The assessment of work ability Søren Brage Directorate for Labour and Welfare Norway

Side 2 To secure employment and work ability

Side 3 Work ability in context – a model

Side 4 Work ability in context – a model Health Functional ability

Side 5 Work ability in context – a model Health Functional ability Work strain

Side 6 Work ability in context – a model Health Functional ability Work strain

Side 7 Work ability in context – a model Health Functional ability Work strain Occupational skills General competencies

Side 8 Work ability in context – a model Health Functional ability Work strain Occupational skills General competencies Work content Demands

Side 9 Work ability in context – a model Health Functional ability Work strain Occupational skills General competencies Work content Demands Work organisation Environment

Side 10 Definition  A person P has complete work ability if, and only if, P has the work specific manual and intellectual competence, strength, as well as tolerance and courage, relevant virtues, other qualifications and has the physical, mental and social health that is required to fulfil the tasks (or alternatives within a set of tasks) and reach the goals (with some requirements of quality) which belong to the job in question, given that the physical, psychological, and organizational work environment is acceptable to P, or can with adjustments easily be made acceptable to P – Nordenfelt. L. The concept of work ability, 2008, p 137.

Side 11 Assessments in social security  Increasing focus on resources, ”residual work capacity”, functional abilities instead of disease – ”work although ill” – Netherlands, UK, Denmark, Norway  Work lane, rather than security lane  Increasing multiprofessional assessments

Side 12 Situations for work ability assessments  Guidance – Return to work, rehabilitation, job matching – focus on resources and possibilities – Comprehensive, including  Benefit decision – Disability and incapacity benefits – focus on deficits – Grading – Limited, excluding  Evaluation – Follow-up of clients – Effective measures

Side 13 The medical dimension  Strong medical influence – Continental Europe – Finland  Benefit decisions  Weak medical influence – Denmark, Norway  Guidance

Side 14 The client dimension  Strong – Denmark, Norway, UK  Guidance  Weak – Netherlands (CBBS)  Benefit decision

Side 15 The instrument dimension  Decisive instruments or structured interviews – Iceland, UK, Netherlands, Australia  Benefit decision  Procedures – Denmark, Norway  Guidance

Side 16 Health Condition ( disorder/disease ) Interaction of ICF Concepts Environmental Factors Personal Factors Body function&structure (Impairment ) Activities(Limitation)Participation(Restriction)

Side 17 ICF in social security  provides a nomenclature for describing functional abilities and resources  provides an understanding af function as a health state  provides a cross-professional language  provides a classification for the registration of social security data  has international support and use

Side 18 Research  Nordenfelt (2008).The concept of work ability.  Gould, Ilmarinen, Järvisalo, Koskinen (2009). Dimensions of work ability.  SOU 2009:89. Gränslandet mellan sjukdom och arbete.  Brage, Østerås, Krohne, Steiran (2008). Funksjons- vurderinger ved langvarig sykefravær og ved vedtak om langtidsytelser (Sluttrapport).

Side 19 Takk for oppmerksomheten!