Sickness and Disability Policy Interventions

Abstract

This chapter is based on a OECD study (2010, Sickness, disability and work: Breaking the barriers (A synthesis of findings across OECD countries)) and a comparative six country cohort study (Anema et al. J Occup Rehabil 2009;19(4), 419–426) initiated by International Social Security Agency (ISSA) to provide an insight in changes and effects of sickness benefit and disability policies. Considerable convergence is found on the compensation policies in OECD countries in the past 20 years, countries with more generous benefit systems have seen more downward change whereas countries with the least generous benefit systems have seen an upward shift. In addition, most countries shifted their policy orientation from compensation to integration and from a largely passive to a more active employment-oriented approach. The OECD study showed a positive effect of compensation measures on the number of disability beneficiaries, whereas the change in integration policies had only a very small effect on disability benefit recipiency rates.

The comparative six country ISSA study evaluated the implementation and effectiveness of integration and compensation measures sustainable on RTW of workers on long-term sick leave due to low back pain. It showed that countries with an active integration policy approach, e.g., in the Netherlands as well as countries with a strict compensation policy approach, e.g., USA and Israel were both successful. Work interventions were the most effective component of a successful integration policy approach. To understand the positive effects of implementing work interventions on RTW and the sickness benefit and disability recipiency rates the Dutch approach is discussed as an example in the last part of the chapter.