The Role of Earnings-related Social Insurance in Permanent Disability Risk Management

Research output: Book/ReportDoctoral thesisCollection of Articles


Work disability is a major social problem that causes a welfare loss for individual workers, employers, and the whole of society. Thus, disability risk management has gained increasing attention in recent years, and statistics show that the number of disability pensions has fallen sharply in this millennium in Finland. Despite the good development, serious problems remain, since the number of disability pensions among those under 40 has remained nearly unchanged. Reducing permanent disability to work among the younger age groups is a challenge for the future, in which workplaces, occupational health care, and social insurance have important roles to play.

Previous studies have identified a significant number of socio-demographic, medical, economic, and psychological factors that affect the probability of returning to work once the risk of disability has materialized. However, less research has addressed the role of social insurance and the impact of insurers' actions on the successful return to work (RTW). This dissertation contributes to this research gap.

Social insurance has traditionally been seen as a passive scheme limited to financial compensation for the losses incurred. However, both workers’ compensation insurers and earnings-related pension insurers in Finland have been engaged in proactive disability risk management and rehabilitation for several decades. Over time, even more emphasis has been placed on the prevention of permanent disability. The insurers’ motives to manage permanent disability risks are both financial and humanitarian. Above all, the aim is to avoid permanent disability benefits, which impose high costs on the insurance system.

This dissertation examines the role and significance of earnings-related social insurance in permanent disability risk management. It conceptualizes the role of social insurance in the return-to-work process and identifies the factors predicting a successful RTW. Thus, the focus is on secondary prevention, i.e., those measures aimed at preventing permanent disability to work after the realization of the risk (e.g., a severe occupational injury or long-term illness). The research is based on the experiences of disabled workers. It models their life course and reveals their views on the role of social insurance in managing permanent disability risks. The practical motivation of this dissertation is to develop the permanent disability risk activities of social insurers by expanding the understanding of the phenomenon.

The results indicate that the social insurance system as well as social insurers are important actors in the prevention of permanent disability to work. The social insurer can reduce the probability of permanent disability through its own activities. The results reveal that, above all, the insurer's customer orientation and the customer's involvement in the RTW process support success. The contribution of this dissertation relies on the empirical evidence of the insurer-related factors connected to successful return to work. The synthesizing framework of the results reveals the perceived insurer roles within permanent disability risk management, their connection to the successful RTW, and the underlying mechanisms explaining this connection. The dissertation expands the understanding of permanent disability risk management by refining the previous theories related to the factors explaining the RTW, positive encounters between the insurers and the disabled workers, and the role and activities of the insurer in the RTW process.
Original languageEnglish
Place of PublicationTampere
ISBN (Electronic)978-952-03-2310-3
Publication statusPublished - 2022
Publication typeG5 Doctoral dissertation (articles)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028


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