Response to interpellation 2024/25:406 on correct compensation in case of illness
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
The debate concerns the right to sickness benefit and how the livelihood of persons with permanent reduced work capacity shall be ensured. M argues that the government does not answer questions regarding persons who unintentionally fall out of the sickness insurance due to various authorities' assessments 1 2. S considers that system errors cause people to be denied sickness benefit despite permanent illness and demands that the concept of the labor market be harmonized to avoid poverty 3. M emphasizes that the new granting of sickness benefit has increased significantly and that the government prioritizes preserving work capacity through coordinated rehabilitation efforts 4 5. M argues that the regulatory framework must be followed and that support for returning to work is prioritized 5.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Statsrådet Anna Tenje (M)
Mr. Speaker! Jessica Rodén has asked me how I and the government intend to ensure that persons with permanent reduced work capacity do not get stuck on sickness benefit but receive the sickness compensation they are entitled to, and what measures I and the government intend to take so that fewer people are left completely without support after a rejection of an application for sickness compensation.
To be entitled to sickness benefit, it is required that the ability to work can be considered permanently impaired and that rehabilitation measures are not judged to be able to lead to the insured regaining any ability to work. When assessing how impaired the ability to work is, Försäkringskassan shall take into account the insured's ability to support themselves through gainful employment on the labor market.
On 1 September 2022, new provisions regarding compensation to older persons of working age, the so-called elderly rules, were introduced. The rules have resulted in an increase in the new granting of sickness compensation. The new granting has also increased among those who are not covered by the elderly rules. The number of persons in the age group 19–59 years who were newly granted sickness compensation has increased from approximately 4,300 in 2021 to approximately 6,400 in 2024.
As the government notes in the budget bill for 2025 (prop. 2024/25:1), measures must be taken to counter the situation where those on long-term sick leave who are assessed to have a permanent reduced capacity for work in normally occurring jobs remain passively in the sickness benefit system. Therefore, in the regulatory letters for 2025, the government has given Försäkringskassan and Arbetsförmedlingen a mandate to promote work capacity in gainful employment on the labor market.
Försäkringskassan shall, within the framework of the assignment, develop the work regarding how work capacity in gainful employment on the labor market, for example jobs with support from Arbetsförmedlingen, shall be investigated and taken into account. Arbetsförmedlingen shall, furthermore, within the framework of its existing assignment, review how the agency can assist Försäkringskassan in this work. Those who are denied their application for sickness allowance may, if they have a sickness benefit-generating income, be entitled to sickness benefit instead.
The sickness insurance shall provide economic security for those who cannot work due to reduced work capacity, while at the same time it needs to be designed so that work capacity is taken into account to the greatest extent possible. This is important from both a human and a societal perspective.
Jessica Rodén (S)
Mr. Speaker! The Minister mentions in his answer that more people receive sickness benefit and that the elderly rules have led to a positive development. That is quite true. But let us be honest: It was we Social Democrats who introduced these improvements and abolished the stalemate.
The sickness insurance must hang together. Today we see that different assessments of the concept of the labor market result in people who have a permanent reduced capacity for work still not being granted sickness compensation. It is a systemic error.
We see that a large proportion of those who are denied an application for sickness benefit end up in financial vulnerability. Therefore, we need to ask ourselves what it is we actually want to achieve. Is it reasonable that people who will never be able to work again should live in poverty?
Mr. Speaker! Today, the right to sickness benefit is being tested against gainful employment on the labor market, but what does that mean in practice? Well, it means that people who have an obviously permanent reduced capacity to work are being denied because it is claimed that they can take a job – one that hardly exists. It is undignified and unreasonable. Therefore, we Social Democrats believe that the right to sickness benefit should be tested against the same labor market concept that applies to the sickness allowance. No one should have to search for jobs that do not exist. No one should be sent out into uncertainty and poverty. And let us be clear: No one gets healthy by being made poor.
That people are denied sickness benefits despite their capacity to work being steadily impaired does not lead to miraculous recoveries. It leads to stress, mental ill-health, and eroded trust in the welfare system. We see it clearly in the Swedish Social Insurance Agency's report. It states that 9 percent of those who are denied sickness benefits are left completely without support. They have neither sickness benefit, unemployment compensation, nor social assistance. These are people who have worked, paid taxes, and done the right thing, but who are left behind. It is a betrayal.
My question to the Minister is whether the government is prepared to change the concept of the labor market so that the right to sickness benefit is assessed against actual jobs and not theoretical ones.
Jonathan Svensson (S)
Mr. Speaker! Thanks to my colleague Jessica Rodén, who has taken the initiative for this very important and urgent debate! It is about how people who find themselves in a vulnerable situation should be able to receive a livelihood that one can live on.
In my interpellation, my colleague highlighted above all two groups. First, it was the group that remains on sickness benefit despite a steadily diminished capacity to work. It is obviously a very strange construction, which needs to be rectified. My colleague also highlighted the group of people who are denied, are left completely without compensation, and then lack means of support. The reason why one is left without means of support can obviously vary. It can, for example, be about having fallen out of the social insurance system in different ways. It is that group I would like to take up in this interpellation debate.
A person's possible level of compensation is, as is known, based on a determined sickness benefit-earning income, SGI. In this way, one can receive a compensation that is related to one's regular income. Our social insurance system is constructed with the knowledge that people's lives change. There is therefore a possibility to protect one's SGI in different contexts, for example, if you choose to study or become unemployed. It is very good that that flexibility exists in the system. On the other hand, there are flaws in our system that can lead to people falling out of the sickness insurance unintentionally.
A situation that is unfortunately not entirely uncommon can arise when state agencies make different assessments of an individual's capacity to work. The assessments are often made on correct grounds but against different sets of regulations, which can lead to the individual being caught in the middle. For example, an individual may be assessed as unable to work by Arbetsförmedlingen while Försäkringskassan, based on its own regulations, assesses the person as healthy enough to work.
If the individual does not, in direct connection with their sick leave, register as a job seeker with Arbetsförmedlingen, with everything that entails in terms of activity reporting and job seeking, one risks receiving a zero SGI and thus falling out of the sickness insurance.
There are examples of people who have been on sick leave and, during that time, lost their position and on the first day after the sick leave ended did not register as job seekers with Arbetsförmedlingen. This has then resulted in a zeroed SGI and that the person has fallen out of the sickness insurance.
Mr. Speaker! Of course, the decisions made by case officers at state agencies must be made based on the applicable regulations, but it is unfortunate that individuals who find themselves in a vulnerable situation – as a sick leave often is – due to, for example, ignorance or actual illness, lose their opportunity for compensation within the health insurance. It is even more unfortunate right now when we are in real hard times, when far too many have difficulty putting food on the table and making ends meet.
I therefore want to take the opportunity to ask the Minister how she views that group of people who unintentionally and in unfortunate ways fall out of the sickness insurance and whether she intends to take any measures to reduce the risk of such occurring.
Statsrådet Anna Tenje (M)
Mr. Speaker! As I began by stating, the new granting of sickness benefit to persons in the age group 19–59 has therefore increased by almost 50 percent between 2021 and 2024. It is the exact opposite of what the member implies in his interpellation, and for that very reason, I stand by these figures.
Including those between 60 and 65 years of age, there were some over 11,000 newly granted sickness benefits last year. The last time the figures were this high was around 2014. Given that Försäkringskassan's grants are correct, it means, to use the member's own words in the interpellation, that the risk of persons with permanent reduced capacity for work getting stuck in the sickness benefit without receiving the compensation they are entitled to has not been so low since we last had a moderate-led government.
We have a regulatory framework, and it must be followed. Those who are permanently ill and are entitled to sickness benefit shall receive it. But I am also very keen on helping and supporting, and on safeguarding every person's capacity for work whenever it is possible. Therefore, among other things, the mission of Försäkringskassan and Arbetsförmedlingen to safeguard the capacity for work in gainful employment on the labor market is an important part.
The government allocated nearly 100 million kronor in the budget for 2025 just to finance a number of measures to strengthen the return to work, including increased coordination of rehabilitation efforts, work-oriented rehabilitation support, and a review of increased opportunities for studies for those who have sickness and activity compensation.
For the government, it is a high priority to continue working to ensure that everyone who can work and can be available to the labor market also gets the opportunity to do so through the right support and the right opportunities for return. This is something I do not want to move away from.
Jessica Rodén (S)
Mr. Speaker! The government's policy does not work on its own terms. Despite the government saying that the primary priority has been to fight inflation, inflation continues to dig holes in people's finances. Food prices are high, and housing costs are skyrocketing. Unemployment is currently over 10 percent. This means that we have hundreds of thousands of people in our country who are without jobs.
We also have people who are too ill to work but who are denied sickness benefits. It is not about unemployed people who need education or matching. It is about people who doctors have assessed as permanently unable to work but who are still expected to do so.
Mr. Speaker! We know that today's regulatory framework creates problems. We know that the assessment of work capacity is rigid and sometimes directly detached from reality, and we see that people get stuck on sickness allowance instead of receiving the sickness compensation they should be entitled to.
In the investigation *An evaluation of changes in the sickness insurance regulations during 2021 and 2022*, it is proposed that the assessment of work capacity should become more grounded in reality. Today, people can be denied sickness benefit with reference to the fact that they could perform a job that hardly exists in practice. The investigation is clear that the concept of work capacity must take into account the actual labor market and that it should change in step with how the labor market changes. It is also for this reason that the same investigation proposes that the concept of the labor market within sickness allowance and sickness benefit respectively should be harmonized. These are important proposals, Mr. Speaker.
I become very curious about one thing that the Minister mentions in his answer. The Minister stated that a new assignment has been given to Försäkringskassan and Arbetsförmedlingen to safeguard the ability to work in gainful employment in the labor market. I wonder, Mr. Speaker, how that would help those people who are considered too ill by doctors to be able to work. The Minister is welcome to elaborate on that a bit.
Jonathan Svensson (S)
Mr. Speaker! I thank the Minister for the answer. The Minister mentions that everyone who can work shall work. I believe we are broadly in agreement on that in this chamber. Of course, all possible work capacity should be utilized. But it must occur within reasonable limits.
I did not quite experience the Minister answering my questions. How does she view the group that I highlight, i.e., people who risk falling out of the sickness insurance by mistake? In Sweden, we are probably quite in agreement that we have a strong and relatively well-functioning social insurance system, even though there are things that we may need to adjust, for example the things that my colleague and I highlight here today.
I want to return a bit to how we should handle this issue. I do not feel that the Minister is answering my questions on how she views the group that I choose to highlight here today and whether she intends to take any measures to prevent people from falling out of the sickness insurance under unfortunate circumstances.
I think that is regrettable, because this is an important issue that needs to be handled. A relatively simple measure would, for example, have been to give a targeted assignment to the relevant authorities to carry out a targeted information effort towards the groups concerned. That is one example.
I do not intend to demand that the Minister should, on the spot, have a list of measures to be taken, but I want to give the Minister the opportunity to answer whether any measures are being considered.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.