Henk-Jan Boersema

88 Chapter 5 number of hours per day and/or per week the applicant is able to work, due to mental, physical, and energetic limitations and restrictions for work. Both residual work capacity and (in)ability to work fulltime are therefore important outcomes of disability assessments. These usually lead to the decision of granting disability benefit yes or no, and determine to a significant extent if an applicant could start with reintegration in work. Also in many other European countries, assessing residual work capacity and inability to work fulltime have become part of current work disability assessments [26, 27]. Up to date, little is known about the prevalence of (no) residual work capacity and the (in)ability to work fulltime among working-age cancer survivors. Our previous study across chronic diseases showed that several socio-demographic characteristics and disease-related factors are associated with inability to work fulltime [28]. Especially in cancer patients, it is of great interest to distinguish between the types of cancer, since the prognosis and treatment strategies of the different types of cancers differ so much [29]. Therefore, for each type of cancer, different socio-demographic characteristics and disease-related factors may be associated with inability to work fulltime. Within this background, the aim of this study is to gain insight into (1) the prevalence of no residual work capacity, (2) the prevalence and degree of inability to work fulltime in the case of residual work capacity, and (3) the associations of socio-demographic and disease-related factors with no residual work capacity and the inability to work fulltime in a representative sample of applicants for a work disability benefit after 2 years of sick leave, diagnosed with different types of cancers as the primary diagnosis. METHODS Institutional setting In the Dutch social security system, workers (employed or receiving unemployment benefit) can apply for a long-term disability benefit after 2 years of sick leave according to the Work and Income Act Netherlands [30]. Incidentally, sick-listed workers suffering from severe diseases and fearing they will not return to work can apply for a full and permanent disability benefit at an earlier stage than 2 years after sick leave. In both cases, insurance physicians assess whether applicants have no residual work capacity if (1) they lose their total work capacity within 3 months, (2) when they have a terminal disease with such a bad life expectancy that they will lose their total work capacity within foreseeable time, (3) they have fluctuating work capacity, (4) they are hospitalized, or (5) they are not self-reliant due to a severe mental disorder or a physical disorder [31]. In that case, the insurance physician can conclude to (permanent or non-permanent) full work disability. If applicants are assessed with residual work capacity, the possible limitations in their mental and physical functioning caused by their disease are indicated as

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