Jovica Jovanović

Institute of Occupational Health

    Within the disability evaluation process, three different and potentially conflicting roles for the clinician become clear: patient advocate, provider of information, and medical adjudicator. It is important to understand the requirements of each of these roles so that the patient can best be served. The working ability evaluation is a process of numerous examinations, measurements and estimates that are done by a team of medical and other experts. It is utterly unacceptable to think that the opinion about someone’s working ability is given by some individual specialist of any expert domain especially regarding the invalids category since this can lead to either confusion or undesired conflicts between the patient and those who are professionally and legally qualified to evaluate his working ability. In order to carry out the medical part of the expertise for evaluating the working ability it is necessary have an accurate diagnosis of particular disease, an opinion whether the process is define or can be improved by and adequate therapy in addition to the state of morphology and function of all the organs and systems essential for responding to the biological requirements of the working operations at a given job as well as the estimate of the functional ability of the organs or system. The practical evaluation of the working ability also has to include the professional utilization factor, that is, it is necessary to determine the working operations requirements as well as the conditions in which they are performed at a given job. Within the working ability it is necessary to take into consideration the psychosocial structure of the sick person, years of age, qualification and professional degree as well as the society’s position to accept the proposal made by the medical and other experts. In judging the working ability of the patients having a cardiac disease it is indispensable to view every case separately since it always implies its own factors. The evaluation must be done in specially-qualified institutions having an adequate team of experts including a specialist of occupational medicine, a cardiologist, a safety at work expert, a technologist, a psychologist, a social worker and other medical and non medical staff. Acta Medica Medianae 2004; 43(3): 59-71.