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Preventive tools are not used to prevent sick leave

The Swedish Social Insurance Agency can approve benefits for preventive measures against ill health and long-term sick leave. The Swedish National Audit Office (Swedish NAO) audit shows that these benefits are relatively unknown and are rarely used preventively. In addition, the Government’s remit to the Social Insurance Agency is unclearly formulated.

Healthcare professionals examines patients' back in care environment.


Long-term sick leave is a major problem that seriously affects individuals and society.

In order to reduce the risk of future work incapacity and long-term sick leave, the Social Insurance Agency can grant preventive sickness benefit and workplace-oriented rehabilitation support. Both benefits can be used for preventive purposes, i.e. before the individual has been on sick leave.

The Swedish NAO’s audit shows that preventive benefits are relatively unknown to the public, employers and healthcare services. Moreover, the audit shows that the work on these benefits has low priority within the Social Insurance Agency and that they are relatively rarely used. The benefits are usually granted for rehabilitation purposes – that is, not preventively – for individuals who are already on sick leave. Preventive sickness benefit is also used more in geographical areas that have a high level of sick leave, where it is probably of most importance to have preventive measures.

“To identify individuals who are in need of preventive measures, the Social Insurance Agency’s case officers dealing with sickness benefits and preventive benefits need to cooperate more closely with each other. In this way, resources could be directed to where they are most useful," says Nina Granqvist, project leader for the audit.

The Swedish NAO notes that there are geographical differences in the extent to which the benefits are granted, and the results indicate that they are primarily given to individuals and employers who have previously received them. The risk is therefore high that individuals and employers who are not already in the system are missing out on benefits.

The audit also shows that the individual’s chance of accessing preventive sickness benefit is greater if contact with the Social Insurance Agency goes through specialist care, compared to the individual receiving care through primary care.

The Swedish NAO considers that the shortcomings are partly due to the Social Insurance Agency’s remit to prevent sick leave not being clear. Apart from a clarification in April 2021, the remit has not been included in the Government’s appropriation directions since 2013, and the Social Insurance Agency’s guidance lacks clear formulations on preventive work.

“The audit shows that preventive benefit to counter ill health and long-term sick leave does not work as intended. The Social Insurance Agency needs to improve its information about these benefits and also take other measures," says Auditor General Helena Lindberg.

Recommendations in brief

The Swedish NAO’s recommendations to the Government include clarifying the Social Insurance Agency’s responsibilities and remit as regards preventing sickness absence, incapacity for work and sick leave.

The recommendations to the Social Insurance Agency include

  • ensuring that all relevant actors receive the necessary information about the benefits and their preventive purpose
  • developing internal contacts between case officers dealing with sickness benefits and case officers dealing with preventive benefits in order to more easily identify individuals in need of preventive measures.
  • considering simplifying the application procedure for rehabilitation support.

See the report for the full recommendations.

Press contact: Olle Castelius, phone: +46 8-5171 40 04.

Presskontakt: , telefon: 08-5171 42 06.

Updated: 23 August 2021

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