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Sickness, Disability and Work: Breaking the Barriers

A Synthesis of Findings across OECD Countries

image of Sickness, Disability and Work: Breaking the Barriers

Too many workers leave the labour market permanently due to health problems or disability, and too few people with reduced work capacity manage to remain in employment. This is a social and economic tragedy common to virtually all OECD countries. It also raises an apparent paradox that needs explaining: Why is it that the average health status is improving, yet large numbers of people of working age are leaving the workforce to rely on long-term sickness and disability benefits?  

This report, the last in the OECD series Sickness, Disability and Work: Breaking the Barriers, synthesises the project’s findings and explores the possible factors behind the paradox described above. It highlights the roles of institutions and policies and concludes that higher expectations and better incentives for the main actors – workers, employers, doctors, public agencies and service providers – are crucial. Based on a review of good and bad practices across OECD countries, this report suggests a series of major reforms are needed to promote employment of people with health problems. 

The report examines a number of critical policy choices between: tightening inflows and raising outflows from disability benefit, and promoting job retention and new hiring of people with health problems. It questions the need for distinguishing unemployment and disability as two distinct contingencies, emphasises the need for a better evidence base, and underlines the challenges for policy implementation.  

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Key Trends and Outcomes in Sickness and Disability

What are the main challenges policy makers across the OECD will need to address in the future? This chapter highlights the key outcomes and trends in the field of sickness and disability during the past 10-15 years, focusing on four areas: labour market integration of people with disability and workers with reduced work capacity; financial resources of those people; costs of sickness and disability benefits schemes; and beneficiary dynamics. It concludes that despite reforms and good economic conditions until recently, employment, unemployment, income and poverty outcomes have not improved for people with disability. Disability benefits have become the main working-age benefit in most countries and their role as a benefit of last resort is still increasing in many cases. However, outcomes also suggest that policy can have a large influence on beneficiary developments: Several countries have recently seen a promising turnaround in beneficiary trends.

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