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9 Overall Conclusions
Pages 369-384

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From page 369...
... an individual's health condition places on his or her ability to function and participate fully in society. In keeping with these models, assessment of individuals' functional abilities relevant to work requirements is an important part of determining whether they are able to meet workplace demands and sustain work performance on a regular and continuing basis.
From page 370...
... 2. The validity of the results of work-related functional assessments is en hanced by a comprehensive approach that includes test results and other information about an individual's physical and mental functional abilities from multiple sources, as well as relevant social and environmental factors and the full scope of tasks involved in a job and sustained gainful employment.
From page 371...
... may limit an individual's ability to participate in work on a regular and continuing basis even if the person is able to perform the relevant work requirements. •  individual's capacity to perform work requirements success An fully in one specific work environment does not necessarily indi cate the ability to perform the same work in a different setting.
From page 372...
... Third-party sources (e.g., friends and family members, health care and social service professionals, workplace colleagues and employers) who are sufficiently familiar with the applicant's activities, health, and functional status can be particularly helpful for providing ancillary information on health and behavioral matters, physical and mental functioning, and workplace performance, although such reports are at times influenced by such factors as selfinterest, mixed motives, and partial or inaccurate observations.
From page 373...
... While specific assessment instruments measure physical and mental functional abilities at the impairment, body part, or organ system level, "integrated" assessment instruments that provide information regarding the integrated effect of individuals' impairments on general daily life and participation can capture the additive and sometimes multiplicative effects of multiple impairments and comorbid conditions on individuals' functional abilities. Several evidence-based instruments and instrument sets are available that provide integrated information about individuals' overall functional capabilities and limitations and could provide helpful information for determinations of work disability.
From page 374...
... In addition, there are a number of threats to the validity of assessments of functional abilities, including testing of maximal versus typical performance, assessment of episodic activity versus sustained task performance, absence of standardized testing conditions, mixed-motive incentives, compromised test integrity owing to prior use of the test in low-stakes testing applications, and diverse test populations on whom tests may not have been validated. Symptoms associated with depression (e.g., fatigue, difficulty concentrating, and slowed response speed)
From page 375...
... •  Successful work performance is more than the sum of the spe cific tasks and skills required, and the overall limitation to suc cessful work for an individual is often more than the sum of single impairments. •  hreats to the validity of assessments of functional abilities T include testing of maximal versus typical performance, assess ment of episodic activity versus sustained task performance, absence of standardized testing conditions, mixed-motive incen tives, compromised test integrity owing to prior use of the test in low-stakes testing applications, and diverse test populations on whom tests may not have been validated.
From page 376...
... Assessment instruments developed for use in research applications may not account for cultural, linguistic, or literacy factors, such as limited English proficiency or low literacy, that limit access to such assessments. Consequently, few or no assessments are available that can capture valid and reliable administration and scoring information for these populations.
From page 377...
... A number of factors, including age, gender, lower socioeconomic status, race, ethnicity, cultural group, and geographical location, may limit the quality and quantity of functional information avail able for a disability applicant. •  Functional assessment instruments vary in the extent to which they have been tested or adapted across diverse populations, making it important to consider an instrument's performance across multiple subgroups.
From page 378...
... Conclusions 2-1. n keeping with current models of disability, assessment of individuals' I functional abilities relevant to work requirements is an important part of determining whether they are able to meet workplace demands and sustain work performance on a regular and continuing basis.
From page 379...
... 2.  The validity of the results of work-related functional assessments is enhanced by a comprehensive approach that includes test results and other information about an individual's physical and mental functional abilities from multiple sources, as well as relevant social and environ mental factors and the full scope of tasks involved in a job and sustained gainful employment.
From page 380...
... 5-1.  iven the complexity of measuring physical function and the multidi G mensional nature of work participation, no single instrument has yet been demonstrated to provide a comprehensive assessment of an individual's physical functional abilities relevant to work.
From page 381...
... who are suitably familiar with the applicant's activities, health, and functional status can be particularly helpful in providing ancillary information on health and behavioral matters, physical and mental functioning, and work place performance, sometimes supported by written documents. Such reports are at times influenced by such factors as self-interest, mixed motives, or inaccurate observations.
From page 382...
... 3-9.  hreats to the validity of assessments of functional abilities include T testing of maximal versus typical performance, assessment of episodic activity versus sustained task performance, absence of standardized testing conditions, mixed-motive incentives, compromised test integrity owing to prior use of the test in low-stakes testing applications, and diverse test populations in whom tests may not have been validated.
From page 383...
... Conclusions 3-5.  hen evaluating the utility of a functional assessment instrument for W informing disability determinations, it is important to consider the in strument's performance across multiple subgroups (e.g., age, gender, socioeconomic status, race, ethnicity, cultural group)


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