Evaluation of a worker
This man has a fruit shop. With the crutches you see at the back, he is able to move from his home to the street where he can do his work. He is proud of being able to make a living for himself; and with good reason. © G.Van Den Bergh
A systematic approach to the rehabilitation process is needed. When a person comes to a rehabilitation center, for instance, an evaluation of the worker is needed, to make a plan. This evaluation can be described by these six steps:
1. What is the medical diagnosis of the patient?
2. What types of impairment is related to the medical diagnosis and what is the extent of the impairment?
A good, detailed description of the impairment is needed, based on an interview with the patient and an examination of the clinical function level. The evaluation must be individualized to the specific person and to the specific work task of relevance. It is complicated to make such evaluations, and knowledge on many dimensions is needed. There are a number of different systems to measure impairment. Some are developed to please benefit systems; as economic benefits may follow certain reductions in function. Others are quite complicated and many are used for research. There are forms for self-reports, questionnaires for pain affecting function, questionnaires for depression and psychiatric ratings, well- being forms, personality tests and measures for behavior, just to name a few. In developing countries, a focused interview by a skilled person might be the best method. Also, there are a number of measures for the examination of the worker, different functional measures and tests. Again, simple clinical examinations and evaluations are probably the most useful approach, in combination with descriptions given by the patient.
3. Is the impairment caused by, or aggravated by, the work?
This is of course important information, as aggravation of the impairment must be avoided. However, it is not uncommon that this type of evaluation has not been performed, leading a patient into a very unhealthy work situation, bound to lead to disaster. For instance, if a worker has developed an asthmatic condition due to work in the cotton fields, it is not wise to give him a new job in another dusty factory.
4. What is the impact on the impairment on the patient’s ability to obtain employment
Sometimes a disability will have no impact on the work at all. For instance, office work can be performed by persons without legs, as long as the office worker has the skills for the work to be done. The only problem will be transport to and from the office.
5. What kind of sources for information on work capability should be considered?
Often work place visits and meetings with employers are needed to be able to evaluate the situation properly. This type of preparatory work is very important.
6. Is the patient entitled to any economic benefits?
Several countries have some kind of economic benefits. In most situations, the worker needs help with these issues.
© University of Bergen/Author: B.E. Moen