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Medicina y Seguridad del Trabajo
versão On-line ISSN 1989-7790versão impressa ISSN 0465-546X
Resumo
VICENTE PARDO, José Manuel. Management of Work Disability is More than an Economic Issue. Med. segur. trab. [online]. 2018, vol.64, n.251, pp.131-160. ISSN 1989-7790.
Work incapacity arises depending on multiple variables: health and health variable, management variable, territorial variable, psychosocial and personal variable, economic variable and normative variable, the correct management must analyze all of them. In the adaptation of work disability, the health (illness) and health (health care) variables are elementary, but the deviation from disability must be the subject of a particular and complete analysis where personal, social, economic variables, the normative and those of the management of those entrusted to the various entities are really significant. The processes that most frequently cause prolonged falls are «lumbago» and «anxiety, adaptive disorders and depression» and should be addressed with early attention to avoid its long duration. The detailed data on territorial variability in incidence, duration and prevalence of temporary disability by autonomous communities, reflect that the Autonomous Communities with mot sick leaves per thousand affiliates are the communities with the shortest leaves duration and the richest as well. The globally considered permanent disability is presented in a much differentiated way by territories, being the richest communities the least incapacitated. Some significant variables regarding the degree of disability are not related to their medical cause. The economic variability weighs significantly on absenteeism due to temporary disability, decreasing in the crisis and rising with the economic improvement. The normative approach, with more control or controllers does not seem to conclude in a better control.
Conclusions:
Understood that temporary disability (DT) is initiated, followed and completed, in most situations by the primary care physician, a correct integral management must be reached. More control or more controllers does not report better control of situations. The best assessment of the work incapacity situation requires complete shared labor medical information of the processes, evolution and limitations and the precise knowledge of the work for which one is incapacitated. Disability has always a singularity expressed both by illness and by work for the incapacitated. To improve the adequacy of work incapacity situations, action protocols and their training dissemination should be implemented. The correct management must have all the data on the variables that condition the work disability with a direct and updated analysis of the behavior of the disability, interrelated data referring to illness and functional limitations, age, sex, job, position, company activity, type of company, employment situation, lost days in TD, degree and disability, family situation, home, and social and economic factors.
Palavras-chave : incapacity for work; management; occupational health.
