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Rehab Measures Database

Work Disability Functional Assessment Battery

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Purpose

The Work Disability Functional Assessment Battery (WD-FAB) is a self-reported assessment measuring an individual’s functional ability to work.

Link to Instrument

Acronym WD-FAB

Area of Assessment

Activities of Daily Living
Assertiveness
Attention & Working Memory
Balance – Non-vestibular
Behavior
Cognition
Communication
Coordination
Depression
Dexterity
Executive Functioning
Functional Mobility
Gait
General Health
Language
Life Participation
Mental Health
Motivation
Negative Affect
Occupational Performance
Personality
Positive Affect
Processing Speed
Quality of Life
Range of Motion
Reading Comprehension
Reasoning/Problem Solving
Seating
Social Relationships
Strength
Stress & Coping
Upper Extremity Function

Assessment Type

Patient Reported Outcomes

Cost

Free

CDE Status

Not a CDE – last searched 11/20/2022

Key Descriptions

  • The initial 1.0 version of the measure was developed in 2011 and has subsequently been updated to the 2.0 and current 3.0 versions.
  • The latest version of the instrument (WD-FAB 3.0) measures two domains: Physical Functioning and Mental Health, each consisting of 4 scales.
  • Four scales in the Physical Functioning domain include Basic Mobility, Upper Body Function, Fine Motor Function, and Community Mobility
  • Four scales in the Mental Health domain include Communication and Cognition, Resilience and Sociability, Self-regulation, and Mood and Emotions
  • WD-FAB uses Item Response Theory as well as computer adaptive testing, allowing items most relevant to the individual to be included, using prior responses from the individual.
  • WD-FAB includes over 300 items for the 8 scales, and with computer-adaptive testing (CAT) respondents may answer 6-8 items per scale to obtain a total score.
  • Responses are made using a 4-point or 5-point Likert scale, ranging from “strongly agree” to “strongly disagree” and from “yes, without difficulty" to "unable to do".
  • Raw scale scores are standardized on a national normative sample and then converted into t-scores. Lower scores indicate lower functioning levels.

Number of Items

331 items (WD-FAB 3.0)

Equipment Required

  • computer

Time to Administer

15-20 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Instrument Reviewers

Michael Jackson, Doctoral Student in Vocational Rehabilitation, University of Wisconsin-Madison under the direction of Lindsay Clark, PhD, Assistant Professor, Department of Medicine

Body Part

Head
Neck
Upper Extremity
Back
Lower Extremity

ICF Domain

Body Structure
Body Function
Activity
Participation

Measurement Domain

Activities of Daily Living
Cognition
Emotion
General Health
Motor
Sensory

Professional Association Recommendation

SSA/NIH – Developed for use in Social Security Administration disability determination process

Considerations

  • Results must be linked to and interpreted based on workplace demand.
  • WD-FAB creates multidimensional functional profiles of persons applying for work disability benefits to inform work disability adjudication decisions, treatment planning for rehabilitation, subsequent return to work decisions, and identification of matching work environments.
  • Item pools are not static and may be replenished and updated.
  • Scores are trackable over time.

Non-Specific Patient Population

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Normative Data

U.S. Social Security Administration Claimants: (Ni et al., 2014; n = 1017; mean age = 49.65 (9.85) years)

  • Mean score on Whole Body Mobility Scale = 48.51 (SD = 10.87)
  • Mean score on Changing and Maintaining Body Position Scale =  50.07 (SD = 10.38)
  • Mean score on Upper Body Function Scale = 50.06 (SD = 10.22)
  • Mean score on Upper Extremity Fine Motor Scale=  49.89 (SD = 9.67)
  • Mean score on Wheelchair Mobility Scale (= 115) = 50.05 (SD = 11.11)

 

Adults with Physical Disability: (Meterko et al., 2015; n = 497; mean age = 56.02 (8.52) years; work disability duration = 3.83 (2.43) years; 52.31% male)

  • Mean score on Whole Body Mobility Scale (= 471) = 33.56 (6.91)
  • Mean score on Changing and Maintaining Body Position Scale (n = 493) = 34.99 (7.49)
  • Mean score on Upper Body Function Scale (= 491) 34.69 (7.69)
  • Mean score on Upper Extremity Fine Motor Scale (= 494) = 43.42 (7.66)

 

Adults with Mental Disability: (Meterko et al., 2015; n = 476; mean age = 51.2 (9.81) years; work disability duration = 7.43 (5.21) years; 33.61% male)

  • Mean score on Self-Efficacy Scale (= 476)  = 34.75 (13.74)
  • Mean score on Mood & Emotion Scale (= 474) = 35.15 (9.63)
  • Mean score on Behavioral Control Scale (= 468) = 42.89 (10.48)
  • Mean score on Social Interactions Scale (= 473) = 36.76 (8.94)

 

Adults with Physical Disability or Injury: (McDonough et al., 2018; = 50; mean age = 48.3 (13.9) years; subjects had 1 or more musculoskeletal conditions: shoulder (n = 21), knee (= 16), lower back (n = 13), ankle/ foot (n = 10), neck (= 8), hip (n = 7); 66% overweight or obese)

  • Mean score on Whole Body Mobility Scale =  51.1 (SD = 7.3)
  • Mean score on Changing and Maintaining Body Position Scale =  49.6 (SD = 7.1)
  • Mean score on Upper Body Function Scale = 49.1 (SD = 7.3)
  • Mean score on Upper Extremity Fine Motor Scale = 53.97 (SD = 5.0)

 

U.S. Social Security Administration Claimants and General Population Sample: (Marfeo et al., 2018; Claimant sample: n = 1695; mean age = 44.73 (11.64) years; General sample: n = 2025; mean age = 42.19 (12.76) years; expanded mental health component of WD-FAB)

  • Mean score on Cognition & Communication subdomain
    • 5-10 item computer adaptive test (CAT) (= 1692) = 38.8 (6.78)
    • Full item bank (= 1692) = 38. (7.04)
    • Full item bank – general sample (= 2005) = 50.0 (10.2)
  • Mean score on Self-Regulation subdomain 
    • 5-10 item computer adaptive test (CAT) (= 1413) = 42.7 (9.57)
    • Full item bank (= 1413) = 42.7 (10.6)
    • Full item bank – general sample (= 2020) = 49.5 (11.94)
  • Mean score on Resilience & Sociability subdomain
    • 5-10 item computer adaptive test (CAT) (= 1409) = 43.4 (10.21)
    • Full item bank (= 1409) = 43.3 (10.44)
    • Full item bank – general sample (= 1989) = 49.5 (12.14)
  • Mean score on Mood & Emotion subdomain
    • 5-10 item computer adaptive test (CAT) (= 1015) = 35.0 (11.91)
    • Full item bank (= 1015) = 34.9 (12.33)
    • Full item bank – general sample (= 1000) = 49.9 (10.25)

Construct Validity

Convergent validity:

Adults with Physical Disability or Injury: (McDonough et al., 2018)

  • Adequate correlation between patient-report and provider-report on Whole Body Mobility (r = 0.49)
  • Excellent correlation between patient-report and provider-report on Changing and Maintaining Body Position (r = 0.65)
  • Excellent correlation between patient-report and provider-report on Upper Body Function (r = 0.63)

Adults with Physical Disability: (Meterko et al., 2015)

  • Adequate and Excellent correlations between the Changing and Maintaining Body Position Scale with the Physical Component Score (PCS) of the Veterans RAND 36 Item Health Survey (VR-36) (= 0.42) and the PROMIS Physical Function 10-Item Short Form (PPF10) (= 0.65)
  • Adequate and Excellent correlations between the Upper Body Function scale with VR-36 PCS (r  = 0.43) and PPF10 (= 0.69) 
  • Poor and Adequate correlations between the Upper Extremity Fine Motor scale with VR-36 PCS (= 0.23) and PPF10 (= 0.54) 
  • Adequate and Excellent correlations between the Whole Body Mobility scale with VR-36 PCS (r = 0.55) and PPF10 (= 0.70)

Adults with Mental Disability: (Meterko et al., 2015)

  • Poor to Adequate convergent validity between the Self-Efficacy scale and the scales of the 24-Item Behavior and Symptom Identification Scale (BASIS-24) (= -0.30 to -0.46)
  • Adequate to Excellent convergent validity between the Mood and Emotions scale and BASIS-24 scales (= -0.39 to -0.74)
  • Poor to Adequate convergent validity between the Behavioral Control scale and BASIS-24 scales (= -0.28 to -0.59)
  • Poor to Excellent convergent validity between the Social Interactions scale and BASIS-24 scales (= -0.24 to -0.63)
  • Adequate to Excellent convergent validity between the Self-Efficacy (= 0.46), Mood and Emotion (= 0.67), Behavioral Control (= 0.32), and Social Interaction (= 0.56) scales and the Mental Component Score (MCS) of the VR-36

 

Discriminant validity:

Adults with Physical Disability: (Meterko et al., 2015)

  • Excellent discriminant validity between WD-FAB Physical Function scales and Mental Component Scores of the VR-36
    • Changing and Maintaining Body Position scale (r = 0.12)
    • Upper Body Function scale (r = 0.21)
    • Upper Extremity Fine Motor scale (r = 0.24)
    • Whole Body Mobility scale (r = 0.15)

Adults with Mental Disability: (Meterko et al., 2015)

  • Excellent discriminant validity between WD-FAB Behavioral Health scales and Physical Component Scores (PCS) of the VR-36
    • Self-Efficacy scale (= 0.06)
    • Mood and Emotions scale (= 0.21)
    • Behavioral Control scale (= 0.07)
  • Adequate discriminant validity between the Social Interactions scale and the PCS of the VR-36 (= 0.31)

Floor/Ceiling Effects

Adults with Physical Disability: (Meterko et al., 2015)

  • Adequate floor effect of less than or equal to 2% across all Physical Functioning scales 
  • Adequate ceiling effect for all Physical Functioning scales: less than 1% except for the Upper Extremity Fine Motor scale (12.4%)

Adults with Mental Disability: (Meterko et al., 2015)

  • Adequate floor effect of less than or equal to 2.5% and ceiling effect of less than 2% across all Behavioral Health scales

U.S. Social Security Administration Claimants and General Population Sample: (Marfeo et al., 2018)

  • Excellent: No floor effects for claimant sample for Cognition & communication, Self-regulation, and Resilience & sociability subdomains on 5-10 item CAT and full item bank; no floor effects for general sample for Mood & emotions subdomain for full item bank
  • Adequate floor effects of less than 1% found for the general sample on full item bank for Cognition & communication, Self-regulation, and Resilience & sociability subdomains; similar floor effects found for the claimant sample on the 5-10 item CAT and full item bank for the Mood & emotions subdomain.
  • Excellent: No ceiling effects for the claimant sample on 5-10 item CAT and full item bank for the Mood & emotions subdomain and the full item bank for the Self-regulation subdomain
  • Adequate ceiling effects of less than 1% found for the claimant sample on the 5-10 item CAT and full item bank for the Cognition & communication and Resilience & sociability domains, the 5-10 item CAT for the Self-regulation domain, and the full item bank for the general sample on the Mood & emotions subdomain.
  • Adequate ceiling effects for the general sample on the full item bank for the Cognition & communications (7.88%), Self-regulation (4.7%), and Resilience & sociability (12.97%) subdomains

Bibliography

Jette, A. M., Ni, P., Rasch, E., Marfeo, E., McDonough, C., Brandt, D., Kazis, L. & Chan, L. (2019). The work disability functional assessment battery (WD-FAB). Physical Medicine and Rehabilitation Clinics30(3), 561-572.   

Marfeo, E. E., Ni, P., McDonough, C., Peterik, K., Marino, M., Meterko, M., Rasch, E. K., Chan, L., Brandt, D., & Jette, A. M. (2018). Improving assessment of work related mental health function using the work disability functional assessment battery (WD-FAB). Journal of Occupational Rehabilitation28(1), 190-199.  

McDonough, C. M., Ni, P., Peterik, K., Hershberg, J. D., Bell, L. R., Chan, L., Brandt, D. E., & Jette, A. M. (2018). Validation of the work-disability physical functional assessment battery. Archives of Physical Medicine and Rehabilitation99(9), 1798-1804. 

Meterko, M., Marfeo, E. E., McDonough, C. M., Jette, A. M., Ni, P., Bogusz, K., Rasch, E. K., Brandt, D. E. & Chan, L. (2015). Work disability functional assessment battery: feasibility and psychometric properties. Archives of Physical Medicine and Rehabilitation96(6), 1028-1035. 

Ni, P., McDonough, C. M., Jette, A. M., Bogusz, K., Marfeo, E. E., Rasch, E. K., Brandt, D. E., Materko, M., Haley, S. M., & Chan, L. (2013). Development of a computer-adaptive physical function instrument for Social Security Administration disability determination. Archives of Physical Medicine and Rehabilitation94(9), 1661-1669.