Abstract:

the declaration of «non-incapacity and the unfit one» or that of «unfit and not incapacity» implies a controversy in the decision since it supposes to have taken two opposite qualifications on a worker: the health status and the work. The non-incapacity signifies the assessment of ability to work and that of not, fit exact the opposite, considering that he/she cannot work. Beyond the different application rule, different entities, professionals and purposes of qualification, what is certain is that the worker affected by this controversy is left without public administrative resources to solve such a controversial classification, which can finally lead to the loss of jobs. The causes of such controversy can be found in the specific regulations (which do not establish synergies or convergences in the decision), the lack of completed and shared information among the scope of work, the health area and the area of disability management; the lack of an arbitration body, and the non-definition and confusion of the terms and concepts valued are the causes of such controversy. Occupational health is a continuum care and therefore the administrations and entities involved must collaborate, share information, act synergistically and converge in their decisions. The public authorities must make the normative updates to try to avoid the ambiguity or the fragmentation decision that leaves the worker helpless. The medical discharge assessment is a medical procedure, which goes beyond its immediate consequence of ending the economic benefit that was being perceived and forces the employee to return to work. As soon as the discharge is extended, the ability to work is valued not only with occupational medical criteria but with a medical performance, through a medical examination. The EVIs Disability Assessment Teams of the NSSI (Spain’s Social Security National Institute) must know in a certain, detailed and exhaustive manner the work for which the incapacity for work is considered. It cannot be and not be at the same time, it cannot be NOT SUITABLE because work entails serious problems for your health or because the psychophysical capacities prevent you from working and, at the same time, being NO DISABILITY i.e. not being impeded for work, not having a decrease or a cancellation of work capacity.

Conclusions:

To improve the communication among the work environment, the healthcare area and the area of management and control of the disability, with shared information on the health of the worker and work, for a precise and joint clinical assessment of the worker and avoid controversy. Modification in its composition and functions of the EVI SSNI (assessment body team assessment disability), including new members of the board who can provide greater scientific content and technical medical evaluator labor (doctors of occupational health units, prevention service, primary care doctors and labor technicians) and adding to its functions the resolution of the dispute. Refer to the discharge report as medical report of labor capacity. The EVI should consider non-incapacity status as a full capacity to develop their work and to know what it is about and also must understand that working routine should not involve a deterioration of the workers’ health or a risk of their safety and that of others. To modify the regulations regarding the assessment of disability; to regulate the incapacity (regulation of the work capacity?); to change in the consideration of the habitual profession like reference obliged to evaluate the incapacity, with concrete valuation of the work demands; to reformulate the total permanent disability, assessing whether in concrete circumstances it could not be a long transitory compensation to facilitate the labor incursion in another job. Adoption of joint action protocols for labor, health and disability management. Update of regulations on prevention of occupational risks and social security and disability. Change of the paradigm of competence separation in the qualification of the non-apt and the non-incapacity, when the latter is declared. To consider the preventive nature of the performance actions assess the work capacity. Integrate the assistance healthcare areas, preventive labor and management-inspection of the work incapacity in means not only of collaboration and information interchange but of preventive or prestational integral decisive consideration. To positive value the work capacity in comparison with that of the incapacity value.

Material and method:

The following bibliographic databases have been reviewed up to May 2016: SciELO, PUBMED and the bibliography and medical consultation documentation named in it.