Perceived fairness of claimants undergoing a work disability evaluation: Development and validation of the Basel Fairness Questionnaire.

Background: There are currently no tools for assessing claimants' perceived fairness in work disability evaluations. In our study, we describe the development and validation of a questionnaire for this purpose.

Method: In cooperation with subject-matter experts of Swiss insurance medicine, we developed the 30-item Basel Fairness Questionnaire (BFQ). Claimants anonymously answered the questionnaire immediately after their disability evaluation, still unaware about its outcome. For each item, there were four response options, ranging from "strongly disagree" to "strongly agree". The construct validity of the BFQ was assessed by running a principal component analysis (PCA).

Results: In 4% of the questionnaires, the claimants' perception on the disability evaluation was negative (below the median of the scale). The PCA of the items responses followed by an orthogonal rotation revealed four factors, namely (1) Interviewing Skills, (2) Rapport, (3) Transparency, and (4) Case Familiarity, explaining 63.5% of the total variance.

Discussion: The ratings presumably have some positive bias by sample selection and response bias. The PCA factors corresponded to dimensions that subject-matter experts had beforehand identified as relevant. However, all item ratings were highly intercorrelated, which suggests that the presumed underlying dimensions are not independent.

Conclusion: The BFQ represents the first self-administered instrument for measuring claimants' perceived fairness of work disability evaluations, allowing the assessment of informational, procedural, and interactive justice from the perspective of claimants. In cooperation with Swiss assessment centres, we plan to implement a refined version of the BFQ as feedback instrument in work disability evaluations.