Use of a structured functional evaluation process for independent medical evaluations of claimants presenting with disabling mental illness: rationale and design for a multi-center reliability study

• DOI: 10.1186/s12888-016-0967-6
• Publication Date: 2016-07-29T12:55:02Z
• Authors: Monica Bachmann; Wout de Boer; Stefan Schandelmaier; Andrea Leibold; Renato Marelli; Joerg Jeger; Ulrike Hoffmann-R...; Ralph Mager; Heinz Schaad; Thomas Zumbrunn; Nicole Vogel; Oskar Bänziger; Jason W. Busse; Katrin Fischer; Regina Kunz
• Keywords: Inter-Rater Reliability; Disability benefits

Work capacity evaluations by independent medical experts are widely used to inform insurers whether injured or ill workers capable of engaging in competitive employment. In many countries, evaluation processes lack a clearly structured approach, standardized instruments, and an explicit focus on claimants' functional abilities. Evaluation subjective complaints, such as mental illness, present additional challenges the determination work capacity. We have therefore developed process for claimants with disorders which complements usual psychiatric evaluation. Here we report design study measure reliability our approach determining among patients illness applying disability benefits. will conduct multi-center study, 20 psychiatrists trained assess 30 presenting eligibility receive benefits [Reliability Functional Psychiatry, RELY-study]. The entails five-step interview reporting instrument (Instrument Assessment Psychiatry [IFAP]) document severity work-related limitations. videotape all be viewed three who independently rate Our primary outcome is claimant's percentage (0 100 %), secondary outcomes 12 functions 13 capacities assessed IFAP-instrument. Inter-rater four explored using multilevel models estimate intraclass correlation coefficient (ICC). Additional analyses include subgroups according disorder, typicality claimants, claimant perceived fairness assessment process. hypothesize that show moderate (ICC ≥ 0.6) Enrollment actual referred disability/accident increase external validity findings. Finding levels reliability, continue randomized trial test versus evaluation-as-usual.