Prehab, Illness and repeated short-term absence
Preventive rehabilitation, prehab, is about preventing ill health and sick leave by paying attention to early signs of ill health and acting early as an employer.
Swedish Work Environment Authority provisions (AFS 2015:4) define an “unhealthy workload” as when the demands in the work more than temporarily exceed the resources. This imbalance becomes unhealthy if it is prolonged and the opportunities for rest and recovery are insufficient.
It is important that employees and supervisors can spot signals which may be a sign of ill health and need to be monitored, for example overtime, taking work home, skipping breaks or lunch, high work intensity over long periods, feelings of insufficiency or lack of motivation. Poor quality or late delivery of results, in addition to conflicts and difficulty cooperating also need to be monitored. Other signs of ill health include low mood, psychosomatic symptoms such as pain, sleeping difficulties and gastrointestinal upset. The underlying causes need not be work-related, however if a low mood impacts work, this needs to be followed up by a supervisor.
Short-term absence might also be a sign that something is not quite right. If an employee has been absent on six occasions or more during a 12-month period, an assessment must be conducted.
In the event of repeated short-term absences caused by specific medical conditions, the assessment might result in the employee being granted special high-risk protection from Försäkringskassan where they will be exempt from the qualifying days (waiting period). The employee can also receive compensation from Försäkringskassan for sick pay costs paid by the employer up to and including the 14th day of the period of sick leave. If the assessment finds that other actions need to be taken, occupational health services can help with rehabilitation.
Should there be special reason and for a maximum of 12 months, the employer may request a medical certificate from the first sick day, a “first day” certificate. Chapter 7, Section 3 of the Villkorsavtal, Villkorsavtal-T (delegated employment policy) states that an employer may require the employee to submit a medical certificate from the first day to each following sick period.
The employer may also request that the medical certificate be issued by a doctor appointed by the employer, preferably from occupational health services. A decision for a “first day certificate” must be negotiated in accordance with Section 11 of the Employment (Co-Determination in the Workplace) Act.
To clarify the different steps of charting suspected ill health or short-term absence, a process map has been created. Process map illness and repeated short-term absence
In Adato, you can document conversations and adaptations that are carried out with the aim of preventing ill health under the heading "prehab". Except for previous signs of ill health, notes in prehab can be written on repeated short-term absences and during sick leave before day 15.