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


Marfeo, Elizabeth E.; Haley, Stephen M.; Jette, Alan M.; Eisen, Susan V.; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M.; Chan, Leighton; Brandt, Diane E.; Rasch, Elizabeth K.


American Academy of Physical Medicine and Rehabilitation (AAPM&R)


Archives of Physical Medicine and Rehabilitation, 2013, Volume 94 (Number 9), Seite 1645-1652, Philadelphia, Pennsylvania: Saunders, ISSN: 0003-9993 (Print); 1532-821X (Online)




Physical and mental impairments represent the two 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 paper 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, two 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 (ICF) 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 five 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 three 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, 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.

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Archives of Physical Medicine and Rehabilitation

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Informationsstand: 29.01.2014

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