The Social Insurance Agency is criticised for, among other things, informally withholding previously granted sickness allowance and for changing a favourable decision to the disadvantage of the individual without assessing whether the prerequisites for doing so were met

The Social Insurance Agency granted AA sickness allowance for a period of eight months in accordance with her application. However, she was not informed of the decision other than through payment notices on the Agency’s “My pages” website and the fact that some payments were made. When the sickness allowance was withheld part way through the period, no formal decision was taken on the matter and AA was not informed. Subsequently, a new decision on sickness allowance was taken at a lower level, without making it clear that the new decision was an amendment of the previous decision on sickness allowance.

The Parliamentary Ombudsman criticises the handling of AA’s case in several respects. The Parliamentary Ombudsman states, inter alia, that when a decision is made to grant a benefit for a longer period of time or for several periods of time, it is often appropriate for the individual to be informed of the decision – this is to clarify what actually applies and what rights and potential obligations the individual has. The Parliamentary Ombudsman further points out that when the Social Insurance Agency intends to change a previous decision in a way that is disadvantageous to the individual, it must examine whether the prerequisites for doing so are met. If this is found to be the case, the decision must be documented and the individual must be informed that the previous decision has been replaced by a revised decision. The Social Insurance Agency is criticised, because this did not happen in AA’s case. The Parliamentary Ombudsman is also critical of the fact the Social Insurance Agency withheld the granted benefit during the investigation period without making any formal interim decision on the matter.

The Social Insurance Agency is also criticised for a lack of telephone accessibility and for delays in handling a request from a party seeking access to information in their case.