[Changes in pensioning and psychosomatic assessment]

Appropriate evaluation of a patient's handicapping or disabling conditions, of his or her capacity for work and gainful activity rank among the recurring tasks in inpatient rehabilitation. Published recently, the Beeinträchtigungsschwere-Score (BSS; a score for determining the severity of a condition) constitutes a highly practicable instrument for these purposes, well suited to the clinical setting. Particular difficulties are encountered in the assessment of patients already in the pension award process, a population where the original disease picture has been superimposed by numerous chronification factors of a psychological, social and economic nature so that a so-called invalidity pensioning career has set in. The article gives an overview of this phenomenon of invalidity pensioning career and the sequence of its various phases, setting out the use of the BSS for social-medical evaluation in an inpatient rehabilitation setting.