1. Work ability assessment for vocational rehabilitation
Hans Jakob Beck
Medcial director
VIRK, vocational rehabilitation fund Iceland

2. Agenda: Short description of VIRK The setup Theory
Example of ICF in the assessment process
Conclusion

3. VIRK-Vocational rehabilitation fund
Non profit organization founded in Iceland in 2008 in co-operation of Labor unions and the Confederation of Employers
Organized on a national level covering the whole labor market
Funded by 0,39% of the total salary on the labor market by employers, pension funds and the state
Virk's role is to prevent that people leave the labor market due to disability by providing vocational rehabilitation, counselling and promoting activity
Second parallel role is to assess disabilities and work ability

4. Information from applicant
The setup
Doctors referral
Assessment of indiaction for voc rehab
No service
Into service
Special evaluation/ICF
Information from applicant
Basic evaluation /ICF
Vocational rehab
Work ability assessment
WORK

5. Basic evaluation d850, d820, b140, d920, b152, d870, d760, d570, b134
e factors
ICF based questions
You and the job market
Education
Interest/hobbies
Social skills-personal abilities
Social and financial issues
Health
Known risk factors for RTW included in the basic evaluation

6. Example of using ICF in Basic evaluation
In the developmental phase of the basic evaluation we took a close look at others evaluation process. What influenced it the most was arbeidsevnemethonden coming from Denmark, Egenvurdering coming from Norway and Sassam kartan coming from Sweden. The conclusion was 6 important categories, here is example of how they connect to codes in the ICF system .

7. Special evaluation EUMASS core set
-multidiscip. team-
b126, b130, b164, b280, b455, b710, b730, d110, d115, d155, d177, d220, d230, d240, d399, d410,d415, d430, d440, d445, d450, d470, d570, d720,
EUMASS core set
Instruction about the use of qualifiers and information about each code
Review of the rehabilitation plan and recommendation

8. Work ability assessment
When?
If further vocational rehabilitation interventions seem no longer indicated and the goal of return to work has not realized.
How?
A physician meets the individual and also evaluates the information gained under the rehabilitation process. Can also ask for further multidisciplinary evaluation
Questions posed:
Has vocational rehabilitation been fully tried out?
Does the individual now have ability to work?
If yes, what is the working capacity and what kind of jobs are recommended?

9. The use of environmental factors in basic evaluation
This is the model we use to evaluate the environmental factors. In chapter 1 in the basic evaluation we have incorporated the model of Yvonne Heerkens. There we have all the environmental factors in the ICF system gatherd together and further structured into four main categorise; social connection at work , work conditions,
Heerkens, 2004

10. Theory

11. New approach needed Epidemiologic transition
Most health problems chronic
Changing labor marked and social demands
Disability/ability need to be considered
Not only the disease
New model of health
Biopsychosocial model
ICF

12. Figure 2. Suggested attention given to domains of patient’s illness and service involved.
Derick Wade Clin Rehabil 2015;30:
Copyright © by SAGE Publications

13. Chapter 1: Attitude toward work and connection to the labor market
Does your health or condition have any effect on the following factors?
None
A little
Some
A lot
A great deal
Not relevant
Relating to coworkers?
Getting to work on time?
Ability to work in a team?
Finishing projects/tasks on time?
Working on a job related project?
Completing the work day?
Looking for a job?

14. Chapter 2: The ability to acquire new knowledge and skills
Does your health or condition have any effect on the following factors?
Learning new things?
None
A little
Some
A lot
A great deal
Not relevant
Remembering things?
Organizing yourself?
Completing projects/tasks?
Dividing attention or dealing with more than one thing at the same time?
Paying attention and keeping your concentration?
Accepting guidance?
Learning new things
Attending a regular organized job?

15. Chapter 3: Interests
Does your health or condition have any effect on the following factors?
None
A little
Some
A lot
A great deal
Not relevant
Reading for fun?
Participating in organized social activities?
Attending entertainment, such as art exhibitions or going to the cinema?
Pursuing interests?
Travelling for fun?

16. Chapter 4: Social skills – personal competence
Does your health or condition have any effect on the following factors?
None
A little
Some
A lot
A great deal
Not relevant
Coping with anger and irritation?
Reacting to criticism?
Controlling your emotions?
Coping with increased stress?
Motivation (in regards to what you usually want to do)
Showing consideration?
Ability to relate to others?
Coping with every day life?
Persistency, to endure at work

17. Chapter 5: Social and financial circumstances
Does your health or condition have any effect on the following factors?
None
A little
Some
A lot
A great deal
Not relevant
Relations with your closest relatives?
Support from your closest relatives and/or friends?
Developing new contacts?
Keeping up contacts with others (relatives, friends and fellow workers)?
Ensuring your financial security?
Managing your income?

18. Chapter 6: Health
Does your health or condition have any effect on the following factors?
None
A little
Some
A lot
A great deal
Not relevant
Controlling your diet?
Mental well-being?
Controlling use of tobacco?
Use of narcotics?
Controlling use of alchohol?
Controlling use of medicines?
Exercising on a regular basis?
Energy needed for daily activities?
Getting uninterrupted sleep?
Falling asleep?
Waking up fully rested/refreshed?
Physical well-being?

19. ICF factors: Chi square weight against work or disability at follow up

20. ICF average Psychological wellbeing Physical wellbeing Work Disability
2,6
2,6
3,1
Work
Disability

21. Conclutions
VIRK is can been seen as an attempt to react upon merging social problem of chronic health problems and increased disability
VIRK´s model is a paralell vocational rehabilitation and work capacity assessment
ICF is used as a conceptual framework and evaluation tool

22. Thanks for your attention

23. Thanks for your attention