Incapacity for work and reintegration in 2026: what has changed for employers?

Since 1 January 2026, new rules have applied which are intended to help prevent long-term incapacity for work and strengthen the return to work process. [1] The reform, generally referred to as ‘Reintegration 3.0’, places greater emphasis on prevention, early follow-up, contact with employees who are incapacitated for work and cooperation with the health and safety advisor/occupational physician. The rules on medical certificates, guaranteed pay and medical force majeure have also been changed.

Prevention has gained a more prominent role

From now on, an employee who is not yet incapacitated, but whose health problems could lead to time off work, may also ask the employer to look into the possibility of adapting the work station or providing adapted or alternative work.

The employer must inform the employee as soon as possible of the action to be taken in response to this request, or that the request cannot be granted. From a legal perspective, it is advisable to document such requests and the subsequent response carefully.

Fewer medical certificate exemptions

Previously, it was possible to exempt employees, for up to three calendar days per year, from the requirement to submit a medical certificate for the first day of incapacity. Since 1 January 2026, this has been limited to two calendar days per year. Employers would be well advised to check their employment regulations and amend them where necessary if they still refer to an exemption for three days per year.

Employers with an average of fewer than 50 employees may still derogate from this requirement through a collective labour agreement or the employment regulations. This means that they can stipulate that employees must always submit a medical certificate, including for the first day of sickness.

Longer period in the event of a relapse

When an employee becomes incapacitated for work, the employer continues to pay all or part of their salary for a certain period. This is known as guaranteed pay.

In the event of a relapse, entitlement to guaranteed pay only arises again when there are at least eight weeks between the two periods of incapacity. Previously, fourteen calendar days was sufficient. This waiting period does not apply if the employee demonstrates with a medical certificate that the new absence is due to a different illness or accident.

Gradual return to work

The rules for employees who gradually return to work with the agreement of the medical advisor have also been changed. If an employee becomes fully incapacitated for work again during this period, the employer is no longer liable to pay guaranteed pay, irrespective of how long the gradual return to work had already lasted. Previously, this exclusion applied only during the first twenty weeks.

Mandatory contact procedure

Since 1 January 2026, every employer has had to include a contact procedure in the employment regulations for employees who are incapacitated for work, specifying who is responsible for such contact and how often it will take place as minimum requirements.

The aim is to maintain the connection with the incapacitated employee and, where possible, to prepare for their return to work. The contact may not be used to check on the employee’s incapacity or to put pressure on them.

Earlier start of a reintegration process

The previous waiting period of three months for the employer has been scrapped. From now on, the employer can start a formal reintegration process from the beginning of the incapacity for work. To do so, it must inform the employee of its intention in advance by registered letter and the employee must consent to the start of the process.

In addition, the employer can start a reintegration process as soon as the employee has been off work for at least eight weeks and a prior assessment shows that there is work potential (see below).

Introduction of the assessment of work potential

After eight weeks of incapacity, the employer must arrange for a standardised assessment of work potential to be carried out through the internal or external occupational health service. This involves examining whether the employee, given their condition and the specific work context, still has opportunities to perform adapted or other work.

If work potential is identified, the employer can have a pre-return-to-work visit proposed (informal reintegration) or request a formal reintegration process.

Employers with at least 20 employees must start a formal reintegration process no later than six months after the start of incapacity if work potential is identified. This obligation applies to cases of incapacity that started on or after 1 January 2026.

Medical force majeure after six months

Since 1 January 2026, it has been possible to initiate the special procedure for terminating the employment contract on grounds of medical force majeure after at least six months of uninterrupted incapacity, compared with nine months previously.

There must be no formal reintegration process ongoing at that point. A full or partial resumption of work lasting less than fourteen calendar days does not interrupt the six-month period.

New solidarity contribution

From 2026, a new solidarity contribution has replaced the former responsibility contribution for employers with an average of at least 50 employees. The contribution is 30% of the sickness benefits paid during the second and third months of primary work incapacity of certain employees who, at the start of their incapacity, are at least 18 and not yet 55 years old.

The contribution does not apply to, among others, employees in a gradual return to work process, employees who become incapacitated within the first 30 days of their employment and certain categories such as temporary agency workers, flexi-job workers, apprentices and occasional workers.

What do employers have to do?

Employers would be well advised to review their policy on incapacity for work and reintegration in good time. Specifically, this means amending the employment regulations, developing the mandatory contact procedure, monitoring the new deadlines and obligations regarding work potential and aligning internal processes. Timely implementation can not only help ensure that employees get back to work sooner and on a more lasting basis, but also limit legal and financial risks.

[1] Act of 19 December 2025 implementing a strengthened return to work policy, Belgian Official Gazette 30 December 2025; Royal Decree of 17 December 2025 amending the Codex on Well-being at Work as regards the reintegration of employees who are incapacitated for work and the prevention of long-term absence, Belgian Official Gazette 30 December 2025.