gms | German Medical Science

Background: The way of assessing work disability depends on the particular physician-claimant relationship [1]. In this specific situation, physicians engage in different roles, e.g. being adviser and adjudicator. On the claimants’ side, no transparent assessments and a lack of communication and involvement [2] may have a negative impact on their perceived fairness of the assessment.

Aim: The aim was to develop and validate a self-administered questionnaire for claimants to measure their perceived fairness of the disability assessment.

Method: Experts in social medicine drafted a preliminary questionnaire on claimant’s perceived fairness. To measure construct validity, we included items of the „Cologne Patient Questionnaire“ (CPQ) and the „Satisfaction with Life Scale“. We recruited claimants from four assessment centres. For external validation, the physicians also completed a short questionnaire. To explore underlying factors and shorten the questionnaire, we used a confirmatory factor analysis.

Results/findings: 305 claimants (female 62℅; age 47.4) and 465 physicians participated. The physicians perceived the assessment slightly fairer (7-point-scale, 6.0 vs. 5.7, p<0.01). Claimants’ perceived fairness correlated with ‘confidence in physicians’ (r=0.84, p<0.01), ‘bullying of claimants by physicians’ (CPQ) (r=-0.71, p<0.01) and life satisfaction (r=0.24, p<0.01). The final 16-item questionnaire covers four factors: physicians’ interviewing skills, degrading behaviour and attention towards the claimant and emotional aspects (Cronbach’s α=0.91).

Discussion and conclusions: The questionnaire provides insight into the claimants’ experiences when undergoing a disability assessment. As perceived fairness addresses mainly the physicians approach in the assessment, it is a modifiable factor and may serve as an indicator for quality assurance.