Early interventions and disability insurance:
Experience from a field experiment
by
Per Engström
, Pathric Hägglund
‡
and Per Johansson
Abstract
This paper estimates the effects of early interventions in the Swedish sickness insurance
system. The aim of the interventions is to screen and, further to, rehabilitate sick listed
individuals. We find that the early interventions – in contrast to what is expected –
increase the inflow into disability benefits by around 20 percent. In order to explain the
results, we develop a simple theoretical model based on asymmetric information of the
health status. The model predicts that the treatment effect is larger for individuals with
low incentives to return to work. In order to test this prediction we estimate effects for
sick listed employed and unemployed separately. Consistent with the model’s prediction,
we find that the effect is larger for the unemployed than for the employed.
Keywords: monitoring, screening, vocation rehabilitation, disability insurance, sickness
insurances, unemployemnt insurance, randomized experiment
JEL-codes: C93, H51, H55, I18, J22
Johansson acknowledges financial support from The Swedish Council for Working Life and Social
Research FAS and the Swedish social insurance administration. The paper has benefited from
comments by seminar participants at SEW St. Gallen, SSB Oslo and at the conference on
Absenteeism and Social Insurance Utrecht University September 2011, Eva Deuchert, Laura
Hartman, Edwin Leuven and Mats Persson and Olof Åslund.
Department of Economics Uppsala University, UCLS, and IFAU.
‡
The Swedish Social Insurance Inspectorate (ISF) and the Swedish Institute for Social Research.
Department of Economics Uppsala University, UCLS, IFAU, ISF, and IZA. Email
