Karolinska Institutet is liable as an employer to provide organised work adjustment and rehabilitation services. The aim of rehabilitation is to restore the best possible functional capacity − given the demands and possibilities of the operation − to an employee who has a reduced physical or mental capacity.
As a support for rehabilitation work at Karolinska Institutet the HR department has developed a five-step procedure that describes the rehabilitation process.
It is important to identify early indications of illness in order to prevent the need for sick leave and rehabilitation. Experience shows that prospects for a good outcome increase when rehabilitation is initiated at an early stage.
Early signs can be identified in regular contact with managers and co-workers, appraisal interviews, staff meetings, KI's rehabilitation network, contacts with health promotion services, Previa occupational health services and through preventive work in the working environment.
Some examples of early indications of illness in a co-worker include:
- change in behavior, poorer relations in the group
- pattern of short-term absences, often away on Friday through Monday
- signs of abuse
- withdraws, talks less and does not participate in coffee breaks
- less interest in work, poorer order and quality
It is important to maintain contact with an employee on sick leave, since rehabilitation can be easier to implement if there is a functioning dialogue.
Karolinska Institutet invests in a number of measures to make KI a healthy and attractive workplace, to improve the working environment and to reduce absence due to sickness. One project is the Satsa Friskt (Go healthy) project with a primary goal to improve the working environment and lower the rate of absence due to sickness.
There are four sub-projects:
- Career forum
- Overcome stress
- Physical activity on prescription (FaR)
- Health and design (Breathing space)
These sub-projects are now included in regular KI activities.
Other regular projects
- Karolinska Institutet has implemented a major employee survey to investigate, follow up and improve the work environment at KI.
- Investments are also continuously being made in leadership development at KI.
- KI Health Promotion works very actively with a variety of activities, events/campaigns, seminars, lectures etcetera aimed to improve health. There are also several fitness facilities at KI.
- Health Promotion representatives spread information on KI fitness programs and promote health issues and projects intended to make KI healthier place to work and study. There are some 90 health promotion representatives at KI.
- KI also takes a number of preventive measures with regard to the physical working environment.
Rehabilitation must always be planned when rehabilitation measures may improve the situation for an employee. A rehabilitation plan covers the measures and support needed in order for an employee to function in the best possible way or return to his/her regular work or other tasks.
An employee's own assessment of his/her situation, information from the responsible manager, a physicians' assessment and that of the Swedish Social Insurance Agency (Försäkringskassan) are the most important bases for a rehabilitation plan. It is important that rehabilitation is initiated as soon as possible to secure a good outcome. In most cases it is the employee's own workplace that has the best prerequisites for success with rehabilitation.
Who is responsible?
As an employer KI is responsible for rehabilitation and work adjustment measures stipulated by the Work Environment Act (Chap. 3, Sections 2 and 3), i.e. KI is obliged to take measures. It is recommended that responsibility for the work environment with regard to rehabilitation is delegated to the immediate manager at KI.
The Swedish Social Insurance Agency is responsible for taking the initiative to plan rehabilitation, although KI's guidelines state that KI is to follow up and expedite rehabilitation planning on the basis of criteria stipulated below. The Swedish Social Insurance Agency can also subsidize work aids and transport.
It is the responsibility of the employee to submit information needed to map needs, be involved in the planning of suitable rehabilitation and actively participate in rehabilitation to the best of one's ability.
When should rehabilitation be implemented?
According to the rehabilitation guidelines at KI the manager in charge is to maintain early and continuous contact with an employee who is on sick leave. The manager in charge must also plan for rehabilitation when an employee:
- has been away for more than four weeks (preferably already after two weeks) due to illness,
- has been sick six or more times during the most recent 12-month period,
- has requested it, or
- the employer requires it for special reasons.
What should a rehabilitation plan contain?
The rehabilitation plan should include:
- the reason for reduced work capacity (physician's certification)
- need for rehabilitation and adjustment
- measures needed to bring about return and adjustment to the work situation,
- who is responsible, measures, schedule of planned rehabilitation measures
- clear follow up of measures taken and the outcome in order to obtain a clear basis for assessment
How is rehabilitation to take place?
As the employer KI is responsible for mapping needs together with the employee and making any possible workplace adjustments that can facilitate a positive return to work. This may involve:
- adjustments in workload, workplace, tasks and/or work hours.
- practice work with regular tasks or new ones
- competence development, coaching/career development support
- training/change in lifestyle through various forms of fitness promotion or Previa
- transfer (obligation to create new work)
- other job on the regular labour market.
Where is rehabilitation planning done?
Rehabilitation planning is done preferably with the support of Previa or KI's rehabilitation network which includes appointed representatives from the Swedish Social Insurance Agency, Previa, health promotion and the HR department.
KI cooperates early in rehabilitation unless it is obvious that early rehabilitation planning is not necessary to affect an earlier return. The administrative manager and HR administrator should always be informed.
Solution within the department
During the first 90 days of sick leave the Social Insurance Agency reviews the capacity of the person on sick leave to handle his/her regular work or other suitable work which the employer can temporarily offer the insured party.
For KI this means that the manager in charge in the department/equivalent is to assess whether or not an employee can fully or to some extent handle his/her regular work. If this does not work the manager in charge must investigate the possibility for the employee to do something else, entirely or in part, temporarily or permanently, that needs to be done within the group/unit/department. It is important that everything that is done for rehabilitation purposes is documented in writing. If this is not possible then the department must contact the central HR department no later than by the 90th day of sick leave for further handling of the case.
It is important that rehabilitation planning is initiated early, preferably after two weeks of sick leave, and no later than after four weeks. It is recommended that the department/equivalent receives assistance from the rehabilitation network at KI or Previa.
Adjustments and work practice may be necessary at the time of this review by the department. Read more about adjustments and work practice under Rehabilitation planning. The employer is not required to generate new work tasks.
Solution within KI
As of the 91st day of sick leave the Social Insurance Agency extends the review of one's right to sickness benefits to include the possibility of doing some other available work for the employer.
For KI this means that with support from the HR department, the department investigates the possibility to transfer the employee to another open position elsewhere within Karolinska Institutet. The department remains responsible for the employee until a possible solution has been found.
It is very important that this investigation of the possibility to transfer to another job anywhere within KI is begun as early as possible.
KI drafts a document, a so-called "Employer statement", on the possibility for the person on sick leave to take on another job within the public authority, at the request of the employee. The employee sends this document to the Swedish Social Insurance Agency.
If there is a risk that the insured person will not be able to return to work with the employer before the fixed time limit of 180 days then the person on sick leave should be offered support through the Swedish Public Employment Service. Up until the 180th day of sick leave the person on sick leave can seek a new job with the help of the Swedish Public Employment Service, while maintaining his/her eligibility for sick pay. Karolinska Institutet/department remains responsible for the person on sick leave at this stage.
An employee is entitled to a leave of absence from his/her job in order to try out another job. A condition for this is that the employee has had a reduced work capacity due to sickness for a period of at least 90 days and is covered by an agreement with another employer after 180 days into the period of sick leave. The employee may be on a leave of absence for a maximum of 12 months including the above-mentioned sick leave period.
Solution outside of KI
As of the 181st day of a sick leave period an assessment is to be made – unless there are particular reasons not to – of whether or not the insured person can do work on the regular labour market outside of KI or another suitable job that is available. If the Swedish Social Insurance Agency determines that the insured party can handle another job on the regular labour market, sick pay will be suspended.
The trial on the regular labour market can be postponed if need be for particular reason. This should be done if it is highly probable that the insured person can return to work for his/her current employer after further treatment or rehabilitation.
Various adjustment/career development efforts directed toward a solution outside of KI may be necessary.
If sickness allowance is not granted
Current labour legislation is applicable if the Social Insurance Agency does not grant sick pay and the person cannot return to work with his/her employer. Contact the HR department for further information.
Extended sick pay after 364 days
Extended sick pay (beyond 364 days) may be granted by the Social Insurance Agency for particular reasons for a maximum of 550 days upon application by the insured. When sick pay is extended, the person on sick leave must be assessed during this period as capable of returning to work and a very clear plan must be drafted for return to work.
This means that the employee may still be able to return to work at KI and that active rehabilitation work is carried out by the employer.
In som exceptions, the sickness benefit can be extended again after approved application after 914 days, this is known as the extended sickness benefit. There are no time limits in these cases.
Continued sickness pay after day 364
For particular reasons, given serious illness, further sick pay may be granted. If continued sick pay is granted there is no set time limit.