Ben Baumberg Geiger1, Kayleigh Garthwaite2, Jon Warren2, Clare Bambra2. 1. a School of Social Policy , Sociology and Social Research (SSPSSR), University of Kent , Canterbury , UK. 2. b Institute of Health and Society, Faculty of Medical Sciences , Newcastle University , Newcastle , UK.
Abstract
PURPOSE: It has been argued that social security disability assessments should directly assess claimants' work capacity, rather than relying on proxies such as on functioning. However, there is little academic discussion of how such assessments could be conducted. METHOD: The article presents an account of different models of direct disability assessments based on case studies of the Netherlands, Germany, Denmark, Norway, the United States of America, Canada, Australia, and New Zealand, utilising over 150 documents and 40 expert interviews. RESULTS: Three models of direct work disability assessments can be observed: (i) structured assessment, which measures the functional demands of jobs across the national economy and compares these to claimants' functional capacities; (ii) demonstrated assessment, which looks at claimants' actual experiences in the labour market and infers a lack of work capacity from the failure of a concerned rehabilitation attempt; and (iii) expert assessment, based on the judgement of skilled professionals. CONCLUSIONS: Direct disability assessment within social security is not just theoretically desirable, but can be implemented in practice. We have shown that there are three distinct ways that this can be done, each with different strengths and weaknesses. Further research is needed to clarify the costs, validity/legitimacy, and consequences of these different models. Implications for rehabilitation It has recently been argued that social security disability assessments should directly assess work capacity rather than simply assessing functioning - but we have no understanding about how this can be done in practice. Based on case studies of nine countries, we show that direct disability assessment can be implemented, and argue that there are three different ways of doing it. These are "demonstrated assessment" (using claimants' experiences in the labour market), "structured assessment" (matching functional requirements to workplace demands), and "expert assessment" (the judgement of skilled professionals). While it is possible to implement a direct assessment of work capacity for social security benefits, further research is necessary to understand how best to maximise validity, legitimacy, and cost-effectiveness.
PURPOSE: It has been argued that social security disability assessments should directly assess claimants' work capacity, rather than relying on proxies such as on functioning. However, there is little academic discussion of how such assessments could be conducted. METHOD: The article presents an account of different models of direct disability assessments based on case studies of the Netherlands, Germany, Denmark, Norway, the United States of America, Canada, Australia, and New Zealand, utilising over 150 documents and 40 expert interviews. RESULTS: Three models of direct work disability assessments can be observed: (i) structured assessment, which measures the functional demands of jobs across the national economy and compares these to claimants' functional capacities; (ii) demonstrated assessment, which looks at claimants' actual experiences in the labour market and infers a lack of work capacity from the failure of a concerned rehabilitation attempt; and (iii) expert assessment, based on the judgement of skilled professionals. CONCLUSIONS: Direct disability assessment within social security is not just theoretically desirable, but can be implemented in practice. We have shown that there are three distinct ways that this can be done, each with different strengths and weaknesses. Further research is needed to clarify the costs, validity/legitimacy, and consequences of these different models. Implications for rehabilitation It has recently been argued that social security disability assessments should directly assess work capacity rather than simply assessing functioning - but we have no understanding about how this can be done in practice. Based on case studies of nine countries, we show that direct disability assessment can be implemented, and argue that there are three different ways of doing it. These are "demonstrated assessment" (using claimants' experiences in the labour market), "structured assessment" (matching functional requirements to workplace demands), and "expert assessment" (the judgement of skilled professionals). While it is possible to implement a direct assessment of work capacity for social security benefits, further research is necessary to understand how best to maximise validity, legitimacy, and cost-effectiveness.
Entities:
Keywords:
Social security; disability; disability assessment; eligibility; work requirements
Authors: David Y von Allmen; Sarah Kedzia; Raphael Dettwiler; Nicole Vogel; Regina Kunz; Wout E L de Boer Journal: Front Psychiatry Date: 2020-07-03 Impact factor: 4.157
Authors: Regina Kunz; David Y von Allmen; Renato Marelli; Ulrike Hoffmann-Richter; Joerg Jeger; Ralph Mager; Etienne Colomb; Heinz J Schaad; Monica Bachmann; Nicole Vogel; Jason W Busse; Martin Eichhorn; Oskar Bänziger; Thomas Zumbrunn; Wout E L de Boer; Katrin Fischer Journal: BMC Psychiatry Date: 2019-07-03 Impact factor: 3.630
Authors: André Strahl; Christian Gerlich; Georg W Alpers; Katja Ehrmann; Jörg Gehrke; Annette Müller-Garnn; Heiner Vogel Journal: BMC Med Educ Date: 2018-06-13 Impact factor: 2.463