Title
Medico-legal reasoning in disability assessment: A focus group and validation study
Author
de Boer, W.E.L.
Donceel, P.
Brage, S.
Rus, M.
Willems, J.H.B.M.
TNO Kwaliteit van Leven
Publication year
2008
Abstract
Background. Decisions on disability pensions are based, among others, on medical reports. The way these medical assessments are performed is largely unclear. The aim of the study was to determine which grounds are used by social insurance physicians (SIPs) in these assessments and to determine if the identification of these grounds can help improve the quality of assessments in social insurance practice. The article describes a focus group study and a questionnaire study with SIPs in four different countries. Method. Using focus group discussions of SIPs discussing the same case in Belgium, the Netherlands, Norway and Slovenia (N = 29) we determined the arguments and underlying grounds as used by the SIP's. We used a questionnaire study among other SIPs (N = 60) in the same countries to establish a first validation of these grounds. Results. Grounds in the focus groups were comparable between the countries studied. The grounds were also recognized by SIPs who had not participated in the focus groups. SIPs agreed most on grounds with regard to the claimant's health condition, and about the claimant's duty to explore rehabilitation and work resumption, but less on accepting permanent incapacity when all options for treatment were exhausted. Conclusion. Grounds that SIPs use refer to a limited group of key elements of disability evaluation. SIPs interpret disability in social insurance according to the handicapped role and strive at making their evaluation fair trials. ICF is relevant with regard to the health condition and to the process of evaluation. Identification of grounds is a valuable instrument for controlling the quality of disability evaluation. The grounds also appear to be internationally comparable which may enhance scientific study in this area. © 2008 de Boer et al; licensee BioMed Central Ltd. Chemicals / CAS: tramadol, 27203-92-5, 36282-47-0
Subject
Workplace
Arbeidsparticipatie
tramadol
adult
article
controlled study
disability
health status
human
medicolegal aspect
pension
questionnaire
rehabilitation care
social insurance
validation process
work resumption
Belgium
classification
comparative study
cultural factor
daily life activity
decision making
disabled person
information processing
insurance
legal aspect
methodology
Netherlands
Norway
occupational medicine
organization and management
physician
Slovenia
social security
standard
work capacity
Activities of Daily Living
Belgium
Cross-Cultural Comparison
Decision Making
Disabled Persons
Eligibility Determination
Focus Groups
Humans
Insurance, Disability
Netherlands
Norway
Occupational Medicine
Pensions
Physicians
Slovenia
Social Security
Work Capacity Evaluation
To reference this document use:
http://resolver.tudelft.nl/uuid:0bcb6698-316a-4f28-ad71-abebbf9d6c66
DOI
https://doi.org/10.1186/1471-2458-8-335
TNO identifier
241075
ISSN
1471-2458
Source
BMC Public Health, 8
Article number
335
Document type
article