As defined in the legislation on earnings-related pensions, the assessment of work ability and the assessment of the need and options for rehabilitation are based on overall deliberation. This takes into account the applicant’s whole life history, age, education, work experience and social factors, as well as the restrictions resulting from an illness, injury or impairment and any work ability that may still remain.

If the applicant’s functioning capacity does not meet the requirements of his or her occupation, it is determined whether the applicant would be able to manage in some other job, if necessary with the help of vocational rehabilitation. Rehabilitation always takes precedence over a disability pension. The payment of a disability pension may even be suspended if the recipient, without a weighty reason, turns down the rehabilitation or training offered by the pension provider.

The pension provider must ensure that the employee’s options for rehabilitation have been determined. No decision on a disability pension can be made before that. If the pension application is rejected, the pension provider must see to it that the applicant is given information about rehabilitation options and is referred to rehabilitation that meets his or her rehabilitation needs or to other services in cooperation with bodies arranging such services.

The medical adviser’s role in the assessment of work ability

The role and tasks of the pension provider’s medical adviser differ from the role and tasks of a physician treating a patient. The medical adviser makes an overall assessment of the decline in the applicant’s work ability and the applicant’s remaining ability to earn a living through work, if necessary with the help of vocational rehabilitation. The pension provider’s medical adviser fits the individual case into the overall framework, the general decision-making practice and legal practice.

From the perspective of insurance medicine, the medical adviser assesses under which conditions the applicant can continue at work. The medical adviser participates in the preparation of the decision as an expert together with lawyers, makers of pension decisions and other experts. A physician who has treated the applicant cannot serve as a medical adviser who participates in the preparation of the decision.

Knowledge of work life to support the decision-making practice

For considering disability, pension providers also have practical knowledge of work life. Pension insurance companies have set up advisory boards that monitor and guide the handling of disability pension issues and the application practice. The advisory boards include representatives of employers’ and employees’ organizations. Other pension providers also have advisory organs of a similar type.