Utredningsansvaret hos Försäkringskassan – exemplet sjukersättning
Publicerad i Nordisk socialrättslig tidskrift nr 40.2024, september 2024 s. 199–220
Sickness insurance, which addresses people’s livelihoods when they encounter the social risk of illness, is a complex system. Each case requires thorough and careful investigation, both in terms of legal regulation and the individual’s actual situation. During the past years, the Supreme Administrative Court (HFD)has issued several precedent-setting judgments that not only clarify the legal situation but also partially set new requirements for the investigation of the actual circumstances that must be conducted. This article examines how three of the Court’s judgments; HFD 2019 ref. 48, HFD 2022 ref. 47 and HFD 2013 ref. 60, are treated in the Swedish Social Insurance Agency’s own guidance 2013:1 on sickness compensation (a kind of invalidity pension; sjukersättning). The study shows that the current version 12 of guidance 2013:1 on sickness compensation references the relevant judgments. However, it also shows that no significant change has been made to the proposals for investigative actions or questions to involved actors. The so-called DFA chain, whose legal basis is unclear, continues to dominate. This can create ambiguity and uncertainty, not just for the insured but also for the agency’s employees. It should be a task for the Social Insurance Agency, both as an employer and as a government agency, to work to eliminate ambiguities and work systematically to establish a legally secure investigative procedure and to enable the principle of care to become an integral part of the application of the sickness insurance, with the example from sickness compensation.
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