Strengthened return-to-work policy in cases of incapacity for work

The government intends to develop a comprehensive plan for the prevention of and reintegration of persons who are long-term incapacitated for work.

The government agreement announced what is referred to as a third wave of measures, aimed at strengthening the accountability of all actors involved and ensuring systematic cooperation between them: workers, employers, insurance institutions and healthcare providers. This is achieved through adjustments to the benefits system and labour law, with the objective of reducing long-term absences and promoting a return to work.

A first set of these measures was approved yesterday by the Chamber as part of the strengthened return-to-work policy (RTW policy). Publication in the Belgian Gazette is still pending. This e-zine discusses the new rules.

At the same time, the Code on Well-being at Work is being amended with regard to the practical aspects of the RTW policy. The corresponding royal decree has also yet to be published in the Belgian Gazette.

Meanwhile, in the context of the budget agreement, a fourth wave of measures has been announced. This fourth wave aims to turn the RTW policy into a single integrated system, with three priorities: preventing inflow through prevention and early detection, strengthening medical follow-up and annual reassessment, and accelerating reintegration and the accountability of all parties involved. These measures will be the subject of further legislationg.

Replacement of “residual capacities” by “work potential”: the assessment of incapacity for work will henceforth be based on work potential, a more positive approach that takes into account both the current and future capabilities of the worker.

Strengthened cooperation in reintegration pathways: workers are required to actively cooperate in the assessment of their work potential and in reintegration-related contacts. Failure to cooperate will lead to stricter sanctions, such as the suspension or reduction of benefits in the event of repeated absences without valid justification.

New obligations for beneficiaries without an employment contract: they must register with a competent reintegration service within 14 days and respond to invitations for guidance contacts. Non-compliance will lead to sanctions such as a reduction of benefits.

Abolition of the presumption of incapacity for work: the possibility to review the status of incapacity for work during a reintegration pathway is expanded. The presumption will continue to apply only in cases of hospitalisation or quarantine due to a contagious disease.

Financial accountability: part of the administrative costs will henceforth be allocated on the basis of the success of reintegration actions and the results of thematic checks carried out by physicians.

Establishment of the GAOCIT database: this central database within RIZIV/INAMI collects electronic certificates of incapacity for work of all socially insured people for the purpose of gathering knowledge. The data is used for analysis, reporting and the development of scientific standards for prescribing behaviour.

Data mining and feedback to physicians: RIZIV/INAMI is granted the authority to perform data mining on these data and to send reports to physicians regarding their prescribing behaviour. In the future, physicians may be held financially accountable in cases of deviating prescribing behaviour.

Privacy and retention period: the retention period of data in the GAOCIT database is limited to five years. Clear rules apply regarding access to, processing of and purposes of the data. RIZIV/INAMI acts as the data controller.

Solidarity contribution in cases of long-term incapacity for work: employers (except those with an average of fewer than 50 employees during a given reference period) must pay a quarterly contribution equal to 30% of the total benefits for employees aged 18 to 54 who have been incapacitated for work for more than 30 days. This measure is intended to encourage employers to actively engage in reintegration efforts. Exceptions apply to certain employees, such as temporary agency workers and flexi-job workers. The rules will take effect on 1 January 2026, but only for periods of primary incapacity for work commencing on or after 1 January 2026.

Abolition of the existing accountability contribution: the new solidarity contribution replaces the old quarterly accountability contribution for employers with a high inflow into disability.

Sanctions for non-compliance with reintegration obligations: employers with 20 or more employees who fail to request the occupational physician to initiate a reintegration pathway for employees with work potential within six months of the start of incapacity for work are liable to a level 2 sanction under the Social Criminal Code. The fine is multiplied by the number of employees concerned.

Mandatory mention in the work regulations: active absence policy, in particular the procedure for maintaining contact with employees on incapacity for work.

A new Article I.4-71/2 of the Code on Well-being at Work (yet to be published in the Belgian Gazette) would clarify that this procedure must at least specify: 1° who will contact the employee on incapacity for work; 2° the frequency of contact. This procedure is part of an active absence policy aimed at facilitating and preparing the return to work in cases of incapacity for work. It is not intended to verify whether an employee’s absence for health reasons is justified.

Extension of the relapse period: the period during which an employee is entitled to guaranteed salary in case of relapse is extended from 14 days to 8 weeks. These rules apply to incapacity for work occurring from 1 January 2026 onwards.

Removal of the limitation on the neutralisation of guaranteed salary: the limitation to 20 weeks in case of partial resumption of work is removed; the neutralisation will again apply for the entire period of work resumption. These rules apply to incapacity for work occurring from 1 January 2026 onwards.

Adjustment of medical force majeure: the period of uninterrupted incapacity for work required to initiate a procedure for termination of the employment contract due to medical force majeure is reduced from 9 to 6 months.

Limitation of exemption from medical certificate: the exemption from submitting a medical certificate on the first day of illness is limited to twice per calendar year.

The law enters into force on 1 January 2026.

The work regulations must be revised:

• The rules regarding exemption from submitting a medical certificate must be adjusted.
• Employers who do not yet have a procedure must include a contact procedure for employees on incapacity for work in the work regulations (via the normal procedure for amending work regulations, with agreement from the works council or employees). Those who already have a procedure must verify its compatibility with the new rules.

Employers may not need to fear immediate sanctions from social inspection, but it is recommended to comply as soon as possible.