Reflections from the Opinion Festival’s Work Life track — with Dr Toomas Põld and Dr Liisi Luht

Meliva chief physician Dr Toomas Põld took part in the panel “On sick leave — and at work!?”

Around 18,000 people a year use long-term sick leave, meaning leave lasting more than two months — a significant number. As of 15.05.2024, a legal amendment came into force allowing a person to take up work under adjusted conditions or reduced hours while on long-term sick leave (over two months). The aim of this change is to prevent lasting health problems from developing and to help prevent job loss.

One of the biggest challenges with the amendment, from the employee’s perspective, is potential uncertainty about their health or the continuity of their benefit payments. From the employer’s perspective, the concern is taking on responsibility for shaping safe working tasks and a working environment that won’t harm the person’s health. What role does the occupational health physician play in this situation? An occupational health physician can advise both the treating doctor and the employer.

Key points of the legal amendment:

  • From day 61 onward, an employee can take up part-time work while on sick leave — this must be confirmed by the treating doctor who issued the sick leave certificate, who informs the employer what adjustments the person would need (including working hours, workload, work environment, and which tasks the person can and can’t do).
  • The employer must agree to, and confirm, that they can offer the person the option to return to work under adjusted conditions.
  • The Estonian Unemployment Insurance Fund (Töötukassa) also offers various services for employees with health limitations and their employers, including assistive devices, workplace adjustments, occupational rehabilitation, counselling, and retraining options.

While working under sick leave, it’s also possible to receive a wage-gap benefit from Tervisekassa (the Estonian Health Insurance Fund) — the employer must maintain at least 50% of the employee’s wage, and Tervisekassa then reimburses 50% of the agreed wage based on the person’s pay the day before going on sick leave. In total, the person should end up receiving 100% of their previous salary (despite working part-time) — meaning the benefit could motivate people to return to work sooner. The employer, in turn, only needs to pay for the hours the person is actually able to work.

Meliva occupational health physician and pulmonologist Dr Liisi Luht took part in the panel “Illness, disability? Doesn’t matter, we all want to work”

One point that stood out from the discussion was that an employer can’t support an employee with reduced work capacity if the employer isn’t aware of that reduced capacity or disability in the first place. Often, the employee doesn’t say anything, and the employer doesn’t know how to ask. Employees are often afraid to speak up, fearing job loss. From the employer’s side, it came through clearly that an employee remains highly valuable to them even when unexpected health-related limitations arise, and that employers would very much like to keep such employees on board going forward.

For both sides to feel satisfied and comfortable, though, they need the opportunity to adapt to the new situation together. An occupational health physician can act as a go-between for information between an employee with reduced work capacity and their employer — as the employer’s partner, assessing the employee’s health-related limitations and, in doing so, helping the employer adjust the work environment to suit the employee.

Mõtteid Arvamusfestivalilt Tööelu alalt. Osalesid dr Toomas Põld ja dr Liisi Luht
Reflections from the Opinion Festival’s Work Life track — with Dr Toomas Põld and Dr Liisi Luht

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