A limb to stand on? A scoping review of employability assessment in Australian total and permanent disability insurance claims.

Purpose: Employability assessment helps in deciding to pay or decline Australian total and permanent disability insurance claims, yet it has not been critically examined. This paper reviews employability assessment from forensic vocational assessment, life insurance/superannuation, and legal perspectives.Methods: In a scoping review, we searched six multidisciplinary databases and various industry-specific resources. Items pertinent to forensic employability/vocational assessment and life insurance total and permanent disability claims were included. Return-to-work assessment, the vocational assessor, medical or functional evaluation, and case law items were excluded. Quality appraisal measures were used for research studies and other items. From 104 full-text reviews, 39 items were included for thematic synthesis from the three perspectives of interest.Results: Our review found that employability assessment is derived from forensic vocational assessment, but methodology differs in claimant contact and psychosocial aspects. Employability assessment practice is informed by policy, market changes, and legal interpretation. Assessors may work for opposing sides in forensic or indirect settings therefore high standards and credentials must prevail.Conclusions: Foundational research into the effectiveness of employability assessment and the experience of claimants is warranted. Future research into methodology, assessor credentials, and legal aspects will broaden understanding of this relatively new topic.Implications for rehabilitationEmployability assessment is an emergent and hitherto unexamined model that operates in the multi-billion-dollar Australian total and permanent disability insurance market.Total and permanent disability insurance policies and their legal interpretation are ever-changing and substantially inform employability assessment practice.Employability assessment lacks methodology and variables that are common elements in proven forensic vocational assessment models in the United States.Training and credentialing of rehabilitation professionals who conduct employability assessments are required to withstand legal scrutiny and meet international forensic standards.

Issues facing employability assessment in total and permanent disability insurance claims: A rehabilitation perspective.

BACKGROUND: Expert employment information helps life insurers to decide total and permanent disability claims. The employability assessment model was developed a decade ago by rehabilitation counselors and has not been critically examined. OBJECTIVE: This exploratory descriptive study aims to elicit key issues of employability assessment within Australian life insurance. METHODS: Ten rehabilitation advisors with knowledge of employability assessment in the total and permanent disability sector participated in a single focus group. They each nominated issues of concern about employability assessment. These issues were collated then discussed within the group. Qualitative thematic analysis was used to identify key issues. RESULTS: The predominant theme was the forensic nature of employment evidence. There were three categories of key issues. First, assessment providers- their training, qualifications, experience, and role. Second, methodology- approaches that provide most realistic information about a claimant's likelihood of work. Third, policy definitions that illustrate reliance on legal interpretation of employability. CONCLUSIONS: To withstand legal scrutiny, the credentials of providers, assessment methodology, and quality of forensic reports are key issues which need to be addressed. This foundational study will contribute to broader research on this topic, with implications particularly for rehabilitation, life insurance, and claimants.

Using an adapted Delphi process to develop a survey evaluating employability assessment in total and permanent disability insurance claims.

BACKGROUND: No research has been undertaken about employability assessment of total and permanent disability (TPD) insurance claims. Employability assessment provides vocational information to life insurers to help decide claims. To determine how helpful employability assessment is, a new measure was needed to survey insurers. OBJECTIVE: To generate survey items by harnessing the knowledge and agreement of rehabilitation advisors with expertise in employability assessment. METHODS: A panel of 10 (89% of eligible Australian rehabilitation advisors) participated in an adapted three-round Delphi process. Rounds 2 and 3 were incorporated into a novel real-time card sort format. RESULTS: From 94 potential items submitted for first round qualitative analysis, 36 items in four domains-quality, content, utility, and claims-were generated. Two quantitative ranking rounds in one face-to-face session produced a 21-item prototype. The final electronic survey instrument contained 11 sections seeking insurer demographics and feedback on: external providers; employability assessment concepts, components, quality, and usefulness; functional, occupational, labor market items; and finally, cost and type. Our Delphi process was anonymous, completed in four weeks with 100% response rate and 75% agreement. More time between Rounds 2 and 3 would enhance statistical analysis. CONCLUSIONS: Our adapted Delphi methodology for survey item generation is generalizable for any panel able to meet in person.

Vocational aspects of life care planning for people with spinal cord injury.

Spinal cord injury (SCI) is a catastrophic event with profound, long-term consequences in all aspects of an individual's life, including employment. The life care plan (LCP) is a methodology that is used to document the continuum of care needs that an individual with SCI will have across his or her life span. The LCP also highlights the critical stages of development necessary to maximize the person's functional potential and productivity. This article provides a brief overview, with a case study example, of how the LCP can be used in addressing an individual's post-injury employability needs.

Transitions related to infection with human immunodeficiency virus (HIV).

Discovery of one's human immunodeficiency virus (HIV) infection, or receiving a diagnosis of acquired immune deficiency syndrome (AIDS), sets in motion a variety of transitions for individuals. Transitions may be characterized by changes in identity or role, changes in physical capacity and functioning, changes in outlook, changes in relationships, changes in routine, etc. Workplaces also face transitions to deal with increasing numbers of workers who are infected with HIV. A model for vocational rehabilitation counselors to assist individuals living with HIV infection in adjusting to their transitions is presented, and resources for providing informational support of individuals and organizations are described.