Abstract
BackgroundThe decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance.MethodsA study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression.ResultsThe rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence.ConclusionsThere is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.
Highlights
The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts
This process is likely to be a substantial strain on the persons involved [1], and the length of the rehabilitation is likely to reflect the anticipated effect of the process, as well as the attitudes and the capacity of the local employment and welfare office
Each employment and welfare office can exercise discretion in their decisions in the rehabilitation process. This discretion may lead to variations in the rehabilitation process between municipalities, where the employment and welfare offices put more effort in finding and providing more opportunities for rehabilitation for people with better prospects in the labour market, and where disability pensions are given sooner when labour market prospects indicates that a return to work is less likely
Summary
The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. Each employment and welfare office can exercise discretion in their decisions in the rehabilitation process This discretion may lead to variations in the rehabilitation process between municipalities, where the employment and welfare offices put more effort in finding and providing more opportunities for rehabilitation for people with better prospects in the labour market, and where disability pensions are given sooner when labour market prospects indicates that a return to work is less likely. Another factor that may differ between municipalities is the quality of the healthcare and the medical rehabilitation for people who have temporarily left the labour market because of health problems
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