Table 1 Some work disability assessments (translated from Norwegian). The claimant’s main diagnosis (ICD-10) is given

Cert. 7: ‘Development of depression, little ability to set limits and a great deal of stress in close relationships [have] eventually made her unable to function at work. It is known that it takes a very long time for a person to return to occupational functioning after developing such a state, and it is unlikely that she will be able to gain employment within the foreseeable future’ (elderly woman, F33).

Cert. 12: ‘Her ability to work is assessed as greatly reduced owing to prolonged depression. In addition, she is much preoccupied with pain and what this is doing to her. Her condition is assessed as chronic. She will, as she now appears, not be able to function in any job, nor in job training. She is assessed as disabled in the ordinary job market. Further treatment in psychiatric secondary care is not indicated’ (middle-aged woman, F33.1).

Cert. 43: Relationships with immediate family, especially a daughter with special needs, are described generally. There is no information as to whether the daughter’s situation has affected the claimant’s disability or not. The described activity limitations refer to interpersonal interactions: ‘Poor ability to impose herself, speak up about her own opinions, needs etc.’ Appropriate treatment is described as completed. No measures to improve her work ability are reported. She is judged to be permanently disabled, suffering from chronic ‘reduced perseverance, pain in her body after effort, has to rest for days afterwards’. The expert writes that ‘the causes of her physical complaints seem obscure, but underlying psychological condition and personal factors have at least been contributing factors’ (middle-aged woman, F41.8).

Cert. 57: ‘Assessment: X now wants to gain a disability pension. Based on what is described above, he believes that he will not be able to get into employment again. If he is required to do so, his anxiety level will increase significantly, with the risk of alcohol abuse and hence increased risk of suicide. He is now more satisfied with his life than for many years, he has control with respect to alcohol, he has leisure pursuits that he is satisfied with, and he feels that he gradually has learned to come to terms with life. He has made use of the therapy hours here at the clinic in a very satisfactory manner and has gained insight into how his life has been the way it has. [...]. The patient is now [an elderly man] who is seeking disability benefits. The undersigned supports him in this. For the patient, having to deal with a job with many obligations now will destroy the life he has today’ (elderly man, F60.6)

Cert 73: This is a claimant who is described as having been addicted to drugs since he was a teenager. He is currently on medication-assisted treatment. ‘The extensive and continuous drug addiction has resulted in major social-medical problems. During treatment it has emerged that he no longer believes that he can cope with work or work training. His image of himself is very poor [….]. I assess the patient as having had 100% reduction in work ability for many years, and I find it hard to envisage that this will change in the future’ (middle-aged man, F11.2).