In high income countries, up to 12 percent of the working age population receive permanent disability benefits with minimal information on the consequences of this major event. We aimed to compare health status in future and past disability pensioners.

Data from the population based Hordaland Health Study (HUSK) in Norway 1997-99 (N=18 581), was linked to official disability benefits registries. We stratified participants who were awarded a disability pension before, during and after the health survey, and compared health status at different stages across these strata covering seven years before, to seven years after the award.

Disability pensioners reported more physical conditions, somatic and mental symptoms, and lower Health Related Quality of Life (HRQoL) than the remaining sample, throughout the strata. The average number of physical conditions was similar across all groups defined by temporal proximity to disability pension award, but more medication prescription was reported after the award. However, we found a significant non-linear increasing trend in symptoms and a fall in HRQoL approaching the award, with a reversing of this trajectory afterwards. For most measures, the level of health problems was equal in the strata 3-7 years before compared to 3-7 years after award.

The design precludes any firm conclusions as to what causes the observed results, but candidate explanations include temporary health deteriorating effects from the disability pensioning process, beneficial effects of being removed from harmful work conditions and recovery after increasing health problems leading up to disability pension award.