The International Classification of Functioning, Disability and Health (ICF) is a classification published by the World Health Organisation (WHO). The German translation ("Internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit", revision of October 2005) is available from BfArM for online search, for download as PDF or as a print edition.

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ICF is used across specialisations and national boundaries as a consistent standardised terminology to describe a person's functional health status, disability, social impairment and relevant environmental factors. ICF makes it possible to record systematically the bio-psycho-social aspects of the consequences of illness under consideration of contextual factors.

The classification was published by the WHO in 2001 as successor to the ICIDH; it was translated by experts from Germany, Austria and Switzerland in an honorary capacity. All rights to the ICF, including the German translation, remain with the WHO.

ICF defined in Germany through the rehabilitation guideline and Bundesteilhabegesetz (BHTG)

Predecessors of the ICF have had a significance influence on social legislation in Germany. The basis for its application is the Federal Joint Committee (G-BA) Rehabilitation Guideline and the Bundesteilhabegesetz (BHTG).

Structure of ICF

ICF is a multi-axial monohierarchical classification with alphanumeric codes. It consists of:

  1. Introduction
  2. One-level classification (only chapter titles)
  3. Two-level classification (chapter titles and, where applicable, group titles and four-digit codes)
  4. Detailed classification with definitions (complete systematic index)
  5. Annexes (e.g. Annex 2: Guidelines for coding ICF)

ICF as a classification of the components of health

Thanks to the bio-psycho-social model that it is based on, the ICF is not primarily focused on deficits, i.e. it is not really a classification of the "consequences of disease". On the contrary, it classifies "components of health": body functions and structure, a list of domains of activities and participation as well as a list of environmental factors.

It is thus also resource-oriented and takes a neutral viewpoint with regard to aetiology. For that reason, the ICF can be applied to all people, not just those with disabilities. It is universally applicable.

The concept of interactions between the different components which is at the heart of the ICF is illustrated by the following diagram, the component "Personal Factors" is not included in the ICF (diagram from: International classification of functioning, disability and health: ICF, World Health Organisation 2001, p. 18):

ICF as part of the WHO Family of International Classifications

Same as ICD-10, the ICF is part of the WHO Family of International Classifications. Whereas the ICD classifies diseases, the ICF classifies the consequences of diseases in relation to body functions, activities and participation.

The perspectives of ICD-10 and ICF are thus complementary. Together, they provide a comprehensive picture of the health of a person or population. In that way, they create a basis for decisions on measures in individual rehabilitation or health politics.

Special edition for children and youth: ICF-CY

WHO also publishes ICF-CY, a classification derived from ICF specifically for children and young people. It takes into consideration the special aspects of functions under development and the special environment of children and adolescents. The German version of ICF-CY is only available from bookshops.

Further development of ICF

The WHO has further developed the ICF in recent years. The corresponding updates up to and including 2017 are included in the ICF browser of the WHO. In Germany, the 2005 version remains valid for the time being.

For further development, the ICF has been incorporated into the ICD-11 maintenance platform.

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