Attitudes towards evaluation of psychiatric disability claims: a survey of Swiss stakeholders
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Authors
Schandelmaier, Stefan
Mager, Ralph
Bachmann, Monica
Kedzia, Sarah
Busse, Jason
Guyatt, Gordon
Jeger, Joerg
Author (Corporation)
Publication date
21.08.2015
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Type
01A - Journal article
Editors
Editor (Corporation)
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Parent work
Swiss Medical Weekly
Special issue
DOI of the original publication
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Series
Series number
Volume
145
Issue / Number
3334
Pages / Duration
1-17
w14160
w14160
Patent number
Publisher / Publishing institution
EMH Schweizerischer Ärzteverlag
Place of publication / Event location
Edition
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Abstract
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.
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ISBN
ISSN
0036-7672
1424-3997
1424-7860
1424-3997
1424-7860
Language
English
Created during FHNW affiliation
Yes
Strategic action fields FHNW
Publication status
Published
Review
Peer review of the complete publication
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Citation
Schandelmaier, S., Leibold, A., Fischer, K., Mager, R., Hoffmann-Richter, U., Bachmann, M., Kedzia, S., Busse, J., Guyatt, G., Jeger, J., Marelli, R., de Boer, W., & Kunz, R. (2015). Attitudes towards evaluation of psychiatric disability claims: a survey of Swiss stakeholders. Swiss Medical Weekly, 145(3334), 1–17. https://doi.org/10.4414/smw.2015.14160