171 Summary Experts from 16 countries responded and we found that inability to work fulltime is assessed in a majority of those countries. In almost all cases, assessments are conducted by medical examiners specialized in insurance medicine. In all countries, both physical and mental disorders are accepted causes for inability to work fulltime, and health complaints, psychosocial and environmental factors are also mentioned as accepted causes in a number of countries. Methods to assess inability to work fulltime vary considerably across countries. Only in the Netherlands, a professional guideline specific for the assessment of inability to work fulltime is in use. In the register based study described in Chapter 4, we explored the prevalence, degree and associations with disease-related and sociodemographic factors of inability to work fulltime in a year cohort of assessments of all applicants for work disability benefit, two years after sick leave, in the Netherlands. Almost 40% of all applicants with residual work capacity were assessed with inability to work fulltime, the majority of them was assessed as not able to work over 4 hours per day. Applicants with higher age, female gender (compared to male), higher education (compared to lower) and multimorbidity had higher risk of being assessed with inability to work fulltime. The type of (ICD10) disease group mattered, as applicants with diseases such as the diseases of the blood, respiratory system and neoplasms showed higher risks, and diseases of the musculoskeletal system showed lower risks of being assessed with inability to work fulltime. In Chapter 5, we used the same year cohort as in chapter 4, but focused on a group of applicants with a primary diagnosis from the ICD10 disease group cancer (n=3757, 9% of total cohort). We explored the prevalence and associations for being assessed with no residual work capacity and inability to work fulltime. We found that the prevalence of no residual work capacity was over 40%. From the less than 60% of the applicants with residual work capacity, 61% were assessed with inability to work fulltime. For inability to work fulltime applicants with lymphoid and haematopoietic cancers showed higher and with cancers of the locomotor system lower odds. Age and gender were significantly associated with inability to work fulltime. In chapter 6 we focused on applicants with a primary diagnosis of mental and behavioral disorders, the largest group in the total cohort (n=12901, 32%). We explored the prevalence and associations of no residual work capacity and inability to work fulltime. We found a prevalence of 22.5% for no residual work capacity and from the sample with residual work capacity, 41.4% were assessed with inability to work fulltime. For the association with inability to work fulltime, differences were seen across diagnosis groups. Applicants with diseases from the diagnose group (post) traumatic stress disorders, mood affective disorders and schizophrenia and delusional disorders showed higher risks, and applicants in the diagnose groups adjustment-, personality- and A
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