Rehabilitation efforts before and after tightening eligibility for disability benefits in Norway.

This paper reports the use of vocational rehabilitation among applicants for disability benefits in Norway before and after the eligibility criteria were tightened in 1991. The data sources were documents of 668 applicants from 1990 and 1993 in two countries. Vocational rehabilitation is the preferred benefit in the National Insurance Act, and was a core issue in the restriction reform. Nevertheless, rehabilitation was tried by only 14% of the applicants in 1990, and by no more than 19% in 1993. Eight per cent of the applicants were referred to an employment officer before determination in 1990, and 14% in 1993. In order to study different pathways from work to applying for disability benefits, six types of 'social security careers' were constructed. The commonest comprised sick pay only, the second led through unemployment, and the third included rehabilitation. Rehabilitation may also be offered to applicants who are refused disability benefits. This was the alternative determination for 4% of the refused cases in 1990, a proportion that increased to 12% after the reform. The main reason for the relatively infrequent use of rehabilitation is probably the continuous downgrading over many years of resources and institutions for this task.