Objectives In Sweden, people with a substantial and permanent disability have been entitled to personal assistance (PA) since the reform took effect in 1994. To qualify for government attendance allowance, a person must belong to one of the groups predefined in the Act Concerning Support and Service for Persons with Certain Functional Impairments (LSS) and require PA with their basic daily needs for more than 20 h a week. The aim of the study was to investigate how the LSS Act provides possibilities to work for people entitled to measures for special support and special service.

Method Cross-sectional analysis based on data from the Swedish Social Insurance Agency and from a questionnaire survey of a sample of people entitled to PA (total of 15515). The response rate was 67%.

Results Generally more men (27%) than women (21%) considered that PA is a prerequisite for their ability to work. Among those who were mentally retarded, were autistic or had a condition resembling autism (group 1), 33% responded positively. Persons belonging to the group with considerable and permanent, intellectual functional impairment after brain damage in adulthood (group 2), experienced least possibilities to work (11%). Among those with other lasting physical or mental functional impairments (group 3), 22% experienced that PA gave them a possibility to work. Of those who had responded positively, 25% were born in Sweden and 22% were born abroad.

Conclusions Personal assistance seems to provide possibilities of active participation in the labour market for persons with substantial and permanent disability.