Applying for a disability benefit after two years of sick leave: What do workers expect?

Introduction
What do workers expect when they apply for a disability pension? This study focused on the expectations of workers when claiming a disability benefit after two years of sick leave. The aim is to investigate what their arguments for these expectations are, and the relation between these expectations and the actual outcome of the disability evaluation process.

Methods
Claimants for a disability benefit filled out an internet questionnaire. The main question concerned their expectation of being granted a disability benefit and the reasons for that expectation. Additionally, personal characteristics and the first question of the Work Ability Index (WAI) were inventoried. This was compared to the actual outcome of the application for a disability benefit.

Results
2780 disability claimants were approached and 206 participated in this survey. Of these, 84% expected to receive a benefit, while 72% actually received it. The most frequently cited argument was the severity of the disorder. Arguments for expecting not to receive a disability benefit were more varied. The agreement between the expectation of a benefit and the decision about granting the benefit as expressed in Cohen’s kappa was 0.39. A low score on the first WAI question, low education level and higher age were significantly associated with the expectation of receiving a benefit. The combination of a low WAI score (lower than three) and expectation of a disability benefit were significant outcome predictors. 

Discussion
The value of this study is the importance of the prediction of the patient regarding the receipt of a disability benefit. Furthermore, the WAI score can be an important element in the disability assessment procedure and can support this assessment. Therefore, inclusion of the views of workers about obtaining disability benefits and their estimation of work ability (WAI score) should be integrated in the procedure of disability assessments.