The article calls for further scientific debate on the perspective of personal factors in the light of the International Classification of Functioning, Disability and Health. A structure that organizes concepts in relation to a personal factors perspective can enhance the comprehensiveness, transparency and standardization of health information, and contribute to the empowerment of persons with disabilities. Implications for rehabilitation The present study collected data from scientific literature reviews, discussion rounds and qualitative secondary analyses in order to develop a representation and organization of information describing persons' lived experience of health from a personal factors perspective in the light of the International Classification of Functioning, Disability and Health. The following representation structure for health-related information from a personal factors perspective was developed: (i) Individuals facts (i.e., socio-demographical factors, position in the immediate social and physical context, personal history and biography), (ii) subjective experience (i.e., feelings, thoughts and beliefs, motives), and (iii) recurrent patterns of experience (i.e., feelings, thoughts and beliefs) and behavior. With this study, we aim to stimulate further scientific discussion about the personal factors component in the International Classification of Functioning, Disability and Health, including its application and subsequent validation for potential implementation into clinical practice.

BackgroundIndividuals who are sick and unable to work may receive wage replacement benefits from an insurer. For these provisions, a disability evaluation is required. This disability evaluation is criticised for lack of standardisation and transparency. The International Classification of Functioning, Disability and Health (ICF) was developed to express the situation of people with disability. We discuss potential benefits of the ICF to structure and phrase disability evaluation in the field of social insurance. We describe core features of disability evaluation of the ICF across countries. We address how and to what extent the ICF may be applied in disability evaluation.DiscussionThe medical reports in disability evaluation contain the following core features: health condition, functional capacity, socio-medical history, feasibility of interventions and prognosis of work disability. Reports also address consistency, causal relations according to legal requirements, and ability to work. The ICF consists of a conceptual framework of functioning, disability and health, definitions referring to functioning, disability and health, and a hierarchical classification of these definitions. The ICF component ’activities and participation’ is suited to capture functional capacity. Interventions can be described as environmental factors but these would need an additional qualifier to indicate feasibility. The components ‘participation’ and ‘environmental factors’ are suited to capture work requirements. The socio-medical history, the prognosis, and legal requirements are problematic to capture with both the ICF framework and classification.SummaryThe ICF framework reflects modern thinking in disability evaluation. It allows for the medical expert to describe work disability as a bio-psycho-social concept, and what components are of importance in disability evaluation for the medical expert. The ICF definitions for body functions, structures, activity and participation, and environmental factors cover essential parts of disability evaluation. The ICF framework and definitions are however limited with respect to comprehensive descriptions of work disability.

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BackgroundMedical work capacity evaluations play a key role in social security schemes because they usually form the basis for eligibility decisions regarding disability benefits. However, the evaluations are often poorly standardized and lack transparency as decisions on work capacity are based on a claimant’s disease rather than on his or her functional capacity. A comprehensive and consistent illustration of a claimant’s lived experience in relation to functioning, applying the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets (ICF-CS), potentially enhances transparency and standardization of work capacity evaluations. In our study we wanted to establish whether and how the relevant content of work capacity evaluations can be captured by ICF-CS, using disability claimants with chronic widespread pain (CWP) and low back pain (LBP) as examples.MethodsMixed methods study, involving a qualitative and quantitative content analysis of medical reports. The ICF was used for data coding. The coded categories were ranked according to the percentage of reports in which they were addressed. Relevance thresholds at 25% and 50% were applied. To determine the extent to which the categories above the thresholds are represented by applicable ICF-CS or combinations thereof, measures of the ICF-CS’ degree of coverage (i.e. content validity) and efficiency (i.e. practicability) were defined.ResultsFocusing on the 25% threshold and combining the Brief ICF-CS for CWP, LBP and depression for CWP reports, the coverage ratio reached 49% and the efficiency ratio 70%. Combining the Brief ICF-CS for LBP, CWP and obesity for LBP reports led to a coverage of 47% and an efficiency of 78%.ConclusionsThe relevant content of work capacity evaluations involving CWP and LBP can be represented by a combination of applicable ICF-CS. A suitable standard for documenting such evaluations could consist of the Brief ICF-CS for CWP, LBP, and depression or obesity, augmented by additional ICF categories relevant for this particular context. In addition, the unique individual experiences of claimants have to be considered in order to assess work capacity comprehensively.

In 2010, we proposed a personal factor classification which was published in this journal. Since then, the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO) and the biopsychosocial model were increasingly incorporated into the German Social Law Code for participation and rehabilitation, implying that personal factors are indispensable for individual assessments. For the present study, we aimed to come up with an updated version of the personal factors classification based on current research. To achieve this goal, we employed a qualitative approach to re-examine the basic structure, consistency, and selection of categories in the classification from our 2010 study, to amend and supplement the categories to reflect best practice personal factor classifications. Our findings indicate that the basic structure remained largely unchanged, with relatively minor changes, including the deletion of 5 categories from our 2010 classification, 10 categories revised in format or content, and 13 new categories. We believe our revised classification to be useful for supporting users in systematically, comprehensively, and transparently reporting influences on specific aspects of individuals’ life and living background on their functioning and participation, thus facilitating an equitable allocation of disability benefits.

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Unlike in IOP and VP, there is a dearth of JM research in the RTW context. Integrating the broad organizational and occupational JM knowledge from IOP and VP with the biopsychosocial framework of RTW could provide a sound basis for developing JM applications in vocational rehabilitation counseling that promote sustainable work reintegration of persons with disabilities. (PsycINFO Database Record