Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory

Abstract

Purpose: Many high-income countries are witnessing a shift of focus on eligibility for disability benefits towards promotion of work reintegration. However, little is known about how countries assess work capacity, and how a job match is then obtained. The current study aims to compare work capacity assessments and available efforts to achieve a job match in eight high-income OECD countries. Methods: A survey was conducted among key stakeholders concerning organization of work capacity assessments in social security settings, and efforts made to obtain a job, across eight OECD countries: Australia, Denmark, Finland, Iceland, Sweden, the Netherlands, the United Kingdom and the United States. Results: In most countries, work capacity is assessed at several time points, with variations in moments and in information used for job matching. In countries obtaining information on personal and work levels, the search to find a job match usually begins with the persons who have disabilities. Conclusion: Although a shift towards a holistic focus in work capacity assessment has been recognized, medical factors still prevail. Limited emphasis is placed on the implications of functional limitations for the possibilities of work. A holistic approach to assessment needs to be coupled with holistic support measures through provision of coordinated and high quality job matching services.IMPLICATIONS FOR REHABILITATION Besides determining eligibility for benefits the outcome of the work capacity assessment can also be used for other purposes such as reintegration and should not result in a static description of work capacity but also deliver insight in support needs. Involving multiple institutions and disciplines in work capacity assessments may result in a broader overview of the claimants’ capacities, however this places high demands on cooperation and data sharing of all those involved. Incorporating the claimants own perspective on work capacity and possibilities to work might improve the legitimacy of the process and reasonably also the achievement of a good and sustainable job match. This can be achieved by using self reported questionnaires and interviews in the assessments.