Work Capacity Assessments for Disability Benefit Determinations: An International Comparison

Authors

• Lila Rabinovich

Abstract

Disability protection programs constitute a critical safety net for individuals unable to work due to disabling health conditions. Yet countries differ along a number of dimensions in terms of how their social safety nets assist people with disabilities. Learning from other countries’ approaches can be useful for countries seeking to make reforms to their own systems. This paper examines procedural differences in national disability determination approaches in order to provide insights into the systems and counterpoints to the U.S. Ideally, these insights will aid reflection on the American approach. The research focuses on work capacity assessments for disability determination processes. The recognition that work capacity goes beyond a purely medical diagnosis is evident across our sample countries. In particular, current systems rely to a significant degree on an assessment of claimants’ functional capacity, beyond their medical condition. However, differences remain across the countries in the way they measure functional capacity and how that measurement translates into a work capacity determination. Moreover, there are variations in whether and to what extent a claimant’s medical and functional data is complemented by vocational or biographical information. Finally, for all of the countries included, there is an absence of structural, standardized consideration of the functional requirements of actual jobs in the economy and other environmental factors, against which the claimant’s capacity to work can be weighted.

Key Findings

• This paper examines work capacity assessments for disability determination processes in eight countries: Australia, New Zealand, Spain, Luxembourg, Iceland, United Kingdom, Ireland, and Canada. We find that current systems rely to a significant degree on an assessment of claimants’ functional capacity, beyond their medical condition.
• Nevertheless, there remains an almost universal primary emphasis on the medical aspects of disability, even as countries have pivoted toward a greater focus on functional capacity and away from purely medical diagnoses. This persistent emphasis does not consider other individual needs and capacities or environmental factors such as the functional requirements of actual jobs in the economy.
• Moreover, there are variations between countries in whether and to what extent a claimant’s medical and functional data is complemented by vocational or biographical information. Although most countries do consider this information to some extent, how this is weighed against or alongside other evidence remains unclear.
• Finally, for all of the countries included, there is an absence of structural, standardized consideration of the functional requirements of actual jobs in the economy and other environmental factors, against which the claimant’s capacity to work can be weighted.
• The optimal approach to work capacity assessments will depend significantly on country-level contextual factors; politics, socioeconomic setting, resources, types of programs, and programmatic and policy goals.
• While it is unlikely that a perfect system free of biases and weaknesses can be developed, the availability of comparative overviews of different ways of assessing work capacity is valuable as researchers and policymakers continue to search for answers.

Citation

Rabinovich, Lila. 2021. “Work Capacity Assessments for Disability Benefit Determinations: An International Comparison.” Ann Arbor, MI. University of Michigan Retirement and Disability Research Center (MRDRC) Working Paper; MRDRC WP 2021-438. https://mrdrc.isr.umich.edu/publications/papers/pdf/wp438.pdf

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Project

• UM21-03: Survey of Disability Determinations Around the World

Paper ID

WP 2021-438

Publication Type

Working Paper

Publication Year

2021