Abstract
BackgroundWork disability is a major problem for both the worker and society. To explore the work opportunities in regular jobs of persons low in functional abilities, we tried to identify occupations low in task demands. Because of the variety of functional abilities and of the corresponding work demands, the disabled persons need to be classified by type of disability in a limited number of subgroups. Within each subgroup, occupations judged suitable for the most seriously disabled will be selected as having a very low level of the corresponding task demands. These occupations can be applied as reference occupations to assess the presence or absence of work capacity of sick-listed employees in regular jobs, and as job opportunities for people with a specific type of functional disability.MethodsRegistered data from 50,931 disability assessments within the Dutch social security system were used in a second order factor analysis to identify types of disabilities in claimants for a disability pension. Threshold values were chosen to classify claimants according to the severity of the disability. In the disability assessment procedure, a labour expert needs to select jobs with task demands not exceeding the functional abilities of the claimant. For each type of disability, the accessible jobs for the subgroup of the most severely disabled claimants were identified as lowest in the corresponding demand.ResultsThe factor analysis resulted in four types of disabilities: general physical ability; autonomy; psychological ability; and manual skills. For each of these types of disablement, a set of four to six occupations low in task demands were selected for the subgroup of most severely disabled claimants. Because of an overlap of the sets of occupations, 13 occupations were selected in total. The percentage of claimants with at least one of the occupations of the corresponding set (the coverage), ranged from 84% to 93%. An alternative selection of six occupations for all subgroups with even less overlap had a coverage ranging from 84% to 89% per subgroup.ConclusionThis study resulted in two proposals for a set of reference occupations. Further research will be needed to compare the results of the new method of disability assessment to the results of the method presently used in practice.
Highlights
Work disability is a major problem for both the worker and society
The task demands of the jobs in the job file of the Claim Assessment and Monitoring System (CAMS) were based on on-site observations by specialised labour expert (LE), with scheduled updates
The title/common subject of the four second order factors were: general physical ability, covering various aspects of the musculoskeletal system; autonomy, i.e. to act autonomously and independently in the working situation; the abilities to cope with various psychological task demands; and manual skills and grip strength
Summary
Work disability is a major problem for both the worker and society. To explore the work opportunities in regular jobs of persons low in functional abilities, we tried to identify occupations low in task demands. Occupations judged suitable for the most seriously disabled will be selected as having a very low level of the corresponding task demands These occupations can be applied as reference occupations to assess the presence or absence of work capacity of sick-listed employees in regular jobs, and as job opportunities for people with a specific type of functional disability. In case the disability is more severe, major interventions in the person domain and/or in the job will be required to facilitate return to work Examples of such interventions are: enhancement of abilities by education and by training of skills; adaptation of the task demands, and so on [4,5,6]. Another way to deal with the consequences of the medical situation of these employees may be to reappoint him/her to another job, more suited to his or her reduced abilities
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