The return to work practices in Finland

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1 The return to work practices in Finland Kuntoutuspäivät, Jan Schugk Confederation of Finnish Industries EK

2 Sickness absence levels in Finland are high SOURCE: SICKNESS, DISABILITY AND WORK: BREAKING THE BARRIERS OECD 2010

3 Absence due to illness in the Nordic countries Absence due to illness and accidents, percentage of theoretical regular working time Sweden Finland Denmark Norway

4 Health 2011 study: perceived health has improved Percentage of people in different age groups assessing their health as good or fairly good National Institute for health and welfare, 2012

5 Percentage of disability pension recipients in Finland is significantly high SOURCE: SICKNESS, DISABILITY AND WORK: BREAKING THE BARRIERS OECD 2010

6 Annual amount of new disability pensions Other illness Cardiovascular disease Musculo-skeletal disease Mental disorders Finnish Centre for Pensions, 2014

7 Health 2011 study: working ability has improved Percentage of people in different age groups assessing themselves as fully able to work National Institute for health and welfare, 2012

8 Framework for managing working ability

9 The EK framework for managing work ability Active interaction at the workplace Monitoring and controlling absence due to illness Prevention of disability to work Early intervention program Return to work program Health and safety at the workplace Co-operation to promote work ability at the workplace KEY PROCESSES Monitoring health and wellbeing risks Indicators and metrics for wellbeing and work ability Healthy ways of living Recovery Stress management TOOLS LIFE BALANCE

10 The EK framework for managing work ability The framework was developed based on a work life agreement of a joint working group of all social partners The emphasis of the framework is on the systematic management of work ability and wellbeing, but it also underlines life balance and self management The framework has been widely accepted by both employer and employee organisations In order for the framework to deliver tangible results, an ongoing dialogue and genuine cooperation on managing work ability between employers, employees and occupational health services is necessary

11 Monitoring and controlling absence due to illness Clear practice for informing ones superior on the absence Handling of medical certificates - Manager > Payroll > Occupational health services The role of OHS in controlling absence due to illness defined Systematic and comprehensive monitoring and reporting to management - Average sickness absence percentage and absence days per employee - Causes of sickness absence - Costs of sickness absence There needs to be a clearly agreed procedure on how the person on sick leave and his/her superior keep in contact and how abundant sick leaves are discussed between superior and employee

12 Return to work program The workplace and the person on sick leave keep in touch during the absence as agreed - Returning to work is kept in mind from early on - The actual return to work is anticipated and planned Return to work program - Joint discussions/negotiations between employee, employer and occupational health services - E.g. temporary or permanent arrangements regarding duties at work, partial sick leave, training or working time Active monitoring of working ability, its development and wellbeing at work once the employee has returned to work

13 Focus on preventing and managing disability to work ( day rule)

14 day rule focus on return to work Social Insurance Act - The possibilities of the employee to continue working must be assessed at the latest when the employee has received sickness benefits for 90 days - The Social Insurance Institution (SII) can discontinue the payment of the benefits if an assessment is not performed - The sickness benefits must be applied for within 60 days of the beginning of the disability Occupational Health Act - The employer must notify the occupational health services at the latest when the employee has been off work due to illness for 30 days - Assessment made by OH physician: estimate of the employee s possibility to return work within the limits of his/her working ability (assessment made in cooperation with the employer and the employee)

15 Goals of the changes in the Social Insurance and Occupational Health Acts Early intervention regarding disability to work - Discussion by manager and employee, actions at the work place - Occupational health services notified of all prolonged absence Improved process to assess working ability - Cooperation of employee, employer and occupational health service - The occupational health service coordinates necessary cooperation with other health care units - Focus on remaining ability to work and the possibilities to return to work within the existing limits of the working ability Extending careers by avoiding disability pensions and lengthy sick leaves - Often work is the best form of rehabilitation - Early return to work decreases the likelihood of permanent disability

16 Delegation of tasks in health care and at work Agreed practices are applied on all employees on longer sick leave The treating physician assesses the functional capacity, the occupational health physician assesses the working ability At the workplace the employer, the employee and the occupational health physician assess the options to return to work within the limits of the employee s working ability - Work or working time arrangements - Partial sickness benefit - Subsidiary work

17 The role of the Social Insurance Institution (SII) The SII requests a medical assessment on the working ability well in advance of reaching the limit of 90 days of sickness allowance The medical certificate forms have been renewed to support the new practice The payment of the sickness benefits is not interrupted if this would be obviously unjust - The statement is not made due to reasons that are not in control of the employee - Serious illness or injury (cancer, hospital care etc.)

18 Potential problems Do all the OHS units have the necessary expertise, skills and readiness to perform accurate assessments of the remaining working ability and the options to return to work? How do other health care providers react and what is their willingness and readiness to cooperate (specialists, rehabilitation, pension insurance) Many workplaces do not have a tradition to discuss issues regarding working ability What can the content of the work performed within the limits of the remaining working ability of the employee be, how different can it be from the employee s original work? What is the procedure if the employer is not willing to make any changes or the employee doesn t approve the suggested actions?

19 Partial sickness allowance

20 Partial sickness allowance Partial sickness allowance is intended to allow earlier return to work while not yet able to work full-time - Employees can make an agreement with their employer to return to work on a part-time basis - While employed part-time, employees are paid a partial sickness allowance by the Social Insurance Institution The partial sickness allowance is intended for persons who are employed or self-employed on full-time basis - The partial allowance is payable after a waiting period of ten working days on full sickness allowance - During the waiting period, the employee may not pursue any employment

21 Partial sickness allowance The amount of the partial sickness allowance is half of the regular sickness allowance The partial sickness allowance is payable for up to 120 working days - It is not available for periods that have been planned to last less than two weeks - All days on partial sickness allowance during the preceding two years count towards a 120-day maximum If the employee is unable to work for health reasons for more than 10 days while receiving partial sickness allowance, he/she will again start to receive the regular sickness allowance

22 Vocational rehabilitation

23 Vocational rehabilitation options Work trials and job coaching - When returning to work following a long sick leave or if it is necessary to switch to a new task, support is available in the form of a work trial - A work trial can be carried on as job coaching if the task requires new professional skills Vocational training - If work that is suitable for the employee s health/working ability cannot be arranged at the workplace or on the basis of the employee s previous training and work experience, the pension insurance company can provide support in training for a new profession

24 Partial rehabilitation allowance Fixed-term partial disability pension or a so called partial rehabilitation allowance can be granted if it has been estimated that the employee s ability to work has been reduced by at least 2/5 (40 %) Partial rehabilitation allowance is intended to support the employee in continuing to work or returning to work, with a lighter workload than before - Typically the employee works shorter hours and the pension institution will pay half of the full cash rehabilitation benefit

25 Income during vocational rehabilitation The income for the vocational rehabilitation period includes a rehabilitation allowance or a cash rehabilitation benefit with an added rehabilitation increment - The income equals the notional pension incremented by 33 per cent - Partial rehabilitation allowance also applicable

26 Thank you!

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