Journal of Occupational Rehabilitation

, Volume 25, Issue 3, pp 471–480 | Cite as

Return to Work After Temporary Disability Pension in Finland

  • Mikko LaaksonenEmail author
  • Raija Gould


Purpose When it is possible that the employee’s work ability can be restored through treatment or rehabilitation, disability pension in Finland is granted for a fixed period. We examined which factors are associated with return to work (RTW) after such temporary disability pension. Methods The study included all Finnish residents whose temporary disability pension from the earnings-related pension system started in 2008 (N = 10,269). Competing risks regression analysis was applied to examine register-based determinants for RTW after temporary disability pension due to mental disorders, musculoskeletal diseases, other diseases, and injury over a 4-year follow-up period. Results The overall cumulative incidence of RTW was 25 %. RTW was more probable after temporary disability pension due to injury and musculoskeletal diseases and less probable after temporary disability pension due to mental disorders. Younger age and higher education increased RTW but differences between genders, private and public sector employees, and occupational classes were relatively small. The probability of RTW was higher among those who were employed before their temporary disability pension (subhazard ratio in multivariate analysis 2.41 (95 % CI 2.13–2.72) and among the 9 % who participated in vocational rehabilitation during their pension [SHR 2.10 (95 % CI 1.90–2.31)]. With some exceptions, the results were fairly similar for all diagnostic causes of temporary disability pension. Conclusion Return to work after temporary disability pension was relatively uncommon. Nevertheless, in all diagnostic groups RTW continued for the whole follow-up period. The low educated and those not employed before temporary disability pension need more support in their RTW. The strong association between vocational rehabilitation and RTW suggests that increasing rehabilitation among those with impaired work ability may promote RTW.


Return to work Disability leave Vocational rehabilitation Risk factors 


Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical standard

The dataset consists of register data which were anonymized and not possible to trace back to individuals. The Finnish Centre for Pensions obeys the ethical standards of The Finnish Advisory Board on Research Integrity and monitors that responsible scientific practice is followed in collecting, analysing and reporting of data.


  1. 1.
    Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009;374(9696):1196–208.PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Doyle Y, McKee M, Rechel B, Grundy E. Meeting the challenge of population ageing. BMJ. 2009;339:b3926.CrossRefPubMedGoogle Scholar
  3. 3.
    Organisation for Economic Co-operation and Development (OECD). Sickness, disability and work: breaking the barriers. A synthesis of findings across OECD countries. Paris: OECD; 2010.Google Scholar
  4. 4.
    Niemelä H, Salminen K. Social security in Finland. Helsinki: Social Insurance Institution, Finnish Centre for Pensions, Finnish Pension Alliance and Ministry of Social Affairs and Health; 2006.Google Scholar
  5. 5.
    Pensioners and Insured in Finland 2012. Official Statistics of Finland, Social Protection. Helsinki: Finnish Centre for Pensions and Keva; 2013.Google Scholar
  6. 6.
    Henderson M, Glozier N, Elliott KH. Long term sickness absence. BMJ. 2005;330:802–3.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Dekkers-Sánchez PM, Hoving JL, Sluiter JK, Frings-Dresen MHW. Factors associated with long-term sick leave in sick-listed employees: a systematic review. Occup Environ Med. 2008;65:153–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Blank L, Peters J, Pickvance S, Wilford J, Macdonald E. A systematic review of the factors which predict return to work for people suffering episodes of poor mental health. J Occup Rehabil. 2008;18:27–34.CrossRefPubMedGoogle Scholar
  9. 9.
    Cornelius LR, Klink JJL, Groothoff JW, Brouwer S. Prognostic factors of long term disability due to mental disorders: a systematic review. J Occup Rehabil. 2010;21:259–74.PubMedCentralCrossRefGoogle Scholar
  10. 10.
    Detaille SI, Heerkens YF, Engels JA, van der Gulden JWJ, van Dijk FJH. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies. Scand J Work Environ Health. 2009;35:261–81.CrossRefPubMedGoogle Scholar
  11. 11.
    Krause N, Frank JW, Dasinger LK, Sullivan TJ, Sinclair SJ. Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. Am J Ind Med. 2001;40:464–84.CrossRefPubMedGoogle Scholar
  12. 12.
    Wynne-Jones G, Cowen J, Jordan JL, Uthman O, Main CJ, Glozier N, van der Windt D. Absence from work and return to work in people with back pain: a systematic review and meta-analysis. Occup Environ Med. 2014;71:448–56.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Berecki-Gisolf J, Clay FJ, Collie A, McClure RJ. Predictors of sustained return to work after work-related injury or disease: insights from workers’ compensation claims records. J Occup Rehabil. 2012;22:283–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Franche RL, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil. 2005;15:607–31.CrossRefPubMedGoogle Scholar
  15. 15.
    Statistics Finland. Classification of socio-economic groups. Handbooks 17. Helsinki: Central Statistical Office of Finland; 1989.Google Scholar
  16. 16.
    Fine J, Gray R. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94:496–509.CrossRefGoogle Scholar
  17. 17.
    Putter H, Fiocco M, Geskus RB. Tutorial in biostatistics: competing risks and multi-state models. Stat Med. 2007;26:2389–430.CrossRefPubMedGoogle Scholar
  18. 18.
    Post M, Krol B, Groothoff JW. Self-rated health as a predictor of return to work among employees on long-term sickness absence. Disabil Rehabil. 2006;28:289–97.CrossRefPubMedGoogle Scholar
  19. 19.
    De Rijk A, Janssen N, Alexanderson K, Nijhuis F. Gender differences in return to work patterns among sickness absentees and their associations with health: a prospective cohort study in The Netherlands. Int J Rehabil Res. 2008;31:327–36.CrossRefPubMedGoogle Scholar
  20. 20.
    Brouwer S, Reneman MF, Bültmann U, van der Klink JJ, Groothoff JW. A prospective study of return to work across health conditions: perceived work attitude, self-efficacy and perceived social support. J Occup Rehabil. 2010;20:104–12.PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Hardeveld F, Spijker J, De Graaf R, Nolen WA, Beekman AT. Prevalence and predictors of recurrence of major depressive disorder in the adult population. Acta Psychiatr Scand. 2010;122:184–91.CrossRefPubMedGoogle Scholar
  22. 22.
    Pensioner and Insured in Finland 2008. Official Statistics of Finland, Social Protection. Helsinki: Finnish Centre for Pensions, Keva and the State Treasury; 2010.Google Scholar
  23. 23.
    Organisation for Economic Co-operation and Development (OECD). Sickness, disability and work: breaking the barriers, vol. 3. Paris: OECD; 2008.Google Scholar
  24. 24.
    Vlasveld M, van der Feltz-Cornelis C, Bültmann U, Beekman ATF, van Mechelen W, Hoedeman R, Anema J. Predicting return to work in workers with all-cause sickness absence greater than 4 weeks: a prospective cohort study. J Occup Rehabil. 2011;22:1–9.Google Scholar
  25. 25.
    von Celsing AS, Svärdsudd K, Eriksson HG, Björkegren K, Eriksson M, Wallman T. Determinants for return to work among sickness certified patients in general practice. BMC Public Health. 2012;12:1077.CrossRefGoogle Scholar
  26. 26.
    Piccinelli M, Wilkinson G. Gender differences in depression. Critical review. Br J Psychiatry. 2000;177:486–92.CrossRefPubMedGoogle Scholar
  27. 27.
    Virtanen M, Kawachi I, Oksanen T, Salo P, Tuisku K, Pulkki-Råback L, Pentti J, Elovainio M, Vahtera J, Kivimäki M. Socio-economic differences in long-term psychiatric work disability: prospective cohort study of onset, recovery and recurrence. Occup Environ Med. 2011;68:791–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Johansson G, Hultin H, Möller J, Hallqvist J, Kjellberg K. The impact of adjustment latitude on self-assessed work ability in regard to gender and occupational type. Scand J Occup Ther. 2012;19:350–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Vermeulen SJ, Tamminga SJ, Schellart AJ, Ybema JF, Anema JR. Return-to-work of sick-listed workers without an employment contract: what works? BMC Public Health. 2009;14:232.CrossRefGoogle Scholar
  30. 30.
    Ahlgren Å, Bergroth A, Ekholm J, Schüldt K. Work resumption after vocational rehabilitation: a follow-up two years after completed rehabilitation. Work. 2007;28:343–54.PubMedGoogle Scholar
  31. 31.
    Vermeulen SJ, Anema JR, Schellart AJ, van Mechelen W, van der Beek AJ. Intervention mapping for development of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders. BMC Public Health. 2009;9:216.PubMedCentralCrossRefPubMedGoogle Scholar
  32. 32.
    Hoefsmit N, Houkes I, Nijhuis FJ. Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review. J Occup Rehabil. 2012;22:462–77.PubMedCentralCrossRefPubMedGoogle Scholar
  33. 33.
    Schandelmaier S, Ebrahim S, Burkhardt SC, de Boer WE, Zumbrunn T, Guyatt GH, Busse JW, Kunz R. Return to work coordination programmes for work disability: a meta-analysis of randomised controlled trials. PLoS One. 2012;7:e49760.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Kuoppala J, Lamminpää A. Rehabilitation and work ability: a systematic literature review. J Rehabil Med. 2008;40:796–804.CrossRefPubMedGoogle Scholar
  35. 35.
    van Oostrom SH, Driessen MT, de Vet HC, Franche RL, Schonstein E, Loisel P, van Mechelen W, Anema JR. Workplace interventions for preventing work disability. Cochrane Database Syst Rev. 2009;15(2):CD006955.Google Scholar
  36. 36.
    Gensby U, Labriola M, Irvin E, Amick BC III, Lund T. A classification of components of workplace disability management programs: results from a systematic review. J Occup Rehabil. 2014;24:220–41.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Finnish Centre for PensionsEläketurvakeskusFinland

Personalised recommendations