Changes in legislation lead to earlier return to work after prolonged sickness absence

Press relase, Helsinki 21.10.2015

Employees are returning to work slightly sooner after long periods of work disability, and days at work have increased since the 2012 changes to the Health Insurance and Occupational Health Care Acts. This is reported in a study by the Finnish institute of Occupational Health (FIOH), which was published in the Occupational and Environmental Medicine journal.


The clearest change was seen among those whose work disability had lasted about three months, whereas among those with shorter sickness the change was not so significant.

More and more employees returning to work after prolonged sickness absence

People are returning to work much sooner after prolonged work disability as a result of legislative changes. This was most clearly seen among those who had been on sick leave for almost three months: their work participation was two per cent higher after the changes. In 2008‒2011, people did not return to work as often after long sickness absences.

”Our research results provide positive evidence that by monitoring absences from work and determining the requirements for return to work, we can prevent prolonged work disability,” explains Jaana Halonen, Specialist Research Scientist at FIOH.  

”However, we must take into account the fact that the changes in work participation were small in comparison with the results of a study concerning partial sick leave benefit,” says Eira Viikari Juntura, Research Professor. In a previous study, the work participation of those who were on partial sick leave benefit was five per cent higher than among those on full sickness benefit for the same length of time.

Effects of legislative changes in public sector

FIOH’s Finnish Public Sector (FPS) study has collected data on sick leave for over twenty years. The participants of the study at hand consisted of workers who had taken part in the FPS follow-up study and who had, according to employers’ registers, a continuous sickness absence of 30, 60 or 90 days before (2010) and after (2013) the legislative change. After each period of work disability, each employee’s established return to work was followed for a year. As sickness absences decreased steadily from 2008 to 2014, work disability periods from 2008 were also included.

Legislative changes to the Health Insurance and Occupational Health Care Acts  (30-60-90 day rule)

The aim of the legislative change is to prevent the prolongation and recurrence of work disability periods and to thus promote return to work. The new law requires the employer to inform occupational health services (OHS) when an employee’s sick leave has lasted over 30 days. The employer must then apply for sickness benefit from Kela (The Social Insurance Institution of Finland) when sick leave has lasted 60 days. OHS assesses the remaining work ability of the employee, following which the employer, employee and OHS determine whether the employee is able to return to work at the latest when sickness benefit has been paid for a total of 90 days (requirement for continuation of KELA sickness benefit).

Investigation of effects of legislative changes in private sector

FIOH and KELA have together examined OHS reports on the 90-day rule. They found that reports were not always delivered, and that sometimes the requirements for return to work were not properly assessed. It is likely that return to work could be promoted by focusing on the assessment of work ability and the determination of requirements for return to work in the future. FIOH will continue investigating the effects of the legislative change together with KELA and the Finnish Centre for Pensions, with funding from the Academy of Finland. It will be of particular interest to study whether changes have occurred among employees in the private sector.

Article:

Halonen JI, Solovieva S, Pentti J, Kivimäki M, Vahtera J, Viikari-Juntura E. Effectiveness of legislative changes obligating notification of prolonged sickness absence and assessment of remaining work ability on return to work and work participation: a natural experiment in Finland. Occupational and Environmental Medicine 2015 Oct 13. doi: 10.1136/oemed-2015-103131. [Epub ahead of print]

Further information:

Jaana Halonen, Specialist Researcher Scientist, FIOH, tel: +358 43 82 44 264, jaana.halonen[at]ttl.fi
Eira Viikari-Juntura, Research Professor, FIOH, tel: +358 40 73 69 259, eira-viikari-juntura[at]ttl.fi

The Finnish Institute of Occupational Health (FIOH) researches, develops and specializes in well-being at work. It promotes occupational health and safety and the well-being of workers. It is an independent institution under public law, working under the administrative sector of the Ministry of Social Affairs and Health. It has five regional offices, and its headquarters are in Helsinki.

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The Finnish Institute of Occupational Health (Työterveyslaitos) researches, develops and specializes in well-being at work. It promotes occupational health and safety and the well-being of workers. It is an independent institution under public law, working under the administrative sector of the Ministry of Social Affairs and Health. It has five regional offices, and its headquarters are in Helsinki. It employs about 560 people.

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