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The sick-leave process in Sweden
All workers (employed and unemployed) are covered by public sickness
and disability insurance schemes. Sickness insurance covers the loss of
income owed to work absence because of illness. For the employed, the
employer compensates absence during the first 14 days (the first day is
not compensated). After two weeks, the SIA is responsible for benefit
payments. For the unemployed, the SIA steps in from day two of the sick-
leave spell. The benefit level is 80 percent of foregone earnings. In 2010,
the cap was set at SEK 26,500 (
€ 2,790) per month, and the maximum
benefit period was 2.5 years.
During the first seven days of sick leave, it is in practice up to the individual
to decide how ill (s)he is and the extent to which this warrants absence
from work. The individual merely has to inform the employer or the SIA
that he or she is ill. From the eighth day, a medical certificate is required.
Depending on the information in the medical certificate, the SIA decides
whether the illness has reduced the applicant's capacity for work, i.e.,
inability to work. After the first payment, if the case is not expected to
be finished within the next few weeks, it is handed over to a personal
caseworker who takes charge of the case from that point. The sample
in this study contains individuals assigned to a caseworker.
The employer is responsible for any rehabilitation of the individual, unless
the individual is unemployed, when instead the employment agency is
responsible for her or his rehabilitation. The SIA is obliged to assess the
need for rehabilitation and to coordinate all resources to assist the sick-
reported person in getting back to work as soon as possible. The two most
common instruments for assessing the need for rehabilitation are Sassam
and assessment meetings (AM).
1
Both have the main purpose of making
possible a rapid and sustainable return to work. Sassam is a face-to-face
meeting where the sick-reported individual and the caseworker have a
structured discussion about questions dealing with benefit eligibility, i.e.,
medical diagnoses, ability to work, and working tasks. The result of the
assessment determines how the sick leave will progress.
AM is a formalized meeting between the sick-reported individual, the
caseworker, and at least one additional party, usually the doctor or the
employer. At the meeting, the person's working capacity and the possibility
of returning to the current or another temporary position at the workplace
are discussed. Appropriate vocational rehabilitation programs are also
discussed.
2
The sick-leave process in Sweden contains time-set assessments, or
eligibility checks, of the individual’s working ability and entitlement to
benefits. During the first 90 days of the sick spell, the working capacity
1
Sassam
is a Swedish abbreviation for “A formalized method for sick-leave investigation and
rehabilitation.”
2
In contrast to
Sassam
, AM is stipulated by law (Social Insurance Code, ch. 110, 14 §). Both
Sassam
and AM are mandatory and failure to participate can lead to the withdrawal of benefits.