Conceptual Foundation for Measures of Physical Function and Behavioral Health Function for Social Security Work Disability Evaluation

Abstract

Physical and mental impairments represent the two largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person's underlying capabilities as well as activity demands relevant to the context of work. The objective of this paper is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, two content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and There are no conflicts of interest to disclose of the author and co-authors.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Objects. These content models informed subsequent measurement properties including item development, measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. NIH Public Access

Work-related measures of physical and behavioral health function: Test-retest reliability

“…2,3 In conjunction with SSA, we developed new instruments to measure physical and behavioral health function relevant for work that may improve the disability determination process. 4–8 …”

“…4 The item pools were then administered to samples of SSA claimants and US adults from the general population. Factor analyses were used to assess the structure of the item pools.…”

Interpreting physical and behavioral health scores from new work disability instruments

“…Support from the SSA represents a significant resource for disabled workers and their families. Previous literature has described both conceptual and programmatic challenges that SSA faces in efficiently and comprehensively characterizing a person’s potential ability to work (4, 5). In its 2007 report, entitled, “Improving the Social Security Disability Decision Process,” an Institute of Medicine (IOM) panel noted that, as medical treatment and assistive technologies advance, the diagnostic basis for the SSA’s work disability adjudication process have become less useful as a marker of work disability (6).…”

“…A unique feature of this new instrument is its conceptual foundation that uses principles outlined by the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) (4). The ICF highlights the multifactorial nature of disability by focusing on biologic, personal, and social perspectives of disability (4, 7–10).…”

“…The ICF highlights the multifactorial nature of disability by focusing on biologic, personal, and social perspectives of disability (4, 7–10). Factors related to a person’s ability to work are complex and extend beyond disease symptoms and impairments alone, but include factors such as functional activity limitations, psychological well-being and contextual factors (11, 12).…”