Disability assessment interview: the role of detailed information on functioning in addition to medical history-taking.

Abstract

OBJECTIVE: To investigate whether the provision of detailed information on participation and activity limitations, compared with medical information alone, influences the assessment of work limitations by physicians. METHODS: Three groups each of 9 insurance physicians used written interview reports to assess work limitations in 30 patients with low back pain or lower extremity problems. Each group was given different kinds of information on the patient: the first group received only medical information; the second group received detailed information on participation and activity limitations; and the third group was provided with both types of information. Agreement percentages within the groups and differences between the groups in scores given on the work limitation items of the Functional Ability List were measured. RESULTS: The groups showed no important differences in agreement percentages (mean percentage approximately 80%). The physicians who received either medical information or both forms of information indicated fewer work limitations compared with physicians using detailed information on participation and activity limitations. CONCLUSION: Information on participation and activity limitations provided by the patient has only limited influence on inter-rater reliability. However, there was a significant difference in scores on assessed work limitation items compared with medical history-taking alone. Therefore, in disability assessment interviews physicians should ask for medical information as well as detailed information on participation and activity limitations.