Self-reported Work Disability Research Articles

Understanding disability benefits decision-making among adults with self-reported work disabilities: A qualitative study

BackgroundTake-up gaps in safety net programs, long documented in the US, are an important policy problem as non-take up compromises the equity objectives and efficacy of programs. The Social Security Disability program is an example of this: more than 20 million adults report a work disability, but only around 11 million currently receive disability benefits through the Social Security Disability Insurance or Supplemental Security Income programs. ObjectivesWe examine decision-making around benefits application among adults with self-reported work disability who have never applied for disability benefits. MethodsWe conducted 39 interviews with work-disabled adults who have never applied for disability benefits. Thematic analysis identified key barriers and inhibitors to disability application. ResultsHigh transaction costs involved in disability applications coupled with the widespread perception of low approval rates was mentioned as a critical deterrent. Uncertain and lengthy medical processes after disability onset were also frequently reported as a key deterrent. Stigma about receiving disability benefits did not emerge as a factor in application behavior, although a change in self-concept involving an adjustment to benefit-receiving, work-disabled status was cited as a barrier to claiming. ConclusionOur results broadly align with those of other research that examined the information, transaction, and social costs of applying for benefits. Nevertheless, the qualitative data afford a more in-depth, grounded understanding of the primary factors affecting application decisions, and how those interact. These insights are important to inform targets for interventions to reduce barriers to take-up of benefits among potentially eligible adults with disabilities.

The Influence of Chronic Diseases on Self-Reported Work Disability: Evidence From the Korean Labor and Income Panel Study 2003-2018.

To investigate the relationship between the types of chronic diseases and self-reported work disability. We used data from the Korean Labor and Income Panel Study from waves 6 to 21 conducted from 2003 to 2018. New cases of work disability were defined as those who reported that they had work limitations due to their health problems. Information on chronic disease was collected using a questionnaire during the sixth wave of the survey. To evaluate the effects of chronic disease on self-reporting work disability, Cox proportional hazard models were used. The three most influential diseases on work disability were ophthalmologic diseases, chronic kidney diseases, and cardiovascular diseases during the 15-year follow-up period. Work disability is strongly and significantly associated with the aforementioned chronic diseases.

Early Determinants of Work Disability in an International Perspective

This study explores the interrelated roles of health and welfare state policies in the decision to take up disability insurance (DI) benefits due to work disability (WD), defined as the (partial) inability to engage in gainful employment as a result of physical or mental illness. We exploit the large international variation of health, self-reported WD, and the uptake of DI benefits in the United States and Europe using a harmonized data set with life history information assembled from SHARE, ELSA, and HRS. We find that the mismatch between WD and DI benefit receipt varies greatly across countries. Objective health explains a substantial share of the within-country variation in DI, but this is not the case for the variation across countries. Rather, most of the variation between countries and the mismatches are explained by differences in DI policies.

Validation of a self-reported work disability questionnaire for ulcerative colitis.

Ulcerative colitis (UC) may severely limit patients’ capacity to work. Recently, we validated a work disability questionnaire (WDQ) for Crohn disease. As UC shares clinical characteristics with Crohn disease, we hypothesized that the questionnaire might also be useful for UC. The study was aimed to validate the WDQ for use in UC.Consecutive patients with UC (n = 142, 67 women; age 48 ± 1) completed the UC-WDQ and the inflammatory bowel disease questionnaire-9 (IBDQ-9), and EuroQoL-5D quality-of-life questionnaires. Validation of the UC-WDQ included an assessment of its construct validity, including: discriminant validity, convergent validity, and reproducibility (test–retest). We also calculated the intraclass correlation and the Cronbach alpha.1.Discriminant validity: Mean UC-WDQ scores were 12.8 ± 4.4 (remission phase) and 17.2 ± 6.1 (with clinical activity) (P < .05).2.Convergent validity: The correlations of UC-WDQ were r = 0.74 (P < .001) with IBDQ, r = 0.44 (P < .01) with disease activity, r = 0.56 (P < .01) with EuroQoL-5D, and r = 0.60 (P < .01) with the EuroQoL-5D visual scale.3.Reproducibility:Test–retest reproducibility: UC-WDQ scores obtained after a 2-week interval were similar (15.8 vs 15.1), (r = 0.91, P < .01).Intraclass correlation was 0.93 (95% confidence interval 0.92–0.95).Cronbach alpha was 0.94.The UC-WDQ is a valid and reliable tool for measuring work disability in patients with UC.

Dental treatment as perceived etiology of temporomandibular disorders

ABSTRACTObjective: To characterize patients who believe their temporomandibular disorders (TMD) symptoms are caused by their prior dental treatment.Methods: A sample of 337 patients were selected and classified into dental treatment-related and non-dental treatment-related groups, according to their personal belief of their TMD etiology. The relationship between patients’ perceived etiology and patient characterization was analyzed using Chi-square and t-test.Results: One-hundred and thirty-one patients perceived that the cause of their TMD was dental-related. Within this group, 27.5% of the 131 patients considered that their TMD was specifically caused by prior dental treatment. These patients possessed significantly greater disability (self-reported work disability, family interference, and higher level of depression) compared to the patients who did not believe their TMD was caused by dental treatment.Conclusion: Dentists should recognize that their dental treatments could possibly be the cause of patients’ TMD symptoms, according to patients’ beliefs.

Development and Validation of the Short Crohn's Disease Work Disability Questionnaire.

The aim was to develop and validate a self-reported short Crohn's disease work disability questionnaire (sCDWDQ). (1) Development of a shortened questionnaire-Patients' responses to the validation process (n = 108) of a previously developed, 16-item Spanish Crohn's disease work disability questionnaire (CDWDQ) were analyzed using the Rasch model for multiple response items. After this process, a 9-item sCDWDQ was obtained. (2) Validation phase-The validation assessed the questionnaire's convergent validity, discriminant validity, test-retest reproducibility, and internal consistency. Spearman rank correlation, t test, intra-class correlation and Cronbach's alpha were used for the analysis. One hundred fifty-one patients were included in the validation phase. (1) Convergent validity was confirmed by correlations between the sCDWDQ and clinical activity (r = 0.66, P < 0.01), the short inflammatory bowel disease questionnaire IBDQ-9 (r = 0.74, P < 0.001), Euroqol-5D (r = 0.63, P < 0.01), the EuroQol-5D visual analog scale (r = 0.54, P < 0.01), and overall work impairment (r = 0.66, P < 0.01); (2) Discriminant validity-sCDWDQ scores were higher in patients with active disease (20.1 ± 6.3 versus 13.0 ± 3.8 inactive, P < 0.001), in those requiring previous sick leave (19.6 ± 6.9 versus no sick leave 14.2 ± 4.8, P < 0.01) and in those requiring hospitalization (20.0 ± 7.3 [n = 29] versus no hospitalization 14.1 ± 7.3 [n = 90], P < 0.01); (3) Internal consistency was also good (Cronbach's alpha = 0.92); and (4) Reproducibility-sCDWDQ measures obtained 2 weeks apart showed an excellent intraclass correlation coefficient of 0.92 (95% confidence interval, 0.90-0.94). The self-reported sCDWDQ appears to be a simple, valid, and reliable tool for measuring work disability in Crohn's disease.

The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey.

BackgroundMost knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail.MethodsWe developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults.ResultsFibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician’s diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale.ConclusionsPersons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia.

The Effect of a Compulsory Schooling Reform on Disability Pensioning – Evidence from the Danish Registers

A growing literature is examining the effects of compulsory schooling reforms on various measures of health later in life (SRH, hospitalization, mortality, BMI, health behaviors and self-reported work disability). However, few studies explore spillover effects of education on disability, and even fewer allow for heterogeneous treatment effects by gender. Yet, disability pensions constitute a large share of health care spending and have implications for health care utilization. Using comprehensive register data from Denmark providing administrative data on both health and disability on the entire Danish population coupled with a major compulsory schooling reform from 1958 that substantially lowered the costs of education and enhanced its quality in rural areas, we estimate Probit, OLS and linear treatment effects models which show that both men and women in rural born cohorts subject to the reform have a lower rate of disability pensioning and fewer medical diagnoses for chronic illnesses later in life compared to urban born counterparts and pre-reform cohorts from both regions. Furthermore, we find that an important channel of transmission of education to disability and health for both men and women is through higher income. A possible explanation for the symmetric effects of education on male and female disability in this setting could be that women in older cohorts in Denmark are more active on the labour market compared to other countries.

The risk of developing a work disability across the adulthood years

BackgroundWork disability has implications for individual health, national health care expenditures, economic productivity, and the social safety net. Knowledge about population dynamics and risk factors associated with work disability are not delineated by cross-sectional research. ObjectiveIn this paper the authors estimate, for the first time, the prospective lifetime risk that a head of household will report a work disability. MethodsUsing forty years of longitudinal data from the Panel Study of Income Dynamics (PSID), we estimate the lifetime risk of developing a work disability and conduct a logistic regression analysis to examine personal characteristics that increase the likelihood of a self-reported work disability. Life table methods are used to calculate lifetime prevalence, and to compute covariate effects. ResultsBetween the ages of 25 and 60, over half (54.6%) of U.S. household heads will self-report a work disability, and approximately one quarter (24.1%) will self-report a severe work disability. Persons with income below 150% of the federal poverty level, or lower educational attainment, have an increased likelihood of reporting a work disability. ConclusionsThis study finds that more than half of U.S. household heads will self-report a work disability, which is a higher prevalence than in existing cross-sectional estimates. The social context for this finding is that work disability is a major driver of spending on health care services and the social safety net.

Work-related psychosocial and mechanical risk factors for work disability: a 3-year follow-up study of the general working population in Norway

This study examines the impact of work-related psychosocial and mechanical risk factors for work disability in the general working population. A randomly drawn cohort from the general population in Norway aged 18-66 years was followed for 3 years (N = 12 550, 67% response rate at baseline). Eligible respondents were in paid work for ≥ 10 hours per week in 2006 and were still in paid work or had quit working because of health problems (work disability) in 2009 (N = 6745). Five work-related psychosocial factors and eight mechanical exposures were measured. The outcome of interest was self-reported work disability at 3-year follow-up. In total, 2.6% (176 individuals) reported work disability at the 3-year follow-up. Disability rates were higher among women, older workers, and those with fewer years of education and higher levels of psychological distress and musculoskeletal complaints. After adjusting for these factors, work-related psychosocial predictors of disability were low levels of supportive leadership [odds ratio (OR) 1.61, 95% confidence interval (95% CI) 1.02-2.56] and monotonous work (OR 1.53, 95% CI 1.09-2.16). Mechanical factors were neck flexion (OR 2.49, 95% CI 1.36-4.56), prolonged standing (OR 1.79, 95% CI 1.21-2.46), whole-body vibration (OR 4.15, 95% CI 1.77-9.71), and heavy physical work (OR 2.23. 95% CI 1.08-4.57). The estimated population risk attributable to these factors was about 45%. Monotonous work, prolonged standing, neck flexion, and whole-body vibration appear to be the most consistent and important predictors of work disability.

The Impact of Obstructive Sleep Apnea on Self-Reported Work Disability among Software Professionals

The Impact of Obstructive Sleep Apnea on Self-Reported Work Disability among Software Professionals

Anchoring Vignettes with Sample Selection due to Non-Response

Summary Anchoring vignettes are a powerful tool for enhancing self-reported data comparability across countries or socio-economic groups, since they may correct for differential item functioning, i.e. the individual heterogeneity in the interpretation of the survey questions. The parametric solution of this approach is called the compound hierarchical ordinal probit (CHOPIT) model. Since vignettes are particular versions of questionnaires, their collection can suffer from sample selection bias due to non-response. We extend the CHOPIT model to account for this problem. This extension is, however, complicated by the fact that the variable of interest is ordinal, so the procedures that are adopted in the case of a strictly continuous outcome are no longer applicable and the maximum likelihood approach is therefore the suggested solution. The extended model is then applied to investigate and compare across countries the effects of differential item functioning and sample selection on the response scale differences in the self-reported work disability vignettes that were collected in the Survey of Health, Ageing and Retirement in Europe. When the collected vignette rate is high, the bias that is induced by the selection mechanism on the CHOPIT estimates is negligible. When the collected vignette rate is low, sample selection affects the model estimates, leading to a reversing of the directions of some differential item functioning corrections provided by the standard CHOPIT model.

Cross-Country Differentials in Work Disability Reporting Among Older Europeans

Descriptive evidence shows that there is large cross-country variation in self-reported work disability rates of the elderly in Europe. In this paper we analyse whether these differences are genuine or they just reflect heterogeneity in reporting styles. To shed light on the determinants of work-disability differentials across countries, we combine a wide set of individuals’ socioeconomic and health status characteristics with macro-economic indicators describing the institutional background of the country of residence.

TRENDS IN THE ABILITY TO WORK AMONG MEN AND WOMEN IN THE OLDER AMERICAN POPULATION: 1997-2007.

Since the passage of United States (US)' Social Security Amendments in 1983, the age for full Social Security benefits has been increasing from age 65 to 67 depending on one's year of birth. These increases introduce incremental savings in the long-term funding of the US public pension system, but they assume that American workers will be able to continue working past the age of 65. In this study, we examine self-reported work disability for men and women using the 1997 through 2007 National Health Interview Surveys. There are small but significant decreases in work disability and fairly significant increases in labor force activity among men and women in their 60s and for women in their 50s over the 11-year period, and relatively little difference between men's and women's trends. Changes in the educational composition of the population play a major explanatory role in the decrease of work disability. Without this compositional shift, work disability would have increased. Increased obesity over this period exerted an opposite effect; without this change, the decrease in work disability would have been greater.

Work Disability in Systemic Sclerosis

Systemic sclerosis (SSc) is a multisystem disease associated with significant morbidity and increased mortality. Little is known about work disability in SSc. We undertook this study to determine the prevalence and demographic and clinical correlates of work disability in a large cohort of patients with SSc. Cross-sectional, multicenter study of patients from the Canadian Scleroderma Research Group Registry. Patients were assessed with detailed clinical histories, medical examinations, and self-administered questionnaires. The primary outcome was self-reported work disability. Multiple logistic regression was used to assess the relationship between selected demographic and clinical variables and work disability. Of the 643 patients available for this study, 133 (21%) reported that they were work disabled. Work disability in SSc was common, even in people with short disease duration, and increased steadily with increasing disease duration: among those who were <or= 65 years and who reported being either disabled or working, 28.0% and 44.8% of patients with disease duration of < 2 and 10-15 years, respectively, reported that they were work-disabled. The significant correlates of work disability included co-morbidities, disease duration, diffuse disease, disease severity, pain, fatigue, and physical function. Work disability is prevalent, occurs early, and is associated with markers of disease severity and functional status. Further research is needed to identify other, potentially modifiable, risk factors for work disability in SSc.

Dynamics of work disability and pain

This paper investigates the role of pain dynamics in subsequently affecting dynamics in self-reported work disability and the dynamics of employment patterns of older workers in the US. Not only is pain prevalence quite high, there also are many transitions in and out of pain at these ages. We investigate pain and its relationship to health (work disability) and work in a dynamic panel data model, using six biennial waves from the Health and Retirement Study. We find that the dynamics of the presence of pain are central to understanding the dynamics of self-reported work disability and through this pathway, pain dynamics are also a significant factor in the dynamic patterns of employment.

Labor Market Status and Transitions During the Pre-Retirement Years: Learning from International Differences

Many western industrialized countries face strong budgetary pressures due to the aging of the baby boom generations and the general trends toward earlier ages of retirement. We use the American PSID and the European Community Household Panel (ECHP) to explain differences in prevalence and dynamics of self-reported work disability and labor force status. To that end we specify a two-equation dynamic panel data model describing the dynamics of labor force status and self-reported work disability. When we apply the U.S. parameters to the equations for the thirteen European countries we consider, the result is generally that work disability is lower and employment is higher. Furthermore, measures of employment protection across the different countries suggest that increased employment protection reduces reentry into the labor force and hence is a major factor explaining employment differences in the pre-retirement years.

Self Reported Disability and Reference Groups

Social networks and social interactions affect individual and social norms. We develop a direct test of this using Dutch survey data on how respondents evaluate work disability of hypothetical people with some work related health problem (vignettes). We analyze how the thresholds respondents use to decide what constitutes a (mild or more serious) work disability depend on the number of people receiving disability insurance benefits (DI) in their reference group. We find that reference group effects are significant and contribute substantially to an explanation of why self-reported work disability in the Netherlands is much higher than in, for example, the US.

Dynamics of Work Disability and Pain

This paper investigates the role of pain in affecting self-reported work disability and employment of elderly workers in the US. We investigate pain and its relationship to work disability and work in a dynamic panel data model, using six biennial waves from the Health and Retirement Study. We find the dynamics of the presence of pain is central to understanding the dynamics of self-reported work disability. By affecting work disability pain also has important implications for the dynamic patterns of employment.

Work Disability is a Pain in the *****, Especially in England, The Netherlands, and the United States

This paper investigates the role of pain in determining self-reported work disability in the U.S., the U.K. and The Netherlands. Even if identical questions are asked, cross-country differences in reported work disability remain substantial. In the U.S. and the Netherlands, respondent evaluations of work limitations of hypothetical persons described in pain vignettes are used to identify the extent to which differences in self-reports between countries or socio-economic groups are due to systematic variation in the response scales.