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Sickness, Disability and Work: Breaking the Barriers: A Synthesis of Findings across OECD Countries (Complete Edition ‐ ISBN 9789264088856)

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Too many workers leave the labour market permanently due to health problems or disability, and too few people with reduced work capacity manage to remain in employment. This is a social and economic tragedy common to virtually all OECD countries. It also raises an apparent paradox that needs explaining: Why is it that the average health status is improving, yet large numbers of people of working age are leaving the workforce to rely on long‐term sickness and disability benefits?  

This report, the last in the OECD series Sickness, Disability and Work: Breaking the Barriers, synthesises the project's findings and explores the possible factors behind the paradox described above. It highlights the roles of institutions and policies and concludes that higher expectations and better incentives for the main actors ‐ workers, employers, doctors, public agencies and service providers ‐ are crucial. Based on a review of good and bad practices across OECD countries, this report suggests a series of major reforms are needed to promote employment of people with health problems. 

The report examines a number of critical policy choices between: tightening inflows and raising outflows from disability benefit, and promoting job retention and new hiring of people with health problems. It questions the need for distinguishing unemployment and disability as two distinct contingencies, emphasises the need for a better evidence base, and underlines the challenges for policy implementation.  

Executive Summary and Policy Conclusions

Chapter 1 . The Economic Context for Disability Policy

‐1.1. The importance of workers with disability to the economy and society

‐1.2. Workers with disability face greater barriers in the labour market

‐1.3. Trends in disability benefit rates, the business cycle and population ageing

‐1.4. Conclusion

‐Annex 1.A1. Defining and Measuring Disability

‐Annex 1.A2. Additional Supporting Evidence

Chapter 2 . Key Trends and Outcomes in Sickness and Disability

‐2.1. Insufficient labour market integration of people with disability

‐2.2. Poor financial resources of people with disability

‐2.3. High costs of sickness and disability benefit schemes

‐2.4. Benefit system dynamics

‐2.5. Conclusion

‐Annex 2.A1. Additional Supporting Evidence

Chapter 3 . The Direction of Recent Disability Policy Reforms

‐3.1. Key reform trends across the OECD

‐3.2. Policies converge despite continuing differences

‐3.3. The effect of policy changes on disability benefit rolls

‐3.4. The political economy of reform

‐3.5. Conclusion

‐Annex 3.A1. OECD Disability Policy Typology: Classification of the Indicator Scores.

‐Annex 3.A2. OECD Disability Policy Typology: Country Scores Around 2007

Chapter 4 . Transforming Disability Benefits into an Employment Instrument

‐4.1. From disability assessment to work‐capacity assessment

‐4.2. Moving to an activation stance

‐4.3. Making work pay: reforming tax and benefit system

‐4.4. Conclusion

Document Type: Review Article

Publication date: 2010-11-01

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