Well, the RULES say:
Note that the Range Master - not the Range Officer on the individual stage - can waive the penalty. So they can make it as neutral as they want to. Will they change the match to accomodate a disabled shooter? Not that I have seen.
10.2.10 Special penalty: A competitor unable to fully execute any part of a
course of fire due to incapacity or injury may, prior to making his
attempt at the course of fire, request that the Range Master apply a
penalty in lieu of the stated course requirement.
10.2.10.1 Exception – In a weak hand/strong hand stage, a competitor who
has physical use of only one hand may use the same hand for
both weak and strong without penalty.
10.2.10.2 If the request is approved by the Range Master, a minimum of
one procedural penalty, up to a maximum penalty of 20% of the
competitor’s points “as shot” (rounded up to the nearest whole
number), will be deducted from the competitor’s score. For
example, if 100 points are available in the course of fire and the
competitor actually scores 90 points, the special penalty is a
deduction of 18 points. The Range Master may waive any or all
procedural penalties in respect of a competitor who has a significant
physical disability prior to the competitor making his
attempt at the course of fire.