Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Insurance, Disability”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources
PubMed2002

[Comparison of expertises between long-term care insurance (SGB XI) and the law on ambulatory care for disabled individuals in Berlin (HPG)].

A long-term care insurance (SGB XI) was established in Germany in 1995. Previously, care for predominantly disabled and disabled elderly people in Berlin was regulated by a law enforced by the Berlin government (HPG). The objective of this study was to investigate the differences in age, sex, diagnosis and care of the disabled individuals at home. In a cross-sectional study, the social medicine certificates of 3.916 disabled individuals were evaluated. The certificate assesses the grade of disability and the care needed for a person entitled to benefit from either the HPG or later from SGB XI. Disabled females benefiting from the HPG and SGB XI regulations are in the majority. The male: female ratio for HPG was 1:2.215 and for SGB XI 1:2.759. The differences between male and female as well as between HPG and SGB XI are statistically significant. The even higher proportion of females for those benefiting from SGB XI is due to the demographic change over time. The results of the study also show that the certificates differ in diagnosis, in the care needed at home, and in the grades of disability. By logistic regression analysis, the univariate method shows the amount of care needed at home to be greater for the HPG than for the long-term care insurance. The collective of disabled persons benefiting from HPG were derived from the ambulatory and the stationary sector. In this study, those individuals who were investigated and supported by SGB XI originated from the ambulatory sector, although the law also supports those under hospital care. By calculating analysis of multivariate logistic regression with grades of disability taken as dependent and disability of a given person as independent variables related to the grades of disability when applying SGB XI were compared to HPG. The independent variables have different hierarchies for both laws and need to be divided into more specific subgroups. Interestingly, age and sex did not influence the grading of disability. Diseases leading to disability differ between male and females. Males suffer mostly from neurologic and psychiatric and females from orthopaedic diseases. The criteria for the particular grades are too broad and a better specification is suggested, in that the grades should be increased from three to five. For exceptional cases, a more flexible procedure should be allowed, which is possible under the present SGB XI regulations.

Adolescent↗
PubMed1995

[Interrater reliability of expert assessment by the health insurance medical service in determining eligibility for disability benefits].

In this paper, we present the first study on the inter-rater reliability of a standardised examination of functional disability, employed by the medical service of the German statutory health insurance system ("Medizinischer Dienst der Krankenversicherung", MDK). 215 elderly adults (mean age 84) living in 6 nursing homes in Munich were included in the study. They were assessed by three medical students and two nurses of the respective nursing homes using the standardised questionnaire of the MDK. Inter-rater reliability of both a summary judgement of disability and of single items, such as impairments in activities of daily living, was assessed by kappa-coefficients. Inter-rater reliability was higher for the overall assessment of disability (kappa = 0.82 between nurses, kappa = 0.57 between medical students) than for most single items. Reliability was particularly low for some items on mental status (such as "restlessness") or perceptions (particularly visual perception) which require clearer definition. This pattern was consistently observed for the two types of comparisons (inter-students, nurse-nurse) and for different subgroups of the study population.

Activities of Daily Living↗
PubMed2004

Disability prevention and communication among workers, physicians, employers, and insurers--current models and opportunities for improvement.

PURPOSE: To review prevailing models of disability management and prevention with respect to communication, and to suggest alternative approaches. METHOD: Review of selected articles. RESULTS: Effective disability management and return to work strategies have been the focus of an increasing number of intervention programmes and associated research studies, spanning a variety of worker populations and provider and business perspectives. Although primary and secondary disability prevention approaches have addressed theoretical basis, methods and costs, few identify communication as a key factor influencing disability outcomes. Four prevailing models of disability management and prevention (medical model, physical rehabilitation model, job-match model, and managed care model) are identified. The medical model emphasizes the physician's role to define functional limitations and job restrictions. In the physical rehabilitation model, rehabilitation professionals communicate the importance of exercise and muscle reconditioning for resuming normal work activities. The job-match model relies on the ability of employers to accurately communicate physical job requirements. The managed care model focuses on dissemination of acceptable standards for medical treatment and duration of work absence, and interventions by case managers when these standards are exceeded. Despite contrary evidence for many health impairments, these models share a common assumption that medical disability outcomes are highly predictable and unaffected by either individual or contextual factors. As a result, communication is often authoritative and unidirectional, with workers and employers in a passive role. CONCLUSION: Improvements in communication may be responsible for successes across a variety of new interventions. Communication-based interventions may further improve disability outcomes, reduce adversarial relationships, and prove cost-effective; however, controlled trials are needed.

Communication↗
PubMed1984

Changing the method for calculating quarters of coverage: the impact on workers' insured status.

The 1977 Social Security Amendments specified that, beginning in 1978, a worker would be credited with one quarter of coverage for a designated amount of annual earnings. For 1978, a worker received one quarter of coverage (up to a total of four) for each $250 in annual earnings from employment or self-employment. Before 1978, a worker who was paid $50 in wages in a calendar quarter was credited with a quarter of coverage. A person who had $400 or more in self-employment income in a year was credited with four quarters of coverage. Some workers received more quarters of coverage under the new provisions than they would have under the old, and other workers received less. Since a worker's receipt of benefits depends on his or her insured status, which is based on quarters of coverage, this change can affect a worker's eligibility for benefits. This study indicates that if $250 in annual earnings had been required for one quarter of coverage in 1977, more than 2.1 million workers would have had a change in their insured status for disabled worker benefits, and about 700,000 workers would have had a change in their insured status for survivor benefits. Those whose insured status was affected were most likely to have had marginal earnings records--for example, they had four to seven quarters of coverage when six were needed. (This effect was expected when the legislation was passed.) This article examines those whose eligibility for benefits was most likely to have been affected.

Adolescent↗
PubMed2000

[Routine documentation based on disability data of the legal health insurance].

Data on sickness absence of employees are routinely used for health reporting and the analysis of work-related morbidity by institutions of the German health insurance. Since the insurance system comprises several different branches, these health reports differ in respect of objectives, data selection, methods of analysis, and presentation of results. A further lack of comparability is caused by the heterogeneous populations, since membership in a certain health insurance depends on social status and job requirements. Aim of this paper was to review the methods and characteristics of health reports as they are routinely published in Germany. By evaluating these reports recommendations should be derived to improve comparability. The review showed that at least four different kinds of health reports should be differentiated: company-based health reports, health reports for business branches, morbidity statistics, and reports from research projects. Such reports have different objectives and therefore require different methods of data analysis. However, group-specific and common standards could be set up and it is suggested that health insurance institutions should work out report guidelines based on the recommendations given in this review.

Absenteeism↗
PubMed1979

[The term "inability to pursue an employment" from the ophthalmologist's viewpoint (author's transl)].

The judgement of disablement is of special economic and social-medical importance. While there are nearly no differences between physicians concerning the judgement of disablement in cases of grave ophthalmological clinical pictures, there exist greater differences in the judgement of so-called "bagatelle"-injuries and -diseases, which demand a temporary unilateral eye-dressing. The problem of functional unilateral vision up to now was considered under the aspect of a lasting disease, but not for a short period of time. A unique decision concerning the disablement should be aimed at by all medical practitioners. In addition to the judgement of disablement the private insurances demand a detailed report for the temporary impairment of disablement, which by no means can be demanded from the ophthalmologists.

Adolescent↗
PubMed1997

[Norwegian fibromyalgia epidemic--its rise or possible decline. What is the trend based on disability statistics?].

The Norwegian National Insurance Scheme (Folketrygden) offers universal coverage to all inhabitants between 16 and 67 years with respect to disability pension. During the 1980s, the number of new disability-pensioners increased rapidly. In 1991, 8.5% of the population at risk received this pension. So called "diffuse" conditions in the musculoskeletal system accounted for a large proportion of new cases. Myalgia/fibromyalgia became a major reason for disability pension. In 1989 more than 7% of the new cases had this diagnosis. The parliament (Stortinget) passed controversial amendments to the National Insurance Acts in 1991 and 1995 which restricted the criteria for obtaining a disability pension. At present the law demands that "a scientific concept of disease" should be applied in these matters. The numbers of new disability-pensioners decreased significantly during the period 1989-1993. The figures from 1994 and 1995 perhaps show a new upward trend, including also "diffuse" diagnoses like fibromyalgia. The use of "diffuse conditions" as a cause for disability pension is discussed in light of the official request for a scientifically justified diagnosis.

Adolescent↗
PubMed1999

Health insurance limitations and exclusions under the Americans With Disabilities Act.

The Americans With Disabilities Act (ADA) provides protection for persons with disabilities in employment, public services, and certain public accommodations. It may also require employers and health insurers to provide coverage for various treatments and procedures associated with certain disabilities. The following article provides employers and health insurers with useful information surrounding the pitfalls and complexities of the ADA as it relates to health insurance coverage.

Architectural Accessibility↗
PubMed1992

[Psychiatric evaluation in civil law].

Aspects of civil law of importance for the psychiatrist as expert witness are those dealing with disability pensions accident insurance, compensation in civil law and rights of the seriously disabled. The legal basis of each is briefly outlined, and some guidelines given for psychiatric court reports. Some outstanding theoretical and practical problems are mentioned.

Disability Evaluation↗
PubMed1996

The independent medical examination: cardiology assessment.

Insurance companies frequently seek medical opinions from various specialists concerning the severity of a medical problem, the appropriateness of a treatment plan and a assessment of the degree of medical impairment in persons who claim they are entitled to disability benefits. The insurer is requesting a medical opinion from a physician not involved in the care of the claimant and with no regular business ties to the insurance company; the insurance industry refers to this as an independent medical examination (IME). The purpose of the cardiology IME is to have an objective assessment concerning symptomatology and disease severity, and to reach a conclusion as to whether the cardiology problem is expected to prevent a return to work. The cardiologist needs to narrow the focus on the heart solely in terms of its primary function, that is, its ability to pump blood.

Disability Evaluation↗
PubMed2006

Health insurance coverage of direct support workers in the developmental disabilities field.

There is mounting evidence that employer-provided health insurance is an important factor in recruiting and retaining a competent and motivated direct support workforce within health and human services occupations. A review of the literature in this area, including new information related to the developmental disabilities field, is presented to assist nonprofit employers and government officials in designing initiatives to address increasing health care costs. Approaches to financing health coverage for frontline staff and a new program in New York that will provide subsidies to agencies to enhance existing coverage are discussed.

Adult↗
PubMed2004

Disability in society-medical and non-medical determinants for disability pension in a Norwegian total county population study.

The objective of this study was to describe sociomedical determinants and developments for the medically based disability pension in Norway by linking individual based data from a county health survey to data on disability from the National Insurance Administration. Two cross-sectional total population health surveys with an approximate 10-year interval were conducted in Nord-Trøndelag county, HUNT I (1984-86) and HUNT II (1995-97), which allows for analyses of changes over time, supplied with official incidence data on disability pension. The large-scale variations and overall increasing incidence rates of disability pension in Norway during the last 20 years also applied to the county of Nord-Trøndelag. The prevalence of disability pension generally increased in the population from the mid-1980s to the mid-1990s. A striking finding was a consistent pattern of increasing prevalence of disability pension with decreasing socio-economic status and education. A geographic pattern for disability pension prevalence on a municipality level suggested that structural and cultural factors were important in determining the level of disability in society. Medical determinants alone cannot explain either the dramatic variations or the overall increased incidence rates of disability pension in the last two decades in Norway. The results demonstrate the importance of social, non-medical and contextual determinants for disability pension, how these determinants result in important prevalence differences by socio-economic status, and their impact on the level of disability in society.

Adult↗