title: Associations between prognosed future work capacity among long-term sickness absentees and their actual work incapacity two years later.
abstract: BACKGROUND
  Studies indicate that long-term sickness absence reduces the ability to return to work (RTW). Multidisciplinary medical assessments (MMA) have been used as a method to receive a more versatile assessment of long-term sickness absentees (LTSA) and thereby a better basis for adequate medical and vocational rehabilitation, and an increasing ability to maintain or regain work capacity.
  
  
  OBJECTIVE
  The objective of this study was to investigate the associations between the prognoses of LTSAs' future work capacity made at a MMA and the assessments of their work incapacity made by the Social Insurance Offices (SIO) two years later.
  
  
  METHODS
  385 LTSAs referred to an MMA by SIOs in the Stockholm area in Sweden between 2001 and 2006.
  
  
  METHODS
  Data was collected at the MMA on demographic factors, health, diagnoses, and future work capacity. Information on SIO decisions on sickness benefits and disability pension and what measures the SIO had taken was extracted from the case files at the SIOs. Descriptive statistics and multiple regression analyses were used to assess the associations between the prognosis and decisions on benefits, controlling for individual factors.
  
  
  RESULTS
  Of those predicted to be able to maintain or regain work capacity, 68% received full-time benefits two years later. Work capacity was negatively affected by high age, full time sickness absence at MMA and number of physical symptoms at MMA. The prognosis at the MMA was not significantly related to work capacity when socio-demographic and health factors were controlled for. However, this was partly due to the fact that the MMA also included recommendations for vocational rehabilitation and that this factor had an effect on assessed work incapacity after two years.
  
  
  CONCLUSIONS
  The prognosis of future work capacity evaluated at a multidisciplinary medical assessment correlated with actual work capacity two years later. However, a range of other factors were decisive for the result. The study shows that the link between the prognosis and recommendations for vocational rehabilitation should be followed by the SIOs responsible for enhancing RTW among individuals on long-term sick leave.
authors.affiliation: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Lundh
authors.affiliation: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Klas
authors.initials: K
authors.lastname: Gustafsson
authors.affiliation: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Linder
authors.affiliation: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Pia
authors.initials: P
authors.lastname: Svedberg
authors.affiliation: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.affiliation: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Marklund
mesh_terms: D000041:Absenteeism; D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D062707:Return to Work / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data; D013548:Sweden; D014938:Work Capacity Evaluation
keywords: Sick leave; disability pension; multidisciplinary medical assessment; work capacity