Proposals on joint administration of supplementary work injury insurance

Sweden's rules are to become clearer as to what is to be considered a work-related injury and, as such, covered by work injury insurance. For example, the law will state clearly that psychological injuries caused by harassment and violations of health and safety rules can be work related. These are among the likely outcomes of a report by a government commission in March 1998. The report also discusses an alternative, whereby the labour market organisations should assume responsibility for administering work injury insurance. However, many trade unions and employers' organisations are sceptical about this idea.

The Swedish work injury insurance system, which covers both accidents and illnesses caused by work, was last changed in 1993. More stringent rules of cause and effect made it much more difficult for certain kinds of illnesses to be accepted as work-related. For example musculo-skeletal disorders, normally considered to be caused by repetitive strain and heavy loads, were no longer recognised as work-related injuries. The reason for the change of policy was that it was considered to be difficult to decide if the inability to work was related to working conditions or was a consequence of normal ageing or the natural development of an illness.

Therefore, in order for an injury to be recognised as a work injury, two conditions must be fulfilled: first, there must be a high degree of probability that a certain factor in the work environment can lead to the injury; and secondly, there must be overwhelming evidence that the injury in the individual case is caused by this factor.

In addition, the special benefit which guaranteed workers 100% of their wages during periods of absence caused by work injuries was discontinued in 1993. Instead, an injured worker who is off work for a temporary period now receives only normal sickness benefit or rehabilitation benefit, which are both lower than the pay the injured worker would have received had he or she remained at work. Where the injury leads to a permanent reduction of the ability to work, the worker receives a life annuity.

Fewer cases

After the change in 1993, the number of reported injuries has been drastically reduced. In the 1980s the case load was as high as 250,000 a year; a decade later the figure had been reduced to 108,000. The number of work injury cases recognised by the health insurance administration has been reduced even further. In 1992, some 67,000 injuries were recognised and compensated for; five years later only 7,300 injuries were deemed to be work related.

A growing number of people believe that the present system of work injury insurance fails to give adequate protection. This was the reason for the appointment of a commission of 15 experts from ministries, authorities and organisations to investigate the situation and recommend changes in the insurance administration. The commission, which presented its report in March 1998, made the following proposals:

• the burden of proof - the obligation for the worker to prove his or her case - should not be modified, but the law should be elucidated so that it is made clear that injuries caused by harassment and violations of health and safety rules could be recognised as work injuries.;

• the work injury insurance system should be extended to cover all students in vocational training or university colleges;

• the administration of the insurance system should also be improved by concentrating work injury cases in a selected small number of health insurance offices, which would thereby be able to maintain and develop their competence;

• as work injury cases are often very complicated, the health insurance offices should receive extra financial resources for the improvement of their competencies; and

• specialists and experts in occupational medicine should be consulted more frequently than is now the case.

Scepticism on a jointly-run insurance system

The commission also had the task of considering an alternative form of administration of insurance, where employers and trade unions would jointly assume organisational and financial responsibility for a compulsory supplementary work injury insurance scheme. This would mean that the insurance costs would be more clearly seen as a production cost.

If such an alternative were to be introduced, the commission states, the employer's duty to insure employees would have to be regulated by law along with the basic insurance conditions. Although there are no obvious major obstacles for creating such a model both, the Swedish Confederation for Professional Employees (Tjänstemännens Centralorganisation, TCO) and the blue-collar Swedish Trade Union Confederation (Landsorganisationen, LO) have viewed the proposal with scepticism. The Swedish Confederation for Professional Associations (Sveriges Akademikers Centralorganisation, SACO), on the other hand, is positive to the idea. "SACO has for some time suggested that a compulsory work injury insurance is a clear alternative to the present public insurance. It would provide a more direct and transparent administration and increase the employers' interest in preventing work injuries from occurring at all," says the SACO director Anders Lönnberg.

The employers, however, do not like the idea of assuming responsibility for administering the insurance system jointly with the unions. They dislike the idea of a dual construction - ie that the injured person should first receive compensation through the public health insurance administration and then a supplement from a joint compulsory insurance. "This would reduce the incentive to prevent accidents. We would also prefer a pure work accident insurance. If work illnesses are included, today's employers could be forced to pay for damages inflicted earlier," says Alf Eckerhall, one of the representatives of the Swedish Employers' Confederation (Svenska Arbetsgivareföreningen, SAF) on the commission.

If the parties are given the responsibility for work injury insurance, this would also mean that they would be forced by law to conclude collective agreements, which is an interference in the freedom of collective bargaining, say Margareta Sjöberg of SAF and Jan Svensson of the Federation of Swedish County Councils (Landstingsförbundet) in a joint statement added to the report.

TCO feels, like SACO, that the commission's report is a step in the right direction. However, like LO, it criticises the fact that the report omits to recommend any change in the worker's burden of proof. The unions are also pressing for the special work injury benefit to be reintroduced. The basic principle, they say, should be that the injured worker should not suffer financially as a result of his or her injury.

The report will now be sent out to all concerned for comment. A government bill is to be expected by autumn 1998 at the earliest.

Commentary

Injuries caused by repetitive strain and heavy loads are by far the most common injuries affecting men and women today. The heaviest criticism against the present insurance concerns the fact that it is difficult for injuries of this kind to be recognised as work injuries. Even if the handling of cases in the health insurance offices is improved, the proposals of the commission will probably not lead to these injuries becoming recognised as work related to any greater extent than at present.

It is also fair to say that the Government is unlikely to propose that trade unions and employers' organisations should assume responsibility for the administration of a compulsory work injury insurance system. There is too much scepticism towards the idea both among trade unions and employers. (Lena Sköld, NIWL)