Purpose: People with a work disability pension receive vocational rehabilitation (VR) services from the Dutch Social Security Institute (SSI) in order to facilitate return-to-work (RTW). The SSI offers tailored VR existing of two trajectories (aimed at getting fit for work or aimed at returning to work). The purpose of this study is to describe the current practice of VR. This includes a description of client characteristics, RTW barriers and the intensity, duration, content and the outcomes of the offered trajectories.
Materials and methods: We analyzed data from 197 clients that were randomly selected from clients who attended a VR trajectory between 1 January t 2017 and 31 December 2018. Data were obtained from the SSI registration databases and client files.
Results: Both VR trajectories at the SSI have a different aim, but in practice the content of the VR interventions often overlaps. Around half of both trajectories reached their goal. Reasons for unsuccessful trajectories were that the client did not find work or barriers were more complex than initially assessed.
Conclusions: The SSI delivers tailored VR to the specific needs of the client, however substantiations for why a certain VR intervention is offered are limited. Guidelines are needed to support professionals.
Keywords: Disability pension; labor experts; long-term sick leave; social security; vocational rehabilitation.
This study shows the usual practice of vocational rehabilitation by the Dutch Social Security Institute for all clients with a work disability pension who attended between January 2017 and January 2019.The rationale why a certain vocational rehabilitation intervention is offered by vocational rehabilitation professionals is often unclear or missing.This missing rationale may lead to unwanted practice variation, which is a barrier for evidence-based vocational rehabilitation.Tools and guidelines are needed to support professional decision making and evidence-based vocational rehabilitation and improve return to work.