139 Inability to work fulltime and the association with paid employment one year after assessment Measures Dependent variable: Paid employment Paid employment was defined as being employed and working with income of 12 hours or more per week, in line with previous research [16]. Not having paid employment was defined as not working or working with income less than 12 hours per week. For the determination of having paid employment at baseline (i.e. at the time of disability assessment), register data on work status at four months after the disability assessment was used, as it usually takes time before employment transitions, such as termination of a contract, are administered in the income records [17]. Applicants were considered to have paid employment at one year follow-up when they were employed and working with income of 12 hours or more per week, for at least 3 consecutive months around the period of 12 months after the date of the disability assessment. Independent variable: (In)ability to work fulltime The (in)ability to work fulltime was assessed by an insurance physician and reported by the number of hours per week an applicant is able to work on a five-point scale ranging from no more than two hours per day to at least eight hours per day. Being able to work eight or more hours per day was considered as having a normal ability to work, being able to work six hours or less per day, was considered as having an inability to work fulltime. Socio-demographic and disease-related factors Socio-demographic factors included age at date of assessment, sex (male/ female), educational level and working hours before sick leave. Age was classified according to working life stages: early (up to 35 years), mid (35 up to 50 years) and late (50 years and older) work life stage. Educational level was categorized into low (primary school, lower vocational education, lower secondary school), middle (intermediate vocational education, upper secondary school), and high (upper vocational education, university). Working hours per week were classified as the number of hours an applicant worked the year before sick leave, which is roughly two years before the work disability assessment. Working less than 32 hours per week was considered part time work. The type of diagnosis was registered by the insurance physician using the Dutch Classification of Occupational Health and Social Insurance (CAS), derived from the International Statistical Classification of Disease and Related Health Problems [18]. For generalizability, the primary, secondary and tertiary (when available) CAS-diagnoses were recoded to the 22 chapters of the ICD10. For the primary disease group in the multivariable logistic regression model, the variable was recoded into 15 categories, due to a small sample size in certain disease groups. We differentiated 14 ICD10disease groups with 25 cases or more in the subsamples working or not 7
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