Nearly half of Swedes who apply for long-term sickness compensation are denied, and fighting the decision rarely pays off: in 2025, only 4.8% of denials were overturned on reconsideration, News55 reported this week.
The gap between a doctor’s note and a benefit check is the crux of the story. Having a medical certificate proving you are ill does not guarantee compensation. Your treating physician treats you; Försäkringskassan, the Swedish Social Insurance Agency, separately assesses whether you are entitled to payment. A diagnosis alone is not enough — what decides the matter is whether you can work, Martin Jonasson explained to News55.
A Doctor’s Certificate Proves Illness, Not Inability to Work
The two assessments run on different tracks. The clinician documents disease; the agency measures work capacity against the labor market. That distinction explains why applicants with genuine, documented conditions still receive avslag — denials — at roughly a 50% rate.
Most people granted sickness compensation have already been on sjukpenning, the standard sick pay. Those who lack it are told how to protect their SGI, the income figure that sick pay is calculated from, and are informed about other support such as livränta or municipal försörjningsstöd, plus a transition meeting with Arbetsförmedlingen, the Public Employment Service.
In Plain English: What a Denial Actually Means
- A doctor’s certificate is evidence of illness, but Försäkringskassan decides separately whether you can do any work — that is the test that matters.
- Sick pay is higher but temporary and must be reapplied for; sickness compensation is lower but runs indefinitely.
- A written appeal must reach the agency within two months of the decision, and 2025 figures show only about one in twenty denials is reversed.
Sick Pay Versus Sickness Compensation: Two Different Contracts
The two benefits differ in both amount and duration. Sjukpenning is usually the higher payment, but it is time-limited and requires fresh applications. Sjukersättning pays less yet continues until further notice, which is why it is treated as the more secure — if harder to obtain — form of support. As Martin Jonasson put it to News55: sickness compensation usually has a lower replacement level but offers greater financial security precisely because it runs indefinitely.
| Outcome in 2025 | Figure |
|---|---|
| Share of sickness-compensation applicants denied | About half |
| Denials overturned when taken to court | 10.3% |
Why an Appeal Is Almost Never Worth the Paper
An applicant can request omprövning — a formal reconsideration — but it must be submitted in writing within two months of the decision, per Försäkringskassan’s own guidance cited by News55. The 2025 numbers show how rarely that changes anything: 4.8% of denials were altered after reconsideration. Litigation fares only marginally better; of those who took the case to court, 10.3% saw the decision reversed.
When Staying Out of Work Can Harm More Than Working
Kollega interviewed Lars Englund, a general practitioner and researcher who has watched Försäkringskassan’s rules tighten over the years, with disease concepts removed and the path to benefits narrowed. He argues that this need not be a bad thing, because work itself can be protective.
“Research shows the risk of feeling unwell increases the longer you stay home. It is better to return to work part-time,” Englund told Kollega.
He notes that some diagnoses genuinely prevent work, but for conditions such as burnout depression and many psychiatric diagnoses the prognosis is often good — and prolonged sick leave can do more harm than good. He compares sick leave to a drug’s side effects: appropriate in an acute phase, but if extended it can become passivizing and push the patient out of working life entirely. Returning to work, he argues, rests on self-efficacy — the belief in one’s own ability, a sense of self-worth, and the feeling of control over one’s life — and long-term absence makes that return harder.
Englund also cautioned against turning life’s hardships into medical problems. Social insurance, he said, is not meant to compensate for worry, financial trouble or low mood; protecting the patient’s right to remain in working life matters, and routine sick-listing can absolve employers of their duty to accommodate people with physical or mental ailments. Sickness compensation, in his view, is justified mainly for older patients who have had fragile health for years and have tried every form of rehabilitation. The best route back to work, he said, is early and sustained contact with the employer.
Contraindications & When to Consult a Professional
Anyone denied sickness compensation should treat the two-month written deadline as a hard contraindication against delay — missing it forfeits the reconsideration route. If you lack sjukpenning, act promptly on the agency’s instructions to protect your SGI, since that income basis underpins future benefits. Seek professional guidance — from Försäkringskassan, a union, or legal counsel — before investing in court action, because the 10.3% reversal rate means litigation succeeds for only about one in ten appellants. And anyone whose absence from work is stretching into months should consult their physician about whether graded, part-time return could protect both health and income.
The 4.8% reversal rate is not an anomaly to bet against but the baseline reality of the system as it stood in 2025 — a system in which the medical and the administrative verdicts on sickness have grown steadily further apart.
References
- News55 — reporting on Försäkringskassan denial and appeal statistics for 2025 and agency guidance on reconsideration deadlines.
- Kollega — interview with general practitioner and researcher Lars Englund on sick leave, work capacity and rehabilitation.
- Försäkringskassan (Swedish Social Insurance Agency) — guidance on sjukpenning, sjukersättning, SGI protection and omprövning, as cited by News55.
