, the AVERT trial randomized 2104 patients in 56 acute stroke units in 5 countries, comparing “usual care” with “usual care plus very early, high-intensity mobilization.” At three months, a good outcome (modified Rankin Scale 0–2) was seen in 480 people (46%) in the very early group and 525 people (50%) in the usual care group, adjusted odds ratio 0.73 (95% CI 0.59–0.90, P=0.004). Deaths were 88 versus 72, with no difference shown (odds ratio 1.34, 95% CI 0.93–1.93, P=0.113)
Evidence grade: A
Notes: Contested: both pieces of evidence come from stroke; applying them to other causes of disability, such as spinal cord injury, amputation or burns, is an extrapolation. What AVERT shows is that “the earlier and harder the better” does not hold, not that “early mobilization is useless.” In the trial, the great majority of people in both groups got out of bed within 24 hours; the difference was in frequency and total amount. When choosing a facility, check whether it has a rehabilitation medicine department and full-time rehabilitation therapists and occupational therapists; don't go only by the word “rehabilitation” on the signboard. For how to transfer between primary-level and tertiary hospitals and how the deductible threshold is calculated, see Section 24, Item 1 (tiered referral). For community rehabilitation and the provision of assistive devices, see Item 7 of this section (ask the county disabled persons' federation about everything).
Sources: Langhorne P, Ramachandra S; Stroke Unit Trialists' Collaboration (2020). Organised inpatient (stroke unit) care for stroke: network meta-analysis. Cochrane Database of Systematic Reviews, 4:CD000197. https://doi.org/10.1002/14651858.CD000197.pub4；AVERT Trial Collaboration group (2015). Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet, 386(9988):46-55. https://doi.org/10.1016/S0140-6736(15)60690-0

Section 33, Item 17·Outcome Lifespan

When your hearing declines, get hearing aids; the reason to get them is to hear, not to prevent dementia

Contested Value for cost Standard

In plain terms

The claim that “wearing hearing aids prevents dementia” has not held up so far. A three-year trial of nearly a thousand people found no difference overall. A difference was seen only in the part of the group whose risk of cognitive decline was already high. So the reason to get hearing aids is to hear now, to talk with people, and to hear cars when crossing the road, not for the sake of your brain several decades from now.

Cost: Hearing aids cost from several thousand to tens of thousands of yuan, mostly paid out of pocket. They need a fitting, and several return visits for adjustment. Real money A few hours Some willpower Benefit size medium
Benefit: The ACHIEVE trial, run in 4 communities in the US, enrolled 977 people aged 70 to 84 who had untreated hearing loss and no substantial cognitive impairment. They were randomly assigned to two groups: one received a hearing intervention (hearing counseling and hearing aids), the other a health education control, with follow-up every 6 months. The primary endpoint was the change in global cognitive score over 3 years. In the primary analysis pooling the two source populations, there was no significant difference between the groups: hearing intervention group −0.200 (95% CI −0.256 to −0.144), control group −0.202 (95% CI −0.258 to −0.145), difference 0.002 (95% CI −0.077 to 0.081), P=0.96. A prespecified sensitivity analysis showed that the effect of the intervention differed between the two source populations (interaction P=0.010). Participants from the long-running cardiovascular health observational study were older, had more risk factors for cognitive decline and had lower baseline cognitive scores. The researchers concluded that the hearing intervention might reduce 3-year cognitive change in people at higher risk of cognitive decline, but not in people at lower risk. The trial reported no serious adverse events attributable to the study
Evidence grade: A
Notes: Contested: the claim common online that “hearing aids cut cognitive decline by nearly half” comes from a subgroup in this trial, not from its main result; the main result was no difference between the groups. Keep “getting hearing aids” and “preventing dementia” apart: the first is worth doing; don't use the second as the reason. Candidates with hearing disabilities can be exempted from the foreign-language listening test in the gaokao; see Item 13 of this section (reasonable accommodations). People with hearing impairments should wear hearing aids when driving; see Item 15 of this section (C5).
Sources: Lin FR, Pike JR, Albert MS, et al.; ACHIEVE Collaborative Research Group (2023). Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet, 402(10404):786-797. https://doi.org/10.1016/S0140-6736(23)01406-X

Section 33, Item 18·Outcome Personal freedom

To say an adult “can't manage their own affairs,” you must apply to a court for a determination; family members' say-so doesn't count

Value for cost Standard

In plain terms

Whether an adult is a person “without capacity for civil conduct” or “with limited capacity for civil conduct” can be determined only by a court. Family members, employers and residents' committees cannot decide it on their own. An interested party or a relevant organization has to apply to the court. Conversely, if the person's intellectual or mental health recovers, an application can also be made to have their capacity determined as restored. This procedure is both a restriction and a protection.

Cost: Applying to the court means paying litigation fees, usually a few dozen to one hundred yuan. Assessment fees are separate, usually several thousand yuan, paid up front by the applicant. The whole process takes several months. A little money A few hours Some willpower Benefit size medium
Benefit: Article 21 of the Civil Code (民法典): “An adult who cannot understand their own conduct is a person without capacity for civil conduct, and civil juristic acts are performed on their behalf by their statutory agent.” Article 22: “An adult who cannot fully understand their own conduct is a person with limited capacity for civil conduct, and civil juristic acts are performed on their behalf by their statutory agent or with the consent or ratification of their statutory agent; however, they may independently perform civil juristic acts that purely benefit them or that are appropriate to their intellectual and mental health condition.” Article 24: “For an adult who cannot understand or cannot fully understand their own conduct, an interested party or a relevant organization may apply to the people's court to determine that adult to be a person without capacity for civil conduct or a person with limited capacity for civil conduct.” The same article also provides that, after such a determination, on the application of the person, an interested party or a relevant organization, the people's court may, according to how far the person's intellectual and mental health has recovered, determine that they have become a person with limited capacity for civil conduct or a person with full capacity for civil conduct. Relevant organizations include residents' committees, village committees, schools, medical institutions, women's federations, disabled persons' federations, lawfully established organizations for older people, civil affairs departments and so on. Article 23 provides that the guardian of a person without capacity or with limited capacity for civil conduct is their statutory agent (nationwide, in effect from January 1, 2021)
Evidence grade: A
Notes: The application goes through the court's special procedure, which is faster than an ordinary civil case but still takes several months. You need to submit a hospital's diagnostic certificate, and in most cases the court will also commission a forensic assessment; the assessment fee is usually several thousand yuan, paid up front by the applicant. Signing for someone or disposing of their property without going through this procedure may later be held invalid; even a house that has been sold may have to be returned. One more point to remember: limited capacity for civil conduct does not mean the person can do nothing. Things appropriate to their intellectual and mental condition, and things that purely benefit them, they can do themselves; don't take everything over for them. For how the guardian is determined, see Item 19 of this section (guardians).
Sources: 中华人民共和国民法典（第二十一条、第二十二条、第二十三条、第二十四条）. https://flk.npc.gov.cn/detail?id=ff808081729d1efe01729d50b5c500bf

Section 33, Item 19·Outcome Personal freedom

An adult's guardian is set by a statutory order; if the person under guardianship harms someone, the guardian pays compensation

Value for cost Standard

In plain terms

When an adult loses capacity, guardians come in order: spouse; parents and children; other close relatives; and finally other individuals or organizations willing to serve. If there is a dispute, the residents' committee, village committee or civil affairs department appoints one; if you disagree, you can go to court. While the person is still lucid, they can designate a future guardian in writing. If the person under guardianship harms someone, the guardian pays compensation.

Cost: No money. If there is a dispute, it has to be resolved at the residents' committee, the village committee, the civil affairs department or a court. No money A few hours Some willpower Benefit size medium
Benefit: Article 28 of the Civil Code (民法典): an adult without capacity or with limited capacity for civil conduct has as guardian the following persons capable of guardianship, in order: “(1) spouse; (2) parents and children; (3) other close relatives; (4) other individuals or organizations willing to serve as guardian, subject to the consent of the residents' committee, village committee or civil affairs department of the place where the ward resides.” Article 31: where there is a dispute over who should be guardian, the residents' committee, village committee or civil affairs department of the ward's place of residence appoints one; anyone who disagrees with the appointment may apply to the people's court for an appointment, or may apply directly to the people's court. In making the appointment, it “shall respect the true wishes of the ward and follow the principle of what is most beneficial to the ward.” Where the ward's rights and interests are left unprotected before the appointment, the residents' committee, the village committee, a relevant organization designated by law or the civil affairs department serves as temporary guardian. Article 33: “An adult with full capacity for civil conduct may consult in advance with their close relatives or other individuals or organizations willing to serve as guardian, and determine their own guardian in writing.” Article 1188: “Where a person without capacity or with limited capacity for civil conduct causes harm to others, the guardian bears tort liability. Where the guardian has fulfilled their guardianship duties, their tort liability may be reduced.” If the ward has property, compensation is paid out of the ward's own property, and any shortfall is paid by the guardian. Article 1189: where a guardian entrusts guardianship duties to someone else, the guardian still bears tort liability, and the entrusted person, if at fault, bears corresponding liability (nationwide, in effect from January 1, 2021)
Evidence grade: A
Notes: Article 33 is voluntary guardianship. Settling the choice of person in writing while the person is lucid can head off most of the disputes that come later; for how to write it, see Section 17, Item 1 (voluntary guardianship). Be careful with the compensation part: if you hand the person over to a residential care facility or to relatives to look after, the liability still lies with the guardian, and the entrusted person bears corresponding liability only when they are themselves at fault. So buying guardian liability insurance for the ward makes sense. Article 78 of the Mental Health Law (精神卫生法) also provides that a guardian who abandons a patient or fails to perform guardianship duties, causing harm, bears liability for compensation according to law.
Sources: 中华人民共和国民法典（第二十八条、第三十一条、第三十三条、第一千一百八十八条、第一千一百八十九条）. https://flk.npc.gov.cn/detail?id=ff808081729d1efe01729d50b5c500bf

Section 33, Item 20·Outcome Money

If you are refused a job, denied regular status or paid less because of a disability, you can sue, but first work out the cost of the process

Value for cost Standard

In plain terms

The law prohibits discrimination against people with disabilities in hiring, conversion to regular status, promotion, professional title evaluation, pay and social insurance. You can complain to the competent department, and you can also sue in court. But even if you win the case, the other side does not pay your lawyer's fees for you. So complain first, apply for legal aid at the same time, and only then consider a lawsuit.

Cost: Lawyer's fees from several thousand to tens of thousands of yuan, paid by you. A first-instance trial under ordinary procedure takes 6 months or more and can be extended. You have to keep the evidence yourself. Real money Time every day Lots of willpower Benefit size medium
Benefit: Article 3 of the Law on the Protection of Persons with Disabilities (残疾人保障法): “Discrimination on the basis of disability is prohibited. Insulting or infringing upon persons with disabilities is prohibited.” Article 38: “Persons with disabilities shall not be discriminated against in the recruitment, conversion to regular status, promotion, professional title evaluation, labor remuneration, living welfare, rest and leave, social insurance and other aspects concerning employees.” The same article also provides that the employer of employees with disabilities shall provide appropriate working conditions and labor protection suited to the characteristics of those employees, and shall modify workplaces, work equipment and living facilities according to actual needs. Article 64: “Where, in violation of this law, persons with disabilities are discriminated against in the recruitment of employees or other respects, the competent department concerned shall order correction; workers with disabilities may bring a lawsuit in the people's court according to law.” Article 4 of the Regulations on the Employment of Persons with Disabilities (残疾人就业条例): “Discrimination against persons with disabilities in employment is prohibited.” Article 13: employers may not discriminate against employees with disabilities in promotion, grade advancement, professional title evaluation, pay, social insurance, living welfare and so on. Article 42 of the Legal Aid Law (法律援助法) provides that applicants who have materials proving that they belong to “specific groups such as minors, older persons and persons with disabilities without a fixed source of income” are exempt from verification of financial hardship. Article 45 provides that legal aid institutions providing legal aid services to older persons and persons with disabilities shall provide accessible facilities, equipment and services according to actual circumstances (nationwide)
Evidence grade: A
Notes: The cost of the process has to be worked out first. A first-instance trial under ordinary procedure takes 6 months or more and can be extended; under summary procedure, 3 months. Lawyer's fees are not among the litigation costs listed in Article 6 of the Measures on the Payment of Litigation Costs (诉讼费用交纳办法), and the rule in Article 29 that costs are “borne by the losing party” does not include lawyer's fees. So first take the two low-cost routes: complain to the human resources and social security bureau or the disabled persons' federation, so the competent department orders correction; and at the same time apply for legal aid, since Article 42 exempts people with disabilities from verification of financial hardship. Gathering evidence is the hardest step. When you are turned down at an interview, the other side rarely leaves a written reason; if you can record audio or keep chat records, keep them. If you are already employed, go through labor arbitration as a labor dispute; for keeping evidence and time limits, see Section 19, Item 8 (keep evidence before leaving). The beneficiary of this item is you yourself.
Sources: 中华人民共和国残疾人保障法（第三条、第三十八条、第六十四条）. https://flk.npc.gov.cn/detail?id=ff8080816f135f46016f1d134c88132b；国务院 (2007). 残疾人就业条例（第四条、第十三条）. https://www.gov.cn/zhengce/zhengceku/2008-03/28/content_6646.htm；中华人民共和国法律援助法（第四十二条、第四十五条）. https://flk.npc.gov.cn/detail?id=ff8081817b6472a3017b6577820f0061