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PubMed1980

[The life expectancy after cardial infarct regarding the social-insurance company (author's transl)].

German insurance statistics indicate that the age for admission to disablement benefit after myocardial infarct has not increased during the past ten years, which means that there has been no improvement. From among the pensioners in the workers' annuity insurance (Rheinprovinz) as many as 63.0% survived the 7 years' observation period in the case of anterior and 80.1% in the case of posterior wall infarction. While in respect of posterior wall infarction the age dependence has been less distinct, the survival rate reduced by 86.7% in case of male patients younger than 40 years to 49.4% in case of patients of 60 years and over. Minor differences only have been found to exist in respect of females. Regarding the deceased, it has been discovered that also the mean survival rate in years strongly depended on infarct locality, i.e. anterior or posterior wall. Disability benefit used to be granted already on the average 2 years after infarction which means that applications were already filed in the year when the infarct occurred or in the year thereafter. This gives rise to the conclusion that there are too many doctors to whom a myocardial infarction diagnosis creates the impression that the majority of patients will never be able to undertake any kind of professional activity again.

Adult↗
PubMed1997

[Disability in the private pension system in Chile].

BACKGROUND: The degree of disability of workers ascribed to the private allowances system in Chile, is judged by Medical Commissions that apply norms that establish percentages of incapacity, without considering prognosis. AIM: To communicate the causes of disability among Chilean workers ascribed to the private allowances system, their mortality and to correlate the causes of death with diagnoses. SUBJECTS AND METHODS: We analyzed 13,456 consecutive cases judged between August 1990 and April 1992. Mortality was registered up to 12 months after judgment. RESULTS: Total incapacity was determined in 4,158 cases (30.9%), partial incapacity in 1,340 (9.9%) and minor incapacity in 7,958 (59.1%). Osteoarticular diseases were the main cause of disability in 4,460 patients (33.1%) and 77.8% of patients with malignant tumors were considered as having total incapacity. Mortality was 17% among subjects with total incapacity, 1.5% among those with partial disability and 1% among those with minor disability. The cause of death was related to the main disabling disease in 94% of subjects with total incapacity and 66.6% of those with partial incapacity. CONCLUSIONS: Osteoarticular diseases are the main cause of inability among workers ascribed to a private pension system.

Chile↗
PubMedDate not supplied

Independent medical evaluations and impairment ratings.

A significant need exists for quality independent medical evaluations (IMEs). The examiner must understand disability issues to specifically answer the questions of the client who requested the IME. The authors discuss these issues and outline step-by-step the performance of a thorough evaluation and the compilation of a complete report.

Causality↗
PubMed1975

[Comparative characteristics of the work capacity of schizophrenic patients with various types of the course of the disease process (based on epidemiological study data)].

The paper contains data on the study of 1413 schizophrenic patients according to indices of qualification and invalidity groups. The largest category of working patients were those who were diagnosed as periodical schizophrenia. Close to this group were patients with the sluggish form. Shift-like schizophrenia occupied a position between periodical and sluggish on the one side and more progressive within the framework of continous (paranoid and malignant) on the other. A drop in the percentage of working patients from attack to atlack was the least in periodical schizophrenia. The professional qualifications prior to the onset of the disease influenced the working adaptation more in a less progressive form.

Age Factors↗
PubMed1984

[Work capacity and social security of women subjected to radical surgery for breast cancer].

The paper deals with an analysis of social and occupational rehabilitation of 1,031 females radically operated on for breast cancer. The term of follow-up ranged 5-26 years. On primary examination for disability rating 449 females (43.5%) were awarded Group 1-2 and 50 (4.9%)-Group III. 376 females (36.5%) did not apply for disability rating and went to work. 156 women (15.1%) were on pension or housewives. 822 females (79.7%) returned to employment, 285 (34.6%) of them being Group II invalids. 698 females (84.9%) went to work shortly after treatment. 619 women (60%) were beneficiaries on the rolls-378 (36.6%) of them received disability and 241 (23.4%) old-age benefits.

Adult↗
PubMed2006

The functional IME: A linkage of expertise across the disability continuum.

Disability assessment remains a significant challenge especially in welfare systems like workers' compensation and disability insurance. Many of today's managed care strategies do not impact on the seminal issue of return to gainful employment. Employers, insurers, attorneys and case managers routinely request independent medical examinations (IMEs) as a means of determining degree of disability, functional limitations, work restrictions and "estimated" physical capacities. However, this approach is limited because physicians are not trained in the functional model of disability assessment. IMEs address pathology and impairments which represent a portion of the disability continuum described by the World Health Organization, Nagi, Guccione and others [e.g. pathology-impairment-disability-handicap]. Functional capacity evaluations or FCEs are often performed by physical and occupational therapists who are trained in a function-based model of disability assessment. Unlike an IME physician who completes "Estimated Physical Capacities", therapists measure actual physical functioning. The value of both IMEs and FCEs can be enhanced through a "functional IME" that combines both models; medical-based examination and a function-based disability evaluation. This combination enhances the assessment of the relationship of pathology to impairment and impairment to disability status especially, in musculoskeletal disorders which tend to drive costs in workers' compensation.

Humans↗
PubMed1975

[Earning- and working disability in long-term diabetic patients].

On the basis of the experiences of the Berlin Central Institution for Diabetes and Metabolic Diseases is reported on the capacity to earn their living and the fitness for work of diabetics, especially of 268 long-term diabetics at the age in which they can earn their living and at the retirement age. 31% of these patients belonged to the group of pensioners, 19% of them are still working. 69% of the long-term diabetics are at working age, of them 24% are already pensioners due to diabetes and 4% due to other diseases. Among the complications of diabetes leading to pensioning are frequently mentioned retinopathy, nephropathy in the wider sense, macroangiopathy and neuropathy, rarely, however, instable metabolism. The peculiarities are discussed. In answering the difficult question of the estimation of the incapacity to earn one's living in diabetics in every case the diabetologist should be consulted.

Berlin↗
PubMed1992

[Analysis of the capacity of handicapped patients in comparison with non-handicapped patients].

A catalogue of psychological items has been developed that enables any disabled person's job-related abilities as well as the psychological requirements of any job to be assessed. With this newly developed instrument, ability profiles of slow learners and of non-disabled persons have been drawn up. Structural analysis of these data show specific differences in the ability structure of the two groups. The results indicate new ways for well-directed, disability-related promotion in vocational rehabilitation.

Activities of Daily Living↗
PubMed1982

Physical working capacity shortly after myocardial infarction.

The change in the circulatory function during the early postmyocardial infarction phase was studied in 10 untreated, middle-aged men, who were not suffering from angina pectoris. During a period from 7-10 days to 12 weeks after sustaining acute myocardial infarction, the patients carried out 5-9 exercise tests, in which the initial load was 10 W; this load was increased by 10 W/min up to 100 W or a load corresponding to a heart rate of 100 and 120 beats/min, respectively. Expressed as work per heart beat, the circulatory function increased in 9 of the 10 patients, and the mean value increased by between 4 and 15%, depending on the degree of loading. In patients who have undergone uncomplicated myocardial infarction and who are not suffering from angina pectoris, the circulatory function during submaximal work seems to return to the normal level fairly quickly and not to constitute an obstacle to early physical rehabilitation.

Blood Pressure↗