UWV raises incapacity percentage following objection

My client was a 49-year-old man who originally worked for DAF as a final inspection mechanic. As a result of back problems he became incapable of working on 27 February 2007. From 24 February 2009 he was categorised as 35-80% incapacitated. With effect from 24 July 2011 his incapacity benefits were changed to the 55-65% category.

As my client’s health condition had deteriorated and his symptoms had increased, be requested a reassessment of his incapacity benefits. The insurance scheme doctor and the occupational consultant of the Dutch Administrative Office for Employed Persons’ Insurance Schemes (Uitvoeringsinstelling werknemersverzekeringen or UWV) concluded that my client’s incapacity situation was unchanged. My client could not agree with this course of events, so he came to me. On behalf of my client, I submitted an objection to the UWV’s decision.

In the objection, I argued that the insurance scheme doctor failed to carry out the assessment with due care by merely conducting a brief physical examination and failing to obtain further information from the doctors treating my client. This was necessary as my client had already stated that a neurostimulator had been placed in his spinal cord.

As a result, the insurance scheme doctor presented an inaccurate and incomplete picture of the limitations suffered by my client. On behalf of my client, I argued that the UWV’s decision was based on unsatisfactory medical information because the insurance scheme doctor did not adequately represent my client’s limitations, which resulted in an overestimate of his capacity for work. My client’s symptoms had increased over the years and there was no improvement in his condition. If anything, his health had worsened over time. The implantation of a neurostimulator had not cured his symptoms. My client’s neurologist had stated in a letter that with the implanted neurostimulator my client could only carry out limited physical exertion. He would be unable to do any work that placed strain on his back.

The occupational assessment was conducted on the basis of the functional capability list (FCL) prepared by the insurance scheme doctor. As the FCL was prepared without due care, the results of the occupational assessment were also incorrect. The functions described were not suitable for my client. On behalf of my client, I concluded that the degree of incapacity suffered by my client had been determined incorrectly and requested UWV to reconsider the decision and to categorise my client’s incapacity as 80% or higher.

On the basis of the grounds put forward and further investigation, UWV concluded that my client’s incapacity percentage had increased and declared the objection well-founded.

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