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 |