Sick employee: your obligations from day 1 to 6 months
Last updated: September 2026
Monday morning, 7.30 a.m. "I'm ill, I won't be in today." For a single day, little changes. But if your employee stays away for weeks or months, a clock has been ticking since 1 January 2026, with fixed moments at which you have to act. Miss one and it can cost you money.
The rules are not new to anyone who has read our articles on illness. What is often missing is the overview: what do you have to do, and when, and which obligation applies to your company? We set it out here, from the sick call to six months of absence.
In this article: what has changed since 2026, the timeline of your obligations, what applies depending on the size of your company and what you can already arrange today.
In short: since 1 January 2026, every employer must have a contact procedure for sick employees in the work regulations, and must request an assessment of work capacity after 8 weeks. From 20 employees, you start a reintegration pathway within 6 months if that capacity is positive. From an average of 50 employees, you pay a solidarity contribution of 30% of the sickness benefit during the second and third months.
What has changed since 1 January 2026?
The law on the strengthened return-to-work policy has tightened the rules on incapacity for work on several points. Most measures apply to incapacities for work that began on or after 1 January 2026 (FPS Employment, Securex, accessed 28 September 2026).
| Measure | For whom | What changes |
|---|---|---|
| Contact procedure in the work regulations | All employers | New: who makes contact and how often |
| Exemption from a medical certificate | Employers with 50 or more employees | Only 2 days per calendar year instead of 3 |
| Relapse period for guaranteed salary | All employers | 8 weeks instead of 14 days |
| Assessment of work capacity | All employers | Must be requested after 8 weeks |
| Reintegration pathway | Employers with 20 or more employees | Must start within 6 months if work capacity is positive |
| Solidarity contribution | Employers with an average of 50 or more employees | 30% of the sickness benefit, second and third months |
| Medical force majeure | All employers | Possible after 6 months instead of 9 |
Source: FPS Employment, Liantis, FPS Employment, reintegration pathway and NSSO, accessed 28 September 2026.
What do you do when? The timeline
The obligations follow one another in a fixed order. Below are the moments that matter, each with what you have to do.
Day 1: the sick call
Your employee reports the absence and, where needed, provides a medical certificate. If you have 50 or more employees, your employee may now take a first day of illness without a certificate only twice per calendar year, instead of three times (FPS Employment, Liantis, accessed 28 September 2026).
Your employee's exact obligations are set out in our article on sick leave and the employer's rights and obligations.
The first 30 days: guaranteed salary
During the first month, you pay the guaranteed salary. If an employee falls ill again with the same illness within 8 weeks of returning to work, that is a relapse: you do not pay a new period of guaranteed salary. If a medical certificate shows that it is a different illness or a different accident, the guaranteed salary is due again (Securex, accessed 29 September 2026). Previously, that period was 14 days. The new rule applies to incapacities for work that began on or after 1 January 2026 (Liantis, FPS Employment, accessed 28 September 2026).
How to calculate the guaranteed salary for white-collar and blue-collar workers is explained in our article on guaranteed salary during illness.
Throughout the absence: keeping in touch
Since 1 January 2026, your work regulations must contain a procedure for keeping in touch with employees who are unable to work. It sets out at least who makes contact on behalf of the employer, for instance the employer, the HR manager or the line manager, and how often (Liantis, Securex, accessed 28 September 2026).
Mind the purpose: that contact is meant to prepare the return to work, not to check whether your employee is really ill. That check is the job of the control doctor. How to amend your work regulations is explained in our article on drawing up work regulations.
Months 2 and 3: the solidarity contribution
After the guaranteed salary period, the health insurance fund takes over. If you have an average of 50 or more employees, you have paid a solidarity contribution of 30% of the primary incapacity benefits since 2026, over two months from the 31st day of incapacity for work (NSSO, Acerta, accessed 28 September 2026).
The contribution applies to employees who are under 55 at the start of their incapacity for work, who have been unable to work for more than 30 days, and whose incapacity began on or after 1 January 2026. For anyone working with flexible staff, this matters: temp workers, flexi-jobbers and occasional workers in agriculture and horticulture, hospitality and the funeral sector are excluded, as are employees whose incapacity begins during the first 30 days of their employment (NSSO, accessed 28 September 2026). Periods of gradual return to work do not count either.
According to Acerta, the contribution would be extended to the fourth and fifth months from 2027. More on the calculation and the exceptions in our article on the solidarity contribution and return to work.
After 8 weeks: the assessment of work capacity
After 8 weeks of incapacity for work, you must request an assessment of your employee's work capacity, through your internal or external service for prevention and protection at work. That obligation applies to all employers, whatever their size (FPS Employment, Acerta, accessed 28 September 2026).
That assessment answers one question: can your employee, possibly with adjustments, return to work with you? If you do not request it, you risk, according to Acerta, a level 3 penalty: an administrative fine of €1,000 to €10,000 or a criminal fine of €2,000 to €20,000 (Acerta, Securex, accessed 28 September 2026).
Within 6 months: the reintegration pathway
If the work capacity is positive, as an employer with 20 or more employees you must start a reintegration pathway within 6 months of the start of the incapacity for work. If you do not, you risk a level 2 penalty: an administrative fine of €250 to €2,500 or a criminal fine of €500 to €5,000 (FPS Employment, Securex, accessed 28 September 2026). These amounts apply to offences from 1 February 2026.
Watch the starting point. Those 6 months run from the start of the incapacity for work, not from the assessment. If you wait with the assessment until well after the eighth week, the time left to start a pathway quickly becomes tight.
After 6 months: medical force majeure
An employment contract can end on the grounds of medical force majeure if the employee is permanently unable to do the agreed work. Since 2026, the procedure can start after 6 months of uninterrupted incapacity for work, instead of 9. According to Securex, any reintegration pathway under way must be completed first (FPS Employment, Securex, accessed 28 September 2026).
What applies to your company?
Not every obligation applies to every employer. The size of your company determines what you have to do.
| Obligation | Fewer than 20 employees | 20 to 49 employees | 50 or more employees |
|---|---|---|---|
| Contact procedure in the work regulations | Yes | Yes | Yes |
| Relapse period of 8 weeks | Yes | Yes | Yes |
| Assessment of work capacity after 8 weeks | Yes | Yes | Yes |
| Reintegration pathway within 6 months | No | Yes | Yes |
| Solidarity contribution, months 2 and 3 | No | No | Yes |
For the solidarity contribution, it is the average number of employees over a reference period that counts, not the number on a given day (NSSO, accessed 28 September 2026). Hovering around 50? Have it checked.
How do you prepare?
Step 1. Check your work regulations. Is the contact procedure in there, with who makes contact and how often? If not, amend them.
Step 2. Appoint one contact person and agree how that person handles the contact: focused on the return, not on control.
Step 3. Put the fixed moments in your diary as soon as an employee is off sick for longer: day 31, week 8, month 6. Anyone who misses the eighth week loses precious time for a pathway.
Step 4. Ask your service for prevention and protection at work now how to request the assessment, so that you do not have to start searching in week 8.
Step 5. Budget for the solidarity contribution if you have 50 or more employees, and bear in mind that temp workers and flexi-jobbers are not covered by it.
What employers should remember
- A contact procedure for everyone. Since 1 January 2026, your work regulations must set out who contacts a sick employee and how often.
- Relapse within 8 weeks: no new guaranteed salary.
- An assessment after 8 weeks for everyone. Every employer requests an assessment of work capacity after 8 weeks.
- From 20 employees: reintegration pathway within 6 months if the capacity is positive, otherwise a level 2 penalty.
- From 50 employees: solidarity contribution of 30% in months 2 and 3, not for temp workers and flexi-jobbers, and only 2 days a year without a medical certificate.
- Medical force majeure has been possible after 6 months since 2026.
How Recruit helps you
A sick employee brings administration that must not go wrong: guaranteed salary, a correct declaration and, for larger employers, a contribution that has to apply to the right employees.
With Recruit:
- Accurate payroll - Guaranteed salary aligned with your employee's status and Joint Committee
- Overview of your staff - Knowing who works for you, under which status and since when
- Dimona and social documents - Immediate employment declaration and documents kept
- Flexible staff paid correctly - Students, flexi-jobbers and temporary staff, each according to their status
- Personal support 24/7 - A dedicated contact who knows your file and your sector
Try Recruit or contact our HR experts for tailored advice.
Frequently asked questions
Does a small company also need a contact procedure?
Yes. The contact procedure in the work regulations applies to all employers, whatever their size, as does the assessment of work capacity after 8 weeks. The mandatory reintegration pathway only applies from 20 employees, the solidarity contribution from an average of 50.
Who contacts a sick employee?
Your work regulations must set out who makes contact on behalf of the employer, for instance the employer, the HR manager or the line manager. The contact is meant to prepare the return, not to check up on the absence.
Do I pay the solidarity contribution for a temp worker?
No. Temp workers, flexi-jobbers and occasional workers in agriculture and horticulture, hospitality and the funeral sector are excluded from the solidarity contribution. Employees whose incapacity begins during the first 30 days of their employment are also excluded.
From when do the 6 months for the pathway run?
From the start of the incapacity for work. That is why you should request the assessment of work capacity as soon as the eighth week is over.
What if an employee falls ill again within 8 weeks?
If it is the same illness, it is a relapse, and you do not pay a new period of guaranteed salary. For a different illness or a different accident, shown by a medical certificate, you do pay guaranteed salary again. That period used to be 14 days and has been extended to 8 weeks since 2026, for incapacities for work that began on or after 1 January 2026.
The information in this article is provided for general guidance only and does not replace professional legal advice. Labour legislation changes regularly. Always consult the legislation in force or contact an HR expert for advice suited to your situation.