tno work and employment wout de boer, md icf and social insurance of work disability
TRANSCRIPT
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Wout de Boer, MD
TNO Work and Employment
ICF and social insurance of work disability
![Page 2: TNO Work and Employment Wout de Boer, MD ICF and social insurance of work disability](https://reader035.vdocuments.us/reader035/viewer/2022072014/56649ead5503460f94bb49fd/html5/thumbnails/2.jpg)
Köln, 14 October 2003
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Disability for work• Does this person meet the social norm of being
entitled to exclusion form work?
• Is he sick enough?
• Can anything be done about his disability
• Has he done what can be expected from him?
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Köln, 14 October 2003
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Projects I drain from• 15 country study on criteria, daily practice,
management and control (2003)
• Working group Council of Europe on criteria and assessment (2001)
• Comparison of 7 types of evaluation for work in the Netherlands (2002)
• EUMASS (european association of medicine in assurance and social security) working group on disability evaluation and ICF
• Comparison of 7 disability scales, Barema’s
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Köln, 14 October 2003
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Viaene: human damage• Disability represents a loss of value of human
existence: a lowering on Y axis
• Due to a specific cause: disease
• Develops in time, X axis, in relationship to Normal expectations that are hypotheses.
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N
Y
XTime
D B
N
C
A
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Köln, 14 October 2003
ICF and social insurance of work disability 6
• Big question is what is Y?
• Second big question is what is the value of a diminution of Y?
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It is not the criterion itself or the concept of disability (earning or working capacity) that determines the Y-axis
Rather, it is the operationalisation that is constructed in an administrative category.
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Köln, 14 October 2003
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Operationalisation• Medical: the judgment on disability is on severity of
sickness Body structure and function Listings, Barema’s
• Functional: the judgment on disability is on restrictions of activities Activities Functional scales
• Rehabilitative: the judgment on disability is on possibilities and lack of effect of rehabilitation
• Curative aspect: if treatment is possible judgment may be delayed or for a short period
• In practice decision making most often contains all, motivation of decision is limited
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ICF?• Conceptually close to practice: language
• Reveals hidden links with personal factors and notably environment: policy
• Personal factors like coping and motivation are missing, this is a pity, technically
• Gradation of severity is problematic, what does it mean to a social norm?
• Big questions (What is Y) are more concrete but not anywhere near to being solved!