The assessment of work ability

1. Søren Brage Directorate for Labour and Welfare Norway The assessment of work ability

2. To secure employment and work ability

3. Work ability in context – a model

4. Work ability in context – a model Health Functional ability

5. Work ability in context – a model Health Functional ability Work strain

6. Work ability in context – a model Health Functional ability Work strain

7. Work ability in context – a model Health Functional ability Work strain Occupational skills General competencies

8. Work ability in context – a model Health Functional ability Work strain Occupational skills General competencies Work content Demands

9. Work ability in context – a model Work organisation Environment Health Functional ability Work strain Occupational skills General competencies Work content Demands

10. Definition • A person P has complete work ability if, and only if, P has the work specific manual and intellectual competence, strength, as well as tolerance and courage, relevant virtues, other qualifications and has the physical, mental and social health that is required to fulfil the tasks (or alternatives within a set of tasks) and reach the goals (with some requirements of quality) which belong to the job in question, given that the physical, psychological, and organizational work environment is acceptable to P, or can with adjustments easily be made acceptable to P • Nordenfelt. L. The concept of work ability, 2008, p 137.

11. Assessments in social security • Increasing focus on resources, ”residual work capacity”, functional abilities instead of disease – ”work although ill” • Netherlands, UK, Denmark, Norway • Work lane, rather than security lane • Increasing multiprofessional assessments

12. Situations for work ability assessments • Guidance • Return to work, rehabilitation, job matching • focus on resources and possibilities • Comprehensive, including • Benefit decision • Disability and incapacity benefits • focus on deficits • Grading • Limited, excluding • Evaluation • Follow-up of clients • Effective measures

13. Strong medical influence Continental Europe Finland Benefit decisions Weak medical influence Denmark, Norway Guidance The medical dimension

14. Strong Denmark, Norway, UK Guidance Weak Netherlands (CBBS) Benefit decision The client dimension

15. Decisive instruments or structured interviews Iceland, UK, Netherlands, Australia Benefit decision Procedures Denmark, Norway Guidance The instrument dimension

16. Body function&structure(Impairment) Activities (Limitation) Participation (Restriction) Environmental Factors Personal Factors Interaction of ICF Concepts Health Condition (disorder/disease)

17. ICF in social security • provides a nomenclature for describing functional abilities and resources • provides an understanding af function as a health state • provides a cross-professional language • provides a classification for the registration of social security data • has international support and use

18. Research • Nordenfelt (2008).The concept of work ability. • Gould, Ilmarinen, Järvisalo, Koskinen (2009). Dimensions of work ability. • SOU 2009:89.Gränslandet mellan sjukdom och arbete. • Brage, Østerås, Krohne, Steiran (2008). Funksjons-vurderinger ved langvarig sykefravær og ved vedtak om langtidsytelser (Sluttrapport).

19. Takk for oppmerksomheten!