Last Thursday, the Minister of Inclusion, Social Security and Migration, Elma Saiz, announced the proposal for a “flexible” sick leave, which allows workers to return to work progressively while they recover from their illness or accident. This is a possibility that already exists in other European countries, such as Sweden, Norway, Finland, Germany, the Netherlands and the United Kingdom and to which the Employment and Social Affairs Committee of the European Parliament was favorable in 2018. Here the proposal has has been received with many reluctance, which is more than understandable, given the sensitivity of an issue that directly affects the health of workers. However, there are technical arguments that suggest that attempting to facilitate an earlier return to work, under safe conditions, may be beneficial for the well-being of these workers.
There are already multiple scientific studies that show that extending work inactivity is not only not always necessary, but it can be harmful. Many diseases or injuries begin with an acute phase, which is completely disabling, but then stabilize in a long-lasting period of progressive recovery, in which the symptoms moderate and the person gradually recovers the faculties required to function. in your daily life. It is at this point where it is worth making an effort from the workplace to ensure that the working conditions are compatible with the worker’s state of health while he finishes healing. Otherwise, it has been proven that the longer a worker remains on sick leave, the more difficult it is for them to return to their usual position, because job maladjustment increases over time.
For example, musculoskeletal diseases, such as low back pain or neck pain, are the first cause of sick leave in our country. Well, for its medical treatment, the latest scientific recommendations indicate that, contrary to what was traditionally believed, it is advisable to avoid excessive rest and stay active. For this reason, it has already been proven that adapting the worker’s functions to facilitate their return to work promotes clinical improvement and prevents subsequent relapses. For this same reason, in the 1980s workers who practiced any sport while on temporary disability could be fired, while now they are no longer penalized for exercising. They can only be fired if the specific practice they carry out shows that they are faking their illness.
Something similar happens with workers affected by certain mental illnesses, which are the second cause of sick leave in Spain. In this regard, it has been proven that long periods of inactivity damage self-esteem in terms of the perception of one’s own ability, lead to social isolation and fuel behaviors of withdrawal and hopelessness that can even aggravate the medical cause of the sick leave. Therefore, accompanying psychological treatment with gradual and controlled exposure to work is an appropriate measure that can promote recovery. When this possibility does not exist, the worry of having to suddenly face all of their responsibilities after being discharged can generate even greater mental pressure for the worker.
The third major cause of temporary disabilities in our country is cancer. Workers with this disease also have great difficulty returning to work when their condition stabilizes. What’s more, they run a serious risk of being excluded from working life, because they may suffer consequences such as pain or chronic fatigue. Even so, patient associations claim that facilitating the labor reintegration of workers who would like to work is essential so that they can once again enjoy a quality of life similar to the one they had before the disease. This return to work has many signs of failing if they are forced to resume all their functions with the same intensity that was required of them before becoming ill, but it is viable if it occurs gradually and with the necessary work support.
In short, understanding that the day before medical discharge the worker is totally sick and that the next day he is totally recovered is a legal fiction that does not adjust to reality. This circumstance can occur in cases of short-term illnesses such as the flu or gastroenteritis. But most illnesses that last longer remain somewhere between discomfort and absolute well-being. The drawback is that our legislation does not allow grays or nuances because it understands health as if it were a binary variable when it is not. Either medical leave or discharge and work, without half measures.
On the other hand, as we have wanted to show here, in practice the problem is more complex, which indicates that more reasonable and proportionate solutions could also be sought than all or nothing. To do this, of course, it would be necessary to have all the guarantees: adequate and specialized medical supervision, a good predisposition on the part of the worker and the company, technical and economic support to make the adaptations that are necessary or extreme care of all occupational risk prevention measures. These are not easy conditions to meet and therefore the reform that would be necessary to be able to apply flexible withdrawals would not be simple. But it does not seem sensible to affirm, from the outset, that the idea has to be automatically discarded because it leaves the health of workers unprotected.