3 Rehabilitation and aids
Rehabilitation within social welfare and health care
Health care has the main responsibility for the medical rehabilitation of persons with
disabilities. Rehabilitation consists of counselling, examination of the need for
rehabilitation, different therapies, rehabilitation periods in an institution, adaptation
training, rehabilitation counselling and aids. A rehabilitation plan is drawn up together
with the client and his or her family. Hospitals and health centres are responsible for
arranging medical rehabilitation. There are separate rehabilitation and prosthetic,
vehicle and appliance units in central hospitals giving expert help in the area of the
whole hospital district. Basic rehabilitation services and basic technical aids are
available at health centres. Services can also be purchased from private institutions and
professionals or from disability organisations.
Aids are given or loaned to the client. This service also includes instruction in the
use of the aid, its replacement and maintenance. Aids are free of charge. Most of the
rehabilitation services are free, but for part of them, such as therapies and
rehabilitation periods in institutions, the clients are charged a small fee.
Health care is responsible for providing rehabilitation at the initial stage, i.e.
acute rehabilitation. Later, social insurance schemes, such as the Social Insurance
Institution and employment accident and motor insurance institutions contribute to
financing rehabilitation.
Medical rehabilitation of seriously disabled persons
Seriously disabled persons are entitled to medical rehabilitation organised by the
Social Insurance Institution, which constitutes either therapy for maintaining working and
functional capacity in out-patient care or a period of rehabilitation in an institution.
This form of rehabilitation is given yearly to about 15,000 seriously disabled persons,
almost a half of whom are children. Rehabilitation is provided free of charge.
Vocational rehabilitation
The purpose of vocational rehabilitation is to improve or maintain the client’s
working capacity and opportunities for earning a living. Vocational rehabilitation may
comprise vocational guidance, examination of the need for rehabilitation, work and
training try-outs, work training, vocational and other education, employment counselling
and job placement, support for running a business, aids needed at work or in studies, and
financial support for rearranging working conditions. Vocational rehabilitation is
organised by the labour authorities, the Social Insurance Institution, employment accident
and motor insurance scheme, employment pension insurance scheme and vocational education
institutions. The amount of the income security during rehabilitation and the conditions
for entitlement vary.
Municipalities organise traditional sheltered work for persons who, owing to their
disability, illness or impairment, do not have access to employment on the open labour
market. There are about 3,000 persons in sheltered employment. Sheltered workshops
maintained by municipalities, joint municipal boards and private agencies number about
130, and provide training and working skills.
Rehabilitation allowance
Those participating in rehabilitation are paid a rehabilitation allowance if they are
not able to work during that time. It is in general of the same size as daily sickness
allowance. The aim of rehabilitation is to promote the access or re-entry to working life
or remaining in it. All people aged between 16 and 18 are provided an opportunity for
vocational rehabilitation. Young people are paid, instead of disability pension, a
rehabilitation allowance on the basis of an individual study and rehabilitation programme.
The purpose is to support their studies and access to employment.
Rehabilitation of those injured in accidents at work or in road accidents
Employment accident and motor insurance institutions indemnify the costs of
rehabilitation when the need for rehabilitation is due to an employment accident,
occupational disease or road accident. Insurance institutions have the primary
indemnification responsibility. This rehabilitation may be both medical and vocational.
An insurance institution indemnifies the client for the costs of rehabilitation to the
amount as the client would have to pay them. On the other hand, municipal social welfare
and health care is not compensated for the costs of rehabilitation. The costs of aids are
however compensated to their full amount to hospitals and health centres. Rehabilitation
clients are remunerated in full the loss of earnings during rehabilitation.
Co-operation of authorities
Since the rehabilitation system is complicated there is separate legislation on
co-operation concerning rehabilitation services. This obliges social welfare and health
care, labour and educational authorities and the Social Insurance Institution to
co-operate in co-ordinating the rehabilitation measures and services. Furthermore, these
authorities are obliged to co-operate with other relevant service systems.
The legislation also obliges municipalities to see to it that there is a working group
on co-operation in respect of rehabilitation services in the municipality. In addition to
the general promotion of this co-operation, the working group can also handle such
problematic cases in which no solution has been found otherwise. It is important that the
client is involved when his or her case is dealt with in the working group.
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