[Disability claim review by non-physicians to meet the legal requirement of Dutch work disability certification laws].
The number of assessments of incapacity for work has increased to such an extent in the Netherlands (450,000 per year, of which 150,000 are first assessments) that experiments are now being undertaken to employ non-physicians for these assessments. There is no shortage of insurance physicians however: the number available is underestimated as many of these have resigned their regular jobs to perform the same activities on a freelance or second basis. A problem is certainly that these physicians are hindered by an exceedingly bureaucratic system in which e.g. patients are summoned by the administrative section to be reassessed who have already resumed working. Non-physicians may assist in the assessments, but in most cases there is a relation between psychic, somatic and social factors, which requires the generalist physician's eye. The main problem is that government regulations lead to a steady growth in the number of (re)assessments required. A possible but onorthodox solution is proposed which involves medical certification of incapacity for work. This may discourage long-term absenteeism and at the same time it may draw the physician's attention to the existence of an industrial health care problem.
Knepper
S
S
Landelijk Instituut Sociale Verzekeringen (Lisv), Amsterdam. sknepper@lisv.nl
D002983:Clinical Competence / Q000331:legislation & jurisprudence; D004608:Eligibility Determination / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D005194:Family Practice; D006801:Humans; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D009426:Netherlands; D011361:Professional Competence / Q000331:legislation & jurisprudence*; D014938:Work Capacity Evaluation