Brief report: Physician discomfort and variability with disability assessments

Completing a disability assessment is a common physician task; yet, little formal training is available.

To assess physician comfort with disability assessments, and evaluate their consistency.

We conducted 2 separate surveys. The "Comfort" survey asked physicians to rate their comfort (1 = very uncomfortable to 10 = very comfortable) with 12 potentially uncomfortable tasks, including disability assessment. The second survey described 2 different patients requesting disability assessment, 1 with acute and the other with chronic back pain; participants assigned each a level of disability.

Resident and staff physicians at an urban county hospital.

For 54 physicians returning "Comfort" surveys, disability assessment had the lowest average comfort rating (4.3, SD 1.9) compared with all other tasks (mean ratings ranged from 4.8 to 8.0). For the 73 physicians returning the "Disability Cases" survey, 88% found Case 1 qualified for limited employment, but varied on the types of limitations imposed. For Case 2, 39% assigned no disability, 39% limited employment, and 22% full disability.

Our pilot studies support the hypothesis that physicians are not comfortable with disability assessment, and their assessments can be highly variable. Physician discomfort and lack of training may contribute to variability in disability assessments.