Attitudes towards evaluation of psychiatric disability claims: a survey of Swiss stakeholders.

Autor:	Schandelmaier S; Swiss Academy of Insurance Medicine, University of Basel Hospital, Basel, Switzerland; Institute for Clinical Epidemiology and Biostatistics, University of Basel Hospital, Basel, Switzerland., Leibold A; School of Applied Psychology, University of Applied Sciences Northwestern Switzerland, Olten, Switzerland., Fischer K; School of Applied Psychology, University of Applied Sciences Northwestern Switzerland, Olten, Switzerland., Mager R; University Psychiatric Hospital Basel, Basel, Switzerland., Hoffmann-Richter U; Department of Insurance Psychiatry, Suva, Swiss Accident Insurance Fund, Lucerne, Switzerland., Bachmann MS; Swiss Academy of Insurance Medicine, University of Basel Hospital, Basel, Switzerland., Kedzia S; Swiss Academy of Insurance Medicine, University of Basel Hospital, Basel, Switzerland., Busse JW; Department of Anaesthesia, McMaster University, Hamilton, Canada; CLARITY Group, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; The Michael G. DeGroote Institute for Pain Research and Care, McMaster Universit., Guyatt GH; CLARITY Group, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada., Jeger J; Institute of Medical Disability Evaluations of Central Switzerland, Lucerne, Switzerland., Marelli R; Institute of Medical Disability Evaluations of Central Switzerland, Lucerne, Switzerland., De Boer WE; Swiss Academy of Insurance Medicine, University of Basel Hospital, Basel, Switzerland., Kunz R; Swiss Academy of Insurance Medicine, University of Basel Hospital, Basel, Switzerland.
Jazyk:	angličtina
Zdroj:	Swiss medical weekly [Swiss Med Wkly] 2015 Aug 21; Vol. 145, pp. w14160. Date of Electronic Publication: 2015 Aug 21 (Print Publication: 2015).
DOI:	10.4414/smw.2015.14160
Abstrakt:	Questions: In Switzerland, evaluation of work capacity in individuals with mental disorders has come under criticism. We surveyed stakeholders about their concerns and expectations of the current claim process. Methods: We conducted a nationwide online survey among five stakeholder groups. We asked 37 questions addressing the claim process and the evaluation of work capacity, the maximum acceptable disagreement in judgments on work capacity, and its documentation. Results: Response rate among 704 stakeholders (95 plaintiff lawyers, 285 treating psychiatrists, 129 expert psychiatrists evaluating work capacity, 64 social judges, 131 insurers) varied between 71% and 29%. Of the lawyers, 92% were dissatisfied with the current claim process, as were psychiatrists (73%) and experts (64%), whereas the majority of judges (72%) and insurers (81%) were satisfied. Stakeholders agreed in their concerns, such as the lack of a transparent relationship between the experts' findings and their conclusions regarding work capacity, medical evaluations inappropriately addressing legal issues, and the experts' delay in finalising the report. Findings mirror the characteristics that stakeholders consider important for an optimal work capacity evaluation. For a scenario where two experts evaluate the same claimant, stakeholders considered an inter-rater difference of 10%‒20% in work capacity at maximum acceptable. Conclusions: Plaintiff lawyers, treating psychiatrists and experts perceive major problems in work capacity evaluation of psychiatric claims whereas judges and insurers see the process more positively. Efforts to improve the process should include clarifying the basis on which judgments are made, restricting judgments to areas of expertise, and ensuring prompt submission of evaluations.
Databáze:	MEDLINE
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