Work disability assessment of cancer survivors: insurance physicians' perspectives

Assessing work disability in cancer survivors is a complex decision-making process. In the Netherlands, physicians employed by the Dutch Social Security Agency (SSA) play a key role in assessing work disability of cancer survivors on long-term sick leave.

To investigate the aspects physicians consider in assessing work disability in cancer survivors, their experiences related to the use of guidelines and their needs related to the use of a prediction rule that aims to support work disability assessments.

A qualitative study involving three consecutive focus group interviews, using a predetermined topic list. The interviews were recorded, transcribed and independently analysed using standard procedures of thematic analysis.

The 29 participating physicians reported feeling responsible primarily for making correct assessments of cancer survivors' work disability, in which they predominantly investigate medical factors. Secondarily, non-medical factors related to the person, their work and/or their social environment were considered. Adherence to guidelines aiming to support physicians making such assessments was variable.

In assessing work disability among cancer survivors on long-term sick leave, physicians considered medical and non-medical factors. The relevance of non-medical factors became more prominent in cases where medical issues were less obvious. There seems to be a need to enhance adherence to guidelines in order to support the work disability assessment of cancer survivors. The development of an implementation strategy for a prediction rule to support the work disability assessment of cancer survivors should be considered.