The Chamber of Representatives today approved a series of ambitious measures from the Minister of Employment, Economy and Agriculture, David Clarinval, aimed at strengthening prevention, reintegration and the return to work of people with work incapacity. These reforms are fully in line with the government agreement and respond to a worrying observation: the continued rise in the number of long-term sick people in Belgium. The government agreement provides for a comprehensive plan for prevention and reintegration of long-term sick people. The approved law was drawn up in collaboration with the Minister of Social Affairs and sets out a first set of measures based on greater accountability among five key stakeholders: employers, workers, doctors, health insurance funds and regional employment services.
At the end of 2024, Belgium had nearly 550,000 people who had been unable to work for more than a year, including over 514,000 employees and 35,000 self-employed workers. The total cost of invalidity benefits for employees now exceeds €9.5 billion per year. This trend is explained in particular by the ageing of the active population, the rising employment rate at older ages, and the increase in musculoskeletal disorders and psychological illnesses. Today, nearly one in three people with invalidity suffers from mental health issues, such as depression or burnout.
David Clarinval, Minister of Employment: “The figures speak for themselves: the policies pursued so far are no longer sufficient. It is time to act in a more structural, preventive and accountable way, without ever abandoning the foundations of our social model. Belgium's social model rests on an essential balance between solidarity and responsibility. Those who are able to work must be encouraged and supported along their journey. Accountability does not mean harshness: it means providing better, earlier and more personalised support. Being sick does not necessarily mean being unable to work. The longer an absence lasts, the harder it becomes to return to work, whereas work is often a fundamental lever for recovery, recognition and social integration. This reform aims to activate talent, prevent lasting exclusion from the labour market, and ensure a fairer and more efficient use of public resources, in a spirit of social justice, inclusion and shared responsibility.”
A reform based on prevention, reintegration and shared responsibility
The government agreement provides for a comprehensive plan for the prevention and reintegration of long-term sick people, based on greater accountability among five key stakeholders: employers, workers, doctors, health insurance funds and regional employment services.
Five key measures to promote return to work
Within this framework, the government is implementing several concrete measures:
- Active absenteeism policy
Employers are encouraged to pursue an active absenteeism policy by creating a work environment that limits long-term absenteeism as much as possible. Workers who are unable to work will be contacted and monitored regularly. This approach must be embedded in the work regulations.
- Reform of the medical certificate
The possibility of taking a day off without a medical certificate will be limited to twice a year, instead of three times currently. This measure aims to hold stakeholders accountable while avoiding abuse, without undermining trust in workers.
- Medical force majeure
The waiting period before an employment contract can be terminated due to medical force majeure will be reduced from nine to six months of uninterrupted incapacity for work. This adjustment helps avoid prolonged deadlock situations.
- Guaranteed salary, relapse period and permitted work
To avoid a “revolving door” effect, the right to a guaranteed salary after returning to work will only apply after eight weeks of effective resumption, instead of the current two weeks.
Furthermore, when a worker partially resumes work with the approval of the advising physician, the employer offering this option will no longer have to pay a guaranteed salary in the event of a relapse during this period, unlike the current twenty-week neutralisation scheme. This measure is intended to encourage employers to reintegrate workers.
- Sanction in case of non-reintegration
A level 2 sanction is planned for employers with 20 or more workers who have not started a reintegration process within six months of the start of the incapacity for work. The aim is to make reintegration a genuine priority rather than a theoretical one.
The federal government continues its policy to strengthen prevention, reintegration and the return to work of people with work incapacity. Ministers have recently agreed on a new package of measures aimed at strengthening both the preventive and reintegration components.