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Swedish social insurance officials struggling with the vagueness of the work ability concept: The case of sickness compensation
Örebro University, School of Law, Psychology and Social Work.ORCID iD: 0000-0002-5683-179X
Uppsala universitet, Uppsala, Sweden.
Göteborgs universitet, Göteborg, Sweden.
2017 (English)Report (Other academic)
Abstract [en]

In a research project – Practices of Frontline Interactions in the Swedish Social Insurance Agency (SSIA) – we are studying how goals and rules are shaped and handled in conversations between officials and clients. A central aim is to develop knowledge about what kind of room these officials have to develop policy in practice and how they make use of it. This is done by a multi-level research approach combining analyses on an institutional and interactional level (Bruhn & Ekström 2017). Data are collected via mixed methods: recorded interactions (official–client), qualitative interviews, and documents. In this paper, except for some minor changes identical with a paper originally presented at the 2nd Conference on Street-level Bureaucracy in Copenhagen 2017, we discuss officials’ room for and use of discretion when assessing work ability in investigations about sickness compensation (previously called sickness pension). To get sickness compensation the individual’s work ability must be permanently reduced (i.e. he/she shall not be able to take part in  working life anymore). Work (dis-)ability is a diffuse and contested concept. It is a core concept not only for officials here in focus, but for several other organisational actors in the field of labour market and health insurance issues as well. Many actors with different missions and interests are recurrently involved in negotiations about how to interpret and take actions on the basis of this concept. The diffuseness of the concept often puts the investigating official – the Street Level Bureaucrat – in a position of having quite lot of room to assess and affect the outcome of the investigations at hand. Internal SSIA statistics also point to quite wide variations in outcome of investigations between different units in the organisation. At the same time there is also internal pressure on the investigators to “keep figures down”. The magnitude of such pressure is related to changes in pressure upon the authorities on the political level. This leads to fluctuations between different fiscal years. Last year (2016), 70% of the applications for this benefit were rejected. This is an increase from earlier years, and a hint of a growing restrictiveness in assessments of what is seen as permanently reduced work ability. In this paper, we discuss the work ability concept in relation to the room for assessment – the discretion – of these sickness compensation investigating officials. It is based on earlier research, official documents, qualitative interviews and speech recordings.

Place, publisher, year, edition, pages
Örebro, Sweden: Örebro universitet , 2017. , p. 28
Series
Working Papers and Reports Social work ; 11
Keyword [en]
Frontline Bureaucrats, Professionalism, Work ability, Swedish Social Insurance Agency, Discretion
National Category
Social Work
Research subject
Social Work
Identifiers
URN: urn:nbn:se:oru:diva-63514OAI: oai:DiVA.org:oru-63514DiVA, id: diva2:1168575
Projects
Practices of Frontline Interactions in the Swedish Social Insurance Agency
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Note

Editors: Anders Bruhn and Åsa Källström

Available from: 2017-12-21 Created: 2017-12-21 Last updated: 2017-12-21Bibliographically approved

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