Empirical Economics

, Volume 45, Issue 1, pp 567–582 | Cite as

Do time limits in the sickness insurance system increase return to work?

  • Pathric HägglundEmail author


This article analyzes the effect of stricter enforcement of the eligibility criteria in the Swedish sickness insurance (SI) system. In 2008, time-restricted assessments of the individual’s working capacity on the 91st and 181st sick day was introduced. Taking advantage of the quasi-experimental feature of the intervention, I find a large and significant increased exit rate around the 181-day assessment. The impact is the result of longer spells outside SI-benefits, indicating that the stricter rules create disincentives to report sick.


Public sickness insurance Policy evaluation Natural experiment 

JEL Classification

H55 I18 J22 J28 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Allison PD (1995) Survival analysis using the sas system—a practical guide. SAS Institute Inc, CaryGoogle Scholar
  2. Barr N (2004) Economics of the welfare state. Oxford University Press, New YorkGoogle Scholar
  3. Black DA, Smith JA, Berger MC, Noel BJ (2003) Is the threat of reemployment services more effective than the services themselves? Evidence from random assignment in the UI system. Am Econ Rev 93(4): 1313–1327CrossRefGoogle Scholar
  4. Carling K, Edin P-A, Harkman A, Holmlund B (1996) Unemployment duration, unemployment benefits, and labor market programs in Sweden. J Public Econ 59: 313–334CrossRefGoogle Scholar
  5. Dolton P, O’Neill D (1996) Unemployment duration and the restart effect: some experience evidence. Econ J 106(435): 387–400CrossRefGoogle Scholar
  6. Hesselius P, Persson M (2007) Incentive and spill-over effects of supplementary sickness compensation. Arbetsmarknadspolitisk utvärdering. Working paper No 16Google Scholar
  7. Hesselius P, Johansson P, Larsson L (2005) Hur påverkar kra-vet på läkarintyg sjukfrånvaron? Erfarenheter från ett socialt experiment IFAU. Report No 7Google Scholar
  8. Hesselius P, Johansson P, Nilsson P (2009) Sick of your colleagues absence?. J Eur Econ Assoc 7(2–3): 583–594CrossRefGoogle Scholar
  9. Hägglund P (2010) Rehabiliteringskedjans effekter på sjukskrivningstiderna. ISF. Report No 1Google Scholar
  10. Hägglund P (2011) Are there pre-programme effects of Swedish active labour market policies? Evidence from three randomised experiments. Econ Lett 112(1): 91–93CrossRefGoogle Scholar
  11. Johansson P, Palme M (1996) Do economic incentives affect work absence? Empirical evidence using Swedish micro data. J Public Econ 59: 195–218CrossRefGoogle Scholar
  12. Johansson P, Palme M (2002) Assessing the effects of a compulsory sickness insurance on worker absenteeism. J Hum Resour 37: 381–409CrossRefGoogle Scholar
  13. Johansson P, Palme M (2005) Moral hazard and sickness insurance. J Public Econ 89: 1879–1890CrossRefGoogle Scholar
  14. Johnson TR, Klepinger DH (1994) Experimental evidence on unemployment insurance work-search policies. J Hum Resour 29(3): 696–717CrossRefGoogle Scholar
  15. Klepinger DH, Johnson TR, Joesch JM (2002) Effects of unemployment insurance work-search requirements: the Maryland experiment. Ind Labor Rel Rev 56(1): 3–22CrossRefGoogle Scholar
  16. Meyer B (1990) Unemployment insurance and unemployment spells. Econometrica 58: 757–782CrossRefGoogle Scholar
  17. OECD (2009) Sickness, disability and work: breaking the barriers—Sweden: will the recent reforms make it? OECD. ReportGoogle Scholar
  18. Socialförsäkringsutredningen (2006) Mera försäkring och mera arbete. SOU. Report No 86Google Scholar
  19. Swedish Social Insurance Agency (2009) Sjukfrånvaron i Sverige—På väg mot europeiska nivåer. Social Insurance Report No 10Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.The Swedish Social Insurance Inspectorate and the Swedish Institute for Social ResearchStockholmSweden

Personalised recommendations