Sickness compensation in Sweden
In Sweden the invalidity pension is called sickness compensation. The purpose is to provide an income to individuals who probably never be able to work full time due to illness, injury or disability.
According to the requirements of the Social Insurance Code (Socialförsäkringsbalken) 33 chapter 5-6 §§ a person with at least 25 per cent reduced ability to work can receive 25, 50, 75 or 100 per cent sickness compensation. The ability to work is assessed in relation to the person’s livelihood. Subsidized work as well as protected work are accommodated within the definition of work ability. Also adapted (custom) work in the open labor market can be included in the definition of work ability depending on whether the adaptation can be considered reasonable from the employer’s point of view.
The assessment of whether the disease or disability affects the person’s livelihood must be hypothetical. It doesn’t have to be related to concrete work within certain professional fields or certain types of work. However, the person has to be able to perform work in such a way that an employer wants to pay for it.
The ability to work has to be permanently reduced and all rehabilitation opportunities, medical as well as vocational, have to be exhausted.
Sickness compensation can be paid from the age of 30 up through the month before a person turns 65. In some cases, a person can be eligible from the age of 19.
People who live in another EU/EEA-country or in a country with which Sweden has an agreement on social security can be insured for Swedish sickness compensation. An application for invalidity pension in another EU/EEA-country will automatically generate an application for sickness compensation in Sweden when the person has lived or worked in Sweden.
To determine if a person meets the criteria for sickness compensation Försäkringskassan needs an extensive medical certificate. The medical certificate has to answer the questions below.
The doctor’s statement is the basis for the assessment. Social circumstances or economic situation, education, former work experiences or age are not taken into consideration. Försäkringskassan may however inquire about the economic and social circumstances to get a holistic perspective on the applicant’s situation.
The applicant will get a case handler from Försäkringskassan who conducts the inquiry. The case handler may call or meet the applicant and ask further questions. The case handler may also make inquires to the physician in charge or to other legitimate healthcare staff as well as to other actors. When the case handler has sufficient basis for decision he or she assesses the right to the compensation according to Swedish legislation and the Swedish requirements for getting sickness compensation.
A special decision maker officer makes a quality control and makes the final decision sickness compensation.
Questions to the physician in charge
In order to be able to consider if a person is eligible for sickness compensation Försäkringskassan (the Swedish Social Security Agency) has to get an actual and detailed medical certificate. It is important that the following items are considered in the medical certificate. Please answer as extensively as possible::
1. Which are the diagnoses that affect the ability to work?
- Please denote the diagnoses with the most important impact on work ability first, avoid abbreviations. Please enter the ICD-10 code as well.
- When was/were the diagnosis/diagnoses made?
- Is there any reason to make a new assessment of the diagnosis/diagnoses?
2. Are there any other medical examinations or supporting documents that are relevant for the assessment? If that is the case please enter them and attach the documents if possible.
3. Please describe in the fields noted below, the patient’s disability that are relevant to the work ability.
- Intellectual function
- Communication and social interaction
- Attention and concentration
- Other psychological functions
- Vision, hearing and speech
- Balance/coordination, motor skills and pain
- Other bodily functions
4. Please give concrete examples of what the patient has difficulties doing because of her/his disabilities as described above, so called activity restrictions (disabilities).
5. Has any medical treatment or remedies been performed?
- If that is the case, during which periods did they last and what results did they give?
6. Are medical treatment or remedies in progress?
7. Are medical treatment or remedies planned?
- If that is the case, please set the timetable if possible.
8. To what extent do you judge the work ability impaired, compared to all acquisitions in the labor market including subsidized work or protected work?
9. How do you judge that the patient’s medical conditions/abilities for work, completely or partially, can develop over time?
- What can the patient do despite her/his medical condition and limitations?