[Recommendation for standardized selection of sociomedical (insurance medical) assessment of work disability]

Two study populations were examined, one for obtaining a frequency distribution of incapacity for work periods, the other for tracing the qualitative aspects of incapacity for work cases. Quantitative appraisal showed that 16% of all cases accounted for 49% of total incapacity time. Qualitative (microanalytic) appraisal of these 16% traced but a few disease groups responsible, amply dealt with in literature on chronic conditions. A shortcoming of apparently rather minor relevance in the individual case, has moreover been found to be systematic: prolonged incapacity for work periods inadequately explained by the diagnoses given on the incapacity certificate. Not least for this reason, appraisal by the insurance medical examination service should occur after three months at the latest. The criteria for initial selection are outlined in terms of three months incapacity for work, frequent recurrence of incapacity periods, and a catalogue of a few diagnostic groups.