Insurance Physician Assessment for Residents of Leiden

Insurance Physician Assessment for Residents of Leiden

The insurance physician assessment by the UWV insurance physician determines, as a resident of Leiden, how illness or limitations affect your work capacity. Essential for benefits such as WIA, Sickness Benefits Act or Unemployment Act. Learn about the process, your rights and preparation tips, with local support via Het Juridisch Loket Leiden.

What does an insurance physician assessment entail for Leiden residents?

The UWV insurance physician (VA) evaluates your medical condition and what you can still do despite your complaints. No treatment, but an objective analysis based on your own account, records and a basic physical examination. For residents of Leiden, this is key for applications for social security benefits like WIA, Sickness Benefits Act or Unemployment Act in cases of work incapacity. The assessment sets the percentage, such as 35-65% or 65-80%.

Legal Basis of the Insurance Physician Assessment

Laid down in the SUWI Act and benefits acts:

• WIA (art. 38, 40): VA confirms illness/disability and limitations via the List of Functional Capabilities (FML).
• Sickness Benefits Act (art. 19): Check on work limitations during illness.
• Unemployment Act (art. 18): Medical review in case of illness.

The FML, with 28 items on physical, mental and social functioning, follows UWV guidelines and medical standards. It provides input for the labour expert.

Steps in the UWV Assessment Process

This is how it works for Leiden:

1. Application to UWV: Start your claim online or via local advisors.
2. Invitation: Within 6-8 weeks, often digital or by phone.
3. Interview: 20-45 minutes on complaints, daily life, work and care.
4. Examination: Simple checks like bending or grip strength.
5. Decision: Ruling within 8 weeks; FML available on request.

Bring a companion and send information beforehand; in Leiden, you can seek help via the Municipality of Leiden.

Rights and Obligations at the Assessment

Rights:

• Access to your file and addition of medical data.
• Companion or interpreter (useful for expats in Leiden).
• Objection within 6 weeks at District Court Leiden; free advice at Het Juridisch Loket Leiden.
• GDPR protection for privacy.

Obligations:

• Attend on time; no-show leads to rejection.
• Cooperate; otherwise risk of benefit termination.
• Answer truthfully; sanctions for fraud.

Leiden Practice Examples of Insurance Physician Assessments

Example 1: Back Pain in Leiden
Jan (45, Leiden-Noord) with hernia complaints. VA asks: "Can you stand for 1 hour? Lift 5 kg?" Jan reports pain when cycling through the city. FML notes lifting restrictions, resulting in 65% WIA.

Example 2: Burn-out
Marieke (32, student from Leiden) with depression. Focus on stress and social contacts. Restrictions on intensive work lead to 80% benefit.

Example 3: Reassessment
Piet (Leiden) with migraines; initially no limitations. Objection with scans at District Court Leiden overturns the decision.

Difference Between Insurance Physician and Labour Expert

FAQ: Insurance Physician Assessment in Leiden

Tips for Your Assessment as a Leiden Resident

Good preparation helps:

• Document: List complaints, medications, limitations (e.g., 'max 30 min walking without pain'). Bring letters from your Leiden GP.
• Be specific: Practice: 'Cycling to Leiden Centraal station is no longer possible.'.
• Seek local help: Contact Het Juridisch Loket Leiden for free support.
• Prepare for objection: Note dates for District Court Leiden procedure.