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8(21)
is assessed against the ability to perform the current working tasks, or
other temporary working tasks, at work. Between days 91 and 180, the
workers are entitled to benefits if they cannot perform any tasks at their
current workplace (the 90-day eligibility check). From the 181st day, the
working capacity is finally evaluated against all the jobs on the regular
labor market (the 180-day eligibility check).
3
The eligibility checks are
supposed to
be performed at the 90th and the 180th day at the latest, but can be
performed at any time beforehand. Although the eligibility checks are
regulated by law and therefore less optional than the assessments of the
need for rehabilitation, they are not performed in 100 percent of cases, and
even less so within the specified time limits. In the study period of 2010,
the SIA administrative records show that only about 60-70 percent of the
eligibility checks were performed on time. The same administrative records
show that the eligibility checks, together with Sassam and AM, are the
most common initiatives taken by the caseworker in the sick-leave process
(The Swedish Social Insurance Inspectorate (ISF), 2014).
Besides the law, the caseworker’s initiatives are also regulated by internal
process documents and operative goals at the SIA. The internal process
documents are continuously updated and consist of detailed descriptions
of the most common initiatives of the sick-leave process. Also, operative
production goals are set for the caseworkers. The goals at the time varied
between the local offices but could typically be specified as percentages of
the number of cases in which the entitlement to benefits, or the need for
rehabilitation, had been investigated within a certain sick-spell length (ISF,
2011).
In sum, although much of the caseworker’s opportunities to take initiatives
in a case are regulated by laws, internal documents and operative goals,
these can never fully cover all possible circumstances of a case. The
caseworker's discretion is therefore considerable: for instance, regarding
if and when assessments of the need for rehabilitation are warranted, and
also when eligibility checks should be performed.
3
See the Social Insurance Code. Exceptions to this rule could be made if, for instance, the
individual were likely to return to work for the existing employer by day 365 at the latest.