Sweden has one of the highest rates of long term sick leave and of disability pension in the world. In a population of 9 million, about 170.000 individuals (1.8%) are on long term sick leave (>6 mo) ...and 530.000 persons (5,8%) have disability pension, most commonly due to musculoskeletal problems. The national social insurance provides a sick allowance of 80% of your salary up to 2.500 EUR/month. A doctor's assessment and certificate is mandatory after 1 week of sick leave but there is no formal time limit for the duration of the sick leave that can be prescribed. This has lead to high increases in national sick rates (Fig.1), especially long term. The national insurance office may, however, independently assess the reasons for such sick leave, an assessment that currently often leads to disability pension within 1-2 years. There is also mandatory worker's compensation, giving the possibility of permanent economical support: "if reasons are not overwhelmingly against...". This is an administrative decision that can be overrun in administrative courts. Settlement procedures usually take several years. The health economical consequences are considerable, since one disability pension costs on average about 11.000 EUR/year and the average disability pension age is 52 years in our country, i.e. a total sum of 143.000 EUR in 13 years of remaining work.
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