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BACKGROUND: Questions exist related to the best way to use medical evidence relative to self-report as part of the SSA disability determination process. OBJECTIVE: To examine concordance between provider and claimant responses along the four dimensions of work related behavioral health functioning: Social Interactions, Mood and Emotions, Behavioral Control, and Self-Efficacy. METHODS: Using secondary ... read moredata from a larger study, which collected data on individuals reporting difficulties with work (claimants) due to mental conditions, 39 items were completed by claimants and their healthcare provider. Inter-rater agreement was assessed using three techniques: Cohen's kappa, percent absolute agreement, and folded mountain plots. RESULTS: A sample of 65 dyads was obtained. Inter-rater agreement was low for most items (k = 0.0-0.20) with a minority of items having fair agreement (k = 0.21-0.40) Percent agreement was fair: Mood and Emotions (46%), Self-Efficacy (44%), Behavioral Control (39%) and Social Interactions (38%) Overall, providers reported lower functioning compared to claimants for the Behavioral Control and Self-Efficacy scales; the reverse trend held for the Mood and Emotions scale. CONCLUSIONS: Results indicate discordance between provider and claimant report of behavioral health functioning. Understanding reasons for and approaches to reconciling the inconsistencies between claimant and provider perspectives is a complex task. These findings have implications for how best to assess mental and behavioral-health related work disability in the absence of an established gold standard measure.read less
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- Marfeo, Elizabeth E., Sue Eisen, Pengsheng Ni, Elizabeth K. Rasch, E. Sally Rogers, and Alan Jette. "Do Claimants over-Report Behavioral Health Dysfunction When Filing for Work Disability Benefits?" Work 51, no. 2 (June 5, 2015): 187-194. doi:10.3233/wor-141847.
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