Factors associated with claiming sickness absence waiting day reimbursement during the pandemic

Abstract Background During the COVID-19 pandemic in Sweden, individuals could claim compensation for the unpaid waiting day of a sickness absence (SA) spell, through a new waiting day reimbursement (WDR) scheme. This scheme was implemented to minimize the incentives of going to work when experiencing symptoms of COVID-19, particularly in occupations that require contacts with others, e.g., some occupations in retail and wholesale. Many who were eligible did not claim WDR, and factors associated with claiming this are unknown. The aim was to investigate factors associated with a greater likelihood of using the WDR among blue-collar workers in the retail and wholesale industry. Methods A population-based prospective cohort study using nationwide linked registers in Sweden. All blue-collar workers in the retail and wholesale industry in 2019 (N = 297,378) were followed 2020/03/11-2021/09/30 regarding WDR and SA spells >14 days. SA spells were matched to WDR based on dates. A Logistic General Estimating Equation (GEE) model was used to estimate probabilities and 95% confidence intervals (CI) of SA spells with WDR, adjusted for sociodemographic and SA-related factors. Results 50% of the workers had any WDR and 57% of all SA spells had WDR. Results from the GEE show that longer SA spells had a lower probability of having WDR, with the probability being lower the longer the SA spell duration (44%; CI 42-46% for spells ≥365 days, 65%; CI 63-66% for spells 15-21 days). SA spells with COVID-19, COVID-like, or other respiratory diagnoses had higher probability of WDR uptake (>70%) than all other spells (45-57%). Most differences regarding sociodemographic or work-related variables were not significant. Conclusions Over 40% of those with a new SA spell when WDR was available did not claim such benefits. Those with shorter SA spells (15-21 days) and diagnoses of COVID-19 or similar diagnoses were more likely to claim the WDR, indicating that it was seen as primarily a COVID-related benefit. Key messages • A substantial proportion (43%) of those eligible for waiting day reimbursement to cover the costs of the otherwise unpaid first day of sickness absence did not claim such benefits. • Factors associated with the SA spell itself had stronger association with claiming the waiting day reimbursement than sociodemographic characteristics of the individual.