What You Need to Know
- Key takeaway #1From 1 January 2026, new rules govern work incapacity and the reintegration of employees in Belgium. The legislative changes are part of the government’s overall plan regarding the prevention and reintegration of employees with long-term work incapacity.
- Key takeaway #2Employers with 20 or more employees are now required to initiate a reintegration trajectory no later than six months after the start of the work incapacity, subject to sanctions.
- Key takeaway #3The work rules must now include a mandatory procedure for maintaining contact with employees with work incapacity.
- Key takeaway #4Several measures reduce the financial burden on employers regarding guaranteed salaries (relapse period, neutralization in case of partial return to work), but a new solidarity contribution is introduced for companies with 50 or more employees.
I. INTRODUCTION
On 30 December 2025, the Belgian Official Gazette published the Act of 19 December 2025 implementing a strengthened return-to-work policy in case of work incapacity, and the Royal Decree of 17 December 2025 amending the Code of Well-being at Work, commonly referred to as “Reintegration Trajectory 3.0”.
These texts are part of the Belgian government’s overall plan for the prevention and reintegration of employees with (long-term) work incapacity. The new rules entered into force on 1 January 2026.
In this client alert we examine the main changes that have been introduced and identify their practical implications for employers.
II. CHANGES REGARDING GUARANTEED SALARY
1. Extension of the Relapse Period from 14 Days to Eight Weeks
How it was until 31 December 2025:
When an employee returned to work after a period of work incapacity and relapsed (with the same illness) within 14 days, no new period of guaranteed salary commenced.
From 1 January 2026, this relapse period is extended to eight weeks.
However, the employee retains the right to the balance of the guaranteed salary if this was not exhausted during the previous period of work incapacity. Also, it remains the case that a new period of guaranteed salary will commence if the employee proves by medical certificate that the new incapacity is due to a different illness or accident.
Entry into force: This measure applies to work incapacities occurring as of 1 January 2026. A period of guaranteed salaries already in progress on 31 December 2025 is not affected.
2. Removal of the Limitation on Neutralization in Case of Partial Return to Work
How it was until 31 December 2025:
If an employee on a progressive return to work (authorized by the advisory physician of the mutual insurance fund) became fully ill again, no guaranteed salary were due during the first 20 weeks from the return to work. However, after that period, the employer again became liable for guaranteed salary in case of relapse.
From 1 January 2026, this 20-week limitation is removed. This means that in case of relapse during a progressive return to work, no guaranteed salaries will be due, regardless of the duration of the partial return to work. The employee is immediately covered by the mutual insurance fund.
Entry into force: This measure applies to work incapacities occurring as of 1 January 2026.
3. New Solidarity Contribution for Long-Term Work Incapacity
In addition to the existing obligation to pay one month of guaranteed salaries, employers will now have to pay a solidarity contribution of 30% of the INMI/RIZIV/NIHDI (National Institute for Health and Disability Insurance) allowance during the second and third months of work incapacity.
This applies to:
- Employees on long-term work incapacity aged between 18 and 54 years (except temporary agency workers, flexi-job workers and employees with less than 30 days of service) working for
- companies with 50 or more employees.
Entry into force: This obligation only applies to periods of primary work incapacity starting as of 1 January 2026.
III. EXEMPTION FROM MEDICAL CERTIFICATE: REDUCTION FROM THREE TO TWO TIMES PER YEAR
How it was until 31 December 2025:
An employee could be absent three times per calendar year for the first day of work incapacity without having to submit a medical certificate.
From 1 January 2026, this exemption is available only two times per calendar. In case of a third absence, the employee must provide a medical certificate from the first day.
Notably, it is still possible for companies with fewer than 50 employees to insist on a medical certificate from day one.
New development: If certain statutory conditions are met, nursing specialists (verpleegkundig specialist / infirmier(ère) spécialiste) may now also issue medical certificates. The nursing specialists must satisfy specific degree and experience criteria (including a master’s degree in nursing and at least 3,000 hours of effective work in a specific care context over the past five years), and there must be a formal collaboration agreement with a physician in place. Employers may request a copy of this agreement in order to verify the competence of the nursing specialist.
IV. REDUCTION OF THE PERIOD FOR INITIATING THE MEDICAL “FORCE MAJEURE” PROCEDURE
How it was until 31 December 2025:
An employer could initiate the medical “force majeure” procedure, potentially leading to the termination of the employment contract, after nine months of uninterrupted employee work incapacity.
From 1 January 2026, only six months of uninterrupted work incapacity is required.
This six-month period can be interrupted only by an effective return to work, and the employee must not relapse within 14 days.
The same reduction from nine to six months applies when a new procedure is initiated because a previous procedure closed without result.
Entry into force: 1 January 2026: However, this amendment also applies to employees who were already on work incapacity in 2025.
V. REINTEGRATION TRAJECTORY 3.0
The “Reintegration Trajectory 3.0” considerably expands the role and duties of employers in facilitating the return to work of incapacitated employees.
1. Proactive Measures to Avoid Absences
Employees who have not yet become incapacitated but who anticipate health-related absences may now approach their employer to explore options such as workstation adjustments, modified duties or alternative positions.
While employers are under no obligation to grant such requests, they must communicate their decision to the employee within a reasonable timeframe.
2. Possibility to Launch the Reintegration Trajectory from Day One
The former requirement of a three-month uninterrupted period of work incapacity before starting a reintegration trajectory has been abolished.
Furthermore, two new options are now available to employers:
- The employer may ask the prevention advisor-occupational physician (PA-OP) to send the employee an invitation for a pre-return-to-work consultation as early as the first day of work incapacity. However, the employee remains free to decline this invitation.
- The employer may also commence a formal or informal reintegration trajectory from the very first day of work incapacity, provided the employee agrees to participate.
3. Compulsory Evaluation of the Employee’s Capacity
After a minimum of eight weeks of work incapacity, employers must arrange for the PA-OP and associated nursing staff to conduct a standardized evaluation of the employee’s remaining “potential to work”:
Where this evaluation indicates that the employee retains some ability to work:
- All employers (discretionary): may request the PA-OP to invite the employee for a pre-return-to-work consultation or to open a reintegration trajectory.
- Employers with a workforce of 20 or more (compulsory): must instruct the PA-OP to initiate a reintegration trajectory within six months from the onset of the work incapacity. This requirement applies exclusively to work incapacities that commenced on or after 1 January 2026.
Penalties: Non-compliance with the compulsory elements exposes employers to level 2 sanctions under the Social Criminal Code. The applicable fine is multiplied by the number of affected employees.
4. Data Exchange Through the TRIO Platform
All relevant parties (PA-OP, treating physician, advisory physician of the mutual insurance fund, etc.) are now expected to communicate through the TRIO digital platform (plateforme TRIO)
It should however be noted that full access to TRIO is still being deployed for some stakeholders. In the meantime, alternative communication channels may be used, as indicated by the competent authorities.
5. Guidance Towards Regional Employment Services
If an employee is found to be permanently unable to perform the agreed work and the reintegration trajectory comes to an end, the PA-OP must direct the employee to the appropriate regional employment agency (VDAB, Forem or Actiris) for further career support and guidance.
VI. ACTIVE ABSENCE MANAGEMENT POLICY: NEW MANDATORY MENTION IN THE WORK RULES
The work rules must now include a mandatory procedure for maintaining contact with employees on work incapacity, specifying at least:
- The person who will contact the employee on work incapacity (for instance, the hierarchical manager, HR, etc.) and
- how often there should be contact.
This active absence management policy aims to facilitate and prepare the return to work in case of work incapacity. It is in no way intended to verify whether the absence for health reasons is justified.
The employer must also ensure that the PA-OP has the necessary information to be able to contact the employee on work incapacity.
VII. IMPACT FOR EMPLOYERS – A TO DO LIST
These reforms place greater responsibilities on employers, who must now make sure that they:
- Adapt the work rules to include a procedure for maintaining contact with employees on work incapacity, specifying the contact person and how often there should be contact.
- Review internal processes related to the management of work incapacity and reintegration, in particular to ensure the assessment of work potential after eight weeks of work incapacity.
- For employers with 20 or more employees: establish a monitoring system to initiate a reintegration trajectory no later than six months after the start of the work incapacity, provided that the employee has “work potential” (for work incapacities starting as from 1 January 2026).
- Verify internal procedures regarding medical certificates to take into account the possibility that these may be issued by nursing specialists, and adapt HR tools, if any, to make sure that only two instead of three sick leave days without certificate can be registered.
- Anticipate the financial impact of the new solidarity contribution for companies with 50 or more employees.
Our L&E team stands ready to assist you in navigating these changes and ensuring compliance with the new requirements. Please do not hesitate to reach out to us for further guidance.
For further information, please contact:
Emmanuel Plasschaert, Partner, Crowell & Moring
eplasschaert@crowell.com
