Sickness benefit abusers to be taken to court

An investigation carried out by the Social Policy Ministry has uncovered widespread abuse in sickness benefit claims and a number of people are to appear in court shortly charged with falsifying evidence.

Vowing a zero-tolerance policy, Social Policy Minister Lawrence Gonzi yesterday said the government intended to reduce payouts for sickness benefit from the annual Lm2 million to Lm500,000.

The minister opened a can of worms as he launched a month-long training event on the Coordination on EU Social Security schemes for Social Security Department employees.

The British government and the British High Commission are sponsoring the event, which is being steered by three experts from the UK Department of Work and Pensions.

A substantial number of suspect claims for sickness benefits have been counter-checked and investigated by a team of doctors and in all cases, all claimants were not in a position to submit themselves for a medical examination to support their claims, Dr Gonzi said.

This, he added, confirmed the government's belief in the prevalent abuse of the system, a claim which had been shot down by the Medical Association of Malta last December.

Sources had said then that the government had sent "warning letters" to 200 doctors for issuing an excessive number of sickness certificates to certain patients for the same condition.

Sources close to the government said one particular doctor issued more than 3,500 sickness certificates in eight months. The doctors are being warned.

A month later, the Employment and Training Corporation said it had come across several cases of what it believed to be "abusive" sickness certificates issued by some doctors to people registering as unemployed.

Sources close to the ETC told The Times the corporation was trying to establish the extent of the problem.

Last year, just over 25,000 certificates for sickness benefits were lodged with the Social Security Department, amounting to 385,724 benefit days paid, to a total of Lm2.01 million.

Of these, 4,375 (17 per cent) were from those in self-employment, resulting in 128,438 (33 per cent) of the total benefit days paid.

The total number of "incapacity days" exceeds 1.04 million days >of work lost through sickness absence to the detriment of the economy, with the unemployed reporting an average of 18 days of sickness per year, the self-employed 10.5 days per year, public sector employees nine days per year, and employees in the private sector 3.6 days per year.

Dr Gonzi said that immediate steps had been taken to act on these statistics.

The Employment and Training Corporation has been alerted and those unemployed who do not submit their certificates in time are losing their priority on the unemployment register.

Moreover, the ETC inspectorate is assisting the Department of Social Security to identify fraudulent claims. In the meantime, an exercise has been carried out on a number of cases and an inter-agency team is currently collecting all the intelligence to start criminal proceedings against those workers who were found at a workplace while claiming sickness benefit.

In the meantime, discussions are under way with the Office of the Prime Minister for the better management of sickness absence in the public service, Dr Gonzi said.

These discussions will soon be concluded following which better administrative tools and procedures for sickness reporting and sickness benefit claims payments will be set up.

He said that the tight measures by the Social Security Department last December saw a sharp drop in expenditure on sickness benefit payouts.

The results are already beginning to show with average monthly expenditure down from Lm165,000 in 2001 to Lm127,000 in December 2003.

Dr Gonzi concluded that he considered curbing benefits abuse as one of the most important achievements of his ministry in the past five years.

"We have saved Maltese taxpayers more than Lm20 million in abuses,'" Dr Gonzi said.

Speaking to journalists, Dr Gonzi said the statistics showed that abuse occurred in all sectors.

"The number of sickness days taken by the self-employed and public sector workers is far higher than in the private sector. However, we need to carry out further investigations to get a good picture of which sector is abusing the system most."

Dr Gonzi insisted that the aim of the exercise was not to attack the medical profession but to weed out the malpractice.

"But we appeal to the medical profession to assist us. I've had meetings with MAM and I will continue doing so. Ultimately, we want to simplify their lives and, yes, we need to remove some of the bureaucracy to make the system more efficient."

Dr Gonzi said the "boarding out" system was also being analysed since abuse was also possible in this sector.