More than half of long-term sick people found fit to work: The MR says stop to fake claims and defends genuine patients

• Belgium is today the European country where inactivity is exploding, with a 150% rise in long-term sickness in 20 years: our system no longer works as it should.

• Every year, this abuse wastes more than 500 million euros: that money must go to those who truly need it.

• Solidarity is not an unconditional right: it also comes with rules, checks and responsibilities.
• Our line is clear: protect genuine patients, support those who can return, and reserve invalidity status for those who truly have no possibility of working.

1. Defending social security also means fighting abuse

Social security is a fundamental pillar of our society. It must protect those who genuinely need it: people who are ill, vulnerable or unable to work. But to remain strong and credible, it must also be fair. And being fair means refusing abuse. Today, Belgium is one of the European countries with the highest inactivity rate, and the number of people on long-term sick leave has risen by more than 150% between 2000 and 2021. This trend is clearly putting our system under pressure.

2. A reality we can no longer ignore

Recent analyses show that, in many cases, people recognised as unfit to work could actually return to work, fully or partially. A study by the INAMI shows that nearly 6 out of 10 people checked no longer met the legal criteria for incapacity. This does not mean that most sick people abuse the system, but it shows that there is a real problem in how situations are assessed and monitored.

The analysis also highlights significant shortcomings. In more than 75% of cases, medical files were incomplete or inaccurate. This means that important decisions are sometimes made without sufficient information. That is bad for both patients and the credibility of the system.

3. A cost for society as a whole

These dysfunctions cost more than half a billion euros a year. Every euro misused is one less euro for those who truly need it. It is also an added burden on workers and future generations.

Genuinely sick people must continue to be fully protected. They have nothing to fear. On the contrary, fighting abuse strengthens social security and ensures its sustainability.

4. Reforming to get people moving again

The goal is simple: better support sick people, while preventing temporary situations from becoming permanent. Today, too many people remain permanently out of work without real support. Long-term invalidity must remain an exception, reserved for those who genuinely have no possibility of working. For everyone else, support towards reintegration must become mandatory.

The reforms introduced by the Arizona coalition go in this direction. They first strengthen monitoring from the very start of incapacity: medical certificates are now time-limited, with a maximum duration of 3 months during the first year and an initial certificate limited to 3 weeks. Patients on long-term incapacity must be reviewed by their doctor at least once a year. Only doctors who genuinely know the patient may issue an incapacity certificate, except in specific cases.

All stakeholders are then made more accountable. Doctors, health insurance funds, employers and workers must cooperate far more systematically. Companies are also financially involved: for workers aged 18 to 54 in companies with more than 50 employees, they must repay part of the benefits paid over several months (up to 30% of the allowance, around 18% of gross salary), which encourages them to actively promote a return to work.

Finally, the system encourages a gradual return to work. Incentives are provided for employers who offer a partial return to work of at least 3 months to someone on incapacity. The goal is clear: to enable an adapted, gradual return rather than leaving people sidelined.

These measures are a step in the right direction, even if health insurance funds are still not held accountable enough.