[Integration of the Insured Person's Perspective in the Quality Assessment of Medical Evaluations].

Integration of the Insured Person's Perspective in the Quality Assessment of Medical Evaluations In the current practice of medical work disability evaluations and other pension assessments, insured persons in Switzerland lack the possibility to routinely provide feedback on the extent to which they felt treated with dignity and respect by medical experts, which, according to occasional complaints, does not always seem to be the case. In order to be able to systematically capture such aspects of interactive fairness, we developed a questionnaire, the Basel Fairness Questionnaire (BFQ). The BFQ contains 30 statements such as «The reviewer listened to me.

Evidence needs, training demands, and opportunities for knowledge translation in social security and insurance medicine: A European survey.

Objective: To perform a European survey of the evidence needs and training demands of insurance medicine professionals related to professional tasks and evidence-based practice.

Design: International survey.

Subjects: Professionals working in insurance medicine.

Functional Interviewing Was Associated With Improved Agreement Among Expert Psychiatrists in Estimating Claimant Work Capacity: A Secondary Data Analysis of Real-Life Work Disability Evaluations.

Objective: Functional evaluations establish functional and work (in-)capacities in the context of disability assessments and are increasingly recommended as a modern technique for work disability assessments. The RELY (Reliable disability EvaLuation in psychiatrY)-studies introduced semi-structured functional interviews in real-life assessments of claimants with mental disorders for evaluating their self-perceived health-related limitations and for investigating the reproducibility of work capacity (WC) estimates. Functional interviews elicit claimants' self-perceptions about their work-related limitations and capacities in the labour market.

The reproducibility of psychiatric evaluations of work disability: two reliability and agreement studies.

Background: Expert psychiatrists conducting work disability evaluations often disagree on work capacity (WC) when assessing the same patient. More structured and standardised evaluations focusing on function could improve agreement. The RELY studies aimed to establish the inter-rater reproducibility (reliability and agreement) of 'functional evaluations' in patients with mental disorders applying for disability benefits and to compare the effect of limited versus intensive expert training on reproducibility.

The assessment of work endurance in disability evaluations across European countries.

Purpose: Chronic disease is often associated with a reduced energy level, which limits the capacity to work full-time. This study aims to investigate whether the construct work endurance is part of disability assessment in European countries and what assessment procedures are used. We defined work endurance as the ability to sustain working activities for a number of hours per day and per week.

Return-to-work coordination programmes for improving return to work in workers on sick leave.

Background: To limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's return to work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain.

Inter-rater agreement in evaluation of disability: systematic review of reproducibility studies.

Objectives:  To explore agreement among healthcare professionals assessing eligibility for work disability benefits.

Design:  Systematic review and narrative synthesis of reproducibility studies.

Data Sources:  Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and review of bibliographies of included studies.

Use of a structured functional evaluation process for independent medical evaluations of claimants presenting with disabling mental illness: rationale and design for a multi-center reliability study.

Background: Work capacity evaluations by independent medical experts are widely used to inform insurers whether injured or ill workers are capable of engaging in competitive employment. In many countries, evaluation processes lack a clearly structured approach, standardized instruments, and an explicit focus on claimants' functional abilities. Evaluation of subjective complaints, such as mental illness, present additional challenges in the determination of work capacity.

Expectation of sickness absence duration: a review on statements and methods used in guidelines in Europe and North America.

Background: Certifying physicians play a key role in the management of sickness absence and are often provided with guidelines. Some of these guidelines contain statements on expected sickness absence duration, according to diagnosis. We were interested in exploring the evidence base of these statements.

Sickness certification in primary care: a survey on views and practices among Swiss physicians.

Questions Under Study: Studies from several countries (Scandinavia, United Kingdom) report that general practitioners (GPs) experience problems in sickness certification. Our study explored views of Swiss GPs towards sickness certification, their practice and experience, professional skills and problematic interactions with patients.

Methods: We conducted an online survey among GPs throughout Switzerland, exploring behaviour of physicians, patients and employers with regard to sickness certification; GPs' views about sickness certification; required competences for certifying sickness absence, and approaches to advance their competence.

Attitudes towards evaluation of psychiatric disability claims: a survey of Swiss stakeholders.

Questions: In Switzerland, evaluation of work capacity in individuals with mental disorders has come under criticism. We surveyed stakeholders about their concerns and expectations of the current claim process.

Methods: We conducted a nationwide online survey among five stakeholder groups.

Towards comprehensive and transparent reporting: context-specific additions to the ICF taxonomy for medical evaluations of work capacity involving claimants with chronic widespread pain and low back pain.

Background: Medical evaluations of work capacity provide key information for decisions on a claimant's eligibility for disability benefits. In recent years, the evaluations have been increasingly criticized for low transparency and poor standardization. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive spectrum of categories for reporting functioning and its determinants in terms of impairments and contextual factors and could facilitate transparent and standardized documentation of medical evaluations of work capacity.

Evaluation of work capacity in Switzerland: a survey among psychiatrists about practice and problems.

Questions Under Study: In Switzerland, psychiatric evaluations of work capacity for determining a person's eligibility for disability benefits are being criticised for a lack of transparency and high inter-rater variability. The aims of this study were to learn about the current practice of psychiatrists, to explore possible sources for lack of transparency and variability, and to contrast practice with current professional guidance.

Methods: A national online-survey among psychiatrists who performed five or more evaluations of work capacity per year.

Reporting about disability evaluation in European countries.

Purpose: To compare the official requirements of the content of disability evaluation for social insurance across Europe and to explore how the International Classification of Functioning, Disability and Health is currently applied, using the rights and obligations of people with disabilities towards society as frame of reference.

Methods: Survey. We used a semi-structured questionnaire to interview members of the European Union of Medicine in Assurance and Social Security (EUMASS), who are central medical advisors in social insurance systems in their country.

Aspects of functioning and environmental factors in medical work capacity evaluations of persons with chronic widespread pain and low back pain can be represented by a combination of applicable ICF Core Sets.

Background: Medical work capacity evaluations play a key role in social security schemes because they usually form the basis for eligibility decisions regarding disability benefits. However, the evaluations are often poorly standardized and lack transparency as decisions on work capacity are based on a claimant's disease rather than on his or her functional capacity. A comprehensive and consistent illustration of a claimant's lived experience in relation to functioning, applying the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets (ICF-CS), potentially enhances transparency and standardization of work capacity evaluations.

Return to work coordination programmes for work disability: a meta-analysis of randomised controlled trials.

Background: The dramatic rise in chronically ill patients on permanent disability benefits threatens the sustainability of social security in high-income countries. Social insurance organizations have started to invest in promising, but costly return to work (RTW) coordination programmes. The benefit, however, remains uncertain.

Evaluation of work disability and the international classification of functioning, disability and health: what to expect and what not.

Background: Individuals who are sick and unable to work may receive wage replacement benefits from an insurer. For these provisions, a disability evaluation is required. This disability evaluation is criticised for lack of standardisation and transparency.

Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study.

Background: Efforts undertaken during the return to work (RTW) process need to be sufficient to prevent unnecessary applications for disability benefits. The purpose of this study was to identify factors relevant to RTW Effort Sufficiency (RTW-ES) in cases of sick-listed employees with chronic low back pain (CLBP).

Methods: Using focus groups consisting of Labor Experts (LE's) working at the Dutch Social Insurance Institute, arguments and underlying grounds relevant to the assessment of RTW-ES were investigated.

Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice.

Background: Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course.

The assessment of efforts to return to work in the European Union.

Background: Assessment of efforts to promote return-to-work (RTW) includes all efforts (vocational and non-vocational) designed to improve the work ability of the sick-listed employee and increase the chance to return to work. Aim of the study was to investigate whether in 13 European countries these RTW efforts are assessed and to compare the procedures by means of six criteria.

Methods: Data were gathered in the taxonomy project of the European Union of Medicine in Assurance and Social Security and by means of an additional questionnaire.

Evidence-based guidelines in the evaluation of work disability: an international survey and a comparison of quality of development.

Background: In social insurance, the evaluation of work disability is becoming stricter as priority is given to the resumption of work, which calls for a guarantee of quality for these evaluations. Evidence-based guidelines have become a major instrument in the quality control of health care, and the quality of these guidelines' development can be assessed using the AGREE instrument. In social insurance medicine, such guidelines are relatively new.

Interviews for the assessment of long-term incapacity for work: a study on adherence to protocols and principles.

Background: Assessments for long-term incapacity for work are performed by Social Insurance Physicians (SIPs) who rely on interviews with claimants as an important part of the process. These interviews are susceptible to bias. In the Netherlands three protocols have been developed to conduct these interviews.

Disability assessments: effects of response mode and experience.

Purpose: To what extent response mode and experience affect the assessment of disability was investigated.

Method: An experiment was conducted in which 34 medical doctors (17 inexperienced and 15 experienced) were required to assess disability of a videotaped client. Participants either gave a probability assessment after each piece of information or only after all information had been processed (step-by-step, SBS, or end-of-sequence, EOS).