Sjukskrivningssystemet - Sjuka som blir arbetslösa och arbetslösa som blir sjukskrivna

Sammanfattning: In 1997 the number of long-term absences due to illness began and continued to rise in Sweden. Traditional explanations of why this is so have been centered on either blaming the individual or blaming the work environment. By focusing on long-term illness of the unemployed, this dissertation suggests that there is a growing residual unemployment within advanced welfare states. The main question this dissertation poses is: “Why are the unemployed in increasing numbers filing for long-term illness benefits and what is preventing them from finding a job and returning to work?” This central question has led to two other questions; “How do street level bureaucrats at the employment agency and the social insurance agency carry out their work to return the unemployed ill back to work?” and; “How do the unemployed ill convey their intention of returning to work?” The main question and the two sub-questions are linked by the simple fact that those that are unemployed and long-term ill stay on sick leave for longer durations than their employed counterparts with similar illnesses. The analytical approach is inspired by phenomenology and ethnomethodology. Focus is on both understanding the street level administrators work and the experienced situation of the unemployed ill. The empirical basis of the dissertation is a combination of observational fieldwork and interviews. Observations were carried out on the day to day working of a coordinated project between the social insurance agency and the employment agency, including observing both administrative meetings between the organizations as well as observing the administrators meetings with the unemployed ill. Interviews were completed with nine unemployed ill individuals. The conclusion is reached through a method of elimination of possible answers to the main question of the dissertation. The author first analyzes and eliminates the meso-level of behavior as the most determining explanation, because the project’s additional resources and methods are still inadequate as administrators are unable to create jobs that are not subsidized through financial support provided by the state. The micro-level of behavior is also eliminated, because it shows that failure to return to work cannot be found in a lack of individual motivation. The conclusion is that the labor market regulates the concept of work ability and that the state adjusts to this definition. State agencies, in their turn, influence the individuals definition of him/her self. The author argues that the primary question of why the proportion of the unemployed who are long-term ill is increasing and what is hindering their return to work, has to be answered at the macro-level of societal change.