Evidence based disability evaluation

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Presentation transcript:

Evidence based disability evaluation Wout de Boer

I have no conflicts of interest to report Conflict of interests I have no conflicts of interest to report

What do we have here? After a period of trial and error in sick leave and certification, a decision is made about the chances of the disabled individual to earn his or her living, expressed in a degree of disability (yes/ no; degrees) which may entitle to a form of benefit. This decision is based on arguments of relational (health-work), social-normative (what can we reasonably expect) and prognostic nature.

% Decision making % Previous Earnings Resources Competences Health Body Struct Condition Functions Functional Capacity Requirements Suitable Work Suitable Jobs Earning Capacity Disability Job Matching Barema Yes/ No % FCL NL How can the connection between health and legal disability be made? What instruments exist? %

Are the decisions correct? One cannot know, at the individual level if, the decisions about the chances of the individual are correct because the actual outcome depends on many other factors. Typically, among other requirements, one hopes that decision-making is reliable.

About some of the decision-makers Medical experts are involved in all schemes, in a decisive position or in a team of deciders about the arguments. Medical experts are invited to participate with the assumption that they express the professional expert consensus, rather than their individual opinion.

What would they need? Professional expert consensus needs to be there (guidelines, instruments etc.) Professional expert consensus needs to be known Professional expert consensus needs to be convincing. What evidence do we have that this is the case?