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PubMed2001

[From limitations to possibilities; the advice from the Donner Committee about disability benefits legislation].

In the Netherlands, the number of people declared unfit to work continues to rise: every working day sees more than 100 new benefit claimants. The average age of these claimants is decreasing and the number of women declared unfit for work is showing a disproportionate increase. Against this background, the Dutch government appointed a committee in June 2000 whose task was to examine the functioning of the legislation. The Donner Committee concluded that the claims made under the disability benefits legislation could not be clarified by a worsening of either the public health or the working conditions. The legislation is based on obsolete ideas in which illness effectively excludes employment. This idea fosters a range of social problems in the employment process, which present themselves as medical problems and therefore remain elusive and unsolved. The result is that people are unnecessarily eliminated from society at a time when paid employment is an increasingly important means of social interaction. The Committee proposes a drastic simplification of the legislation so that a disability benefit can only be claimed in the case of complete unfitness for work. Such a claim can only be made in the case of a serious illness which results in permanent and considerable limitations in everyday functioning. For all other cases involving health problems, the employer and employee need to work together to organise appropriate work. The emphasis is on what the employee can do as opposed to what he/she cannot do. If the employer fails to take the necessary measures then he/she will be obliged to continue paying the salary and if the employee fails to cooperate then he/she can be dismissed. If needs be the employee must be prepared to except a salary reduction of 30%. After two years of absence, dismissal is in every case possible. It is anticipated that as a result of the Committee's proposals, more people will remain in employment but that the number of unemployed as well as the number of legal disputes concerning dismissal will increase.

Disability Evaluation↗
PubMed2001

Misconceptions and misuse of the MMPI-2 in assessing personal injury claimants.

The MMPI-2 enjoys widespread popularity in the psychological assessment of personal injury claimants, in part due to its long history, massive research literature, strong empirical basis, and the availability of commercial interpretative and scoring services. However, the relative paucity of studies examining the forensic role of the MMPI-2, raises concerns about the applicability of traditional interpretative guidelines in the medicolegal arena. This paper analyses MMPI-2 protocols of 2080 cases derived from a forensic psychiatric practice in Brisbane, Australia. The data presented here challenges these traditional MMPI-2 interpretations and calls into question assumptions and commonly employed techniques when applied in this setting. In particular, the validity of codetype-based interpretations, the role the MMPI-2 plays in differential diagnosis, and assumptions regarding diagnostically-specific patterns on the test are challenged. MMPI-2 interpretative cookbooks, computer report-writers, adherence to the intent of the test-developers, and appeals to authority are inadequate substitutes for empirical accuracy, and an active hypothesis-testing interpretative approach, based upon setting-specific base-rate data, is recommended.

Attitude of Health Personnel↗
PubMed2000

Educating back-injured workers: What should we be teaching?

OBJECTIVE: The purpose of this study was to identify what information people with acute and chronic back pain, health care practitioners, employers and case managers felt should be included in an educational brochure for recently back-injured workers. STUDY DESIGN: Four focus groups were convened, each comprising several representatives from one of the four constituencies. Participants rated 32 information items regarding their inclusion in an educational brochure. Ratings were tabulated for ranking and for group comparisons. RESULTS: While consensus was strong for most information items, there were apparent differences between the groups for several items relating to work resumption, medical attention, and legal or compensation consultation. CONCLUSIONS: Perceived educational needs of back-injured workers may differ from those of their health care practitioners and from their employers or insurers. Future efforts to prevent back disability through education should include evaluation of the informational needs of injured workers.

Journal Article↗
PubMed2002

[Work capacity--approach and evaluation criteria].

In occupations involving specific risk factors, the employer is required by law to have his candidates/employees physically examined in the course of pre-placement/work, as a measure of health and safety protection. Upon examination, the occupational health physician issues to the employer a statement of the candidate's/employee's suitability for work. Mandatory pre-placement and periodic medical examinations are also required for workers who may affect the health and safety of the public such as workers in public transportation or food processing. This paper looks into the implementation of regulations and actual practice in performing relevant medical examinations. One of the issues described is the determination of a worker's temporary disability. Practicing physician determines a disability and rates the physical impairment. She or he has to translate clinical information into a decision about whether a patient is able to work. This decision is the basis for healthcare compensation and benefits and requires knowledge not only of the illness or injury and the patient, but also of the job tasks and exposure. From the medical standpoint, it may be difficult to determine when a period of temporary disability has ended or if a degree of impairment has remained, and when the temporary partial or total disability has become permanent. The paper discusses the assessment of total or partial permanent disabilities based on the new Pension Insurance Act (1998) and the differences from earlier criteria, summarising the implementation of new regulations for years 2000 and 2001.

Croatia↗