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Yin N and Heiland F

For example, Sweden requires as high as 86%–99% disability level for full disability
benefits while its minimum disability level is only 0%–25%. The U.S. system does not
offer benefits for mildly or moderately work-limited individuals. It allows disability
benefits only to those with a disability level of 71%–85% or higher.

1.2.4 Policies 4 and 5: Maximum Benefits and Permanence of Benefits
According to the proportion of the work earnings that can be replaced by the maximum
benefit level, Sweden and Netherlands rank the highest with the most generous
replacement rate (≥75%), and the U.S. sets a moderate replacement rate of 50%–75%,
the same as the rate in France and Italy.
The outflow from disability rolls back to employment is almost zero in all the
countries, not only in the country where the disability compensation is long-term
(e.g., strictly permanent in Spain; de facto permanent in Belgium and U.S.) but also
in countries where disability benefits are supposed to be temporary (unless for fully
disabled) such as in Sweden, France, Germany and Italy. In most countries, periodic
legal reviews are required on disability beneficiaries but in practice they rarely occur.
1.2.5 Policies 6 and 7: Medical Assessment and Vocational Assessment

In most countries, the medical assessment is performed by insurance doctors.
However, countries differ in accounting for the opinion of treating doctors. In most of
the countries we study, such opinion is not taken into account in disability assessments.
Germany and Sweden weigh in the medical evaluation. In the U.S., the disability
determination relies on the applicants’ treating doctors’ opinion predominantly. On this
policy measure, the U.S. takes the lead in leniency. While the treating doctors may be
better informed about the applicant’s medical problems, there are also concerns that the
treating doctors are too familiar with the applicant to make an objective assessment.
In terms of vocational assessment, Sweden, like the U.S., takes into account all the
jobs available in the national economy, whereas some other countries, such as Belgium
and France, use one’s previous earnings/occupations as reference in evaluating one’s
residual earning/work capacity.

1.2.6 Policies 8 and 9: Sickness Benefits

Sickness benefits in many countries usually target individuals with less severe
work limitations and serve as a precursor to long-term disability programs. In the
Netherlands, nearly all employees receive 100 percent wage replacement (70 percent
sickness benefit topped up by collective bargaining to 100 percent of the wage)
during the entire sickness period. Germany and Sweden have a higher benefit rate for
sickness than for disability, while in the southern European countries sickness benefits
are usually much lower than disability benefits. The U.S. does not have any sickness
benefit program although some employers and five states provide short-term disability
benefits.
1.2.7 Policy 10: Unemployment Benefits

A worker who suffers health impairment and job separation but still has residual work
capacity may choose to apply for unemployment benefits or partial disability benefits.
This is mostly likely the case in European countries whose disability systems offer
partial benefits. In the U.S., the disability system awards benefits only to the fully
disabled individuals who are not supposed to qualify for any unemployment benefits.
In Spain, disability benefits are more generous than unemployment benefits. Sweden
offers similar levels of disability benefits and unemployment benefits for a resident
but the duration is longer for disability benefits. The U.S. is one of the few developed
countries where disability benefit levels are significantly lower than unemployment
benefit levels, although the duration for unemployment benefits is rather short.
By summing up the scores in the 10 dimensions discussed above, we obtain an
overall policy generosity value for each country. The U.S. ranks as the least generous

International Journal of Population Studies 2017, Volume 3, Issue 1 47