The first instance assessment of all disability sectors in Italy takes place in most parts of the country in two stages. The first step is the applicant's examination and judgment performed by the Local Health Authority (ASL). The second phase is the verification of the National Social Security Institute (INPS) on the ASL report, which ends with its confirmation or suspension and repetition. Disability examination strategies can fluctuate between the evaluation automatism and the personalised approach. Evaluation automatism implies a necessary and shared prediction of the judgment due to a specific diagnosis. The personalised approach favours a rigorously individualised, unrepeatable assessment, specifically adapted to the case examined. In both perspectives, the criteria for defining disability belong to a medical model that measures the disease-related impairment. The degree of sharing of judgments between ASL and INPS can often imply and express the contribution of the evaluation automatism to the procedure.