Your working ability is assessed by a medical expert who is not an employee of the Unemployment Insurance Fund. The fund orders the preparation of expert opinions from health care providers.
The medical expert assesses your working ability on the basis of your application and health data, requesting, if necessary, further information from other doctors and specialists who have treated you.
An expert opinion is usually prepared on the basis of documents, but should the data in the application and health data in the documents be contradictory, the medical expert may ask you to come in for a visit. During the visit, the medical expert will interview you, conduct tests of ability of activity and, if necessary, involve other specialists in the team (e.g. a speech therapist, a special needs educator, an occupational therapist or a psychical therapist).
An expert opinion lists the diagnoses and states forming the basis of the assessment; outlines areas of restriction, degrees of severity and the reasons for and impact of restriction on the ability of activity; provides an assessment of the extent of working ability along with an explanation; and states the prognosis regarding changes in the state of health and estimated duration of partial or no working ability together with an explanation. Additionally, the medical expert makes recommendations on suitable working conditions and activities supporting working ability.
Example of expert opinion summary:
- The applicant has severe restrictions on interpersonal communication which stem from depressed mood, emotional fluctuations and chronic illnesses which amplify these disorders indirectly.
- Active communication with strangers, public speaking and resolving conflict situations is precluded.
- Their working ability is partially restricted. State of health will likely worsen but within two years their working ability is likely to change little.
- Fit to work in a small company or individually. Unfit to work where active communication and/or communication with strangers (e.g. with customers) and public speaking is required or where conflicts may arise. Needs psychological counselling.
If your state of health is particularly severe (precluding work ability*), ‘no working ability’ is established only on the basis of a diagnosis or state of illness and working ability is assessed no further. Therefore, if you confirm at the beginning of the application that you have no working ability, you are not required to fill in the rest of the application. In such a case, the assessment may take place under a simplified procedure: the medical expert will check, on the basis of the health data, if you have a condition which prevents you from working, and prepares an expert opinion.
*The states of health precluding working ability are:
- stage IV cancer
- dialysis treatment
- continuous treatment using equipment (daily 24-hour treatment with an oxygen device or treatment pump, except insulin)
- Alzheimer's disease
- a severe or profound intellectual disability
- bed-ridden patients with no prospects of recovery