Abstract
PurposeTo reach insurance physician (IPs) consensus on factors that must be taken into account in the assessment of the work ability of employees who are sick-listed for 2 years.MethodsA Delphi study using online questionnaires was conducted from October 2010 to March 2011.ResultsOne hundred and two insurance physicians reached a consensus on important factors for return to work (RTW) of employees on long-term sick leave; from those factors, the most relevant for the assessment of work ability was determined. From a total of 22 relevant factors considered for the return to work of long-term sick-listed employees, consensus was reached on nine relevant factors that need to be taken into account in the assessment of the work ability of employees on long-term sick leave. Relevant factors that support return to work are motivation, attitude towards RTW, assessment of cognitions and behaviour, vocational rehabilitation in an early stage and instruction for the sick-listed employee to cope with his disabilities. Relevant factors that hinder RTW are secondary gain from illness, negative perceptions of illness, inefficient coping style and incorrect advice of treating physicians regarding RTW.ConclusionsNon-medical personal and environmental factors may either hinder or promote RTW and must be considered in the assessment of the work ability of long-term sick-listed employees. Assessment of work ability should start early during the sick leave period. These factors may be used by IPs to improve the quality of the assessment of the work ability of employees on long-term sick leave.
Highlights
Long-term sick leave is a recognised major health problem (Henderson et al 2005), and many industrialised countries have high percentages of people who are unproductive and who claim work disability benefits for medical reasons (Black 2008; OECD 2010)
We presented the final list of twenty-two relevant factors to the panellists and asked them to select ten factors that, in their opinion, must be taken into account during the assessment of the work ability of employees who are sick-listed for 2 years
Insurance physicians reached a consensus on nine relevant factors for return to work (RTW) that must be taken into account in the assessment of the work ability of employees on long-term sick leave: work motivation, attitude towards RTW, changing inadequate cognitions and behaviour, early vocational rehabilitation, learning how to cope with disabilities, secondary gain from illness, negative illness perceptions, inefficient coping style and incorrect advice of treating physicians regarding RTW
Summary
Long-term sick leave is a recognised major health problem (Henderson et al 2005), and many industrialised countries have high percentages of people who are unproductive and who claim work disability benefits for medical reasons (Black 2008; OECD 2010). The correct assessment of the sick-listed employees’ ability to work is crucial to enhance the return to work; apparently, physicians lack sufficient knowledge about the proper assessment of workers on sick leave and the management of their return to work Management of work-related disability and absence due to illness is an essential part of the work of occupational health professionals, previous research has. The assessment of the functional ability to RTW of employees on sick leave is performed by general practitioners, family physicians, occupational physicians, insurance physicians, primary care practitioners, specialists or other physicians. In the Netherlands, sick-listed employees between 18 and 65 years of age who are unable to work due to medical reasons and who meet the eligibility requirements can apply for a disability pension after a period of 1.5 years of absence due to illness. After 2 years of sick leave, employees undergo an assessment to determine their work ability, which includes an assessment of their medical condition, functional limitations, working capacity and prognosis regarding impairments, limitations on activity and ability to resume work
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