International Journal of Public Health

, Volume 63, Issue 9, pp 1081–1088 | Cite as

Intervention policies and social security in case of reduced working capacity in the Netherlands, Finland and Germany: a comparative analysis

  • Oskar MittagEmail author
  • Toomas Kotkas
  • Christina Reese
  • Hanna Kampling
  • Henning Groskreutz
  • Wouter de Boer
  • Felix Welti
Original Article



Working age disability is a major challenge for policymakers in European countries. This pertains to both occupational reintegration and social benefits for work incapacity. In many states reforms have been initiated aimed at reducing disability scheme inflow and fostering return to work. Our study was motivated by the question as to which aspects of these reforms seem to have been effective.


Three different approaches were utilized: case vignettes, interviews and expert workshops in the respective countries (Netherlands and Germany in 2012; Finland in 2015), and a systematic search for relevant studies on occupational reintegration was performed.


We found considerable differences as to the assessment of work incapacity and resulting monetary benefits in the three countries. Also, organisation and practices of occupational reintegration vary from one country to another. Major differences concern (1) the timing of interventions, (2) employer responsibility and workplace involvement, (3) incentives and sanctions and (4) organisational and procedural issues.


Our results may partly explain why some reform strategies have been more successful than others, and thus contribute to the further development of social and labour policies in Europe.


Long-term ill or disabled Social security Return to work efforts Policies and practices in the Netherlands Finland Germany 



This study was funded by the Hans-Böckler-Stiftung, a foundation of the Confederation of German Trade Unions (Grant Number 2014-694-4).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Human and animal rights

This article does not contain any study with human participants or animals performed by any of the authors.

Supplementary material

38_2018_1133_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  • Oskar Mittag
    • 1
    Email author
  • Toomas Kotkas
    • 2
  • Christina Reese
    • 1
  • Hanna Kampling
    • 1
  • Henning Groskreutz
    • 3
  • Wouter de Boer
    • 4
  • Felix Welti
    • 5
  1. 1.Section of Health Care Research and Rehabilitation Research, Faculty of MedicineMedical Center University of Freiburg, University of FreiburgFreiburgGermany
  2. 2.Law SchoolUniversity of Eastern FinlandJoensuuFinland
  3. 3.Trade Union of the Metal Industry (Industriegewerkschaft Metall)Frankfurt am MainGermany
  4. 4.Evidence Based Insurance Medicine (EbIM)Universitätsspital BaselBaselSwitzerland
  5. 5.Department for Social Work and Social Welfare, Chair for Social Law and Health Care Law, Rehabilitation and Disability LawUniversity of KasselKasselGermany

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