135 Inability to work fulltime and the association with paid employment one year after assessment INTRODUCTION For people with long-term disabilities, it is often difficult to continue in fulltime jobs due to their health conditions. Reduction of working hours may accommodate these workers to continue in paid employment as working in a parttime job may better match with their residual work capacity [1]. As part of the Dutch disability benefit assessment, long-term sick-listed workers who apply for disability benefits are assessed on their (in)ability to work fulltime. The (in)ability to work fulltime, is one of the key outcomes of the disability benefit assessment, and indicates the number of hours the applicant can sustain working activities per day, and is assessed by insurance physicians from the Dutch Social Security Institute: The Institute for Employee Benefits Schemes (UWV). In previous research we found that about 40% of the workers who apply for disability benefits are assessed as being unable to work fulltime [2]. We also found a large variety between different disease groups, i.e., especially applicants with diagnoses associated with energy deficits, like diseases of the blood, have a higher likelihood of being assessed with inability to work fulltime [2]. Moreover, (in)ability to work fulltime is associated with factors like age, gender, educational level and multimorbidity. Applicants with higher age, higher educational level and multimorbidity, and women have a higher chance of being assessed with inability to work fulltime [2]. Being unable to work fulltime does not mean that these workers are not able to work at all. Most of the applicants are assessed as having residual work capacity and receive partial work disability benefit. Besides financial compensation they are also supported by the UWV to find a suitable new job or to accommodate their current job in a way that the work requirements match with their residual work capacity. From previous research it is known that reduction of working hours may accommodate workers in the return to work process [1, 3]. Høgelund and Holm [4] found that reduced working hours was the most common (about one-third) workplace accommodation among a sample of sick-listed workers. Another multinational cohort study described that working hours adaptations were significantly related to earlier sustainable return to work for applicants with chronic occupational back pain [5]. Butler et al. [6] found that workers with permanent partial impairments who returned to work with work accommodations as reduced working hours had significantly more stable labour market attachment than workers who did not have work accommodations. In a more recent survey study, it was found that about half of the employed cancer survivors received reduced hours and that receipt of this type of workplace accommodation strongly increased the continued employment of cancer survivors five years after diagnosis [7]. Within the social security setting, it is known that having paid employment at the time of the disability assessment has major impact on labour participation in later years: those working (part- and fulltime) and having paid employment 7
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