Skipping the doctor: evidence from a case with extended self-certification of paid sick leave

Abstract This paper examines the impact of a policy reform in a municipality in Norway that extended to workers the right to self-certify sickness absence from work. After the reform, workers were no longer obliged to obtain a certificate from a physician to receive sickness benefits. They could call in sick directly to their line leader and had to engage in a counselling program organized by the employer. To estimate the effect of this reform, we contrast the change in sickness absence among employees who were granted the extended right to self-certify absence with absence among employees who had to obtain a physician’s certificate to be entitled to sickness benefits. We use both a standard difference-in-differences method and the synthetic control method to estimate the effect of the reform. We can rule out large positive effects on absence after the reform, with strong evidence that the policy change actually resulted in a reduction in absence for female workers.