Partial work ability in the work community

Work ability = functioning: work requirements

Work ability consists of the compatibility and balance between a person’s physical, mental, social and cognitive functioning(siirryt toiseen palveluun) and work. One’s work ability can be supported at the workplace in a variety of ways. In case of diminished work ability, temporary or permanent arrangements and changes can be made as necessary and possible. In addition to the person’s own observations, the first signs of diminished work ability can be detected by the supervisor or colleagues, occupational health care or occupational safety and health personnel.

Work ability and work performance vary during one’s career. The cause of a reduction in work ability may be harmful physical or psychological workload due to, for example, deficiencies in competence or work management or inadequacies in the work community’s operations, work arrangements or working conditions. Reasons for reduced work ability can also include physical and mental illnesses, substance abuse and other dependencies as well as lifestyles and stressful life situations related to life outside work.

Ageing can also affect work ability, as it leads to changes in physical functioning (e.g. mobility and balance) and sensory functions (e.g. vision), among other things. With age, recovery also takes more time.

Resilience, which refers to the ability to adapt and recover, helps in dealing with changes in work ability. Resilience includes, among other things, understanding that sometimes unwanted things can happen, the ability to seek support in these situations and find ways to cope with what has happened.

Work Ability House

Work ability can also be described using a house model. The work ability house functions and stays upright when all its floors support each other. The fourth floor, work, often changes quickly and does not always take sufficient account of the employee’s capacity to respond to the changes. If it gets too heavy, it can weigh on the lower layers, with bad consequences.

All floors of the building must be continuously developed. The aim is to ensure the compatibility of the floors when the employee and work change. An individual is responsible for their own resources. The employer and supervisors, in turn, are responsible for the fourth floor of the building: the work and working conditions.

Co-operation between the various parties produces the best results in activities that maintain work ability. The employer can support the development of an individual’s resources in various ways. The employee can actively participate in promoting the well-being of both their own work and their work community.

A person with partial work ability is someone who has partial access to their work ability and is willing to make use of it. By adapting the work, reduced work ability rarely affects work performance. Partial work ability varies by each individual and is linked to the cause of partial work ability and the work and work requirements.

Persons with partial work ability are a very diverse group. Partial work ability comes in many different forms – persons with partial work ability include those recovering from a serious illness, those who have experienced a life crisis or those with disabilities. The most common causes of impaired work ability are mental health and musculoskeletal disorders.

By tailoring the work tasks and working hours, partial work ability is not an obstacle to work performance. Even through small changes in working conditions, it is possible to achieve major benefits that increase the opportunities for persons with partial work ability to earn their living.

The aim of the Non-Discrimination Act is to promote equality. In addition, it prohibits discrimination on grounds of health status, disability or other personal grounds, for example.

Early support refers to all support measures that are taken in order to improve the employee’s work ability and well-being at work. Success requires close co-operation between the employer, employees, occupational safety and health personnel and occupational health care. Early support for work ability has many benefits. It reduces sickness absences and associated costs and presents the employer or supervisor as one who takes care of their employees.

A supervisor’s duties include raising the issue when they observe changes in the employee’s ability to cope with work tasks or signs of a deterioration in the employee’s work ability. The early support model facilitates raising the issue, i.e. jointly agreed practices at the workplace that support employees’ work ability and include raising work ability concerns.

Early caring is more than just a model. It can be seen in encounters with other people and in genuine consideration. Genuine caring promotes a good and confidential atmosphere in the workplace, where the work ability of all employees is promoted even through changing conditions.

Support for employees with partial work ability should be based on resources thinking, focusing on the employee’s strengths and what they are able to do. Using work ability in a meaningful way is both humane and financially viable. Making use of partial work ability in an appropriate way maintains the employee’s remaining work ability and functioning and prevents exclusion.

Examples of workplace support measures for persons with partial work ability

• improvements in ergonomics
• more suitable tools
• fixed-term work arrangements or flexible working hours
• reorganisation of work, such as job rotation
• permanent work arrangements or flexible working hours.

You can find other examples of support measures in the Centre for Occupational Safety publication Diversity, equality and non-discrimination in the work community (p. 23). Even small adjustment opportunities and tryouts often produce a good result.

Examples of services for persons with partial work ability

According to Section 15 of the Non-Discrimination Act, the employer must make reasonable adjustments for a person with a disability when necessary. The needs of the disabled person are the primary priority in assessing whether the adjustments are reasonable. The employer must identify the appropriate adjustments that are necessary in order for the disabled person to be employed or continue to work. Once appropriate adjustments have been identified, it is assessed whether they are reasonable from the employer’s point of view, taking into account the size and financial position of the employer, the nature and scope of the activities and the costs of the adjustments and the support available for them.

The Occupational Safety and Health Act (738/2002) obligates the employer to take care of the health and safety of employees at work, also taking into account individual factors. Taking into account the nature of the work and activities, the employer must systematically and adequately analyse and identify the risk factors and hazards caused by the work, the working hours, the workspaces, other aspects of the working environment and the working conditions and, if they cannot be eliminated, assess the significance of these for the employees’ safety and health. In doing so, the employee’s age, ageing, gender, professional skills and other personal prerequisites must be taken into account, among other factors.

If it is noticed that employees, while at work, are exposed to strain in ways that endanger their health, employers, after becoming aware of the matter, shall, by available means, take measures to analyse the workload factors and to avoid or reduce the hazard. (The Occupational Safety and Health Act, Section 25)

The Occupational Healthcare Act (2001/1383) obligates the employer to arrange occupational health care at its own expense to prevent health hazards and harm caused by work and working conditions and to protect and promote the safety, work ability and health of employees. Occupational health care must be organised and implemented to the extent required by the work, work arrangements, personnel, workplace conditions and their changes.

The purpose of the Occupational Healthcare Act is to promote the following through the co-operation between the employer, employees and occupational health care

• prevention of work-related illnesses and accidents
• improve the health and safety of the work and the working environment
• the health and working capacity and functioning of employees at different stages of their careers
• the functioning of the work community.

Occupational health care refers to the activities of occupational health care professionals and experts that the employer is required to organise in order to promote the prevention of work-related illnesses and accidents, the health and safety of work and the work environment, the functioning of the work community and the health and functioning of employees.

Employees and their representatives have the right to make suggestions for the development of occupational health care operations. Proposals and the measures necessitated by these must be discussed in co-operation.

Activities that maintain work ability refer to planned and goal-oriented activities targeted at the work, working conditions and employees through which occupational health care promotes and supports the working capacity and functioning of those involved in working life.

Statutory activities of occupational health care

According to Section 12 of the Occupational Healthcare Act, the statutory activities of occupational health care include the following:

• investigating, assessing and monitoring work-related health hazards and risks and the health, ability to work and functional capacity of the employees, including any special risk of illness caused by the work and the working environment, and any health examinations as a result of the above factors, having regard to each employee’s personal characteristics
• making suggestions for action to improve the health and safety of the work, to adapt the work to the employees’ abilities where necessary, to maintain and promote the employees’ ability to work and functional capacity and to monitor the implementation of the suggestions for action
• making proposals for measures to improve the health and safety of the work, adapting the work to the employee’s capabilities if necessary, maintaining and promoting the employees’ working capacity and functioning and monitoring the implementation of the proposals for measures
• providing information, advice and guidance in matters concerning the health and safety of the work and the health of the employees, including investigating an employee’s workload if requested by the employee for a justified reason
• monitoring and promoting the ability of employees with disabilities to cope at work taking account of their health requirements, providing them advice on rehabilitation, and referring them to treatment or medical rehabilitation or vocational rehabilitation
• drawing up a statement referred to in chapter 8, section 5a, of the Health Insurance Act (1224/2004) on an assessment of an employee’s ability to work and possibilities to continue working. The statement shall include an assessment by occupational healthcare on the employee’s remaining ability to work and a report the employer has drawn up together with the employee and occupational healthcare on the employee’s possibilities to continue working
• cooperating with representatives of other healthcare services, labour administration, education administration, social insurance, social welfare services, and occupational safety and health authorities; where necessary with the different occupational healthcare providers of the employers in shared workplaces and other necessary parties
• for their part, plan and implement measures to maintain and promote work ability as part of the occupational health care tasks defined in the Occupational Healthcare Act, including, if necessary, determining the need for rehabilitation
• assessment and monitoring of the quality and effectiveness of occupational health care activities.

Prevention of prolonged incapacity for work

The Health Insurance Act and the Occupational Healthcare Act provide for the monitoring of sickness absences as follows:

• 30 days: The employer shall notify the occupational health care service provider of the employee’s sickness absence at the latest when the employee has accumulated 30 days of sickness absence during the year.
• 60 days:
  • Sickness allowance must be applied for within two months of the start of the incapacity for work and partial sickness allowance within two months of the desired starting date for the benefit.
  • Kela determines the employee’s need for rehabilitation at the latest when sickness allowance has been paid for 60 days in the span of two years(sickness allowance and partial sickness allowance). The treating physician gives an opinion on the need for rehabilitation.
• 90 days: An occupational health physician’s statement on the employee’s remaining work ability and opportunities to continue working is required at the latest when 90 sickness allowance days have been accumulated over the course of two years (excluding partial sickness allowance days). The possibility of continuing at work is investigated in co-operation with the employer and employee. The purpose of the statement is to assess the opportunities for returning to work, the need for workplace support measures and to draw up a plan for returning to work. The statement is a prerequisite for the payment of sickness allowance.
• 150 days: If necessary, the occupational health physician assesses the employee’s remaining work ability and, together with the employer and the employee, investigates the possibilities of returning to work before sickness allowance has been paid for 150 days. If the statement has been prepared, it must be submitted to Kela.
• 230 days: If necessary, the occupational health physician assesses the employee’s remaining work ability and, together with the employer and the employee, investigates the possibilities of returning to work before sickness allowance has been paid for 230 days. If the statement has been prepared, it must be submitted to Kela.

Section 6 of the Constitution of Finland (731/1999) on equality prohibits discrimination in general, i.e. people are equal before the law. According to the constitution, no one may, without justifiable grounds, be placed in an unequal position on the basis of gender, age, background, language, religion, belief, opinion, health, disability or any other personal reason.

The purpose of the Non-Discrimination Act (1325/2014) is to promote equality and prevent discrimination as well as to enhance the legal protection of victims of discrimination. The law requires employers to assess and promote equality in their own operations.

The Non-Discrimination Act prohibits discrimination on the basis of age, background, nationality, language, religion, belief, opinion, political activity, trade union activity, family relations, health, disability, sexual orientation or any other personal grounds. The obligation to promote equality applies to all these prohibited grounds for discrimination.

The employer must inform the personnel of the work ability support procedures at the workplace and ensure that the supervisors have sufficient competence to identify the employee’s need for early support and to support work ability. The employer also monitors the implementation and impact of work ability processes.

The employer is responsible for the health and safety of the workplace. Workplace activities that maintain work ability include work hazard identification and assessment, workplace surveys, the prevention of occupational accidents and the promotion of work community operations. Smooth co-operation at the workplace and effective co-operation with occupational health care enable effective work ability support at the workplace.

The supervisor’s tasks include identifying early signs of diminished work ability, monitoring coping at work, discussing work ability issues and documenting the discussion, if necessary. For example, the supervisor can ask occupational health care for an assessment of the employee’s work ability. In addition, the supervisor may hold an occupational health discussion to map out work ability support measures. The initiative for organising an occupational health discussion can also be taken by the employee themselves or by occupational health care.

After a prolonged sickness absence or other absence, returning to work is an important stage in supporting work ability, and it must be planned together with the employee and, if necessary, occupational health care. The supervisor takes care of the necessary orientation and other competence assurance as well as any modification of the work. They also inform the work community of any changes. The supervisor is also tasked with ensuring that the work is sufficiently resourced so that the rest of the work community is not harmfully burdened by the work arrangements.

The development, feedback and goal discussions can also be used as a tool for supporting the work ability of an employee with partial work ability. Discussions between the supervisor and the employee are one of the key tools that guide work performance and develop competence. At the same time, development, feedback and goal discussions are an opportunity for the employee to talk about their own work and related needs and expectations as well as the workload. Discussions are most successful when matters are handled openly and confidentially. As the intervals between development, feedback or goal discussions can be long, for example a year, it is important that the supervisor and employee also discuss the requirements and progress of the work and the factors that affect these.

The subsidy for arranging working conditions facilitates the employment of persons with partial work ability, disabilities and long-term illnesses. The employer may apply for it from the Employment Services Office if the injury or illness of a person employed or to be employed requires the procurement of work equipment, necessary modifications to the workplace or assistance provided by another employee.

Everyone’s work ability varies during their career. The employee takes care of their own well-being, health, work capacity and functioning. If their work ability changes, they have the right to get help from the employer, supervisor and occupational health care.

If the employee’s work ability in relation to the current work tasks changes in such a way that they can no longer be performed as before, the matter should be discussed with the supervisor as early as possible. There are many types of support for working. Examples of these are presented in this digital publication.

It is important for the employee and employer to note that an injury or illness does not always completely prevent the employee from performing their work.

It is possible to adapt and modify the work tasks, working environment and working hours together according to work ability. In the event of an illness or injury that impairs work ability, occupational health care must be involved in the discussions as early as possible. You can also get help from an occupational health and safety representative who is familiar with the conditions of the workplace. The faster an employee’s decreased work ability is addressed, the easier it is to find ways for them to continue in their current position or train themselves for a new task.

Support from the workplace community is also important for employees with partial work ability. It must be agreed with the employee on what and how to explain to the work community about their situation.

The work community must be informed about the work arrangements concerning them or any related changes. The work community must trust that the arrangements and changes are necessary and justified. The workplace’s own work ability operating model and practices ensure that every employee is treated equally in a similar situation.

The occupational health and safety representative participates in the planning, implementation and monitoring of the workplace’s work ability practices. In addition, at the employee’s request, they may participate in the investigation of the employee’s work situation and work ability support, including occupational health discussions.

Occupational health care’s tasks include supporting and monitoring employees’ work ability. Occupational health care guides and supports the employer, supervisor and employee in work ability matters and participates in the preparation of the workplace’s work ability management model. The model is designed for the needs of the workplace. It describes the concrete measures of the workplace and occupational health care for the early support of work ability, supporting return to work and managing sickness absences.

Work ability support is based on practices agreed at the workplace. The operating methods agreed between the management, HR, employees and occupational health care are included in the workplace work ability support model, which is discussed in the occupational health and safety co-operation.

The work ability support model describes the following:

• early caring and raising work ability issues
• sickness absence practices, processing of absence data and documents
• occupational health discussion practices and documents
• rehabilitation referral practices
• support for returning to work
• substance abuse programme, referral practices and documents
• guidelines for preventing harassment and other inappropriate treatment.

Occupational health care analyses and reports on the indicators related to work ability support agreed in the occupational health care action plan at the workplace level, such as sickness absences or the number of occupational health discussions held. Occupational health discussions are an important co-operation model between the employee, supervisor and occupational health care in the planning of support for the employee’s work ability.

Occupational health care assesses the employee’s work ability, functioning and the need for rehabilitation and refers them to rehabilitation. Occupational health care has the responsibility for coordinating the support for work ability regardless of where the employee’s treatment and rehabilitation are carried out. The return to work is planned together with the employee and the employer. Co-operation with other health care, rehabilitation and insurance institutions is implemented as necessary.