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Conceptual Foundation for Measures of Physical Function and Behavioral Health Function for Social Security Work Disability Evaluation

Published:April 01, 2013DOI:https://doi.org/10.1016/j.apmr.2013.03.015

      Abstract

      Physical and mental impairments represent the 2 largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person's underlying capabilities as well as activity demands relevant to the context of work. The objective of this article is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, 2 content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability and Health as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies 5 major domains: (1) behavior control, (2) basic interactions, (3) temperament and personality, (4) adaptability, and (5) workplace behaviors. The content model describing physical functioning includes 3 domains: (1) changing and maintaining body position, (2) whole-body mobility, and (3) carrying, moving, and handling objects. These content models informed subsequent measurement properties including item development and measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work.

      Keywords

      List of abbreviations:

      FAT (Functional Assessment Taxonomy), FFM (5-factor model), ICF (International Classification of Functioning, Disability and Health), PROMIS (Patient-Reported Outcome Measurement Instrument System), RFC (residual functional capacity), SSA (Social Security Administration), SSDI (Social Security Disability Insurance), WHO (World Health Organization)
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      Linked Article

      • Commentary on Measuring Disability
        Archives of Physical Medicine and RehabilitationVol. 94Issue 9
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          This is a commentary on 5 articles in this issue of Archives of Physical Medicine and Rehabilitation that report on several related studies of new approaches to measuring disability. The project was grounded in theory, beginning with the development of a conceptual framework enhanced by a literature review and expert consultation within and outside of the Social Security Administration. The investigators then used item response theory to develop test items, which they organized into computer adaptive testing instruments and tested them for their psychometric properties.
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