. "Conceptual Issues in the Measurement of Work Disability." The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs. Washington, DC: The National Academies Press, 2002.
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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs
Evaluation of Permanent Impairment (American Medical Association, 1993), which is a standardized system for translating the extent of an injury of a body part into a percentage of disability of the whole person. This type of system has been used for the assessment of compensation payments, including for workers’ compensation.
A number of assessments focus on the functioning of the body, for example, assessments of strength, muscular endurance, body coordination and flexibility, and cognitive and sensory functions (Fleishman, 1972, 1999). The problem with this impairment-focused approach is that even though these assessments may be made in the context of relating functional requirements with the requirements of certain jobs, one needs empirical evidence to support the contention that the degree of impairment is going to have a direct relationship to work disability. Without such evidence, the validity of such an approach is highly suspect.
Much of the discussion of assessment of work effectively has been at the level of functional disability. An example would be the assessment of abilities proposed for the Occupational Information Network (O*NET) system (see, for example, Wunderlich, 1999, p. 24). Here abilities such as oral comprehension, memorization, finger dexterity, and depth perception (Wunderlich, 1999, p. 35) will be assessed and compared with the average requirements of particular jobs. Although the intent was that this should be done for all jobs, it has been suggested that this approach could, in principle, provide the basis of an assessment of work disability (Wunderlich, 1999, p. 86). Measures of work-related functional capacity (Lechner et al., 1997) have also been devised to test or ask about activities such as lifting, standing, walking, sitting, and carrying. Although closer in concept to work disability than assessments of pathology and impairment, assessments of capacity to perform work functions are one level removed from the concept of work disability. They look at the specific abilities of the individual for work in standardized ways not directly related to actual work settings. More importantly, they take no account of any environmental barriers or facilitators that might moderate the way in which a person’s functional limitations are expressed as disabilities.
Activity Limitation (at Work)
A direct way of answering at least part of the question about work disability is to carry out a workplace assessment. This gives information about whether the person can actually carry out the requirements for the major components of the job. This is the kind of assessment that is fre-