Doctors’ assessments for determining worker disability vary widely, study finds

Basel, Switzerland – Health care professionals’ judgment varies significantly when they conduct medical evaluations to determine whether workers should receive disability benefits for an injury or illness, and standards are needed to improve the process, according to researchers from the University of Basel.

The researchers reviewed 23 studies from 1992 to 2016 from 12 countries in North America, Europe, Australia, Northeast Asia and the Middle East. The studies occurred either in an insurance setting – where health care professionals evaluated patients – or in a research setting – where patients were evaluated not for assessments but for rehabilitation or other situations.

In 10 out of 16 studies, health care professionals “reached only low to moderate agreement in their judgment of capacity to work,” according to a press release. Higher agreement was strongly linked with the professionals using standards to help with making judgments.

However, many countries lack standards to help with assessments, researchers added. “Promising” elements could include training, use of standardized instruments and discussion about the conflict of interest that can occur when insurers choose experts for evaluations, according to the study. “High quality” research in insurance settings is needed to improve health care professionals’ agreement when conducting evaluations.

“Despite their widespread use, medical evaluations of work disability show high variability and often low reliability,” the researchers wrote. “Use of standardized and validated instruments to guide the process could improve reliability.”

The study was published online Jan. 25 in The BMJ.