Assessing disability

Workers' compensation systems have two main objectives: to help prevent occupational accidents and occupational diseases and to help insureds overcome the financial problems arising from them.

Within the scope of the above objectives, all workers' compensation systems include the risk of disability, which is of special interest owing to its important impact on personal, social and financial fields.

According to the findings of the World Health Organization, musculoskeletal disorders are, in many industrialised countries, the main cause of both short-term and permanent work disability, causing economic losses that may amount to 5% of GNP.

The International Labour Organization estimates that permanent disability accounts for 10% of the 160 million cases of occupational diseases per year. It goes without saying that the figure is higher than this when occupational accidents are also taken into consideration.

In 2003 Eurostat, the Statistical Office of the European Communities, published the report "Employment of disabled people in Europe".This showed that almost 16% of the population in 25 European countries had reported a long-standing health problem or disability (LSHPD). The second most frequent cause of this LSHPD was work-related.

In the USA, a breakdown of the different compensation cases of social security disability insurance and workers' compensation benefits for the years 1970—2000 shows that approx. 32% of the cases involved permanent partial and total disability, accounting for more than 74% of all the benefits paid.

In handling disability, much can be done by preventing occupational injuries and by providing good healthcare services. However, an integral approach to the risk should include how disability is defined and assessed. Transparency and clarity in its assessment are key factors for achieving positive outcomes, such as

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  reducing litigation;
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  better allocation of benefits, i.e. paying benefits to those who are entitled to them but not giving benefits to people who do not deserve them;
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  diminishing the risk of fraud or malingering;
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  better design of rehabilitation strategies;
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  better use of economic and social resources.

Challenges

It has been argued that the current models for the assessment of disability face real challenges from the new trends in occupational injuries and diseases and developments in the labour market and the world of work.

Nowadays, it is more or less accepted that traditional occupational risk factors are better controlled and supervised than formerly. Occupational health-and-safety systems, as well as the workers' compensation systems, have learned from past experience.

However, it is also accepted that new issues like

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  structural changes,
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  new geographical distribution of work,
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  moving and migrant workers,
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  flexible working arrangements,
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  ongoing changes in the work environment,
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  and new technologies

are responsible for a new risk dimension within workers' compensation systems, for which the assessment of disability should be revised and adapted.