Since the start of the De Wever federal government, one theme has stayed firmly at the top of the agenda: using health as a driver for a more sustainable labour market. Helping people on long-term sick leave return to work is now a clear priority. Some measures are already in force; others are on the way and may be subject to change. Read on for an overview of what applies today — and what you should prepare for next.
In this article:
What you should take away
The new framework places greater responsibility on employers than ever before. A proactive approach to absenteeism and taking timely action is no longer optional. With the number of long-term sick leave cases still rising, many organisations are facing the same questions: How can we prevent employees from being off work for months? How do we stay compliant without being overwhelmed by new obligations? How do we ensure timely follow-up without increasing administrative burden?
This is exactly where AG supports you most directly.
- With targeted prevention and early intervention, you can already make a substantial difference. Waldon, our well-being partner, helps you strengthen your prevention strategy through a structured and evidence-based approach to workplace well-being. You gain actionable insights into what your people need to feel happy and healthy and translate those insights into concrete initiatives and a sustainable well-being culture. This positive, research-driven approach helps you detect concerns early, before they grow into long-term absences, turning potential risks into opportunities for improvement.
Does your employee end up on long‑term sick leave?
- Then our return-to-work assistance programme reinforces and complements the new legal requirements. Return to Work provides holistic, people-centred guidance for employees on long-term sick leave due to mental health issues. It supports you even before certain legal obligations take effect. Because Return to Work is designed as a flexible, early-action programme, you can intervene much sooner and reduce the risk of (financial) sanctions linked to late action. Employees receive immediate support from day one: coaching, monitoring and personalised guidance. This increases the likelihood of success in the official programme and supports a smoother, more sustainable return to work.
The bottom line: investing now in strong absenteeism management gives you a clear competitive advantage later. AG helps you get there with: a preventive well-being strategy, effective return-to-work assistance, accessible care via comprehensive health insurance, financial protection in case of occupational incapacity, practical tools and clear communication. Together, we help organisations boost long-term employability, reduce the cost of absenteeism and build workplace culture where employees feel supported and thrive.
What applies today
The measures below may be subject to exceptions or specific situations. Make sure you are fully informed about what exactly applies within your company.
- New solidarity contribution
Employers with at least 50 employees are now subject to a new solidarity contribution. When an employee aged 18-54 is off sick for more than 30 calendar days (not to be confused with the waiting period that sometimes applies to supplementary coverage), you have to pay a 30% contribution on the incapacity benefit in the second and third month.
This obligation ends the moment the employee resumes work. This contribution replaces the previous "accountability contribution" applied to companies with exceptionally high inflow into occupational incapacity.
- Return-to-work assistance programme
The focus is now on early action and individually tailored solutions. An official or flexible return-to-work assistance programme can be started as early as day one of sick leave, with the employee's consent. After four weeks of sick leave, the occupational physician must actively inform the employee about the available return-to-work options. After eight weeks, the external prevention service must make a mandatory assessment of the person’s working capacity.
If accommodations or alternative work are possible, employers with at least 20 employees must start an official return-to-work project within six months of the start of the occupational incapacity. Failure to do so may lead to sanctions.
- Stricter expectations for employees
Employees also face clearer obligations. Lack of cooperation in a return-to-work assistance programme can result in a reduction or termination of their incapacity benefit.
- Doctor's notes
In companies with 50 employees or more, employees can now take only two one-day absences without a doctor’s note per year (previously three). Smaller companies may set their own rules in their employment regulations.
- Replacement income and relapse
In case of relapse, employees only regain entitlement to a replacement income after eight weeks back at work (previously two weeks). Employees returning on a part-time basis are not entitled to replacement income if they later become 100% unfit for work again.
- More predictable outpatient expenses
Since 1 January 2026, medical practitioners can no longer charge supplemental fees to patients entitled to a higher reimbursement rate, whether in the hospital or on an outpatient basis. This applies regardless of whether the practitioner charges the official rates for their services or sets their own rates. For employees entitled to a higher reimbursement rate, this means more predictable healthcare expenses.
For employers, supplementary hospitalisation and outpatient care coverage remains crucial: it encourages employees to seek treatment early, helping to avoid deterioration into long-term sick leave.
Questions?
We closely monitor these policy developments and are here to help you translate them into practical, effective solutions for your organisation.
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