New attempts to cut the number of occupationally disabled people

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The Netherlands still has a very high number of occupationally disabled people and in mid-1999, the state secretary of social affairs and employment launched new plans to reduce the level. The social partners have generally reacted in favour.

A recent surge in the number of occupationally disabled people in the Netherlands, from 880,000 at the start of 1998 to 897,000 at the end of 1998, brought issues surrounding sickness and occupational disability back to the top of the political agenda (NL9904133F). Compared with neighbouring countries, the level of occupationally disabled people in the Netherlands remains disproportionately high. Several different proposals circulated in early 1999 to reduce this level (NL9902124F), but disharmony among cabinet, employers and employees stymied progress in defining a course of action. However, the parties involved unanimously concluded that the degree of reintegration during the first year of an employee's sickness still falls short of the mark, despite the fact that chances of reintegration are highest during this period. A longer waiting period before reintegration translates into increased difficulty in successfully getting an employee back to work. Over recent years, numerous changes have been implemented in the reintegration scheme to stimulate resuming work within the first year of illness.

Changes to the reintegration scheme

As a result of the "privatisation" of the Sickness Benefits Act, based on the Act Extending Compulsory Wage Payment During Sickness (Wet uitbreiding loondoorbetalingsplicht bij ziekte, WULBZ) which came into effect on 1 March 1996 (NL9804171F), employers - rather than public funds - are required to pay sick employees a minimum of 70% of their most recent salary during the first year of illness, and no less than the minimum wage thereafter. In 80% of the cases, however, employees continue to receive their full salary during sickness on the basis of collective agreements or similar arrangements. Sickness Benefits Act privatisation has led to employers taking over primary responsibility from social security providers for prevention and reintegration during the first year of illness. Employers are required to utilise support from a private health and safety service specialising in working conditions, prevention, guidance and supervising employee sickness and reinstatement.

The role of the institutions administering social security benefits (uitvoeringsinstellingen, UVIs), which were initially responsible for prevention and reintegration during the first year of sickness (NL9807188F), shrunk somewhat as of 1 March 1999. This is not to say that their role has disappeared altogether; the UVIs serve as "gatekeepers", preventing unnecessary appeals based on the Occupational Disability Insurance (WAO) Act resulting from employer refusal seriously to accept their reintegration duty in the first year of illness.

As laid down by legislation, the gatekeeper function first requires sick employees to report to the UVI after 13 weeks of illness. A penalty will be imposed on employers failing to ensure that this takes place. Next, employers must at least submit a reintegration plan to the UVI for each reported illness. The plan must state whether the employee is expected to return to work and, if so, it must include the estimated date of return, along with anticipated reintegration measures. The UVI will test out the plan and investigate the validity of an employer's claims that an employee cannot return to the company. If the UVI reaches the same conclusion, it takes over reintegration duties from the employer. Should employers fail to submit a reintegration plan, fail to comply in a timely manner or submit an inadequate plan, the UVI may impose a fine totalling thousands of guilders. Additionally, the UVI may draft a reintegration plan at the cost of the employer, which will be held responsible for its implementation. Finally, the UVI has the power to impose sanctions if the employer, without well-founded reasons, fails to reintegrate an employee within a year despite having appropriate opportunities. In that case, the UVI may hold the employer liable for an amount equal to the salary that could have been earned if suitable employment had been found, augmented by the employer's social security contributions.

In 1997, one year after implementation of the WULBZ, the state secretary of social affairs and employment concluded that the gatekeeper model functioned insufficiently: in some cases, reintegration plans were not submitted or often proved to offer little meaningful content behind a formal facade. UVIs were swamped by reintegration plans and had little or no opportunity to read them and perform checks, let alone react in a timely manner. Moreover, the UVIs did not impose penalties on employers failing to comply with the established regulations.

As a result, 1 September 1997 marked the introduction of several changes to the gatekeeper model. When findings show that a large percentage of 13-week periods of illnesses conclude with employees returning to work without any major problems, the requirement for employers to submit a complete reintegration plan is deemed unnecessary, as long as employers and the UVI expect the employee to return well in advance of one year. In such cases, a summary report suffices. This so-called "interim reintegration plan" includes the presumed date of resumption of work. If reintegration back into the company is unfeasible or doubtful, the employer must submit a complete plan by the 13th week.

Social Insurance Supervisory Board research conducted in 1998 and 1999 indicated that the 1997 policy adaptation did not achieve the intended results. In practice, the interim reintegration plan is nothing more than a sickness report with a return-to-work prognosis, providing no basis for the UVI to test whether employers take their role in reintegration seriously. The definitive plan required once employers and the UVI see absolutely no possibilities for reintegration is often submitted at the end of the first year of sickness and frequently contains little more than the declaration that reintegration in the company is considered impossible. At the end of the year, UVI involvement is often minimal, according to the board's study. Employer reports receive no follow-up, and no investigations are made into the possibility of issuing sanctions.

Disappointing results inspire new measures

On 28 May 1999, prompted by the disappointing results of the 1997 adaptations to policy, the state secretary announced new changes to the gatekeeper model. The overhauled model replaces the obligation to submit an interim reintegration plan after 13 weeks with a requirement that employers report employee illnesses to the UVI after six weeks, after which time the UVI sends a letter emphasising the employer's role in reintegration and the accompanying sanctions. The letter also explains that the employer and health and safety service are entitled to free reintegration advice from the UVI in cases where problems are anticipated. If employee illness is not reported in a timely manner, or if no advice is sought when there is reason to do so, sanctions may be imposed at the end of the year, on the grounds of the employer's lack of commitment. Another adaptation to the model is the right extended to employees to request advice if they believe that their employer is not assisting in reinstatement. Additionally, the state secretary reported a need to improve cooperation between the UVI and the health and safety service.

In July 1999, the Labour Foundation (Stichting van de Arbeid, STAR), a bipartite consultative body for national employers' and employees' organisations, reacted enthusiastically to the basic ideas underlying the proposed changes.

Commentary

It remains to be seen whether the new gatekeeper model will significantly facilitate reintegration during the first sick year. Based on consecutive August reports by the Social Insurance Supervisory Board (1997-9), UVIs are in no shape to perform adequately their gatekeeper duties. The real issue seems to be the lack of UVI personnel and resources, not the dysfunctional design of the gatekeeper model.

Another stumbling block is how to foster cooperation between the UVIs and the health and safety services, given the fact that UVI gatekeeper duties include checking up on the latter and holding them (along with employers) liable in the event the reintegration system breaks down.

All in all, the high number of occupationally disabled people will remain one of the key problems for some time, both for the Dutch economy and the social partners. In October 1999, the unions have expressed fear that they will be completely removed from the implementation of the social security system. (Pieter Fluit, HSI)