Croatia has made progress in recent decades in strengthening disability policy, expanding financial supports, and improving the institutional foundations for disability assessment, rehabilitation and employment promotion. Yet people with disability remain among the most disadvantaged groups in Croatian society. Poverty rates are high, employment outcomes are poor, and educational attainment remains low for people with disability. The gaps in these areas between people with and without disability are larger than in almost any other European country and have widened over the past decade, pointing to deep structural barriers and insufficient early support. Improving the labour market outcomes of people with disability requires a functioning‑centred disability assessment and even more importantly, a more integrated, and stronger early intervention system.
The disability and work‑capacity assessment system plays a central role in shaping access to financial support and services but currently acts as a bottleneck. The establishment of a single assessment body a decade ago, the Institute for Disability Assessment, Professional Rehabilitation and Employment of Persons with Disabilities (ZOSI), was a significant achievement, yet fragmentation persists across systems. Different fields and institutions – the Pension Insurance Institute, the Institute for Social Work, the Health Insurance Institute and the counties – continue to rely on separate assessments, distinct definitions, and overlapping forms. These parallel processes depend heavily on medical documentation and impairment‑based percentage tables rather than on people’s level of functioning which reflects their actual disability experience. Several persistent challenges require more fundamental reform: rising waiting times undermining early intervention; an excessive number of reassessments; reliance on medical documentation; inadequate assessment processes for mental health conditions; and inconsistent definitions and outcomes across institutions. Addressing these issues is essential for ensuring fair, efficient and functioning‑based disability assessment in Croatia.
Croatia is not alone in grappling with these challenges. Many OECD countries reference the International Classification of Functioning, Disability and Health (ICF) and the principles of the UN Convention on the Rights of Persons with Disabilities (CRPD) in their legislation yet still apply predominantly medical approaches in practice. Countries that have attempted to introduce functioning based assessments have often struggled due to weak psychometric design, excessive assessor discretion, and unclear links between functioning and final assessment decisions. A key lesson from international experience is that functioning must be measured directly, using validated tools, rather than inferred from the person’s health conditions. Systems that successfully moved towards functioning‑based assessment – although rare – have done so through long-term reform, investment in training, piloting, and evaluation of processes. These experiences offer important insights for Croatia, particularly the risk of developing new, untested national tools that appear comprehensive but lack scientific robustness, transparency or reliability.
Within this broader landscape, Croatia has an opportunity to modernise its approach by introducing a functioning‑based assessment instrument that meets scientific standards, aligns with CRPD principles and complements the country’s strong professional rehabilitation system. The World Health Organization Disability Assessment Schedule (WHODAS) offers such a tool. WHODAS is validated internationally, measures functioning across six life domains, and produces a 0‑100 metric score that can be integrated transparently with medical evidence if Croatia wishes to do so. Pilot studies across ten countries show that WHODAS captures the lived experience of disability more accurately than diagnosis‑based systems, is feasible to administer in short time, and improves fairness and objectivity. For Croatia, adopting WHODAS could replace the current, largely diagnosis‑driven functioning assessments used for the social‑welfare field and complement work‑capacity assessment processes that currently rely heavily on medical criteria and discretionary decision making from assessors. Introducing WHODAS would also reduce dependency on medical doctors by enabling trained non‑medical professionals to conduct structured interviews, helping to alleviate staff shortages and easing ZOSI’s workload.
Reform of assessment, however, must be embedded within a broader strategy that strengthens early intervention. International evidence shows that spending too much time on sick leave leads to long-term labour‑market detachment. In Croatia, the sickness benefit system provides income protection but does not guarantee a structured return‑to‑work process, meaning too many people remain on sick leave for extended periods without timely support to return to work if possible or referral to professional rehabilitation if needed. Evaluation of whether a worker can return to work (with the necessary support) should take place no later than after three months and should involve expanding the responsibilities of key stakeholders like ZOSI and the Health Insurance Institute. Employers, too, must be part of the solution: workplace adjustments, gradual return‑to‑work arrangements, and structured co‑ordination between employees, employers, health professionals and employment services are essential to prevent permanent labour market exit. Unemployed people with health‑related barriers often remain unidentified until they have already experienced long-term labour market detachment. The Croatian Employment Service plays a key role in identifying unemployed people with health conditions and referring them to professional rehabilitation if necessary. Professional rehabilitation services in Croatia are an asset – comprehensive, relying on an ICF‑based assessment and of high quality – but reach too few people and typically only after long periods of inactivity. Earlier referral to rehabilitation, expanded training opportunities, more flexible eligibility rules and, not least, greater service capacity would significantly increase their impact.
Finally, Croatia needs a stronger evidence base to plan reforms, monitor processes and evaluate outcomes. Data are currently dispersed across institutions and insufficiently linked. Creating an integrated disability data system that connects information from ZOSI, pension and health insurance, social welfare and employment services is essential for understanding trajectories and measuring the effect of policy changes. Evaluation should be built into the design of reforms and should be transparently disseminated.
Overall, Croatia stands at an important juncture. The building blocks for a modern disability system exist – a unified assessment body, strong rehabilitation centres, and growing policy attention. The challenge now is to translate these foundations into a system that has better disability assessment procedures and supports sick people more effectively and earlier. By adopting validated assessment tools such as WHODAS, reducing fragmentation, strengthening early intervention, expanding rehabilitation and building a robust data architecture, Croatia can move towards a more inclusive future in which disability does not equate to exclusion from work.