Pierre Koning

Objectives: This study investigates the longitudinal trajectory of employment prospects, before, during and after the COVID-19 pandemic for individuals with work disabilities in the Netherlands. Methods: We conducted a longitudinal cohort study using monthly administrative data between 2018 and 2022 on work and income from all Dutch individuals with a registered work disability in December 2019. Monthly employment probabilities were modelled with longitudinal multivariate Generalised Estimating Equations analysis, where the dependent binomial variable was ‘employment status’. Employment prospects in permanent versus flexible contracts were estimated as two potential outcomes. We stratified our analyses by sex, age, educational attainment, migration background and sector. Results: Our cohort consisted of 476 617 individuals. Employment probabilities gradually increased between 2018 and 2019, but substantially decreased in the year of the COVID-19 pandemic, mainly in flexible contracts. Strikingly, these downturns took place before the start of lockdowns in March 2020. Especially older aged workers (55–63 year) and workers with lower educational attainment were confronted with a lower likelihood of being employed during the first year of the pandemic. Conclusions: Our results suggest that the lower employment probabilities seem not to be solely due to the COVID-19 pandemic. It is likely that the introduction of new Dutch regulations for employers, effective from 1 January 2020, has strongly decreased the number of workers with work disabilities in flexible contracts. Further research will need to determine whether such effects align with those in the total working population or were restricted to individuals with work disabilities.

With populations aging, long‐term care (LTC) needs and costs rise, intensifying the reliance on informal care. Since spouses predominantly provide such care, it is crucial to understand the transition dynamics from widowhood to institutional LTC, which is the main driver of the public LTC costs in most OECD countries. Our study examines the causal effect of widowhood on the onset of needs for institutional LTC. For this we use recently developed event‐time models that accommodate for variation in treatment time and dynamic effects of treatment. Our results show that partner loss significantly increases the need for institutional LTC. The average effect of partner loss on the need for institutional LTC peaks at a 1.5 percentage point rise 3 months after widowhood and disappears after 10 months. The effect is strongest for individuals with psycho‐geriatric disorders, the oldest old and the frail. Addressing the immediate need for institutional LTC after widowhood remains critical for effective aging‐in‐place strategies.

While it is well known that supplementary private Disability Insurance (DI) has the potential to increase workers' moral hazard, the extra coverage may also increase incentives for private insurers to reduce caseloads by means of prevention and reintegration activities. With unique administrative data on DI contracts of firms in the Netherlands, this paper aims to disentangle these worker and insurer responses to increased coverage. Supplementary insurance increases the insurers' incentive to lower disability risks, but in our setting it also creates an incentive for the insurers to facilitate partial work resumption of disabled workers who have earnings capacity. Using firm‐ and time‐fixed effects models on the absence and employment rates, we find that insurer effort counteracts workers' moral hazard.

Variation in assessor stringency in awarding benefits leaves applicants exposed to uninsured risk that could be systematic if discretion were exercised selectively. Using administrative data on disability insurance (DI) applications in the Netherlands, we show that even in one of the most rule‐based DI programs, there is still between assessor variation in awards, and there is systematic variation in assessment across applicants. Discretion is exercised in favor of lower‐wage applicants relatively more than it is used to benefit higher‐wage applicants. This is evident indirectly from downward discontinuities in pre‐disability wages just above benefit entitlement thresholds and directly from wage‐related differences in the extent to which assessors intervene in the semi‐automated calculation of earnings capacity. While lower‐wage applicants benefit on average, they are exposed to greater risk from between assessor variation in the exercise of discretion. Rule‐based disability evaluation can reduce, but not eliminate, between‐applicant variation in awards.

We examine the targeting effects of stricter screening in the Dutch Disability Insurance (DI) program induced by a nationwide reform. The drastic “Gatekeeper Protocol” increased application costs and revealed more information about individuals’ ability to work. Discontinuity-in-Time regressions on administrative data show substantial declines in DI application rates (40% in one year) following the reform, particularly among difficult-to-verify impairments and less severe health disorders. Individuals that were deterred from applying had worse health and worked less than never-applicants. Changes in average health conditions of awardees were almost fully driven by selfscreening and work resumption during the DI sick-pay period.

This paper estimates Age–Period–Cohort models on employment rates of Dutch Disability Insurance (DI) applicants. We find that the substantial decrease in employment between 1999 and 2013 is explained by year-of-application cohort effects and that period effects are negligible. In turn, application cohort effects partly stem from increasing shares of applicants without permanent contracts. Changes in application cohort effects are largely confined to the years following two DI reforms that increased self-screening among workers. We next analyze changes in employment rates of awarded and rejected applicants and follow a Difference-in-Differences approach. Assuming common compositional cohort effects, we infer negligible effects of changes in benefit conditions.