The report “Working on the WIA – towards a system that works again” advises, among other things, to no longer have social-medical assessments carried out exclusively by insurance physicians and to impose stricter conditions on requests for reassessments. It also advises abolishing the IVA benefit for new cases because the assessments are too complex and time-consuming.
The report is a civil service study conducted independently of politics by several ministries, UWV, CPB, and SCP. According to the report, the changes are necessary due to the rising WIA inflow, sharply increasing backlogs, and structural shortcomings in the system. These problems reinforce each other and lead to longer uncertainty for people and high social costs.
Rising inflow
Over the past ten years, sickness absence and inflow into the WIA have increased significantly again. Sickness absence is well above 5 percent – comparable to the beginning of this century. More than 60,000 people enter the WIA annually; around the introduction of the WIA, that was about 35,000. The chance that a worker ends up in the WIA is now twice as high as shortly after the introduction of the WIA in 2006. The number of people receiving a benefit for full and permanent disability (IVA) has increased from 20% to 40%. In total, 600,000 people now receive a WIA benefit. That is one in thirteen insured employees.
The increased inflow can partly be explained by older workers working longer. This is due to the retirement age being raised and fewer options for early retirement. In addition, the average age of the labor force has increased. Applications from people over 60 years old are also limitedly assessed.
More than 40% of WIA inflow is related to psychological disorders. It concerns more often young people and women. According to the IBO, this reflects a broader social development that also occurs in other countries.
Growing waiting lists
Without additional measures, the backlogs at UWV could rise to nearly 200,000 waiting in 2030. The average waiting time would then increase to about three years. This is socially unacceptable. This is due to the increasing inflow, the complicated assessment, and the shortage of insurance physicians. The expectation is that the number of insurance physicians will not increase in the coming years but rather decrease. As a result, waiting lists and waiting times will continue to grow.
Minimum basic package of measures
The IBO advises a basic package of measures to reduce pressure on implementation and improve quality, which a new cabinet must tackle. First, insurance physicians must be deployed more purposefully. Part of their work can and must be taken over by other professionals. Second, unnecessary reassessments must be prevented by asking employers or parties acting on their behalf to substantiate a request or to pay for a reassessment by UWV. Third, the separate benefit for people who are permanently fully disabled (the Income Provision for Fully Disabled Persons (IVA)) must be abolished. These people will then receive a WGA benefit, just like people who are less than 80% disabled. Insurance physicians must assess and substantiate whether someone can no longer work permanently when granting an IVA benefit. This is particularly complex and time-consuming. This will also reduce the number of reassessment requests and increase financial sustainability. Finally, efforts must be made on prevention and activation, for example through stronger supervision, increased support for reintegration from the WIA, and better support for employers in re-employing partially disabled persons.
Additional policy options and discouraged policies
The IBO has also identified 15 measures that politics can choose from. These involve adjustments within, but also outside, the system. For example, focusing centrally on work resumption. Or stopping the linking of the benefit to previous income and capping it at the minimum wage level. This would be a fundamental change to social security as we know it.
Finally, the IBO considers it unwise to reduce the obligation of continued payment of wages during illness for employers from two to one year: “This is one of the most powerful and successful policy measures to reduce sickness absence and subsequent disability,” the IBO cites the CPB. This measure also leads to significantly higher waiting lists, more inflow into the WIA, and higher costs. In addition, many people reintegrate in the second year with their employer, while it is much more difficult to return to work from a benefit.
