147 Inability to work fulltime and the association with paid employment one year after assessment (e.g. motivation) and environmental (e.g. work accommodations, support at the job) factors, are not included in the data, which is a limitation of our study. Furthermore, having an insufficient amount of energy for work, expressed in an inability to work fulltime, also impacts other daily activities as self-care, social activities, and household and leisure activities. People with inability to work fulltime could, based on their situation, possibilities and preferences, decide or being forced to restrict working activities or restrict their activities in other fields of daily participation to stay in a certain balance [31]. We have no insight into the factors playing a role in this decision-making process from our register data. Implications for practice and future research This study shows that for both working and non-working disability benefit applicants the association of inability to work fulltime with having paid employment one year after the assessment is limited, but within specific disease groups, inability to work fulltime was either positively or negatively associated with having paid employment. Especially applicants with a disease of the musculoskeletal system may benefit from being assessed with inability to work fulltime, whereas applicants with neoplasm, a disease of the respiratory system and applicants diagnosed with more than one chronic disease, inability to work fulltime hinders having paid employment after the disability benefit assessment. Occupational and insurance physicians can integrate this knowledge in supporting workers on sick-leave with return to work, and in the assessment of work disability. Considering the potential to work part-time can be useful for supporting these applicants to remain in paid employment after assessment, also to convince employers to let these people stay in their job two years after sick leave. However, further research is needed to gain more insight into how being assessed with inability to work fulltime contributes or hinders stay at work and return to work after the disability benefit assessment. Additionally, in our study, we only focused on the applicants who were granted a partial disability benefit, as they are partially compensated and are expected to find a job for the part of income loss. Future research on inability to work fulltime and paid employment might include other samples as the associations of being assessed with inability to work fulltime and paid employment after the assessment might be different for those applicants who were granted a full or no work disability benefit. Subsequently, we only looked into having paid employment after the assessment. To gain more detailed knowledge about the impact of the assessment of work disability on labour market participation, future research could focus on other outcomes such as the increase or decrease in number of hours someone works one year after the assessment. 7
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