5
2
Social Insurance Schemes in Sweden
All workers (employed and unemployed) are covered by public sickness and disability
insurance. Most workers are also covered by unemployment insurance . Unemployed
individuals (covered or not by the unemployment insurance) have the possibility to make
use of the sickness insurance. Until July 2008 there was no formal time restriction on the
length of sickness absence in the sickness insurance. Such formal time restrictions exist
in the unemployment insurance.
2.1
Sickness Insurance
Sickness insurance covers loss of income in case of work absence due to illness. For the
employed, the employer compensates absence during the first 14 days (the first day
being uncompensated). Beyond 2 weeks, the SIA is responsible for benefit payments. For
the unemployed, the SIA steps in already from day 2 of the sick spell. The benefit level is
80 percent of foregone earnings. In 2007, the cap was set to SEK 25,187 (
€ 2,519) per
month, and there was no time limit on sickness benefit. Since July 2008, there is a
maximum benefit period of 2.5 years.
During the first 7 days of sick leave, it is in practice up to the individual to decide
whether (s)he is ill 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. As of the
eighth day a medical certificate is required. For sick leave continuing longer than 2 weeks
the employer notifies the SIA about continuation. The SIA sends a letter to the insured
with a form and a request for a medical certificate. A medical certificate is needed for
sickness benefits paid by the SIA. The doctor indicates in the medical certificate the
length and the extent of the sick leave that (s)he believes is needed. Based on the
medical certificate the SIA determines the right to sick leave, a process that normally
takes at least 1-2 weeks after the end of the employer sick pay period. When this first
sick leave period with benefit from the SIA has expired, if necessary, a renewal certificate
is issued. The renewal certificate is also sent to the SIA and a new assessment about the
right to sickness benefits is made. When the renewal certificate expires and the insured is
still sick, the process is repeated.
Based on the information in the medical certificate the SIA decides whether the illness
causes reduced capacity for work (i.e., work inability). For those who have a job, the
work inability is based primarily in relation to the current job. For those who are
unemployed, work inability is assessed against jobs ordinarily available in the labor
market. When caseworkers think that the medical certificate contains insufficient
information, they have the opportunity to refer the certificate back to the doctor for
