Validation of the EUMASS Core Set for medical evaluation of work disability

Abstract

Objective: To perform a content validation of the EUMASS Core Set across six European social insurance systems. The EUMASS Core Set contains 20 categories to describe the functional (in-) capacity of claimants for disability benefits. Methods: We performed an exploratory, cross-sectional study. We used the EUMASS Core Set, added scales to rate the relevance of the 20 categories and added additional questions concerning comprehensiveness, usefulness and sufficiency of the instrument. Medical examiners from European countries filled in this instrument in 10 consecutive claim assessments. Results: Forty-eight medical examiners in six different countries evaluated 446 claimants. The medical examiners used all categories to describe the claimants’ functional (in-) capacity. Medical examiners missed 41 different categories, often mental functions (n = 17). They rated the instrument as useful in 68.4% and as sufficient in 63.2% of the claims. Perceived usefulness varied among countries, but not among disease groups. Perceived sufficiency varied among countries and disease groups. Conclusion: The EUMASS Core Set is promising for reporting about functional (in-) capacities. It contains relevant categories for disability evaluation among countries and disease groups. Adding more mental functions might make it more applicable. Medical examiners found it useful and sufficient to evaluate functional (in-) capacity.

Implications for Rehabilitation

• In medical reports of evaluation of work disability, reporting about functional capacity is often unstructured in free text, making the reports difficult to understand.

• The EUMASS Core Set contains common definitions for expressing functional capacity and is expected to support taking decisions, to improve the quality of decisions and to allow national and international comparisons.

• Our study suggests the EUMASS core set to be comprehensive, useful and sufficient to express functional capacity in disability evaluation.

• Classification
• content validation
• disability evaluation
• EUMASS Core Set
• ICF
• work capacity evaluation

Acknowledgements

The authors would like to thank the EUMASS members for organizing the study at the national levels and the respondents for contributing to this research. We thank Thomas Zumbrunn (Clinical Trial Unit, University Hospital Basel) for data analyses. SB, PD, FF, RF and CO designed the study, recruited medical examiners and assembled the medical examiners data. JA accomplished data analysis; JA and WdB wrote the first draft of the manuscript. SB, PD, FF, RF and CO critically reviewed the manuscript and gave essential input to its various versions.