Prognostic factors for disability claim duration due to musculoskeletal symptoms among self-employed persons

The study population consisted of 276 self-employed persons, who all had a disability claim episode due to MSD with at least 75% work disability. The study was a cohort study with a follow-up period of 12 months. At baseline, participants filled in a questionnaire with possible individual, work-related and disease-related prognostic factors.The following prognostic factors significantly increased claim duration: age > 40 years (Hazard Ratio 0.54), no similar symptoms in the past (HR 0.46), having long-lasting symptoms of more than six months (HR 0.60), self-predicted return to work within more than one month or never (HR 0.24) and job dissatisfaction (HR 0.54).The prognostic factors we found indicate that for self-employed persons, the duration of a disability claim not only depends on the (history of) impairment of the insured, but also on age, self-predicted return to work and job satisfaction.Although many high quality studies have focused on risk factors for the development of musculoskeletal symptoms [1-3], relatively little is known about prognostic factors for the duration of work disability due to musculoskeletal symptoms [4]. This is remarkable, since musculoskeletal pain - and in particular pain in the neck/shoulder and low back regions - has been shown to be strongly associated with long-term sickness absence [5]. Thus, in order to prevent health care costs and personal suffering, information about this topic is of great importance for both the development of specific interventions directed at these prognostic factors as for the identification of people at risk for a long-term work disability period. Although long-term absences only constitute a small fraction of all absence periods, they comprise up to 75% of all absence costs [6,7].In recent years a few studies on prognostic factors for low back pain (LBP) have been published [5,8-14]. One important message which emerges after reviewing these studies is that more high quality prognostic studies for retu