Medical-legal prognosis assessment for the sustainability of work disability
For a **work disability benefit** (IVA or WGA), the **sustainability** of your work disability must be assessed. This is done through a **medical-legal prognosis**, in which the UWV and the court look at your future recovery prospects. Whether you qualify for an **IVA** (full work disability) or **WGA** (partial work disability) depends on this prognosis. This article explains how this assessment works, which criteria are used, and what this means for your benefit.
What is a medical-legal prognosis assessment?
A **medical-legal prognosis assessment** is an analysis of your future earning capacity, based on medical data and legal criteria. This assessment determines whether your work disability is **sustainable** (i.e., not temporary) and whether you qualify for an **IVA** or **WGA**.
The **UWV** (Employee Insurance Agency) and the **court** use this prognosis to determine:
- Whether your work disability will last **at least 15 years** (IVA criteria).
- Whether you can work again within **15 years**, but are currently partially work disabled (WGA).
Legal basis: IVA vs. WGA
The assessment of work disability is regulated in the **Work and Income according to Labor Capacity Act (WIA)**. The most important articles are:
- Article 24 WIA: Definition of **full work disability (IVA)**.
- Article 25 WIA: Definition of **partial work disability (WGA)**.
- Article 26 WIA: Prognosis assessment and **sustainability** of work disability.
- He or she is **unable** to work for remuneration.
- The work disability is **sustainable** (i.e., not temporary).
- The work disability will last **at least 15 years**.
How is the prognosis assessed?
The UWV uses a **structured approach** to assess the prognosis. This happens in various steps:
1. Medical examination and reporting
Before the prognosis is assessed, a **medical examination** is conducted. This may consist of:
- A **consultation with a doctor** with a UWV physician or a specialist designated by the UWV.
- A **physical and psychological evaluation** (for example, in cases of chronic pain, depression, or a chronic illness).
- A **functional test** (for example, a walking test or strength test).
2. Legal criteria: IVA vs. WGA
The UWV looks at various criteria to determine whether your work disability is **sustainable**. These criteria are:
| Criterion | IVA (full work disability) | WGA (partial work disability) |
|---|---|---|
| Sustainability | Work disability lasts **at least 15 years** | Work disability is **sustainable**, but recovery within 15 years is possible |
| Recovery prospects | No realistic chance of recovery | Chance of partial recovery within 15 years |
| Age | Usually over 50 years (but not always) | Possible at any age, depending on recovery prospects |
| Medical prognosis | Chronic condition without improvement | Progressive improvement possible, but not full recovery |
Important: The UWV must **prove** that your work disability is sustainable. If you doubt the assessment, you can **object** or **file an appeal**.
3. Prognosis in practice: examples
To better understand the assessment, we look at two practical examples.
Example 1: IVA (full work disability)
Situation: Hans (55 years old) has suffered from severe back problems for years. After several surgeries, it appears that he is **permanently** unable to work, not even with adaptations. The UWV physician concludes that his complaints **will not improve** and that he **cannot perform any work**, not even in an adapted position.
Outcome: Hans receives an **IVA** because his work disability is **sustainable** and there are **no recovery prospects**.