Be Aware - January 2026

There are more than 500,000 employees in Belgium who’ve been on sick leave for more than a year. This means more than 7% of the Belgian population aged between 18 and 65 is on long-term sick leave, far higher compared to neighbouring countries. Over the last couple of years, the Belgian government has introduced various measures to reduce the number of employees on long-term sick leave.

The government introduced new measures by means of a Royal Decree of 17 December 2025 and an Act of 19 December 2025. The list of measures covers separate topics, as it’s clear only an overall approach could be successful.

 

Adjustments for preventing sick leave

In the past, if an employee on sick leave planned to resume working, they could ask for an examination by the occupational health doctor to check whether they could return to work and whether adjustments were appropriate (eg first resuming on a part-time basis and only going full-time in a second stage).

The new legislation introduces the option to apply the same mechanism proactively, ie when an employee is still at work but claims they might become unable to work for medical reasons. The idea is that when an employee feels their health is deteriorating and fears they might be unable to perform the same work in the near future, adjustments can be introduced before the employee falls ill, avoiding a period of (long-term) sick leave.

This possibility to request an adjustment of the workplace or a change of work applies “when a worker threatens becoming unable to work due to health problems”, without any definition of these terms. No formal requirements apply to the request.

The employer should reply as soon as possible. While the legislation stipulates this reply could also be the employer rejecting the request, the text of the new legislation doesn’t include the criteria an employer should use to determine whether the employer accepts or rejects a request. The legislation only stipulates the employer can request the advice of any of the prevention advisors (eg the occupational health doctor, the prevention advisor psycho-social aspects of work).

 

The procedure for keeping contact with employees on sick leave

As a second measure, the legislator wants to promote employees on sick leave keeping contact with their employer. For long-term sick leave, this is often not the case, which can create an extra hurdle for an employee wanting to return to work.

As of 1 January 2026, the work regulations should include a clause with the procedure for keeping contact with employees on sick leave. The law only states the clause should at least specify who will contact the employees on sick-leave and the frequency of contact.

The aim of this contact is to make it easier for employees to resume work and help them prepare. The purpose isn’t to check whether the employee is actually unable to work.

The privacy legislation hasn’t changed. The law still doesn’t require an employee to share any details on the nature of their illness with the employer. Both the medical certificate issued by the doctor treating the employee, the occupational health doctor’s and the controlling doctor’s decisions never specify which illness the employee has.

The duty to insert this clause in the work regulations applies to all employers, irrespective of the number of employees.

The normal procedure for amending the work regulations applies. If the employer has a works council, it should approve the clause. If there is no works council, the employer should consult all employees on the new clause in the work regulations.

 

An informal visit to the occupational health doctor

The legislator has introduced a new procedure for resuming work. This procedure is deliberately kept as informal as possible.

The procedure consists of the employee contacting the occupational health doctor. Both the employee and the employer can ask to start this procedure. The duration of the sick leave is irrelevant.

The legislation leaves all options open for the occupational health doctor. This doctor can (but isn’t obliged to) contact the other prevention advisors, recommend other work or changes to the workplace, or contact the doctor treating the employee (with the employee’s approval).  

The text of the new legislation again remains silent on the criteria an employer should use to determine whether to accept or reject the occupational health doctor’s recommendations.

 

Minor changes to the formal reintegration procedure

The formal reintegration procedure remains largely unchanged.

When the employer starts a formal reintegration procedure, a new preliminary step is now required. Previously, as the employer didn’t have access to medical data, occupational health doctors often examined employees under a formal reintegration procedure initiated by the employer at a time when the possibilities for resuming work couldn’t be medically assessed (eg an employee still had to undergo surgery).

To avoid those superfluous visits to the occupational health doctor, a new assessment step of the work potential has been introduced. It consists of a questionnaire the occupational health doctor sends to the employee. The occupational health doctor will only carry out a medical examination once the questionnaire shows the employee could potentially resume work.

The employer can only ask the occupational health doctor to send this questionnaire when the employee has been on sick leave for at least eight weeks.

There is no duty to use the questionnaire when the employee requests a formal reintegration procedure.

If the questionnaire shows the employee can resume work, employers with at least 20 employees now have to start a formal reintegration procedure when the employee has been on sick leave for six months.

An employer with at least 20 employees has to take a proactive approach in case of sick leave, for instance by systematically asking the occupational health doctor to send out the questionnaire when the employee has been on sick leave for four months.

The legal requirement to have a formal reintegration procedure pending when the sick leave reaches six months can only be complied with if the employer initiated the procedure with the questionnaire sufficiently in advance.

 

Sanctions are possible for both the employer and the employee

The procedures aimed at resuming work sometimes weren’t followed because either the employer or the employee refused to cooperate with them. The legislative changes aim to avoid this by introducing new sanctions for both the employee and the employer.

A formal reintegration procedure can only lead to resuming work if the employee shows up when invited for a medical examination by the occupational health doctor. The previous legislation didn’t expressly stipulate a sanction if an employee refused to attend a medical examination with the occupational health doctor.

The new legislation stipulates if an employee doesn’t show up twice for a medical examination, the occupational health doctor must inform the social security administration. If the employee can’t justify the absence, the social security administration can start the procedure to suspend the allowance paid by the Belgian state.

For the employer, article 127/1 of the Code on Social Criminal Law stipulates a sanction of level II can be imposed on an employer with at least 20 employees who didn’t start a formal reintegration procedure if the questionnaire showed the employee could resume work. A sanction of level II is a criminal fine of maximum EUR5,000. The fine is multiplied by the number of employees involved.

 

Termination for medical force majeure

The procedure for terminating an employment contract due to medical force majeure (ie the fact the employee is definitively unable to perform the agreed work for medical reasons) remains as it is.

The only change is that the employer can now start this procedure when the employee is on sick leave for at least six months. It used to be nine months.

The procedure for medical force majeure can’t be started when a formal reintegration procedure is still pending. Since the law now obliges employers with at least 20 employees to start a formal reintegration procedure if the employee can resume work, this amendment will have little impact in practice.

 

Periods of short-term sick leave

There are also two changes concerning periods of short-term sick leave.

The 1978 Act on Employment Contracts stipulated an employee didn’t need to submit a medical certificate from a doctor in the first three cases of sick leave lasting only one day. This has now been reduced to two cases per year per employee.

Employers with less than 50 employees can still require a medical certificate in all cases. This requires either a collective bargaining agreement or a clause in the work regulations.

If an employee is on sick leave, resumes work and then goes on sick leave again, the 1978 Act on Employment Contracts stipulated the employee was entitled to a new period of sick pay when having resumed work for at least 14 days. For periods of sick leave starting on 1 January 2026, a new period of sick pay is only due when the employee resumed work for at least eight weeks.

Employees are still entitled to a new period of sick pay, irrespective of how long they resumed work for, if the medical certificate confirms the second period of sick leave was because of a different illness than the first period of sick leave.