Procedures for illness, rehabilitation and work modifications

Last changed: 03 September 2021

The employer must take all necessary precautions to ensure a good work environment. This means that anything that can lead to illness or accident must be managed in a manner that reduces risks. It is important that the employee reports sick leave if they feel ill instead of taking holiday leave, flexitime or compensatory leave. This allows the employer to get correct information regarding sick leave, a better overview of shorter sick leave periods as well as the opportunity to prevent long-term sick leave.


Employees who, due to illness, have reduced working ability must be given help and support to regain this ability and come back to work, either full- or part-time. Support is given through early and coordinated rehabilitation initiatives and work modifications.

Responsibility and roles

The employee's manager is responsible for the work environment, rehab work and work modifications. As manager, you can receive support and guidance from your human resources officer, both in regard to the rehab process and preventative work regarding the work environment. Work environment assignments must be divided within operations in such a way that you as a manager or supervisor are tasked with preventing work risks and ensuring that you have the necessary resources and authority.

Occupational healthcare services act as the employer's medical support in rehab work. The Swedish Social Insurance Agency is jointly responsible for coordinating support, and it is the public authority that must assess work ability and the right to sickness benefit based on information from employees and employers.

Sometimes, employers, doctors and the Swedish Social Insurance Agency make different assessments. This may mean that the employee cannot work, partly or completely, and is deemed ill while the Swedish Social Insurance Agency assesses that they can work somewhere else on the labour market and therefore do not have the right to sickness benefit. It is possible to take sick leave without receiving sickness benefit.

The employee is obligated to take part in rehabilitation work to the best of their ability. This means that they must provide their manager with the information necessary to chart their working ability and need for rehabilitation. For example, this can mean taking part in rehab meetings, writing a return-to-work plan and carrying out the measures you have agreed on.


According to the Public Access to Information and Secrecy Act, secrecy applies to employees' health conditions as well as information regarding their personal conditions in transfer matters.

In accordance with the Act on Sickness Payments, anyone who has information about an employee's health condition or personal conditions are bound to secrecy. Doctor's certificates and opinions must be locked away and protected from unauthorised persons.


If an employee takes sick leave, the employer is largely responsible for the rehabilitation required in order for the employee to return to work in a satisfactory manner. The employee is obligated to take part in rehab and work modification planning. This is to ensure the best possible result. As manager, you must stay in contact with your employee during their sick leave.

Sick leave after day 7 – doctor's certificate needed

If the employee is ill for more than 7 consecutive days, starting from the 8th day, they are required to submit a copy of a doctor's certificate certifying that they are ill. The certificate must state how much they cannot work, part-time or full-time, and the length of the sick period.

In order for the employee to receive sick pay, they must submit their doctor's certificate to their manager, who ensures that it is forwarded to a payroll administrator. If the illness cannot be confirmed through a doctor's certificate, their absence will be deemed not valid, and sick pay will not be paid.

Under specific circumstances, a doctor's certificate may be required for shorter periods of illness. The employer can also request that the employee submit a doctor's certificate from a doctor chosen by the employer, such as an occupational health doctor.

Sick leave for more than 60 days

The immediate manager is responsible for their employee's rehabilitation. If the employee's working ability is expected to be completely or partly reduced due to illness for at least 60 days, the manager must, following consultation with the employee, write a return-to-work plan. The plan must be completed by the time the employee has been on sick leave for 30 days.

If the employee's health does not allow them to currently go back to work, a plan does not need to be written, with or without rehab measures. The plan must then be written when the employee's health has improved. Adato has a template for returning to work.

Sick leave on more than 6 occasions during 12 months

If the employee has been ill more than 6 times during a 12-month period, they and their manager must discuss why and possibly write a plan to improve the employee's health. There is template for this in Adato.

The employer can request that the employee submits a doctor's certificate from the first day of their sick period, but only if there are special circumstances. This is done in consultation with a human resources officer.

Work modifications

It may be necessary to modify the workplace to prevent illness, or as part of rehab work. This may include technical aids, special work tools or changes to the physical work environment. There may also have to be changes to the organisation or division of duties, working hours, methods or psychosocial environment.

It is important to remember that these modifications cannot harm other employees; they cannot have duties that will make them ill in the long-term. The employer is also not obligated to create new duties or a new employment.

Alcohol and other addiction issues

Addiction occurs in the workplace. It is important to take note of signs of addiction, such as changed work initiative, increased absence or changed behaviour in general. More information can be found on the page Alkohol- och drogproblematik (only in Swedish).

Adato and documentation

Adato is a system for monitoring and documenting rehabilitation and other preventative measures. Measures and rehab meetings must be documented, partly to help remember what has been done, partly as support if all rehab measures haven been taken and there are no more important duties for the employee to carry out for the employer. If an employment must end due to such personal reasons, the employer must state which measures have been taken.

Adato sends out reminders via email regarding new rehab matters and helps managers monitor their employees' rehab plans. If you are a manager and have not received an Adato account or are in need of other system support, contact your human resources officer. The employee can request their documentation from Adato.

Closing a rehabilitation matter

There are different ways to close a rehabilitation matter. The employee can return to work, receive full or parts of sickness compensation or the employment can be terminated. When returning to work, there should be a follow-up meeting about a month after rehabilitation was completed in order to see if any further measures are needed.


HR specialists
HR Unit, Division of Human Resources