Medical-legal prognosis assessment for permanent work disability (IVA criteria)
A **medical-legal prognosis assessment** is an essential part of determining whether you are entitled to an **IVA benefit** (Incapacity Benefit for Fully Work Disabled Persons). This assessment determines whether your work disability is **permanent**, meaning: whether you can no longer work for an indefinite period. The UWV (Employee Insurance Agency) and the **Labor Expert** (LE) play an important role in this. This article explains how this assessment works, what criteria apply, and what this means for your benefit.
What is a medical-legal prognosis assessment?
A **medical-legal prognosis assessment** is an analysis of your health condition and the expected duration of your work disability. The UWV and the LE assess whether your work disability is **permanent**, meaning: whether you can no longer work for an indefinite period. This is crucial for obtaining an **IVA benefit**.
The assessment consists of two parts:
- Medical assessment: A doctor assesses your health condition and the severity of your complaints.
- Legal assessment: The LE assesses whether your work disability meets the legal criteria for permanence.
Why is this assessment important?
If your work disability is assessed as temporary, you may receive a WIA benefit (Work and Income according to Labor Capacity Act) instead of an IVA benefit. An IVA benefit is often higher and lasts longer, but it is essential that your prognosis is correctly assessed.
Legal basis: IVA criteria for permanent work disability
The **IVA benefit** is regulated in the Work and Income according to Labor Capacity Act (WIA). To qualify for an IVA benefit, you must meet the following criteria:
- Full work disability: You can no longer perform any work, not even with adaptations or support.
- Permanence: Your work disability is for an indefinite period (at least 1 year, but in practice this is often assessed more strictly).
- No entitlement to WIA benefit: If your work disability is assessed as temporary, you will receive a WIA benefit instead of IVA.
What role does the prognosis play?
The **prognosis** is the expectation of how your health will develop in the future. The UWV and the LE look at:
- The severity and stability of your complaints (e.g., chronic pain, mental disorders, physical limitations).
- The expectation of improvement (e.g., recovery, rehabilitation, medication effects).
- The duration of your work disability (e.g., <1 year vs. >1 year).
Important: If the prognosis indicates that your work disability can improve within 1 year, it is often assessed as temporary. This can lead to a WIA benefit instead of IVA.
How is the prognosis assessed?
The assessment takes place in several steps:
- Medical examination:
- You are examined by a UWV doctor or a specialist engaged by the UWV.
- Your medical records, test results, and any rehabilitation reports are reviewed.
- Labor expert assessment:
- The LE (Labor Expert) assesses whether your work disability is permanent.
- The LE looks at your previous work, any other work activities, and your prospects for recovery.
- Decision-making:
- The UWV makes a decision based on the medical and legal assessment.
- You receive a decision letter with the reasoning.
What are the IVA criteria for permanence?
For an IVA benefit, your work disability must meet the following IVA criteria:
| Criterion | Explanation |
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