FfW Bulgarian report (English language) - Fit for Work Europe

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Interventions 44 Bulgaria (Georgieva et al., 2007; Tzenova, 2011a), possibly predicting the lack of psychological support offered to those with chronic conditions. Research has shown that mental health conditions are more common among people with chronic physical health conditions. For those individuals with co-morbid physical and mental health conditions functional disability can be six times higher than for those with just a physical or mental health condition. The number of days absent from work is also higher for these individuals (Ashby and McGee, 2010). Responding to the psychological needs, as well as the physical needs of those with chronic conditions is therefore crucial if the impact of their disability is to be managed. There is a good tradition of providing rehabilitation such as physiotherapy after medical treatment both through inpatient and outpatient services, as well as through spa-like resorts (Georgieva et al., 2007). Although reimbursable, payment usually has to be made by the patient upfront, potentially affecting the number of people who can access treatment. 27 Nevertheless, there is lack of evidence that rehabilitation from illness is linked to the individual’s return to work. The attitude amongst medical professionals towards return to work is not clear and views of experts are conflicting. Whilst there is some indication that patients are encouraged to return to work as soon as possible following treatment, 28 there is also some indication that doctors view work as an extra burden for ill patients. 29 With the right support in place and education for patients, employees and employers, work as a clinical outcome is something that should be encouraged. Regarding early intervention in the workplace, prevention is always easier than cure. There is evidence that efforts are being made by the government to finance preventive methods in the workplace. For example the ‘Working conditions’ FUND30 has the task of financing activities to improve working conditions in accordance with legislation of the Republic of Bulgaria as part of the programme on working conditions adopted by the National Council. The Fund finances projects of national, sectorial and regional importance. In 2011 diagnosis and early intervention for occupational diseases were one of the Fund’s strategic goals with 1 mln BGN available to target this goal. They also made funds available to finance safety training programmes. Ensuring that workers who have MSDs get access to appropriate health care and support as quickly as possible must be a top priority for employers and health care professionals. Increasing access to GPs, specialist health care professionals as well as experts in vocational 27 Expert interview 28 Expert interview 29 Expert interview 30 See Ministry of Labour and Social Policy http://fund.mlsp.government.bg/fund/f1.htm Fit For Work?
4.2 The social security regime for the work disabled rehabilitation is crucial if workers are to return to work early and prevent the high costs involved in long term absence and disability. It is clear that, in most EU member states, interventions made by the social security system can make a significant difference to citizens of working age with long-term, chronic or work-disabling conditions. Bulgaria, among other European countries, is transforming its welfare system to incentivise and support return to work for disabled persons. Under the current schedule of disability assessment individuals are evaluated mainly on their physical capacity, receiving a category for the degree of disability they have (>90 per cent, 71-90 per cent, 50-70 per cent or
Page 1 and 2: Fit For Work? Rosemary Thomas Kseni
Page 3 and 4: Contents 1. Executive summary 5 2.
Page 5 and 6: 1. Executive summary The ‘Fit for
Page 7 and 8: What can be done? Executive summary
Page 9 and 10: Executive summary We have found imp
Page 11 and 12: Increasing work intensity is a very
Page 13 and 14: 2.2 MSDs: The European context Intr
Page 15 and 16: 2.4 A note on definition Introducti
Page 17 and 18: 2.5 Structure of the report Introdu
Page 19 and 20: Figure 3.1. Number of MSDs inpatien
Page 21 and 22: • Stamina and resilience; • Cog
Page 23 and 24: Work and MSDs in Bulgaria It is imp
Page 25 and 26: of RA and specific leukocyte antige
Page 27 and 28: injuries or back pain 15 ; Sieper,
Page 29 and 30: 2001). The study also found that fo
Page 31 and 32: • Local or whole-body exposure to
Page 33 and 34: workers of developing rheumatoid ar
Page 35 and 36: 3.4 The wider economic and social i
Page 37 and 38: Work and MSDs in Bulgaria Direct co
Page 39 and 40: presented in the Table 3.3 below. T
Page 41 and 42: 3.5 Summary Work and MSDs in Bulgar
Page 43: Job retention and return to work pr
Page 47 and 48: Further indirect costs of disabilit
Page 49 and 50: 4.3 Conditionspecific interventions
Page 51 and 52: RA in Bulgaria who receive biologic
Page 53 and 54: Interventions Since it was first pr
Page 55 and 56: apart from norms of shift work. 43
Page 57 and 58: Box 2. Case Study - EPIQ Electronic
Page 59 and 60: the beliefs that both parties have
Page 61 and 62: 4.6 Summary 4.5.4 Improved employer
Page 63 and 64: 5.1 Recommendations for employers 5
Page 65 and 66: 5.3 Recommendations for GPs and spe
Page 67 and 68: Conclusions and recommendations •
Page 69 and 70: Breen, A., Langworthy, J. and Bagus
Page 71 and 72: der Tempel, H. and van der Linden,
Page 73 and 74: Guzman, J., Esmail, R., Karjalainen
Page 75 and 76: References Nachemson, A., Waddell,
Page 77 and 78: Waddell, G. and Burton, A. K., (200
Page 79 and 80: Appendix 2: Sample ‘Fit’ Note S
Page 81 and 82: Sources: Eurostat Statistical Datab
Page 83 and 84: Sources: Parent-Thirion, Fernández
Page 85 and 86: Hourly labour costs 2007 Average ho
Page 87 and 88: % sickness absence due to health re
Page 89 and 90: Appendix 3: Benchmarking grid Refer
Page 91 and 92: The aim of the project is to stimul
Page 93 and 94: Appendix 4: Fit for Work Europe Wha
Page 96:
We provide: Research Advisory Consu
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