7
Conclusion
This paper studies the effects of two types of early interventions taken by the Swedish
Social Insurance Agency (SIA) on individuals with sickness benefits. The first, Sassam,
screens the working capacity of the individual and the need for vocational rehabilitation.
The second, AM, is a formalized meeting between the sick absent individual, the SIA, and
the employer where the possibility to return to alternative work tasks are discussed and
appropriate vocational rehabilitation measures are decided upon.
We take use of a large randomized social experiment conducted in 2007 by the SIA
and IFAU. In the experiment, individuals were randomly chosen from the inflow of
sickness benefits to be given priority to Sassam and AM during a 6-week period.
Individuals of the randomly chosen control group were not prioritized to these activities
during the same 6 weeks, but could be offered the same activities after the 6 weeks. The
implication of the evaluation design is that the probability of having Sassam and AM early
should be higher in the treatment (prioritized) group, compared to the control group. This
is also found in data: those given priority are found to have a 16.4 and 4.4 percentage
point increased likelihood of receiving Sassam and AM, respectively.
We estimate effects on the prevalence in three states for 15 months after the
experiment was conducted (December 2007 to February 2009). The three – nonexclusive
– states are whether one is i) receiving sickness benefits, ii) unemployed, or iii) receiving
disability benefits (DB).
We find evidence of locking-in effects in sickness absence of being prioritized to
Sassam. Furthermore, we find an around 20 percent increase in the take-up rate of DB
from being prioritized to Sassam 7 to 15 months after the experiment was conducted.
This corresponds to a 5.1 percent increased likelihood of having disability befits when
exposed to Sassam early. We find no statistically significant effects from being prioritized
to AM.
The result of an increasing likelihood of receiving both sickness and DB when being
given priority to the Sassam is surprising. If anything we expected the interventions
performed by SIA to bring the sick absent individual closer to the labor market rather
than the opposite. The reason for this prior was that, despite basically no evidence of
positive effects from vocational rehabilitations of sick absent,
23
there is by now evidence
23
See, e.g., Elders et al. (2000), Bloch and Prins (2001), Alexandersson and Nordlund (2004),
Andrén and Palmer (2004), Blank et al. (2008), Försäkringskassan (2007), and van Oostrom et al.
(2009, 2010).
