Could guidelines on duration of sick leave reduce unnecessary absences?

Differences in the applied criteria for the number of sick leave days attract ongoing attention in Finland, and, currently, possibilities for implementing official guidelines on estimating the need for sick leave are being scrutinised. Guidelines could offer doctors a practical tool in situations where evaluating an employee’s ability to work or required length of sick leave is challenging.

In consequence of the agreement between labour market parties about Finnish pension reform in 2017, possibilities for drafting and implementing guidelines on estimating the need for sick leave will be looked into. According to the Employment Contracts Act, an employee has the right to paid sick leave for a limited period of time if an illness or an accident prevents him or her from working.

It might be difficult to estimate whether an illness prevents an employee from working because the treatment requires absence from work duties. The estimation is even more difficult when diagnosis is based on subjective information received from a patient. As different duties and positions require varying work contribution and capacity for work, a doctor might face challenges when estimating the true impact of an illness or an injury on an employee’s ability to work. This estimation should not be based only on the diagnosis but instead should also take into consideration the following questions: Does the illness truly prevent the employee from working? Will working exacerbate the illness or injury? Is the employee able to work if work duties are adapted to his or her condition? Treating an injury or an illness does not always require absence from work and in some cases a long period of sick leave might even diminish an employee’s working capacity.

Sweden has implemented official guidelines on the duration of sick leave covering the most common illnesses and injuries. The Finnish Institute of Occupational Health has published these Swedish guidelines on their website, but, in consequence of the above-mentioned agreement, the possibilities for drafting and implementing similar national guidelines in Finland are being examined. The guidelines would be based on academic research and clinical experience regarding the average period of disability to work in relation to a certain illness or injury.

Official recommendations on the duration of sick leave could prove to be especially useful for a doctor who, having received insufficient information from his or her patient, is unable to estimate the effects an illness or injury will have on that patient’s ability to work. Sick leave lengths and treatment of patients would presumably become more consistent and equal if doctors had an opportunity to compare their sick leave duration estimation to an official recommendation. If a comparison indicates a substantial difference to the recommendation, it could be useful to evaluate whether or not a reasonable cause for the difference exists.

If the official guidelines are published, they will naturally only include nonbinding recommendations. The duration of sick leave would continue in the future to be determined after a doctor has assessed and examined each individual case. Official guidance on the matter could however be a helpful tool and might also improve the position of an employer if it decreases the number of cases where the length of sick leave is wholly unexpected. Any practical means to control the number of unnecessary and overlong sick leaves is undoubtedly welcome. According to the current information, the possibilities for drafting the guidelines will be examined by labour market organisations, the Social Insurance Institution and the Finnish Institute of Occupational Health by spring 2015.