[ICF and social medicine evaluation of capability of gainful activity: is everything clear?--a discussion article]

The ICF (International Classification of Functioning, Disability and Health) calls attention to the complexities associated with disturbances of health. The question raised is how the various constituents and the resulting network as defined by this Classification can gain importance for medical expertise under the statutory pension insurance scheme concerning work-related capacity. Possible variations of strategy are discussed: clinical intuition, algorithmic pathways, proved medical diagnostics, particular diagnostics of activity according to ICF. A genuine "silver bullet" is not in evidence thus far. It cannot be expected that diagnostics relating to a certain sector of the ICF will basically eclipse the rest. Future standards of medical expertise should specify as clearly as possible the impact of the diverse diagnostic findings on the assessment of work-related capacity. Framing emphasis in this way cannot be performed by the ICF on its own.