Employer Responsibilities for Rehabilitation Plans in Sweden

Every year, sickness absence costs Swedish employers billions. However, financial impact is not the only reason to take rehabilitation seriously. Behind every sick leave case is a person who needs the right support to return to work. As an employer, you do not only have a legal responsibility to act, but also a unique opportunity to make a meaningful difference.

Many managers and HR professionals still experience the rehabilitation process as unclear and difficult to navigate. What rules actually apply? What should a rehabilitation plan include? And when is action required? This guide explains the key concepts and provides a practical overview of the employer’s rehabilitation responsibility, from the first warning signs to the completion of the process.

Table of Contents

• What does the employer’s rehabilitation responsibility involve?
• What is a rehabilitation plan?
• What should a rehabilitation plan include?
• The different stages of the rehabilitation process
• Collaboration between different stakeholders
• The importance of structured rehabilitation work
• Frequently asked questions about rehabilitation

What Does the Employer’s Rehabilitation Responsibility Involve?

Under Swedish legislation, primarily the Work Environment Act (AML) and the Social Insurance Code (SFB), employers are responsible for work-oriented rehabilitation. This means that employers must investigate which adjustments or support measures may help an employee on sick leave return to work as soon as possible. The rehabilitation responsibility applies regardless of whether the illness or injury occurred in the workplace.

The employer is responsible for, among other things:

• identifying signs of ill health and sickness absence
• implementing workplace adjustments when necessary
• assessing rehabilitation needs
• establishing a return-to-work plan
• following up on and documenting rehabilitation measures
• collaborating with relevant stakeholders, such as the Swedish Social Insurance Agency and occupational health services

The rehabilitation responsibility does not only apply during ongoing sick leave. Employers are also required to take preventive action if there are clear risk factors, situations where an employee is still working full-time but showing signs that may indicate a risk of future long-term sick leave. Early interventions at this stage are often both more effective and more cost-efficient than waiting until sick leave becomes necessary.

Real-Life Example

Anna works as a Finance Manager at a medium-sized company. During the autumn, her immediate manager notices that she often stays at the office long after working hours, that her performance has become inconsistent, and that she has, on several occasions, mentioned that she is “barely coping.” She is not on sick leave. On the contrary, she is working more than full-time. Despite this, the employer has a responsibility to act.

Her manager initiates a rehabilitation meeting, an assessment is carried out, and an action plan is developed to adjust Anna’s workload. Thanks to these early interventions, Anna avoids burnout-related depression and never needs to take sick leave.

What Is a Rehabilitation Plan?

A rehabilitation plan, also referred to as a “return-to-work plan,” is a document describing the measures needed for an employee to return to work. The plan should function as a practical support tool throughout the rehabilitation process and clarify responsibilities, actions, and follow-up procedures.

An employer is required to establish a rehabilitation plan when:

• an employee has been on sick leave for 30 days, and
• there is reason to believe that the employee’s work capacity will be reduced for at least 60 days

Rehabilitation Plans in Cases of Risk for Sick Leave

There are situations where a rehabilitation plan should be established even if the employee is still working full-time. If there is a clear risk that the employee may face long-term sick leave, for example due to high stress levels, recurring short-term absences, or signs of mental ill health it is considered good practice, and aligned with the employer’s preventive work environment responsibilities, to establish a plan proactively.

Real-Life Example

Erik works as a salesperson and has had eight short periods of sickness absence over a six-month period, all related to stress and stomach problems. He is currently working full-time, but the pattern is clear. The employer decides to arrange a rehabilitation meeting and, together with Erik, develops a rehabilitation plan.

The plan includes temporarily adjusted sales targets, regular follow-up meetings with his manager, and a referral to an occupational health psychologist. As a result, Erik’s short-term absences stop, and he avoids the long-term sick leave that might otherwise have followed.

The plan should be developed together with the employee and adapted to the individual’s needs and work capacity. There are no legal requirements regarding the exact structure of the plan, but it should be clear, concrete, and possible to follow up on.

What Should a Rehabilitation Plan Include?

A rehabilitation plan may vary depending on the organization and the situation, but it often includes the following:

• a description of the employee’s current work capacity
• identified obstacles to returning to work
• planned workplace adjustments or support measures
• allocation of responsibilities between the employer and the employee
• timelines and goals for returning to work
• dates for follow-up and evaluation

Examples of workplace adjustments may include:

• modified work tasks
• adjusted working hours
• gradual return to work
• technical aids
• the possibility of remote work
• support from occupational health services or external stakeholders

The Rehabilitation Process: 5 Key Stages for Employers

The rehabilitation process may vary between organizations, but it often consists of several recurring stages.

1. Early Identification and Contact

Managers and HR should identify signs of ill health or recurring sickness absence at an early stage. Early dialogue with the employee is important for creating a sense of security and identifying support needs. The earlier action is taken, the better the conditions for successful rehabilitation.

2. Assessment of Rehabilitation Needs

The employer needs to investigate whether there is a need for workplace adjustments or rehabilitation measures. This can take place through supportive conversations, rehabilitation meetings, and collaboration with occupational health services or other stakeholders.

3. Establishing a Rehabilitation Plan

If the sickness absence is expected to be prolonged, or if there is a risk of future long-term sick leave, a return-to-work plan should be established together with the employee. The plan should be documented and followed up continuously.

4. Implementation of Measures

The employer implements the measures and adjustments identified in the plan. This may involve modified work tasks, adjusted working hours, or other support measures.

5. Follow-Up and Evaluation

Rehabilitation efforts need to be followed up continuously to ensure that the measures are effective and adjusted if necessary. The plan should be updated if circumstances change.

Collaboration Between Different Stakeholders

A successful rehabilitation process often requires collaboration between several stakeholders. The employer is responsible for work-oriented rehabilitation, while healthcare providers are responsible for medical rehabilitation. The Swedish Social Insurance Agency, in turn, has a coordinating role and may follow up on the rehabilitation plan when necessary.

Where appropriate, occupational health services, union representatives, and the Swedish Public Employment Service may also be involved in the process.

The Importance of Structured Rehabilitation Work

Structured rehabilitation work creates clarity for both employers and employees. By working preventively and systematically with rehabilitation, organizations can contribute to:

• reduced sickness absence
• faster return to work
• an improved work environment
• increased employee security
• improved long-term workforce planning

Well-functioning rehabilitation work is therefore an important part of both strategic HR work and the organization’s overall work environment responsibilities.

Frequently Asked Questions About Rehabilitation

1. Do I, as an employer, need to establish a rehabilitation plan from the very first day of sick leave?

No. The legal obligation to establish a formal return-to-work plan arises when an employee has been on sick leave for 30 days and there is reason to assume that their work ability will be reduced for at least 60 days. However, as an employer, you should initiate dialogue and assess potential needs from the very first day.

2. What happens if I, as an employer, fail to fulfill my rehabilitation responsibilities?

If an employer fails to meet their rehabilitation responsibilities, this may result in criticism from the Swedish Work Environment Authority and, in serious cases, administrative fines. It may also affect potential legal disputes, for example if an employee claims that insufficient rehabilitation efforts contributed to a deterioration in their health.

3. Should the employee be involved in developing the rehabilitation plan?

Yes. A rehabilitation plan should always be developed in consultation with the employee. Participation is an important prerequisite for ensuring that the plan is realistic and that the employee feels secure throughout the process.

4. Does the rehabilitation responsibility also apply to temporary employees?

Yes. The rehabilitation responsibility applies to all employees, regardless of the type of employment - permanent employees, fixed-term employees, or hourly workers as long as the employment relationship remains in place.

5. Can I dismiss an employee who is on sick leave?

Sick leave in itself does not constitute valid grounds for dismissal. The employer must first have fulfilled their rehabilitation responsibilities and be able to demonstrate that the employee’s work ability is permanently impaired to such an extent that they are unable to perform any work of significance for the employer, even after workplace adjustments or other supportive measures before dismissal can be considered.

6. What is the difference between workplace adjustment and rehabilitation?

Workplace adjustment refers to measures aimed at adapting the work environment or work tasks so that an employee can continue performing their job. Such measures may be implemented both preventively and during an ongoing period of sick leave.

Rehabilitation is a broader concept aimed at restoring or improving an individual’s work ability following illness or injury. In practice, the two concepts often overlap.

7. Must the Swedish Social Insurance Agency (Försäkringskassan) always be involved in the rehabilitation process?

No, not always. The Swedish Social Insurance Agency has a coordinating responsibility and becomes automatically involved when an employee is on sick leave and receiving sickness benefits.

In cases involving shorter periods of sick leave or preventive measures, rehabilitation is often managed solely by the employer, sometimes with support from occupational health services.

8. What are the costs of rehabilitation efforts, and who is responsible for paying them?

The employer is responsible for the costs of occupational rehabilitation, including any workplace adjustments.

Costs related to medical rehabilitation are covered by the healthcare system and the Swedish Social Insurance Agency. In certain cases, employers may apply for financial support for workplace-related adjustments, for example through the Swedish Social Insurance Agency.

9. How long can a rehabilitation plan remain in place?

There is no statutory maximum duration. The plan should remain in place for as long as necessary and be continuously updated based on how the situation develops.

Once the employee has fully returned to work and the objectives have been achieved, the rehabilitation process may be concluded. If circumstances change either positively or negatively the plan should be adjusted accordingly.

10. What should I do if the employee does not want to participate in the rehabilitation process?

An employee has an obligation to participate in rehabilitation efforts to the extent possible.

If an employee refuses to participate without valid reason, this may affect their entitlement to sickness benefits. In some cases, it may also result in employment-related legal consequences.

As an employer, you should document all efforts made to involve the employee and, where necessary, seek support from an HR specialist or legal advisor.