Assessing sick-listed clients’ work ability: A moral mission?

Abstract

Judging the extent to which sick-listed clients’ disabilities qualify them for sickness benefits is increasingly part of frontline work. However, we lack knowledge about the discretional process of assessing work ability. Institutional ethnographic research of caseworkers in the Norwegian Labour and Welfare Administration revealed that they emphasised clients’ residual work ability – meaning what clients could perform despite their medical diagnoses – as well as their inner motivations and work ethic. We argue that frontline praxis is influenced by efforts to fit clients into a category of the deserving ‘sick-listed yet work-capable client’. Because caseworkers lack guidelines to combine health and work, they increasingly apply their ‘moral selves’ in the assessment process resulting in scepticism towards clients’ feigning, or exaggerating symptoms to obtain financial benefits or avoid work. We question whether our findings represent a shift of the Norwegian universalistic welfare model to a more liberal and incentive-strengthening type.