Malingering of disabling mental illness to obtain a temporary work disability benefit: detection and morphology

Background At the 10-year follow-up in the IBSEN (Inflammatory Bowel in South-Eastern Norway) study, there was an increased relative risk of permanent work disability for patients with inflammatory bowel disease (IBD), compared with the age-matched background population. Now we aimed to assess the prevalence of work disability benefits among Crohn’s disease (CD) and ulcerative colitis (UC) patients 20 years after diagnosis, using data from the IBSEN study and the Norwegian Registry for social security benefits (FD-Trygd). Methods In the IBSEN study the participants have had planned a scheduled follow-up visit after 1-, 5-, 10- and 20-years. At the 20-year follow-up, they received a questionnaire about temporary and permanent work disability benefits and those who answered at least one of the questions were included in this study. Patients above 67 years of age (i.e. the standard retirement age in Norway) at the time of diagnosis were excluded. From FD-Trygd, we acquired officially registered information about the patients’ work disability status. UC and CD patients were compared using the Pearson’s Chi-squared (χ 2) test for categorical variables and the Mann-Whitney U test for continuous variables. Results A total of 421 patients attended a 20-year follow-up and information from 418 were included for analysis. Out of those, 281 had UC (51.2% women) with a median age at the 20-year follow-up of 54.3 years (range 29.5–85.2) and 137 had CD (49.6% women) with a median age of 47.8 (range 27.4–84.8). At the 20-year follow-up, 38.1% of the IBD patients (UC 34.9% and CD 44.6%, p=0.061) reported that they had applied for and/or received temporary or permanent work disability benefits. In total 20.3% (UC 18.3% and CD 24.4%, p=0.181) reported they had been granted a permanent work disability benefit, while 10.2% reported that this was due to their IBD (UC 8.2% and CD 14.2%, p=0.067). In FD-Trygd, 27.3% of the IBD patients in the IBSEN cohort (UC 26.3%, CD 29.2%, p=0.537) were registered as having been granted permanent work disability benefits during the 20-year period. Conclusion Every fifth patient reported that they had been granted permanent work disability benefits after 20 years with IBD, but this was related to other diseases (or reasons) in half of them. According to FD-Trygd, however, more than one in four patients had been granted permanent work disability benefits in the same time-period. While differences between the UC and CD patients were found to be insignificant in these data, the difference between patient-reported and registry data is important for further socio-economic analyses and should be examined more closely.

Article 128 of the General Social Security Act establishes requirements for the recognition of the right to temporary disability benefit. Among these, to be attended by public health services is posed by greater uncertainty. The anagement objective of the healthcare field acts as a key element of the event causing temporary disability allowance. Applying this objective standard shifts the criterion of voluntariness, so as to be eligible for temporary disability benefit after verifying the inclusion of pathology in the service portfolio of the National Health System. The aim to declare the right to temporary disability benefits being attended by public health care creates a problem of inequality as health provision is included in the portfolio of complementary services of the Autonomous Communities requirement. Article 128 of the General Law on Social Security Establishes requirements for the recognition of the right to temporary disability benefit. Among these, You be Treated by the public health services is The One That posed Greater uncertainty. The objective rules of the health care field acts as a determinant of the fact Causing the temporary disability benefit. Applying esta objective standard shifts the test of voluntariness, so as to be eligible for Temporary Disability Benefit after verifying the inclusion of pathology in the portfolio of services of the National Health System. The requirement for declaring the right to temporary disability benefits requires to be served by the public health care, a problem of inequality Creates When health provision is included in the portfolio of complementary services of the Autonomous Communities

HT HE dependence of many individuals on earnings from employment gives importance to the risk of interruptions of such earnings because of disabling illness. For many years commercial insurance companies and cooperative groups, such as mutual benefit associations, have provided protection for this risk to limited groups of individuals (25, 28). The governments of a number of countries have also established compulsory disability insurance programs (11, 22). Recently many individuals have proposed a federal compulsory disability insurance program for the United States. In the past decade, several states have adopted compulsory temporary disability benefit plans (1, 24). Under disability insurance programs, protection is provided for temporary or permanent disability or both. The definition of disability and the period during which benefits are provided differ under separate plans. Temporary disability is often defined as inability to perform the usual occupation; permanent disability may be defined as inability to undertake work providing economic and social status reasonably similar to that to which the worker is accustomed (30). Temporary disability protection commonly begins after a short waiting period following the onset of each illness, such as three or seven days. It is often furnished for only a limited period, such as twenty-six or thirteen weeks. Permanent disability coverage begins at the end of the temporary disability benefit period and continues indefinitely (11, 12, 22, 24). The growth of disability insurance plans presents a need for special statistics on the amount of disability in employed 1 From the Milbank Memorial Fund. The study of illness in the Eastern Health District of Baltimore was conducted by the United States Public Health Service and the Milbank Memorial Fund.

The present study aims to analyze the framework of SARS-CoV-2 - a pandemic caused by COVID-19 in Brazil - characterizing it as an occupational disease, and the possibility of the patient apply for the temporary disability benefit from the Instituto Nacional do Seguro Social - INSS . In this sense, the study traverse, preliminarily, the concept of temporary disability, presenting the requirements provided for in the specific legislation, so the laborer can apply for the benefit with the social security agency. Afterwards, the risk caused by COVID-19 to the Brazilian worker versus the need for work for survival will be analyzed. Consequently, the pandemic that has plagued Brazil is addressed, as well as discussing the possible characterization of such as an occupational disease, in a way that allows the worker to be infected by the virus to apply for the temporary disability benefit before the autarchy, being granted to the insured. To this end, it will be used as a deductive research method, in a bibliographic way, based on the Brazilian legal system and on researchers who address the theme. Finally, it is believed that there is a need to grant the temporary disability benefit to workers who apply for it because they have been infected with the COVID-19 virus, since it can be considered an occupational disease, having been acquired in the work environment. , the result of their livelihood, with no other alternative left for the worker other than facing the risk of contagion of the virus to carry out their work.

Тhe analysis of the current legislation on compulsory social insurance in the event of temporary disability and in connection with maternity leads to the conclusion that there are no special terms established for the insured person to apply to the court for protection of their right in the event that the temporary disability benefit has not been accrued or has been accrued not fully. In the scientific literature and law enforcement practice, there is an idea that an employee’s claim for recovery of temporary disability benefits is an individual labor dispute. This is greatly facilitated by the legislative consolidation of the employer’s obligation to pay such benefits to the employee, as well as the rules for the financial provision of benefits both at the expense of the employer and at the expense of the Social Insurance Fund of the Russian Federation. The authors justify the controversy of such a position as not taking into account the complex nature of relations on compulsory social insurance and their social security nature, which is different from labor relations. The legal nature of these relations does not allow applying to the requirements arising from them the terms of applying to the court for the resolution of an individual labor dispute, established by Article 392 of the Labor Code of the Russian Federation, as well as the limitation periods provided for by civil legislation. Based on the results of the study, a conclusion is formulated about the expediency of fixing in the legislation the terms for applying to the court for the protection of the right to insurance coverage under mandatory social insurance, due to the public-legal nature of social security relations, in order to avoid limiting the right of citizens to appeal to the court for a period that is not intended for claims for recovery of temporary disability benefits.

This article reviews and compares disability benefit systems in nine countries—Australia, Germany, Great Britain, Japan, the Netherlands, Norway, South Africa, Sweden, and the United States. It focuses on temporary and partial disability benefit programs and on how such programs may help return persons with disabilities to work. An analysis of the general advantages and disadvantages of temporary and partial disability programs is presented. Specific concerns if such programs were to be implemented in the United States are addressed. Time-limited programs seem to have the potential to improve return to work among persons with disabilities and reduce program costs. Caution is needed in adopting such a program, as implementation would be complex and the employment outcomes of recently adopted time-limited programs overseas are yet to be evaluated. In contrast, the study found that partial disability benefit programs are complex to administer and appear to offer little potential to encourage return to work.

Disability benefits have undergone modifications in light of the Social Security Reform -Constitutional Amendment No. 103/2019: what was called sickness benefit and disability retirement, is now a temporary and permanent disability benefit, in addition to the criteria for calculating income initial monthly. All this modification resulted in its concession in a period of global social instability. This is because, months after the aforementioned constitutional amendment, the whole world is suffering the effects of the COVID-19 pandemic, with changes in all sectors of society. It is worth mentioning that it was no different in relation to the National Institute of Social Security, in view of the granting of disability benefits, having the need to implement its entire digital system, with the creation of a field for the insertion of documents and carrying out indirect expertise, via online. In this scenario, mediation is of crucial importance as a way of solving many cases to be resolved at the administrative level, meeting the movement for legalization, and it may well have its applicability within the scope of cases brought to the National Institute of Social Security and, if implemented, generate effectiveness in the analysis of these benefits in favor of the insured party. This article aims to demonstrate the effectiveness of the use of online mediation, if inserted in relation to disability benefits, in an administrative scope, from a historical-bibliographic research, aiming at the concretization and realization of better quality in the provision of State service, in relation to all the insured affected by some temporary or permanent disability.

. Aim. Calculation of indirect medical costs for pneumonia in the Samara region. Material and methods. Collecting and the analysis of data of federal state and branch statistical supervision for 2010 which formed a basis for the description of the medico-social characteristic of population of patients with pneumonia (the general, primary, hospitalized incidence, a lethality) in the Samara region. Results. Indirect medical costs consist of charges on social payments to patients (temporary disability benefit and disability pensions) and the half-received contribution to gross domestic product as a result of an absenteeism of workers for work. Costs of payment of sheets of temporary disability by reason of pneumonia in the Samara region made 32,9 million rubles, in the Volga federal district – 303,9 million rubles, in the Russian Federation – 1,5 billion rubles for 2010. Losses of a regional gross product by reason of temporary disability because of pneumonia in the Samara region for 2010 made 7,6 million rubles, in Volga federal district – 66,5 million rubles, in the Russian Federation – 464,5 million rubles. The fact of registration of disability the people who have had pneumonia, no therefore the disability pension with this disease isn't charged by the patient. Conclusion. Indirect medical costs of the state of treatment of pneumonia in the Samara region for 2010 make 40,5 million rubles that is 2,1% from costs of the state of all across Russia.Key words: pharmacoeconomic, community-acquired pneumonia, indirect medical costs.

Multiple sclerosis (MS) remains one of the most expensive diseases in the Russian healthcare system due to its early onset, increasing life expectancy of the patients, and the use of costly diagnostic methods and medical treatment. According to experts, even a slight reduction in direct (medical) expenses leads to a sharp increase in indirect costs; this situation necessitates an updated assessment of the number of MS patients, the degree of their disability, and the epidemiological dynamics of the disease. The aim of the study was to assess the economic damage associated with MS using the clinical, epidemiological, medical, and social data available for the city of Ufa. Materials and Methods . Direct medical expenses (outpatient care, visits to specialists, inpatient care, medications for outpatients), direct non-medical costs (temporary disability benefits, disability pensions, social services) were analyzed as well as the losses in the regional gross domestic product (GDP) due to temporary or permanent disability and premature mortality (indirect costs). Results . Because of MS only in the city Ufa, the Russian economy loses 428,222,026.35 rubles per year, mostly due to direct medical costs; of those, almost 50% is spent for immunomodulatory therapy (202,787,862.81 rubles). Annually, 4 596 245.76 rubles are spent for the hospital 24-hour treatment of MS patients, 916,154.28 rubles – for the daycare treatment, and 505,914.56 rubles – for outpatient care. Economic losses from premature death of MS patients in Ufa amounted to 21,570,999.52 rubles per year, and the lost GDP profit was estimated at 328,783,783 rubles. Conclusion. MS remains the leader of high-cost diseases and requires significant expenses from the state-run healthcare system in the Russian Federation. Epidemiological and pharmacoeconomic studies can help planning and modernizing the medical care for patients with multiple sclerosis.

Purpose: The aim was to investigate the feasibility of introducing a novel transdiagnostic occupational rehabilitation program delivered in groups mixing participants with chronic pain, chronic fatigue and common mental disorders.Materials and methods: Observational data on group climate and individual participation were triangulated with qualitative data from focus group interviews on the participants’ experiences with transdiagnostic groups.Results: The study included 222 participants receiving a temporary work disability benefit. Self-reported chronic pain (75%), chronic fatigue (79%), and mental distress (62%) were prevalent and the majority reported overlapping conditions (78%). Program completion among participants was high (96%). Those completing participated actively (95%) in the program. Overall group climate was stable with moderately high engagement. Participants with clinically confirmed mental disorders (22%) showed similar outcomes. Self-reported problems with “working in a group” prior to rehabilitation were not associated with how participants experienced group climate. Qualitative data supported the findings of positive participant experiences with transdiagnostic group settings.Conclusions: Transdiagnostic groups showed high participation rates, moderately high group engagement across symptom profiles and positive participant experiences. Implementing transdiagnostic occupational rehabilitation in groups mixing participants with chronic pain, chronic fatigue and common mental disorders was feasible and acceptable to participants.Implications for rehabilitationMost research has been done on disorder-specific occupational rehabilitation programs, but emerging evidence supports a more generic approach.Transdiagnostic therapies, such as Acceptance and Commitment Therapy (ACT), have shown promising results for both somatic and mental disorders.The feasibility of implementing transdiagnostic rehabilitation groups, their acceptability to participants and the demand for such groups has not been established.This study indicates that it is feasible to introduce a novel transdiagnostic group-based occupational rehabilitation program for mixed groups of sick-listed participants with chronic pain, chronic fatigue and/or common mental disorders.

Purpose. This study aimed to examine the influence of occupational stress on health status and work disability among security guards in Serbia. Methods. Three hundred and ninty nine male security guards (aged 25–65 years) were examined during regular medical preventive check-ups at the Institute of Occupational Health. Data on their health status and permanent and temporary work disability were obtained, and correlations with the levels of occupational stress (measured by occupational stress index [OSI] questionnaire) were analysed. Results. A high prevalence of health impairments, including diabetes (38.8%), dyslipidaemia (82.7%), hypertension (69.9%) and metabolic syndrome (77.7%), was found. Highly significant correlations were shown between reported levels of total stress at work (total OSI score) and measured values of glucose, lipids, blood pressure, heart rate, Framingham cardiovascular risk scale, occurrence of diabetes and impaired fasting glucose, dyslipidaemia, hypertension, metabolic syndrome, coronary heart disease, cerebrovascular insults, degenerative eye-fundus changes, and temporary and permanent work disability. All of these correlations remained significant even after adjustments for age, body mass index and smoking status. Regression analysis confirmed the independent effect of occupational stress on the analysed parameters. Conclusions. There is a significant independent impact of occupational stress on development of health impairments and work disability among security guards.

Introduction Post-traumatic stress disorder (PTSD) is an anxiety condition that can arise in individuals who have undergone traumatic events. Globally, the prevalence of PTSD has been estimated at 1.4%, with merely 42% of these individuals receiving adequate treatment. These episodes can lead to impairments, including disengagement from work-related activities. In Brazil, sickness absence benefits are granted by the National Institute of Social Security (INSS). This study aims to describe the frequency of temporary work disability benefits granted due to PTSD during 2008- 2021 in Brazil. Methods This longitudinal time series study is based on secondary publicly available data encompassing the total count of benefits granted under the ICD10 code F43. The data is further stratified by type (work-related/not work-related), gender (male/female), and residence (rural/urban). Results The findings indicate an average frequency of 10,648 (standard deviation: 2,052) benefits granted for PTSD, constituting 5.0% of the total benefits granted for mental or behavioral disorders. In terms of gender, 58% of these benefits were extended to women. Geographically, 99.6% of beneficiaries hailed from urban areas. Regarding benefit types, 30% were linked to employment, in instances where medical experts recognized a connection between the disorder and the claimants’ work environment and/or conditions. Discussion and conclusion The benefits provided for PTSD within the studied time frame were more prevalent among women, from urban areas, and cases not being work-related. It underscores the significance of offering comprehensive care involving all stakeholders to focus on prevention, early diagnosis, and treatment for individuals impacted by this disorder, especially among the more prevalent groups.

Evaluación de la duración de la baja laboral en pacientes con enfermedad inflamatoria intestinal

Assessment of the length of sick leave in patients with inflammatory bowel disease

Inflammatory bowel disease can decrease the quality of life and induce work disability. We sought to (1) identify and quantify the predictors of disease-specific work disability in patients with inflammatory bowel disease and (2) assess the suitability of using cross-sectional data to predict future outcomes, using the Swiss Inflammatory Bowel Disease Cohort Study data. A total of 1187 patients were enrolled and followed up for an average of 13 months. Predictors included patient and disease characteristics and drug utilization. Potential predictors were identified through an expert panel and published literature. We estimated adjusted effect estimates with 95% confidence intervals using logistic and zero-inflated Poisson regression. Overall, 699 (58.9%) experienced Crohn's disease and 488 (41.1%) had ulcerative colitis. Most important predictors for temporary work disability in patients with Crohn's disease included gender, disease duration, disease activity, C-reactive protein level, smoking, depressive symptoms, fistulas, extraintestinal manifestations, and the use of immunosuppressants/steroids. Temporary work disability in patients with ulcerative colitis was associated with age, disease duration, disease activity, and the use of steroids/antibiotics. In all patients, disease activity emerged as the only predictor of permanent work disability. Comparing data at enrollment versus follow-up yielded substantial differences regarding disability and predictors, with follow-up data showing greater predictor effects. We identified predictors of work disability in patients with Crohn's disease and ulcerative colitis. Our findings can help in forecasting these disease courses and guide the choice of appropriate measures to prevent adverse outcomes. Comparing cross-sectional and longitudinal data showed that the conduction of cohort studies is inevitable for the examination of disability.