In determining work-ability, insurance physicians predominantly consider aspects relating to the 'functions and structures' and 'participation' components of the ICF model important. The 'environmental factor' and 'personal factor' components were not often mentioned. In assessing the short- and long-term prognosis of work-ability, the 'disease or disorder' component was predominantly used. It can be argued that 'environmental factors' and 'personal factors' should also more often be used in assessing work-ability.

ObjectivesTo describe the time perspective of return to work and the factors that facilitate and hinder return to work in a group of survivors of acute coronary syndrome (ACS).MethodsRetrospective semi-structured telephone survey 2 to 3 years after hospitalization with 84 employed Dutch ACS-patients from one academic medical hospital.ResultsFifty-eight percent of patients returned to work within 3 months, whereas at least 88% returned to work once within 2 years. Two years after hospitalization, 12% of ACS patients had not returned to work at all, and 24% were working, but not at pre-ACS levels. For all ACS-patients, the most mentioned categories of facilitating factors to return to work were having no complaints and not having signs or symptoms of heart disease. Physical incapacity, co-morbidity, and mental incapacity were the top 3 categories of hindering factors against returning to work.ConclusionWithin 2 years, 36% of the patients had not returned to work at their pre-ACS levels. Disease factors, functional capacity, environmental factors, and personal factors were listed as affecting subjects' work ability level.