Reincentivizing – a new theory of work and work absence

Hans O Thulesius,Birgitta E Grahn

doi:10.1186/1472-6963-7-100

Abstract

BackgroundWork capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave.MethodsWe used classic grounded theory for analyzing data from >130 interviews with people working or on sick leave, physicians, social security officers, and literature. Several hundreds of typed and handwritten memos were the basis for writing up the theory.ResultsIn this paper we present a theory of work incentives and how to deal with work absence. We suggest that work disability can be seen as hurt work drivers or people caught in mode traps. Work drivers are specified as work capacities + work incentives, monetary and non-monetary. Also, people can get trapped in certain modes of behavior through changed capacities or incentives, or by inertia. Different modes have different drivers and these can trap the individual from reincentivizing, ie from going back to work or go on working. Hurt drivers and mode traps are recognized by driver assessments done on several different levels. Mode driver calculations are done by the worker. Then follows employer, physician, and social insurance officer assessments. Also, driver assessments are done on the macro level by legislators and other stakeholders. Reincentivizing is done by different repair strategies for hurt work drivers such as body repair, self repair, work-place repair, rehumanizing, controlling sick leave insurance, and strengthening monetary work incentives. Combinations of these driver repair strategies also do release people from mode traps.ConclusionReincentivizing is about recognizing hurt work drivers and mode traps followed by repairing and releasing the same drivers and traps. Reincentivizing aims at explaining what is going on when work absence is dealt with and the theory may add to social psychological research on work and work absence, and possibly inform sick leave policies.

Highlights

Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior
Monetary compensation from social security limits the loss of buying power to 0– 20% after tax for people with low to average incomes on
A too soft and disincentivizing social security system was a central political issue leading to a shift in Swedish government in 2006

Summary

Introduction

Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. A too soft and disincentivizing social security system was a central political issue leading to a shift in Swedish government in 2006. In welfare states such as Sweden non-monetary work incentives such as plight and pride seem more important than in laissez-faire economies such as the USA [2,3], where monetary work incentives are stronger [4]. Swedish sick leave compensation is generous a sick leave trajectory often involves shame and distrust Against this background common disease concepts are inadequate to explain sick leave behavior since work capacity alone shows little correlation to disease severity [5,6,7]. Our aim was to generate an explanatory theory of work absence and sick leave and how to deal with it

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Conclusion