Affiliations: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
Note: [] Corresponding author: Göran Lundh, Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. Tel.: +46 8524 832 31; +46 76555 55 06; Fax: +46 8524 832 05; E-mail: gö[email protected]
Abstract: BACKGROUND: Studies indicate that long-term sickness absence reduces
the ability to return to work (RTW). Multidisciplinary medical assessments
(MMA) have been used as a method to receive a more versatile assessment of
long-term sickness absentees (LTSA) and thereby a better basis for adequate
medical and vocational rehabilitation, and an increasing ability to maintain or
regain work capacity. OBJECTIVE: The objective of this study was to
investigate the associations between the prognoses of LTSAs' future work
capacity made at a MMA and the assessments of their work incapacity made by the
Social Insurance Offices (SIO) two years later. PARTICIPANTS: 385 LTSAs referred to an MMA by SIOs in the Stockholm area in Sweden between 2001 and 2006. METHODS: Data was collected at the MMA on demographic factors,
health, diagnoses, and future work capacity. Information on SIO decisions on
sickness benefits and disability pension and what measures the SIO had taken
was extracted from the case files at the SIOs. Descriptive statistics and
multiple regression analyses were used to assess the associations between the
prognosis and decisions on benefits, controlling for individual factors. RESULTS: Of those predicted to be able to maintain or regain work capacity,
68% received full-time benefits two years later. Work capacity was
negatively affected by high age, full time sickness absence at MMA and number
of physical symptoms at MMA. The prognosis at the MMA was not significantly
related to work capacity when socio-demographic and health factors were
controlled for. However, this was partly due to the fact that the MMA also
included recommendations for vocational rehabilitation and that this factor had
an effect on assessed work incapacity after two years. CONCLUSION: The prognosis of future work capacity evaluated at a multidisciplinary medical
assessment correlated with actual work capacity two years later. However, a
range of other factors were decisive for the result. The study shows that the
link between the prognosis and recommendations for vocational rehabilitation
should be followed by the SIOs responsible for enhancing RTW among individuals
on long-term sick leave.
Keywords: Sick leave, work capacity, disability pension, multidisciplinary medical assessment
