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Abstract
Purpose: To investigate the impact of diagnosis, co-morbidity, secondary conditions (e.g. learning problems, subclinical mental and somatic complaints, addictions, and socio-emotional and behavioral problems) and problems in social context on work ability as assessed by Insurance Physicians (IPs) in young adults applying for a disability benefit.
Method: IPs of the Social Security Institute assessed young adults with disabilities (aged 15–27) applying for a disability benefit (n = 1755). Data were analyzed with multilevel ordinal regression techniques.
Results: Primary diagnosis, co-morbidity and subclinical mental complaints were associated with IP-assessed work ability. Persons with mental health conditions as primary diagnosis were less likely to reach a higher work ability than persons with somatic diseases. Young adults with two or more co-morbid conditions and those with psychiatric or developmental co-morbidity were less likely to reach a higher work ability level than persons without co-morbidity. Young adults with subclinical mental complaints were half as likely to reach a higher IP-assessed work ability than young adults without this condition.
Conclusion: Primary diagnosis, type and number of co-morbid conditions and subclinical mental complaints are associated with IP-assessed work ability. Work-ability assessments among adolescents with disabilities applying for disability benefits still focus mainly on medical factors.
Implications for Rehabilitation
Work participation of young adults with disabilities is limited.
Young adults with disabilities often need support to be able to function in social and economic life.
Adequate work ability assessment of young adults with disabilities and subsequent support may help to improve their participation rates.
Declaration of Interest: This study was financially supported by a grant of the UWV Knowledge Centre of the Social Security Institute, The Netherlands.