Abstract
Objective: To evaluate perceived needs and difficulties related to instruments for assessing work ability in individuals with mental disorders.Method: We conducted an online survey of 104 German-speaking medico-legal experts (forensic psychiatric and psychology experts, insurance physicians) and therapists.Results: The large majority of respondents reported they would welcome a standardized, structured instrument for the assessment of work ability. High predictiveness, inter-rater agreement, comprehensibility for laymen, and symptom validity were desired in roughly equal measure as the main characteristic of such an instrument. More women than men, and more medico-legal experts than therapists, considered symptom validation as always necessary. Pain, personality, and affective disorders were perceived to be the most difficult disorders in the context of work ability assessments.Conclusion: Our survey documents professionals' wish for a structured assessment of work ability in both medico-legal and therapeutic settings.
Highlights
Most OECD member states have seen a substantial rise in spending on disability benefits, with mental disorders accounting for at least 30–45% of claims [1]
In most social security systems, the assessment of work ability and of the resulting claim is based on a medical examination [2]
Medicolegal experts were defined as respondents with certified training in insurance-medical assessment
Summary
Most OECD member states have seen a substantial rise in spending on disability benefits, with mental disorders accounting for at least 30–45% of claims [1]. In most social security systems, the assessment of work ability and of the resulting claim is based on a medical examination [2]. While the validity and reliability of such examinations are crucial quality criteria, there is evidence for inhomogeneity of expert decisions and consequent inequality of claimants before the law [3, 4]. The current use of unstructured and non-validated procedures further provokes inaccurate assessments of claimants’ personal resources, potential for rehabilitation, and social and occupational outcomes [5, 6]. Current assessment procedures have been likened to a lottery, where the quality of assessment is largely a matter of chance, due to the random assignment of claimants to experts and to alleged substantial differences in expert competence [7,8,9,10]
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