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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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Transforming Disability Benefits into an Employment Instrument

This chapter addresses the key challenges and recent developments in changing the current disability benefit schemes, which are still too passive in nature, into employment-promoting policy tools. Key elements in the transformation process are a new way of assessing work capacity implemented, thus, benefit eligibility; a new activation and mutual-obligations stance applied at the application phase; a stronger focus on reassessments of benefit eligibility and work capacity of current or long-term benefit recipients; and improved work incentives to make sure work always pays. The chapter concludes that what is needed is to bring the disability benefit scheme closer in all its aspects to existing unemployment benefit schemes and questions the need for distinguishing unemployment and disability as two distinct contingencies.

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