Disability assessment interview: The role of detailed information on functioning in addition to medical history-taking

Spanjer, Jerry; Krol, Boudien; Popping, Roel; Groothoff, Johan W.; Brouwer, Sandra

doi:10.2340/16501977-0323

Cited by 32 publications

(32 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Self-classification and classification on the basis of disease codes results in the same classification for 75% of the respondents in the physical, mental and mixed groups, for 66% of the respondents in the mental and mixed groups, for 90% in the physical and mixed groups, and for 96% in the physical and mental groups. It would thus seem that the perceived limitations indicated by the client to a large extent predict the outcome of the examination conducted by insurance physicians and occupational health physicians as is indicated in other studies [1, 2, 4, 5]. Self-classification has been chosen as the main validation criterion, while the questionnaire may also be useful as an inventory of the limitations perceived by the client who submits an application to the insurance or occupational health physician.…”

Section: Discussionmentioning

confidence: 92%

“…To map the abilities and limitations of the client, insurance and occupational health physicians make use of an insurance-medical research consisting, among other things, of an assessment interview [1–3]. Several studies have noted that the assessment to a large extent is based on the information reported by the insured persons themselves [1, 4, 5]. In a qualitative study, 94 insurance physicians were interviewed about the sources of information they used to assess clients’ work limitations [2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Measuring Clients’ Perception of Functional Limitations Using the Perceived Functioning & Health Questionnaire

Schellekens

Abma

Mulders³

et al. 2010

J Occup Rehabil

View full text Add to dashboard Cite

Background The Perceived Functioning & Health (PFH) questionnaire was developed to collect, in a standardized manner, which work activities are limited due to health conditions according to the perception of the client. In this study the questionnaire’s reliability and validity are investigated. Methods The PFH questionnaire is comprised of 147 questions, distributed over 33 scales, pertaining to the client’s psychosocial and physical work limitations. The PFH data of 800 respondents were analyzed: 254 healthy employees, 408 workers on sick leave and 138 recipients of a disability pension. Internal consistency (Cronbach’s α) for the scales was established. The test–retest reliability was examined for the data of 52 recipients of a disability pension who filled out the PFH twice within an interval of 1 month. Validation was established by taking the nature of the limitations as a criterion: mental limitations, physical limitations or a mix of both. To this end, the respondents were divided into groups distinguished on the basis of self-classification, as well as classification on the basis of disease codes given by insurance and occupational health physicians: a “healthy” group, subjects with only physical (“physical” group) or mental limitations (“mental” group) or mixed limitations (“mixed” group). The scale scores of these groups were compared and tested using analyses-of-variance and discriminant analyses. Results The scales were found to have sufficient to good internal consistency (mean Cronbach’s-α = 0.79) and test–retest reliability (mean correlation r = 0.76). Analyses-of-variance demonstrated significant differences between the scores of the mental, physical and healthy groups on most of the expected scales. These results were found both in groups defined by self-classification as well as in groups based on disease codes. Moreover, discriminant analyses revealed that the a priori classification of the respondents into three groups (mental, physical, healthy) for more than 75% of them corresponded with the classification on the basis of scale scores obtained from the questionnaire. Furthermore, limitations due to specific types of complaints (low back pain, fatigue, concentration problems) or diagnosed disorders (musculoskeletal disorders, reactive disorders, endogenous disorders) were clearly reflected in the scores of the related scales of the PFH. Conclusion The psychometric properties of the PFH with respect to reliability and validity were satisfactory. The PFH would appear to be an appropriate instrument for systematically measuring functional limitations in subjects on sick leave and in those receiving disability pensions, and could be used as a starting point in a disability claim procedure.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Measuring Clients’ Perception of Functional Limitations Using the Perceived Functioning & Health Questionnaire

Schellekens

Abma

Mulders³

et al. 2010

J Occup Rehabil

View full text Add to dashboard Cite

show abstract

“…The latter was also applied in our study. In an earlier study, Spanjer et al [18] reported a comparable inter-rater agreement of IPs on the items on physical abilities of the LFA in simulated assessments of claimants with low back pain or a lower extremity disorder, based on written interview reports of assessments in practice. Before that, similar results were found in a study of Spanjer [19] into the predecessor of the LFA, the work capacity profile of the Function Information System (FIS).…”

Section: Discussionmentioning

confidence: 98%

The dimensional structure of the functional abilities in cases of long-term sickness absence

Broersen

Mulders²,

Schellart

et al. 2011

BMC Public Health

View full text Add to dashboard Cite

BackgroundThe health problems that working people suffer can affect their functional abilities and, consequently, can cause a mismatch between those abilities and the demands of the work, leading to sickness absence. A lasting decrease in functional abilities can lead to long-term sickness absence and work disability, with negative consequences for both the worker and the larger society. The objective of this study was to identify common disability characteristics among large groups of long-term sick-listed and disabled employees.MethodsAs part of the disability benefit entitlement procedure in the Netherlands, an insurance physician assesses the functional abilities of the claimant in a standardised form, known as the List of Functional Abilities (LFA), which consists of six sections containing a total of 106 items. For the purposes of this study, we compiled data from 50,931 assessments. These data were used in an exploratory factor analyses, and the results were then used to construct scales. The stability of dimensional structure of the LFA and of the internal consistency of the scales was studied using data from 80,968 assessments carried out earlier, under a slightly different legislation.ResultsThree separate factor analyses carried out on the functional abilities of five sections of the LFA resulted in 14 scale variables, and one extra scale variable was based on the items from the sixth section. The resulting scale variables showed Cronbach's Alphas ranging from 0.59 to 0.97, with the exception of one of 0.54. The dimensional structure of the LFA in the verification population differed in some aspects. The Cronbach's Alphas of the verification population ranged from 0.58 to 0.97, again with the exception of the same scale: Alpha = 0.49.ConclusionThe differences between the dimensional structures of the primary data and the earlier data we found in this study restrict the possibilities to generalise the results. The scales we constructed can be utilised to produce a compact description of the functional abilities of groups of claimants in the Netherlands. Moreover, the matching work demands can be used to identify jobs low on those demands as being the most accessible for the specific type of disabled employees, particularly severely disabled individuals.

show abstract

“…Previous research by Spanjer et al [9] has shown that the more information about the client the IP has, the higher the number of work limitations the IP will find. A study by Schellart et al [10] of inter-doctor variation between assessments by IPs found that greater adherence to the rules by IPs leads to a greater number of clients being assessed as the highest category of work disability.…”

Section: Introductionmentioning

confidence: 99%

The influence of applying insurance medicine guidelines for depression on disability assessments

et al. 2013

View full text Add to dashboard Cite

BackgroundIn the current study we report on the effects of an implementation strategy in the form of a training programme on the assessed work limitations of a client with depression by insurance physicians (IPs) participating in a RCT. These assessed work limitations of a client were in the form of scores on the List of Functional Abilities (LFA).MethodWe conducted a randomised controlled trial (RCT) for IPs in which we compared the intervention of a specially developed training programme with the usual methods of implementation and training currently used. The outcome was the mean sum score and the inter-rater reliability (Intraclass Correlation Coefficient, ICC) of the LFA scores. These LFA scores were scored by the IPs participating in the RCT for the work limitations of the cases presented in different videos, two videos before the training and two after the training of the intervention group.ResultsAt baseline, the intervention group (IG) consisted of 21 IPs and the control group (CG) of 19. For one participant of the IG and for one of the CG the LFAs of the two case reports after training were not available. Before training the sum scores for the first case report did not differ significantly between the groups, while the mean sum score was higher in the IG than in the CG for the second case report. For both case reports after training a higher score was found in the IG than in the CG. The inter-rater reliability measured for the two case reports before training was about the same in the IG and the CG: 0.64 and 0.65, respectively. For the two case reports after training, the ICC was higher in the IG than in the CG: 0.69 and 0.54, respectively. This difference was not significant however.ConclusionIt would appear that the implementation of a specially designed training programme on guidelines for depression may lead to greater inter-rater reliability in the assessments by insurance physicians of the work limitations of clients with depression. It is, however, important to note that insurance physicians who receive training may find more work limitations than those who do not.Trial registrationNetherlands’ Trial Register NTR1863

show abstract

Disability assessment interview: The role of detailed information on functioning in addition to medical history-taking

Cited by 32 publications

References 16 publications

Measuring Clients’ Perception of Functional Limitations Using the Perceived Functioning & Health Questionnaire

Measuring Clients’ Perception of Functional Limitations Using the Perceived Functioning & Health Questionnaire

The dimensional structure of the functional abilities in cases of long-term sickness absence

The influence of applying insurance medicine guidelines for depression on disability assessments

Contact Info

Product

Resources

About