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Effects of Caseworker Screening on Employment and Health: Quasi-Experimental Evidence from the Swedish Sickness Insurance Program

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Title: Effects of Caseworker Screening on Employment and Health: Quasi-Experimental Evidence from the Swedish Sickness Insurance Program
Language: English
Authors: Pathric Hägglund, Per Johansson (ORCID 0000-0001-6140-9123), Kristian Persson
Source: Evaluation Review. 2026 50(1):30-54.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 25
Publication Date: 2026
Document Type: Journal Articles
Reports - Evaluative
Descriptors: Foreign Countries, Health Services, Health Insurance, Caseworkers, Caseworker Approach, Deception, Leaves of Absence, Review (Reexamination), Role
Geographic Terms: Sweden
DOI: 10.1177/0193841X251358288
ISSN: 0193-841X
1552-3926
Abstract: This paper analyzes the effects of caseworker screening of doctors' medical sick-leave certificates. The analysis uses data from people appealing caseworkers' denial of their benefit claims. Caseworkers at four units made decisions on the appeals. The distribution of the cases to the four units was based on the appealing person's birth date. One of the units was much stricter than the others (7.8% approved in contrast to 16.1% for the others). This allows us to use birth date as an instrument to estimate the effects of being denied sickness benefits. We find that the denial of sickness benefits, on average, has (i) positive effects on the labor-market outcomes and (ii) no negative effects on health outcomes. As the more liberal units deny sickness benefits for most screened medical certificates, we conclude that caseworker screening is very important in separating meritorious from non-meritorious claims. Doctors' conflicting roles make it difficult for them to act in the best of interest of both their patients and society.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1491894
Database: ERIC
FullText Text:
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  Data: Effects of Caseworker Screening on Employment and Health: Quasi-Experimental Evidence from the Swedish Sickness Insurance Program
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  Data: English
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  Data: <searchLink fieldCode="AR" term="%22Pathric+Hägglund%22">Pathric Hägglund</searchLink><br /><searchLink fieldCode="AR" term="%22Per+Johansson%22">Per Johansson</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6140-9123">0000-0001-6140-9123</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kristian+Persson%22">Kristian Persson</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Evaluation+Review%22"><i>Evaluation Review</i></searchLink>. 2026 50(1):30-54.
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  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
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  Data: 25
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  Data: Journal Articles<br />Reports - Evaluative
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  Data: <searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Services%22">Health Services</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Insurance%22">Health Insurance</searchLink><br /><searchLink fieldCode="DE" term="%22Caseworkers%22">Caseworkers</searchLink><br /><searchLink fieldCode="DE" term="%22Caseworker+Approach%22">Caseworker Approach</searchLink><br /><searchLink fieldCode="DE" term="%22Deception%22">Deception</searchLink><br /><searchLink fieldCode="DE" term="%22Leaves+of+Absence%22">Leaves of Absence</searchLink><br /><searchLink fieldCode="DE" term="%22Review+%28Reexamination%29%22">Review (Reexamination)</searchLink><br /><searchLink fieldCode="DE" term="%22Role%22">Role</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Sweden%22">Sweden</searchLink>
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  Data: 10.1177/0193841X251358288
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  Data: 0193-841X<br />1552-3926
– Name: Abstract
  Label: Abstract
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  Data: This paper analyzes the effects of caseworker screening of doctors' medical sick-leave certificates. The analysis uses data from people appealing caseworkers' denial of their benefit claims. Caseworkers at four units made decisions on the appeals. The distribution of the cases to the four units was based on the appealing person's birth date. One of the units was much stricter than the others (7.8% approved in contrast to 16.1% for the others). This allows us to use birth date as an instrument to estimate the effects of being denied sickness benefits. We find that the denial of sickness benefits, on average, has (i) positive effects on the labor-market outcomes and (ii) no negative effects on health outcomes. As the more liberal units deny sickness benefits for most screened medical certificates, we conclude that caseworker screening is very important in separating meritorious from non-meritorious claims. Doctors' conflicting roles make it difficult for them to act in the best of interest of both their patients and society.
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  Data: 2026
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  Data: EJ1491894
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        Value: 10.1177/0193841X251358288
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 25
        StartPage: 30
    Subjects:
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Health Services
        Type: general
      – SubjectFull: Health Insurance
        Type: general
      – SubjectFull: Caseworkers
        Type: general
      – SubjectFull: Caseworker Approach
        Type: general
      – SubjectFull: Deception
        Type: general
      – SubjectFull: Leaves of Absence
        Type: general
      – SubjectFull: Review (Reexamination)
        Type: general
      – SubjectFull: Role
        Type: general
      – SubjectFull: Sweden
        Type: general
    Titles:
      – TitleFull: Effects of Caseworker Screening on Employment and Health: Quasi-Experimental Evidence from the Swedish Sickness Insurance Program
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            NameFull: Pathric Hägglund
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            NameFull: Per Johansson
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            NameFull: Kristian Persson
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              M: 02
              Type: published
              Y: 2026
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              Value: 0193-841X
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              Value: 1552-3926
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              Value: 50
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            – TitleFull: Evaluation Review
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