The Swedish Social Insurance agency has a need to develop a dynamic system to manage employee holidays. Today, all information about employee holidays ar stored in in diffrent holiday lists and takes form of documents such as Excel spreadsheets. This creates unnecessary administrative work and frustration, so the need for a common vacation list exist. A list that contains all employees of the Swedish Social Insurance Agency, which can be shaped as needed. The list should be able to be filtered so that only those people who are of interest to the user are displayed. The user should also be able to easily save the his/hers vaca- tion days. After the agile meetings with the clients of the agency, could a solu- tion be developed. This solution is based on an external code library named Te- lerik, and store employees holidays in a single database. This solution can be added to the Social Insurance Agency's intranet FIA, so that it is easily acces- sible for employees. The new holidays list's design was chosen from the clients wishes and the guidelines of how a good design should be. At present there is no license on the insurance agency to use Telerik, but this solution was chosen anyway because it was considered the best approach for this project. If the solu- tion is selected as the new system for storing holidays, there is an opportunity to continue the project by buying a license for Telerik, add up the vacation list of FIA and use personal data from the Social Insurance Agency's database so all employees are included. / På Försäkringskassan finns behovet av att ta fram ett dynamiskt system för att hantera de anställdas semester. Idag sparas all information om ledighet i semes- terlistor på olika vis i form av dokument som till exempel Microsoft Excel-ark. Detta skapar onödigt administrativt arbete och frustration, så behovet av en ge- mensam semesterlista finns. En lista som innehåller samtliga anställda på För- säkringskassan, och som kan formas efter behov. Listan ska kunna filtreras så att endast de personer som är intressanta för användaren ska visas. De ska också enkelt kunna spara användarens ledigheter. Efter agila möten med beställare kunde en lösning tas fram. Denna lösning har sin grund i ett externt kod-biblio- tek vid namn Telerik, och lagrar anställdas ledigheter i en enda databas. Denna lösning går att lägga upp på Försäkringskassans intranät FIA, så att den blir lätt- åtkomlig för de anställda. Semesterlistans design valdes från beställarnas önske- mål. I nuläget finns ingen licens på Försäkringskassan för att använda Telerik, men denna lösning valdes ändå eftersom det ansågs vara det bästa tillväga- gångssättet för detta projekt. Ifall lösningen väljs till det nya systemet för att lagra ledigheter finns det möjlighet att fortsätta projektet, genom att köpa en li- cens för Telerik, lägga upp semesterlistan på FIA och använda persondata från Försäkringskassans databas för att samtliga anställda ska finnas med.

This study focuses on the case workers, employed by the Social insurance agency and how they experience their work, and the contact with the insured members of the society they deal with on a daily basis. The study is conducted by five interviews from two of the departements that constitutes the agency. Even though the decision making differs in the departements, the informants share many of the same perceptions of their work and how it feels to maintain contact with the insured individuals. The result shows that the case workers maintain a distance to the individual by not trying to engage personally in the different errands. The study also focuses on the organizational endeavours they encounter, for example a high turn over of the staff. The high turn over leads to a difficulty for them to manage all the errands and the employees are there for forced to prioritize among the errands. That becomes a subjective priority based on the case workers view of the importance of the errand. The study has also taken in to account whether or not the case workers engage to coping strategies to cope proffesionally with their insured members. The empirical material has been analyzed mainly with the theories regarding street-level bureaucrats that was first introduced by Michael Lipsky (2010) and Roine Johansson (2007). / Denna studie behandlar hur Försäkringskassans handläggare upplever sina yrken och förhållningssätt till sina uppgifter och de försäkrade individer de möter och har kontakt med. Uppsatsen består av fem kvalitativt genomförda intervjuer på två av myndighetens olika avdelningar. Trots att de beslutsfattande organen på avdelningarna skiljer sig från varandra uppvisar informanterna liknande uppfattningar om arbetet och hur det känns att ha kontakt med de försäkrade. De bibehåller en distans till den försäkrade genom att försöka undvika personligt engagemang till personen. Vidare behandlar studien organisatoriska utmaningar de möter, så som hög arbetsbelastning och stundtals bristande ledarskap. Den höga arbetsbelastningen leder till att de får svårt att hinna med alla ärenden och tvingas att prioritera bland dessa. Det leder till en subjektiv bedömning i vad för handläggaren anses som viktigt. Studien behandlar även om huruvida handläggarna är benägna att använda försvarsstrategier för att kunna vidhålla en professionell attityd till den försäkrade. Det empiriska materialet har bearbetats till största del med hjälp av teorier om gräsrotsbyråkrater av Michael Lipsky (2010) och Roine Johansson (2007)

Ett allt vanligare fenomen i dagens arbetsliv är att tjänsteproduktion organiseras efter modeller som i grunden är anpassade för varuproduktion. En av dessa organisationsmodeller är Lean, som har implementerats inom Försäkringskassan. Försäkringskassans byråkratiska organisation har därmed struktureras upp i ännu fler regler, rutiner och processer. Finns det något utrymme för lärande i en sådan organisation? Denna studie har som ambition att bidra till en ökad förståelse för hur lärande i det dagliga arbetet uppstår i en byråkratisk organisation där regler och rutiner är en del av jobbet. Syftet är att belysa personliga handläggares upplevelse av lärande i det dagliga arbetet. Utifrån syftet har följande frågeställningar formulerats; Hur upplever handläggare att styrande rutiner för arbetets utförande inverkar på deras lärande? Hur upplever handläggare att de lär sig av sina kollegor? I vilken utsträckning upplever handläggare att lärande sker över det egna teamets gränser? Studien bygger på en kvalitativ metodansats och åtta semistrukturerade intervjuer har genomförts med handläggare på försäkringskassan. Det empiriska materialet har analyserats utifrån Wengers teori om Communities of Practice. Resultatet visar att regler och rutiner används för att fylla kunskapsluckor och därmed bidrar till lärande. Handläggare lär också i det dagliga arbetet genom social interaktion som bland annat uppstår vid informella diskussioner och formella möten. Interaktionen leder till ett erfarenhetsutbyte mellan kollegor. Genom att ta del av andra myndigheters eller individers erfarenheter och kompetens har handläggarna möjlighet att utveckla ett lärande över gränser. Dock skiljer sig handläggarnas uppfattningar när det kommer till kunskaps- och erfarenhetsutbyte med aktörer utanför Försäkringskassan. / An increasingly common phenomenon in today's working life is that the production of services is organized through production models that originally was created to organize the production of things. One of these organizational models is Lean, which has been implemented within the Swedish Social Insurance Agency. This bureaucratic organization has thus been structured into even more rules, procedures and processes. Is there any room for learning in such an organization? This study is an attempt to contribute to an understanding of how learning in daily work occurs in a regulated organization where rules and procedures are part of the job. The aim of the study is to investigate the social insurance officers personal experience of learning in the daily work. To answer the purpose of the study the following questions has been formulated; How do social insurance officers experience that common routine descriptions of work design influence their learning? How do social insurance officers experience that they learn from their colleagues? To what extent do social insurance officers experience learning over the boundaries of their own team? The study is based on a qualitative method using eight semi-structured interviews with social insurance officers at the Swedish Social Insurance Agency. The empirical data has been analyzed from Wengers theory Communities of practice. The result shows that rules and procedures are used to fill knowledge gaps and thus contribute to learning. The social insurance officers also learn in daily work through social interaction by informal discussions and formal meetings. By studying other authorities or individuals' experiences, the social insurance officers can develop cross-border learning. However, the perceptions of the social insurance officers differ when it comes to knowledge and experience exchange with actors outside the Swedish Social Insurance Agency.

This thesis contributes to the field of causal inference, where the main interest is to estimate the effect of a treatment on some outcome. At its core, causal inference is an exercise in controlling for imbalance (differences) in covariate distributions between the treated and the controls, as such imbalances otherwise can bias estimates of causal effects. Imbalance on observed covariates can be handled through matching, where treated and controls with similar covariate distributions are extracted from a data set and then used to estimate the effect of a treatment. The first paper of this thesis describes and investigates a matching design, where a data-driven algorithm is used to discretise a covariate before matching. The paper also gives sufficient conditions for if, and how, a covariate can be discretised without introducing bias. Balance is needed for unobserved covariates too, but is more difficult to achieve and verify. Unobserved covariates are sometimes replaced with correlated counterparts, usually referred to as proxy variables. However, just replacing an unobserved covariate with a correlated one does not guarantee an elimination of, or even reduction of, bias. In the second paper we formalise proxy variables in a causal inference framework and give sufficient conditions for when they lead to nonparametric identification of causal effects. The third and fourth papers both concern estimating the effect an enhanced cooperation between the Swedish Social Insurance Agency and the Public Employment Service has on reducing sick leave. The third paper is a study protocol, where the matching design used to estimate this effect is described. The matching was then also carried out in the study protocol, before the outcome for the treated was available, ensuring that the matching design was not influenced by any estimated causal effects. The third paper also presents a potential proxy variable for unobserved covariates, that is used as part of the matching. The fourth paper then carries out the analysis described in the third paper, and uses an instrumental variable approach to test for unobserved confounding not captured by the supposed proxy variable.

The aim of the study was to understand the processing of sickness benefit cases concerning mental illness from the perspective of the social insurance officer in order to contribute with knowledge about legal certainty and expressions of power in relation to the processing of sickness benefit cases concerning mental illness. To achieve this aim, six social insurance officers from one social insurance agency were interviewed using a semi-structured interview format. The interviews were then transcribed and analysed thematically. The authors found, among other things, that cases concerning mental illness were more difficult to process mainly because physicians struggle to formulate sufficient medical certificates. The authors also found that the legal certainty can be questioned because the vast majority of cases that are granted do not go through quality assurance. Furthermore, the rejection rate of cases differed between social insurance officers. Thus, implying that cases are not processed in a similar manner, which is required in order to achieve legal certainty. Expressions of power were found between the social insurance officer and the insured. Instances of officers withholding crucial information from the insured were found, which is an expression of power/knowledge. The authors also found that social insurance officers tend to use a language of power that is difficult for the insured to comprehend in the letters that notify the decision.

In 2020, many Swedes were infected by the COVID-19 virus. The individuals who now suffer from post-COVID conditions have symptoms that resemble the neurological disorder myalgic encephalomyelitis (ME). ME is predicted to increase in the aftermath of the pandemic. Both post-Covid and ME patients commonly encounter misunderstandings, a lack of treatment options and experience difficulties with the Swedish Social Insurance Agency. The purpose of this study is to examine how patients with ME experience their condition to affect the relationships to people in their everyday life and the reception from the health care system as well as the Swedish Social Insurance Agency. The study also examines important factors in coping with the condition. Previous research on the disorder shows difficulties with getting diagnostic legitimacy, a drastically diminished social life, stigma and traumatic experiences with the Swedish Social Insurance Agency. This study is based on six semi-structured video interviews with people who have ME. The analysis of the results has its foundation in Goffman’s dramaturgical theory and his concept of stigma. It further draws on Elias’ and Scotson’s explanation of moral differentiation and Antonovsky’s determining factors of coping with traumatic events. The empiric material shows that having ME leads to a diminished group of friends, which seems to affect the young participants the most. They are also more prone to stigmatization by superficial acquaintances and new contacts. A shared experience among the participants is stigmatization in primary care, which also complicates their encounters with the Swedish Social Insurance Agency. Emotional, practical and financial support make it easier to handle the situation. When needed, it is essential to be able to rest. The situation also becomes easier to handle if the individual is able to create meaning from the new life circumstances. / 2020 smittades många svenskar av covid-19. De individer som drabbats av långtidscovid har en symptombild som liknar den neurologiska sjukdomen myalgisk encefalomyelit (ME). En sjukdom som förutspås öka i spåren av pandemin. Båda dessa patientgrupper möts av oförståelse, brist på behandlingsalternativ och problem med Försäkringskassan. Denna studie ämnar undersöka hur ME-sjuka upplever att sjukdomen påverkar relationen till de människor individen möter i vardagen samt bemötandet från vård och Försäkringskassan. Den fokuserar även på vad som är viktigt för individens hantering av situationen som sjuk. Tidigare forskning om sjukdomen visar på problem med diagnostisk legitimitet, krympta sociala nätverk, stigmatisering och traumatiserande behandling av Försäkringskassan. Studien är baserad på 6 semistrukturerade videointervjuer med ME-patienter. Resultaten har analyserats utifrån Goffmans dramaturgiska perspektiv samt teori om stigma. Vidare används Elias och Scotsons beskrivning av moralisk differentiering samt de faktorer Antonovsky uppger som avgörande för att hantera traumatiska händelser. Empirin visar att ME leder till en reducerad vänskapskrets, vilket de unga lider mest av. Unga är i större mån även utsatta för stigmatisering av ytliga bekanta och nya kontakter. Samtliga deltagare upplever stigmatisering inom primärvården, vilket bidrar till en komplicerad ärendeprocess hos Försäkringskassan. Hanteringen av situationen som sjuk främjas av emotionellt, praktiskt och ekonomiskt stöd, möjlighet att vila samt att utifrån nya förutsättningar finna mening i livet.

Syftet med studien var att ta reda på hur ett antal individer som fått besked om nekad sjukpenning trots läkarintyg upplever och hanterar sin livssituation och deras ekonomiska förutsättningar efter förlorad sjukpenning. För att besvara studiens syfte och frågeställningar genomfördes kvalitativa intervjuer med sju individer som har upplevelse av att få nekad sjukpenning trots läkarintyg. Teorierna som tillämpats i analysen var coping och stigma. Resultatet visade att majoriteten av respondenterna upplevde att de påverkats negativt av beskedet, både ur ett känslomässigt och ekonomiskt perspektiv. För att hantera sin livssituation använde respondenterna både problemfokuserade och emotionella copingstrategier. Resultatet visade även att majoriteten av respondenterna upplever sig stigmatiserade, både i samhället och av myndigheterna. En av studiens viktigaste slutsatser är att det finns brister i sjukförsäkringen. Det saknas samverkan mellan Försäkringskassan, den enskilde och andra myndigheter. Bedömningen av den enskildes sjukdom och arbetsförmåga skiljer sig också mellan läkare och försäkringskassa. / The aim of the study was to explore the experience of individuals who have been denied sickness benefit despite medical certificates and how they master life and their economy without it. To answer the questions of the study, qualitative interviews were conducted with seven individuals who have the experience of being denied sickness benefit despite medical certificates. The theories applied in analyzes were coping and stigma. Results showed that respondents felt they were negatively affected, both from an emotional and financial perspective. To manage their life situation, respondents used both problem focused and emotional coping strategies. Results showed that respondents felt stigmatized, both in society and by the authorities. Conclusion of the study is that there are shortcomings in Swedish health insurance. Collaboration is poor between social insurance agency and the individual. The assistant of the individual’s illness and ability to work differs between doctor and social insurance fund.

Studiens syfte är att undersöka hur förändringsmodellen ADKAR har använts bland enhetschefer på Försäkringskassan och vilken betydelse den har haft för de under en organisationsförändring. För att uppfylla studiens syfte har en organisationsförändring studerats utifrån ett första linjens chefsperspektiv. Studiens teoretiska utgångspunkter baseras på teori och begrepp relaterat till översättning och meningskapande. Utgångspunkterna har använts för att studera hur ADKAR- modellen översatts och skapat mening kring förändringen. Studiens metod är kvalitativ med fokus på fyra semistruktuerade intervjuer och fyra textdokument. Resultatet av studien påvisar att förändringsmodellen ADKAR internaliserats hos cheferna i samband med deras chefsintroduktion. Modellen har blivit ett etablerat sätt att kommunicera och tänka utifrån vid förändring. ADKAR- modellen idientifieras genomgående under förändringen som en vattenfallsmodell. / The purpose of this thesis is to investigate how the change model ADKAR has been used among section directors at the Swedish Social Insurance Agency and what significance it has had for them during an organizational change. To fulfill the purpose of the study, an organizational change has been studied through the perspective of a first line director. The thesis theoretical starting points are based on theory and concepts related to translation and sensemaking. The starting points have been used to study how the ADKAR model has been translated and created sensemaking around the change. The study method is qualitative with a focus on four semi-structured interviews and four text documents.The results of this thesis shows that the change model ADKAR has been internalized in the managers in connection with their manager introduction. The model has become an established way of communicating and thinking from the outside in the event of change. The ADKAR model is consistently identified during the change as a waterfall model.

The diploma thesis called The comparison of medical assessment service (MAS) aim and activities within the health insurance system in the Czech and Slovak Republic and it is focused on the pieces of information related to the system of social security aiming its attention to the health insurance during both the time of Czechoslovakia and its current arrangement of the Czech and Slovak Republics in its theoretical part. Related to that there is also elaborated the issue of the medical assessment service. There is a conclusion of the most important services of the MAS and particular competences of bodies involved into the health insurance. There is also a mention of the body adjusting the public health insurance including the related area of the review medicine to get a more comprehensive view. The diploma thesis main aim is to compare the tasks and activities of the MAS in the Czech and Slovak Republics. There are determined partial aims to get a more comprehensive elaboration. One of them is focused on the benefits that are awarded based on a health condition within the health insurance in these two countries and the other one is the comparison of Czech and Slovak health condition of citizens based on the statistics of temporary sick leaves taking into consideration the conditions while awarding them. The document analysing method is used to reach the aims mentioned above. This method follows Mayring´s proposed plan and the sources where the information was taken from were firstly evaluated from a criteria relevance viewpoint. After that the gained data was compared within a comparative method in a synchronous way. The empiric diploma thesis part contains data organized in well-arranged tables with comments and in the following Chapter 5 Discussion there is data compared according to the methodology mentioned above. The basic system comparison of social security and health insurance in the Czech and Slovak Republics belongs among the topics of the final discussion. The possibility of consolidation of health and social insurances in both countries also taking into consideration the opinions of the involved experts is largely covered here. The most significant discussion focus is the comparison of the aim and activity of the MAS in the Czech and Slovak Republics. The results show that the aim and activity of the MAS are very similar in both countries; which is logical regarding the common historical base. Czech and Slovak main MAS activity within the health insurance is the auditing activity; i.e. the audit of evaluation of the health condition by the involved medical doctor as well as the inspection if the treatment mode of people on sick leave is being followed. It is also possible to notice some nuances in the elaboration in both MAS systems; which are separated today. Regarding the legislation it is possible to say that the Slovak medical assessment service work in a more consistent way that is also supported by the statistic data containing more performed audits of the treatment mode following and a more frequent usage of sanction means towards insurers which is the result of the more detailed strategic planning of inspections. The diploma thesis offers a comparison of health insurance systems and tasks and activities of the MAS in the Czech and Slovak Republics. It can be used as a study document for students of social politics and a social security law. It can also be used as an impulse to other explorations in this area and to start thinking of various possibilities how to arrange the social security system of these two countries.

The main purpose of this dissertation is to analyse and identify problems arising from the Swedish Social Insurance Agency’s (SSIA) perceptions of parents, as they appear in the brochures targeted at expectant or new parents between 1974 and 2007. The aim is to distinguish who are being pointed out, constructed, and normalised as parents; and to analyse the functions of the recipients and the senders respectively. The aim is to be considered in the light of the SSIA’s commitment to gender equality, a policy that promotes equal access to the insurance of parents to share the parent’s insurance more equally. The dissertation is based on a theoretical framework that may principally be described as a feminist discourse analysis, which, among other things, means that a constructivist approach is of central importance. In addition, an intersectional perspective is an important starting point, putting the focus on the interaction and interdependence between different social categorisations. In four analysing chapters, the material is being tackled from different approaches or angles. In the first chapter, a picture is drawn of the institutional and political context that sets the prerequisites of the insurance regulations as well as the way the texts have been written and may be understood. The second chapter presents an analysis, in the terms of space deixis, of whom is/are being pointed out and positioned as recipient/s by SSIA. In the third chapter, an analysis of the normalised notions of parents that are identified in the texts; and of what parents are being favoured and described as ‘normal’. In the fourth chapter, the functions of the different actors are being analysed, showing how the relationship between the SSIA and the parents is constructed from in the texts. The results show that, in all brochures, parenthood is strongly gender-marked and that gender equality, above all, is to be understood as a quantitatively even distribution between mothers and fathers. In today’s brochures, the agency identifies and normalises recipients who primarily are biological mothers with orderly conditions, living in nuclear families with biological children. The older brochures have a higher level of gender neutrality in their texts, where mothers and fathers are placed equally and at the same distance from the position of the sender. The newer brochures, however, represent a wider range of social categorisations, and thus present a more complex picture of parenthood. The results also show that the function of SSIA in the texts is primarily economic, and that there is no obligation for parents to share the parent’s insurance equally, despite the political resolutions that impose this task on the agency.