Keep in mind...
You are using an older version of your web browser. This means that you might not be able to use all of the functions of the website. We recommend that you update to a newer version.

Utlåtande för sjukersättning

Here, you can find information on how to fill in the doctor’s statement for a patient applying for sickness compensation, and who is responsible for what.

What is sickness compensation?

Sickness compensation is a compensation for patients who will probably never be able to work due to illness, injury or disability. All rehabilitation possibilities should have been tested without an improvement in work capacity.

If the patient are between 19 and 29 years old

A person between 19 and 29 years old can only receive full sickness compensation. If the patient can work part-time, then they may be eligible for activity compensation.

If the patient is over age 30

A person who is 30 years old can also receive partial sickness compensation. The patient can be paid sickness compensation up through the month they turn 65.

How do I write a statement that gives Försäkringskassan the right information?

Social security sets high requirements for the medical information to ensure the right person gets the right compensation. When assessing a person’s right to sickness compensation, Försäkringskassan needs information on the patient’s diagnosis, disability and activity limitation. When we look at the medical documents, we use the DDA chain as support.

The DDA chain consists of:
Diagnosis – the diagnosis/diagnoses that cause the impaired function.
Disability – refers to what function is impaired by the disease and what observations have been made.
Activity limitation – the consequences of the diagnosis and disability.

In your doctor’s statement, you must describe the patient’s diagnosis, disabilities, and the activity limitations that these result in.

The statement must clearly indicate what is the patient’s own description and what is your observation and assessment as a doctor.

The activity limitation is to be described in such a way that it is understood that it is a consequence of the stated diagnosis, observations during the examination (status) and the described disability. The chain has to be coherent and the causal connection has to be reasonable.

 

Your role as doctor is to contribute the medical information, while Försäkringskassan performs the DDA analysis. It is important that you clearly distinguish between the problems reported by the patient and the clinical assessment of what you observed in connection with the medical examination or investigation.

Disability

Functions are the body’s various abilities, like being able to tense a muscle or focus attention on something. Disability is when a function is not as good as what is considered to be within the normal range of ability.

The term disability refers to a loss or deviation in physical or mental function.

The impairment has to be a demonstrable variation from what can be considered normal.

Impairments that cannot be observed directly can be clarified through observation of the patient’s behaviour. For example, the doctor may detect memory and concentration difficulties using targeted questions or standardised questions and tests. The doctor can note whether the patient has trouble maintaining a train of thought or forgets wheat they have just been talking about.

Activity limitation

Activity limitation refers to the consequences that a disease or injury has for an individual’s ability to perform activities. Activity limitation must be assessed in relation to what can be expected in daily life, or for a specific work task. In the doctor’s statement, describe the activity limitations caused by the disability.

Example 1 – mobility

The patient has problems in their musculoskeletal system that can impact body functions through e.g. muscle weakness and limitation of movement. This is the disability.

The disability can lead to difficulties changing body position, lifting, carrying or walking. It is this limitation of ability to perform activities that constitutes the activity limitation and must be described at the individual level.

Specification of the activity limitation is often necessary to make the information understandable. For example, an activity limitation can be when the patient

  • is only able to get up from a chair with difficulty in order to lie down in a bed
  • cannot lift a milk container with one arm
  • can only walk a short distance.

Example 2 – pain

The patient has pain, and the consequences for the patient’s cognitive functions must be described. This can be that the patient has a disability due to pain, difficulties concentrating, or reduced energy.

In the next step, it is important to clearly describe how the disability (e.g. pain) produces an activity limitation, and what form the activity limitation takes. This is because a disability in the form of pain, for example, does not necessarily lead to an activity limitation.

Describe the activity limitation by giving examples of how it affects the patient’s ability to perform activities in daily life or in the work life. Examples could be problems with memory, ability to concentrate, or ability to follow instructions.

 

Here is a description of what information Försäkringskassan needs in each field of the doctor’s statement. Keep your language simple and easy to understand. Explain complicated medical terms so that they can be understood by both the patient and the Försäkringskassan administrator.

7800 Läkarutlåtande för sjukersättning

Field 2: From which care provider can Försäkringskassan obtain information about the investigation/documentation?

For example, write Department of Neuropsychiatry at XX Hospital or if the patient will attach the investigation to their application.

Field 3: Diagnosis/diagnoses for the disease causing a reduced work capacity

Indicate which illness(es) are causing the reduced work capacity. The illness with the biggest impact on the work capacity must be stated first. The diagnosis code must always be indicated with as many positions as possible. Please use only letters and numbers.

If the patient has more than three illnesses that affect their work capacity, indicate these under “Other information”.

Is there reason to revise/update a previous diagnosis?

Possible reasons can be

  • that the investigation was performed a long time ago
  • that reassessment was recommended in an early statement or
  • that the clinical picture deviates from what could be expected from the diagnosis made.

Field 5: Disability – describe examination findings and degree of impairment (mild, moderate, major, total) within the relevant function areas

Specify observed impairments (direct or indirect), such as

  • deviations in somatic and mental status
  • radiology and laboratory findings
  • results of clinical physiological studies
  • other test results, e.g. neuropsychological.

In case of mental illness, state not only the basal psychological status, but also the part of the medical history the doctor feels indicates a psychiatric condition.

Source reference for function areas

The help texts of the function areas follow ICF, but are somewhat simplified since there are fewer categories in the doctor’s statement.

Field 5: Intellectual function

Intellectual function, theoretical talent or intelligent refers to the ability to think logically. When solving a problem using logic, we imagine it in our thoughts rather than testing things concretely.

Example: An adult who has graduated with normal grades and is able to handle everyday demands in work and private life is generally of average intelligence. Testing conducted by a psychologist is normally required for a more accurate level assessment.

Field 5: Communication and social interaction

Communication refers to the ability to express and receive verbal, written or other forms of information/messages.

Social interaction refers to the ability to, on a theoretical level, understand how other people think and feel, even if you have not been in the same situation. Lack of ability in relation to social interaction easily leads to misunderstanding, conflicts and difficulties with relationships in private life and at work.

Example: Difficulties such as attention deficiencies, impulse control problems, personality disorders, and affective disorders can lead to difficulties with social interaction. If the difficulties with social interaction are extensive, a diagnosis is made within the autism spectrum.

Field 5: Attention, concentration and executive function

Attentiveness relates to directing focus on the right thing at the right time, as well as shifting, distributing and maintaining attention. The ability also includes a time aspect. A person needs to be able to focus their attention for a long time, i.e. sustain.

Executive function refers to the ability to plan, initiate, carry out, correct, and conclude an action.

Example: Directing, regulating and sustain attention for a prolonged period of time is a major difficulty for a person with ADHD/ADD. Temporary difficulties may be due to illness (e.g. insomnia, depression or fatigue) or injury (e.g. concussion), and can occur at any time during life. Executive function difficulties are also common with ADHD/ADD, but also occur with other conditions.

Field 5: Other mental function

Other mental function refers to other mental functions which relate to energy level, impulse control capability, motivation, judgement, awareness of one’s own behaviour and being oriented in time, place, situation and person.

Example: This field can include affective difficulties, difficulties regulating mood, behavioural disorders, and substance abuse. It can also include effect on awareness and ability to orientate, as well as confusion secondary to bodily disease.

Field 5: Sensory functions and pain

Sensory function refers to the ability to interpret the five senses – sight, hearing, touch, smell and taste. The term sensory function is usually used synonymously with perception. A person may be particularly sensitive and experience discomfort from noise, light, temperature, touch, taste or odour. Conversely, a person may be less sensitive.

Pain refers to the sensation of an unpleasant feeling that suggests a possible or actual injury in some part of the body. It includes sensations of general or local pain in one or more parts of the body, pain in a dermatome (area of skin), stabbing, burning or nagging aches and pains, and disabilities such as myalgia (muscle pain), analgesia (inability to feel pain), and hyperalgesia (hypersensitivity to pain).

Example: Deviations in sensory function (perception) are common, for example, within neuropsychiatry but often lack a specific medical diagnosis. However, pain problems are very common and both be a primary difficulty and secondary to another illness.

Field 5: Balance, coordination and motor skills

Balance refers to the body’s balance function and sense of body position (position perception). Coordination refers to, for example, eye-hand coordination, coordination while walking, and coordinating arm and leg movements. Motor skills refer to difficulties with fine motor skills, gross motor skills or, for example, oral motor skills.

Example: Difficulties with these areas may have occurred early in life, like with a CP injury, or late in life due to, for example, a stroke or neurological disease.

Field 5: Other body function

Other body function refers to deviations or loss of body function and physiological functions based on ICF’s intentions. This field is used to describe observed disabilities (direct/indirect) with deviations in status, as well as those found in another medical investigation.

Example: Other body function refers to the consequences of somatic disease, such as deviations in bodily status, radiology images and laboratory findings, as well as clinical physiological examinations.

Field 6: Activity limitations – describe what the patient has difficulty doing because of the disabilities described above

Provide concrete examples of situations and activities in the patient’s work where difficulties arise. Describe how often these situations occur and the severity of the difficulties.

Describe how you yourself have observed the limitations. If the information is based on medical history/interview or someone else’s observations, you must indicate this.

Also indicate if there is any type of activity the patient should avoid due to significant medial risk or serious risk of accident.

Field 8: Describe whether there are medical reasons for special working hours

Special working hours may be having an irregular arrangement of working hours, as opposed to reducing working hours the same amount each day.

Describe what the patient can do despite their illness or limitations

Describe here whether the patient has any special abilities that can be utilised even if not in a work situation. The information is intended to help Försäkringskassan in their co-ordination role, which involves responsibility for rehabilitation and co-ordination.

Field 10: Contact with Försäkringskassan

Försäkringskassan’s administrator will contact you once the documentation has come in and processing can begin.

 

Who does what?

The patient shall:

  • Ask for a doctor’s statement from the doctor.
  • Apply for sickness compensation with Försäkringskassan.
  • Send the doctor’s statement to Försäkringskassan.

The doctor shall:

  • Write a doctor’s statement for sickness compensation.
  • Give the doctor’s statement to the patient.

7800 Läkarutlåtande för sjukersättning

Försäkringskassan shall:

  • Assess whether the patient is entitled to sickness compensation and pay out compensation if all of the conditions are met.

The areas of responsibility change slightly if Försäkringskassan suggests that sickness benefit be replaced with sickness compensation.

Who does what?

The patient shall:

  • The patient does not need to do anything.

The doctor shall:

  • Write a doctor’s statement for sickness compensation.
  • Send the doctor’s statement to Försäkringskassan.

7800 Läkarutlåtande för sjukersättning

Försäkringskassan shall:

  • Ask for a doctor’s statement from the doctor.
  • Assess whether the patient is entitled to sickness compensation and pay out compensation if all of the conditions are met.
  • Convene a reconciliation meeting if necessary
 

In some cases, Försäkringskassan needs a detailed doctor’s statement (E212) when a person lives in Sweden and has lived or worked in another EU member state. The form (E213) is used by all EU countries and
is always used in this context.

The process is as follows:

  1. The patient sends an application for sickness compensation together with the doctor’s statement.
  2. Försäkringskassan sees that the patient has lived abroad.
  3. Försäkringskassan contacts you, the doctor, and asks you to write a detailed doctor’s statement.

E213 Detaljerat läkarutlåtande

 

Doctor’s statement

In certain cases, Försäkringskassan may pay compensation for issuing of a doctor’s statement. This even applies when the patient has requested a doctor’s statement to attach to their sickness compensation application.

Compensation is only paid for a complete doctor’s statement. If Försäkringskassan is forced to request supplementation of a statement, compensation will not be paid until the supplementation has been received. Another condition is that the patient has not been charged a fee for the statement.

Who can receive compensation?

Compensation can only be paid to doctors working in private care units that have cooperation agreements with the county council pursuant to the national rate, and doctors who are completely outside the publicly-funded healthcare system. Doctors who are employed by the county council, or who are working for a private care unit that has a cooperation agreement with the county council or is part of the free choice of care system cannot receive compensation.

How much is the compensation?

The fee is SEK 2,200 for

  • a statement of health status
  • a detailed doctor’s statement
  • a statement for sickness compensation.

You can also receive compensation when the patient has requested a doctor’s statement for their sickness compensation application. If we consent to you getting help in your investigation from someone with another form of expertise, then that time may be included in the total time required. In such cases, the fee may be higher.

How to request compensation for a doctor’s statement

A doctor who has issued a statement of health status or a statement for sickness compensation can request the fee using form 7807 Request for compensation for doctor’s statement – sickness compensation and activity compensation.

Reconciliation meetings

The personal administrator is the one who determines whether a reconciliation meeting is needed. As a doctor, you can initiate a reconciliation meeting for a patient by contacting Försäkringskassan's administrator.

You can receive compensation if you have participated in a reconciliation meeting. The fee is maximum SEK 750 for the first hour and SEK 375 for each subsequent half hour that is initiated. Send the invoice for reconciliation meeting participation to Försäkringskassan.

Invoices to Försäkringskassan   

 

Vanliga frågor

Villkoren för att få sjukersättning finns beskrivna på Försäkringskassans sidor för privatpersoner.

Information för patienten om sjukersättning

Ja, om patienten har uppehållstillstånd kan hen ha rätt till ersättning från Försäkringskassan. Villkoren finns beskrivna på Försäkringskassans sidor för privatpersoner.

Information för patient som har fått uppehållstillstånd i Sverige

Om patienten är asylsökande och inte har fått uppehållstillstånd ännu har hen inte rätt till ersättning från Försäkringskassan.

Information för patient som fått asyl i Sverige

Ja, patienten kan prova att jobba eller studera på hel- eller deltid.

Information för patienten om sjukersättning

Om arbetsträning kan vara en väg tillbaka till arbetet

Ja. Ring till oss på 0771-17 90 00 så hjälper vi dig. Vi kan tyvärr inte publicera kontaktuppgifter till våra handläggare på webbplatsen.

Ja, det måste vara en läkare som skriver läkarutlåtandet. Men du bör bidra med din kunskap om patientens tillstånd genom att skriva ett utlåtande som kan vara med som ett komplement till läkarutlåtandet. Diskutera med läkaren.

Ja, här hittar du korta beskrivningar av vanliga begrepp inom sjuk- och funktionsnedsättning.

Sjukpenning

Ersättning från Försäkringskassan när en patient inte kan arbeta på grund av sjukdom.

Aktivitetsersättning

Ersättning från Försäkringskassan till den som är under 30 år och har nedsatt arbetsförmåga med minst en fjärdedel under minst ett år på grund av sjukdom, skada eller funktionsnedsättning.

Sjukersättning

Ersättning från Försäkringskassan när en patient inte kommer att återfå sin arbetsförmåga.

Läkarintyg

Ett läkarintyg ska användas om du bedömer att din patient inte kan arbeta på grund av sjukdom.

Läkarutlåtande

Ett utlåtande ska användas vid bedömningar i ett ärende, till exempel när en patient har ansökt om sjuk- eller aktivitetsersättning.

I det nya läkarutlåtandet läggs stor tyngd vid beskrivningen av funktionsnedsättningen. Funktionsnedsättningen ska beskrivas utifrån olika funktionsområden och graderas. I det nya utlåtandet efterfrågar vi konkreta exempel på vad patienten har svårt att göra på grund av sin funktionsnedsättning. Vi efterfrågar inte en bedömning av arbetsförmågan, utan en bedömning av patientens medicinska förutsättningar för arbete.

En annan skillnad är att tidigare och planerad medicinsk behandling eller åtgärd ska redovisas mer utförligt än tidigare. Det finns även möjlighet för intygsskrivande läkare att hänvisa till tidigare utredningar.

Ja, de som ansöker om sjukersättning ska skicka med ett läkarutlåtande.

Det är lämpligt att läkarutlåtandet lämnas på den blankett som Försäkringskassan har fastställt, vilket minskar risken för behov av komplettering.