Reasons for sick leave and disability pension

The majority of long term sickness leaves and disability pensions are granted for unspecific conditions with few objective findings, and a high level of comorbidity. The diagnosis and therapies are based on interpretations of subjective statements from th e patient. Decisions regarding diagnosis, therapy, and sick leave are difficult decisions, and rely on complex societal and cultural factors, approach and avoidance factors specific to each employee and each job situation, as well as by insurance systems and rules for reimbursement. There are also variations in the Nordic countries on these factors. The main objectives of the project are to acquire new knowledge of causality, attributions, diagnostic practice, and choice of therapy of the major reasons fo r sickness leave and disability pensions, based on reports of subjective complaints in patients, with no or few relevant objective findings. The diagnostic practice and interpretations will be mapped in GPs, patients and lay persons by presenting them wit h videos of typical cases. The investigation will take place in Denmark, Norway, and Sweden. Public records will be analyzed for the time course and fluctuations between work, sickness absence, rehabilitation and disability with advanced multi state analy sis. New information on the life span and the probabilities and risk factors for early sick leave and disability pension will be analyzed for the male population. We will also study if it is possible to do a randomized controlled trial, evaluating the eff ect on long term sick leave and disability, functional status, and health.