Insurance Medicine Disability and Social Security in the Netherlands Prof. Haije Wind, MD, PhD insurance physician October 2013 Research Center for Insurance Medicine of Occupational Health Academic Medical Center, Amsterdam
Program Social security in the Netherlands Insurance physicians Research center of Insurance Medicine
The Netherlands The Netherlands the Gateway to Europe. Geographically small 134th position in the world. Densely populated country with 16.7 million people 61th position worldwide About 30% of the Netherlands' GDP derived from activities beyond its borders. Strategic central location 160 million consumers Capital: Amsterdam Currency: Euro ( ) North-South 321.9 km West-East 160.9 km Area: 33,800 km² Population: 16.7 million (half of the EU) within a 482.8 km radius.
Amsterdam
of Occupational Health Samuel Coronel : (Sr) (1827-1892) ± 70 colleagues Head of the Department: Prof. dr. Monique H.W. Frings-Dresen Research Center for Insurance Medicine (AMC-UWV-VUmc-UMCG) Netherlands Center for Occupational Diseases People and Work Outpatient Clinic Expertise Center for Pre-employment Medical Examinations and Worker s Health Surveillance Research on the relation between illness and work
Agenda UWV: Institute for employees benefit schemes Overview of social security in the Netherlands Developments in disability volumes Assessment of disability
UWV - Locations & workforce UWV has offices throughout the Netherlands 11 districts 17 combined front and back-offices 10 separate front-offices 80 Public Employment Service locations 3 Client contact (call) centres Head office in Amsterdam Workforce 2012: 20,360 employees 7
Scope of the UWV organisation Disability Schemes Sickness Benefits Act: short term disability Work and Income according to Labour Capacity Act (WIA): long term disability Disablement Assistance Act for Handicapped Young Persons (WAJONG): minimum benefit for young handicapped persons Unemployment Unemployment Insurance Act (WW): unemployment 8
Development of Social security in the Netherlands Act on accidents 1901/1921 1967 act on invalidity 1919 1967 WAO I: the synthesis 1967 1976 WAO II: 1976 2005 WIA: > 2005 9
Social Security Social Insurance - General Insurance - Workers Insurance Social Provisions
Population by age 4% 12% 23% 6% 14% 0-20 20-50 50-60 60-65 65-80 Older than 80 41% Statistics Netherlands, 2011. Population by age (2011)
High productivity per hour Luxembourg Norway United States Netherlands Belgium France Germany Ireland Austria Australia 0 10 20 30 40 50 60 70 80 90 The Conference Board and Groningen Growth and Development Centre, 2012. GDP per hour in US dollars (2011)
High labour participation rate Switserland Netherlands Sweden Danmark Germany Austria United Kingdom Finland United States Euro area OECD, 2012. 0 10 20 30 40 50 60 70 80 90 Ratio of total employment to the population of working age (2011)
Many part-time employees Netherlands Ireland United Kingdom Germany Denmark Austria Belgium Sweden France United States 0 5 10 15 20 25 30 35 40 OECD, 2011. Part-time work as a percentage of employment as a whole
Low unemployment Netherlands Austria Luxembourg Denmark United Kingdom United States Italy Sweden Finland Belgium 0 1 2 3 4 5 6 7 8 OECD, 2011. Average unemployment 2006-2010, as a percentage of the working population
Development of long term disability
Long term disability international
Participation in labor in europe of persons 20-65 year with and without chronic disease
Change of legislation on disability in the Netherlands From compensation to participation 19
1990: Ruud Lubbers, minister president: the Netherlands are sick Sick leave : > 8% > 900,000 persons on a disability pension
Sickness Benefits Act Continued wage payment by employer * 1996: 6 weeks for large enterprises and 3 weeks for small ones * 1998: 52 weeks * 2004: 104 weeks Benefit at least 70% of salary Incentive for employers and employees to combat sick leave 21
Sickness Benefits Act as Safety Net * Employees who lost their job during continued wage payment * Temporary workers working for employment agencies Employees whose employer goes bankrupt * Unemployed workers * Sickness during first 5 years of employees hired while on disability benefit Administration by UWV 22
Improved Gatekeeper s Act * Act to increase pressure on employer and employee, Act of April 1st 2002 * Offering proof to UWV that sufficient rehabilitation activities have taken place * Obligation to report progress to UWV If not, long-term benefit will be denied * Prolonged period of continued wage payment, up to one year max 23
Effect/Effekt New legislation: more effort by employers and employees, supported by occupational physicians, led to a considerable lowering of the number of disabled workers Ny lagstiftning: mer ansträngning av arbetsgivare och arbetstagare, med stöd av företagsläkare, lett till en avsevärd sänkning av antalet arbetstagare med funktionshinder
Results: strong decrease inflow Inflow long term disability benefits 2001 2002 2003 2004 2005* 2006 2007 2008 WAO 103.9000 92.300 66.300 59.200 19.900 11.000 11.700 8.300 WIA - - - - - 21.000 22.200 23.900 Total 103.900 92.300 66.300 59.200 19.900 32.000 33.900 32.200 % Risk 1.55% 1.34% 0.95% 0.85% 0.29% 0.46% 0.50% 0.47% 2005: because of the extension of the waiting period before a disability pension can be awarded, no new applications during this year 25
Characteristics of long term disability in the Netherlands No separate insurance for accidents and occupational disease Partial disability is also covered Earning capacity in stead of working capacity No reference period Most comprehensive dismissal
Main categories of medical diagnoses for disability benefits in 2010 Mental disorders 31% Musculoskeletal disorders 26% Nervous system 9% Cardiovascular 9% Urogenital 5% Airways 4% Digestive system 4% Other diagnoses 12%
Questions?