Highlights from the ISSA Webinar “From Disability to ability – a changing role for assessment processes”

EPR participated in the webinar organised by the International Social Security Association (ISSA) on 19 September. The article elaborates on some points of interest for EPR members.

The presentation from Sweden highlighted a clearly visible shift in the causes for work-related disabilities, with a reduced share caused by (strenuous) manual labour (at a point or more continuously over the whole professional career) on the one hand and an increased weight attribuable to psychological stress factors on the other, reflecting the general shift to a service and digital economy. It put the emphasis on the importance of psychological conditions in the ”biopsycho-social model” and informed about the increased relevance for “obscure conditions”, in particular if interrelated to mental discomfort and pain. It focused on the Swedish Disability Assessment Model in which items on mental activities are given more weight. The “Activity Ability Assessment” also focuses on the abilities and capacities of a person. The speaker also showed evidence to support his recommendation to use the 6-months window of opportunity after the incident to start with the return-to-work programmes.

The presentation from Italy informed about the ongoing shift from impairment-based social benefits and from tools for the disability assessment based on deficits and restrictions to tools which focus on abilities and capabilities. It illustrated the use of multidisciplinary teams to operate the disability assessment. It showed the good use of regulation and a variety of tools in vocational rehabilitation policies to realise equal treatment in employment and reasonable accommodation at the workplace. The speaker also recalled the economic advantages of preventive policies and of an organisation culture supportive of inclusive enterprises and workplaces.

A key point in the presentation from Germany were the benefits an enterprise or organisation gets when focusing on and investing in the prevention of disabilities and invalidity, e.g. by means of a health care protection programme accessible for insured persons aged 45 or older and by using digital solutions. In Germany, the preventive approach is backed by a National Prevention Strategy. It also put an emphasis on the fact that besides ICF-based tools, other criteria have to be included in the socio-medical disability assessment of a person, in particular when it comes to the evaluation of the reduced earning capacity

The presentation from the Netherlands explained well how the legal obligation for employers and social security institutions to engage in return-to-work activities makes them interested in early interventions. This approach is also pushed by setting economic incentives for employers to avoid having to continue to pay the wage up to 2 years for an employee during sickness leave. In the Netherlands the degree of disability is linked to the loss of the earning capacity of a person, not to a specific limitation or reduced physical or intellectual capability – as this is the case in Germany. The vocational rehabilitation process is supported by labour experts and based on a List of Functional Abilities.