Abuse of the Dutch incapacity benefits system — WAO or Arbeidsongeschiktheidsverzerkering — is a widespread problem that has been fully acknowledged by organizations representing employees, employers and government bodies.

 Critics believe that increasingly it has become culturally and professionally accepted in Holland to go off sick when there is a conflict at work.

Top civil servants and CEOs have been known to choose this "option" when conflicts arise. But, experts say, many of those claimants could have gone back to work far earlier if the proper treatment and support had been available, while others should never have been declared sick in the first place.

17 percent of the Dutch workforce is sick

Currently a million people are in the WAO system with a third of the claimants off with "psychological" problems. Depression, anxiety, stress — the generic Dutch term "overspannen" covers the lot.

In a country of only 16 million people, 17 percent of the workforce draws upwards of 70 percent of their last salary while officially they are "too sick" to work full time.

Depression is number one on the list of illnesses with stress coming in a close second. Women and minority cases are disproportionately high.

Though lauded as a country with a highly motivated and productive workforce, the Netherlands has more people on long-term incapacity leave than in most other Western countries.

The number of WAO claimants grew 18.5 percent last year with increases in the education, government and police sectors, while healthcare held on to top spot for the largest overall number of WAO claimants.

Under the current scheme, an employee is paid by their employer the first year they are sick. After the first year the employee has a state medical assessment and should they be deemed disabled (irreversibly or partially) they qualify for WAO benefits, which can be up to 70 percent of the employees last salary.

Thorny issues become political

The controversial WAO scheme has been debated for years. On 11 November Dutch union FNV rejected the government’s re-jigged benefit plan, citing the outgoing coalition’s WAO plan as “anti-social”.

FNV spokesperson Richard Gielen said, “a million people in the WAO is not just a financial issue, it’s also a social problem with too many people out there not contributing to normal social life,” while the current government coalition sees attempts at getting people back to work a priority before the elections in January 2003.

The current government proposal, which the unions vehemently rejected, is to give claimants more money (now 70 percent of current wage) beginning in 2005 but only if the number of new claimants is reduced by 75 percent. Currently a million people receive WAO.

“Last March Dutch unions and employers' organisations reached a unanimous agreement on a new WAO scheme. It was the first time in history we agreed with employers that the WAO should no longer be the easy way out when there are problems at work,” Geilen said.

The employee/employer WAO proposal essentially limits the WAO to people who are permanently disabled but it will not agree on the conditions of lowering the claimant numbers by 75 percent as the government has proposed.

They feel this will happen over time with the new scheme. The union model argues for the employer to pay for the employee sick leave up to two years — the first year at full salary and the second at 70% — with more incentive on solving workplace problems and conflicts, re-integration or alternative jobs.

“Everybody knows abuse of the WAO system is widespread and there is a culture of avoiding workplace conflicts by going off sick. Even though stress involved in conflicts can make people really sick, more has to be done to deal with workplace situations that lead people to become disabled and Dutch unions and employers recognise that,” said Gielen adding, “more emphasis will be on solving workplace problems.”

“We hope to see a rational government come to power in the New Year and hopefully they will see that the WAO is a matter between employees and employers and give our employee/employer proposal a chance,” Gielen said.

How did this happen?

Companies began dumping older employees into the incapacity benefits scheme because it was cheaper than redundancy packages. Health checks were minimal and once on the WAO, you received 80 percent of your last salary for life.

Eventually the government caught on and tried to fine those companies.

By 1995 it let market forces into the equation and made employers financially responsible for the first year of sick pay before the employee was approved to the state-funded WAO. Firms took out private insurance for such risks, with premiums dependant on the company’s health record.

Although the financial incentives introduced were intended to get companies to take the health of their workers more seriously, according to a recent government report called, “The Donner Commission” lead by the by Christian Democrat MP Piet Hein Donner, only 20 percent of Dutch firms actively work to keep their staff healthy in the workplace and 80 percent of claims could have been prevented.

The commission report, released in 2002, and the latest of literally hundreds of state, academic and private reports over the last 20 years on re-vamping the WAO system, proposed restricting the benefit to people who are totally incapable of work.

It took the commission a full year to review the current disability system and draw up proposals to ensure that fewer people end up in it and that those who do are able to get out more easily. In the words of Mr Donner: "The current system gobbles people up without giving them a way out".

Stuck in WAO limbo

Gabby Choma from the Dutch Repetitive Strain Injury (RSI) Association said: “It is a complicated and difficult system to understand and I warn people that once you get in, it’s sometimes hard to get out".

"Although it is an important social scheme to have in place, it also has been a trap for some people who got dumped by their employers who didn’t want to deal with any complicated workplace issues.”

Choma, operates a help line for RSI suffers and counsels people with work-related health problems through the WAO maze.

“Nobody tells you that you have to make your own arrangements for the WAO but you do. After you have been sick for a year you qualify for benefits, if they accept your case. I advise people to go to the GAK (the institute that assess the medical situation) and register after being off sick for nine months. This ensures the claimant gets their WAO as soon as their employer stops paying their sick pay for a year,” she said.

Branded for life

Some people having been on WAO, who did not want their names used, said they appreciated the opportunity to be on the WAO scheme for a period of time but now that they are recovered, partially recovered or re-skilled, they are ready to get back to work. Many however have had a very difficult time re-entering the labour force.

“It’s almost like having a criminal record,” said one WAO recipient, “because potential employers see me as either a problematic employee or too risky in case I get sick on them too. I can’t even get a job without GAK/WAO approval now.”

“All I want to do is get back to work doing something comparable to what I did before I got sick, but employers are loathe to take me on for fear I become troublesome — or cause too much paper work for them,” she added.

Although the current cabinet and presumably the newly elected government in January will pursue reforming the WAO, according to Geilen from the FNV, the unions are not willing to negotiate further on the matter until 2003.

November 2002

Subject: Working work in the Netherlands