Exploring the concept inability to work fulltime in the context of work disability assessments: a qualitative study

Abstract

Background In many countries inability to work fulltime is recognized as an important concept in work disability assessments. However, consensus is lacking regarding the concept and how it should be assessed. This study seeks to conceptualize and operationalize the concept of inability to work fulltime, and includes perspectives of both patients and physicians. Research questions involve identifying: 1. key elements, 2. measurable indicators, and 3. valid methods for assessing indicators of inability to work fulltime. Methods We used a qualitative study with a thematic content analysis design to conceptualize inability to work fulltime, based on nineteen semi-structured interviews conducted among insurance and occupational health physicians, and representatives of patient organizations. Results Inability to work fulltime is conceptualized as a complex concept which is strongly individually determined and variable due to time and underlying disease. Key dimensions of inability to work fulltime included besides the disease itself, also personal factors like psychological and lifestyle factors, as well as environmental factors related to the work situation and social context. Fatigue, cognitive impairments, and restrictions in functioning in- and outside work were reported as important measurable indicators. A combined use of self-assessment, assessment interviews, and testing, and assessment in the actual (work) setting was identified for assessing these indicators. Conclusion Taking into account the complex and variable nature of inability to work fulltime, we found it advisable to use multiple methods and multiple time points for the assessment. Results of this study provide starting points for further research on the operationalization of inability to work fulltime in a work disability context.

Residual Work Capacity and (In)Ability to Work Fulltime Among a Year-Cohort of Disability Benefit Applicants Diagnosed with Mental and Behavioural Disorders

“…Especially cancers that have a negative impact on energy levels (lymphoid and haematopoietic cancers, and cancers of the respiratory organs) showed increased odds for inability to work fulltime [ 21 ]. This might not be surprising, as energy deficit and fatigue are mentioned as the primary indicators of inability to work fulltime [ 11 , 12 ].…”

“…This part of the assessment results in a conclusion about the (in)ability to work fulltime, reported as the number of hours the applicant can sustain working activities per day. Particularly energy deficit, fatigue and increased need for rest are primary indicators of inability to work fulltime [ 11 , 12 ]. Both residual work capacity and (in)ability to work fulltime are important outcomes of work disability assessments, which usually lead to the decision of granting the benefit or not.…”