Presentation M P23

M P23 (Poster Presentation):
The development of a tool to support the insurance physician with the work disability assessment of people with medically unexplained physical symptoms

Presented by: Frederieke Geraldine Schaafsma


Weerdesteijn KHN1,2, Schaafsma FG1,2, van der Beek AJ1,2, Anema JR1,2

  1. Research Center for Insurance Medicine AMC UMCG UWV VUmc
  2. Department of Public and Occupational Health, EMGO+ Institute, VU University Medical Center



In 2012 more than 11,000 work disability assessments from clients with medically unexplained symptoms (MUPS) were carried out by insurance physicians employed by the Dutch Social Security Agency (SSA). Of these, approximately 30 % were eligible for full benefits. This shows that many people with MUPS are not able to fully participate, resulting in an enormous economic burden for society. Insurance physicians of the SSA have reported difficulty to assess disability claims of this group of clients in an uniform manner due to the broad range of complaints and the complex relation with functioning. To improve the quality of the disability assessment of clients with MUPS and to improve the advice of the insurance physician regarding prognosis for return to work and/or effective interventions for these people a practical tool may be helpful. This tool should be based on the available scientific knowledge about MUPS and on consensus between general practitioners, medical specialists and insurance physicians.


The project will consist of a modified Delphi study with 12 physicians, including insurance physicians all considered experts with MUPS. Using one or two rounds via email and one meeting using the nominal group technique the physicians are asked to come to full agreement on the most relevant factors that can be deducted from the scientific knowledge regarding MUPS for work disability assessments. Based on the results a tool will be developed to assist the insurance physician and to help substantiate the work disability assessment. Next, two groups of 25 insurance physicians will be asked to assess the work disability of two vignette cases with MUPS. The intervention group will have received the tool and a training how to use the tool. The control group will have had no extra help or information. Difference in self-rated satisfaction with their work disability assessments will be assessed.


The primary outcome of the modified Delphi study is consensus on relevant factors for a work disability assessment for patients with MUPS. Secondary outcome is the degree of satisfaction of the insurance physician when using the tool.


The Delphi study will start in 2014 and results are expected in 2015.

Schedule Details

Monday September 29
12:45 - 13:45 Poster Viewing
Session: Disability measurement