300,000 long-term sick have been declared unfit to work until they retire, cases to be reviewed of those that “may now be able to work again”

More than half of the over half a million people on long-term sick leave in Belgium have been declared unfit to work until retirement. The news that over 300,000 people in Belgium have been told that that they can claim sick pay until they retire appears in an article in Tuesday’s edition of the financial daily ‘De Tijd’. The article is based on figures from the National Sickness and Disability Insurance Institute (NSDII). However, the NSDII and the health mutuals are now checking whether some of those previously declared permanently unfit to work might be able to return to the workplace after all.

At the end of 2023, there were a record 526,507 people on long-term sick leave. These are people that have been unable to work through illness or disability for more than a year. The total cost of the benefits paid to this group is more than 9 billion euro per annum. Tuesday’s newspaper article reveals that a large portion of those on long-term sick leave have been declared unfit to work until they retire.

The Federal Health Minister Frank Vandenbroucke (Flemish socialist) says that “Over the past 15 years, more and more people have been declared ‘permanently’ incapacitated for work”. NSDII declares a person “permanently incapacitated” when there is “no improvement or progress” in their condition.  Once they have been declared “permanently incapacitated” this effectively makes it impossible for them to ever work again. However, the “incapacity” can still be re-evaluated by the NSDII or a doctor working for the person’s health mutual at any time.

Of the more than 500,000 Belgians that had been on sickness benefit for more than a year in 2023, 289,397 had been declared unfit for work until they retire. Mr Vandebroucke says that the number of people that have been declared permanently unfit for work during the past 15 years is “totally unacceptable”. On 1 July 2024, the rules changed. Since then, people can be declared unfit for work for a maximum of 1, 3 or 5 years, depending on the type of illness they have. Only in the case of very specific and serious conditions such as dementia, paralysis or advanced cancer can a person be declared “permanently incapacitated”.  Any additional exceptions must first have been given the all clear by a doctor, followed by a second opinion from another doctor or a paramedic before NSDII will approve them.

Mr Vandenbroucke says that “Of course, it is not the intention that people with dementia, for example, should have to go back to the consultant physician. However, our labour market, accessibility to jobs, resources, and also medical science are evolving. People that may not have had the prospect of possibly being able to return to work 10 years ago may be able to now. We especially want to help people back to work that are still able to work”.

Consequently, the health insurance mutuals are now inviting some of the people that were previously declared permanently incapacitated prior to the change in the law but might not have been had they been assessed now for a reassessment.

Each year NSDII will examine a sample of cases to ensure that the health mutuals’ checks are sufficiently thorough. These will be cases of those with conditions that are not on the exceptions list and people under the age of 40 with a mental disorder.

Reference<https://www.vrt.be/vrtnws/en/2025/03/11/300-000-long-term-sick-have-been-declared-unfit-to-work-until-th/