[Work capacity evaluation in occupational disability (supplementary) insurance. What should the medical expert know about industrial practice?].
Up to now it has often been the responsibility of physicians to assess whether an insured person qualifies for disability benefits, although the insurance conditions in fact state that the problem is not purely a medical one. Indeed, it is advisable to take advantage of the expertise available in the field of Occupational Studies when assessing elibility for benefits. The spectrum of occupations is subject to constant change. The "classification of Occupations" published by the Federal Employment Agency in Nuremberg lists some 25,000 occupational designations. Further, several thousand agreements are concluded each year between employers and employees' representatives at various levels and these may need to be taken into account when assessing claims for disability benefits. Occupational Studies is a specialist area in its own right, requiring specific training and experience. The assessment of disability claims calls for close cooperation and teamwork: doctors, insurers and occupational consultants must each contribute their own particular skills to the decision-making process. In the final analysis, however, it is the insurer alone who must take responsibility for accepting or rejecting the disability claim. The present paper starts by discussing the term "Occupational Studies" and goes on to explain the tasks of the occupational consultant. Finally, reference is made to descriptions of occupations as well as workplace features and requirements which the medical expert should take into account when assessing and insured's ability to work in a given occupation.
Hochheim
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Bayerischen Rückversicherung AG, München.
D004185:Disability Evaluation; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005858:Germany; D006801:Humans; D012943:Social Security / Q000331:legislation & jurisprudence*; D014942:Workers' Compensation / Q000331:legislation & jurisprudence*