Ministers would be tearing their hair out. Activating long-term sick workers is undoubtedly the main project of the federal government’s budget conclave. The number of sick people is exploding, and so is the cost they impose on Social Security.
There are more than 520,000 people who are unable to work (ill for less than a year) or disabled (more than a year), which represents an annual cost of 11 billion euros. According to estimates , this amount could rise to 18 billion by 2030. The unions and the left-wing political opposition believe that reforms by the Arizona government (N-VA, MR, Engagés, CD & V, Vooruit), such as limiting unemployment over time or extending careers, will even exacerbate the phenomenon.
The truth and lies of the investigation into long-term patients that is stirring up political life
The government agreement already includes a series of measures to encourage and accelerate the return to work. These measures aim to improve patient monitoring, but also to make companies, mutual insurance companies, and patients themselves more financially responsible.
The government believes that the measures already decided will not be enough, while it is seeking 10 billion euros for its budget.
Social Affairs Minister Frank Vandenbroucke (Vooruit) has prepared a bill incorporating all of these measures. He hopes to have it passed in Parliament before the end of the year, with the aim of entering into force on 1 January 2026.
The partners of the Arizona majority, however, believe that further work will be necessary, as the government intends to make a total effort of 10 billion euros as part of its budgetary work.
Minister Vandenbroucke already announced in La Libre , in mid-September, that he was considering a project aimed at ” reestablishing” contact with people on disability, who are therefore very far from work, and at having their medical situation confirmed regularly so that they can continue to receive benefits.
As part of the budget conclave, each party was asked to submit proposals. A favorable wind brought us those of the Engagés and the MR. These measures will certainly not be adopted as they are, but they help to narrow the debate.
Six months of salary paid by the employer: a saving of 2 billion
In their note dated October 10, Les Engagés write that they wish to ” make employers more responsible for reducing disability and improving conditions for returning to work .” To this end, they propose a spectacular measure: increasing the guaranteed salary period covered by the employer from one to six months. According to them, this would save two billion euros (an additional 400 million per month paid by employers).
Currently, when an employee falls ill, their employer continues to pay them normally for one month. After this period, the worker receives incapacity for work compensation, paid by their mutual insurance company.
The government agreement already provides for a change: the employer will have to – a priori from January 2026 – assume 30% of the cost of the compensation for two months (in the second and third months of the worker’s absence, after the period of one month of guaranteed salary).
A week ago, the Flemish newspaper Het Laatste Nieuws quoted economist Pierre Koning of the Vrije Universiteit in Amsterdam as saying that the Netherlands had also been faced with the problem of long-term sickness. ” The turning point came when employers were obliged to pay sick employees’ salaries for two years. The number of disability claims fell by 35% overnight ,” he said.
The De Wever government will not go that far. That said, we understand that even within the Liberal Party, it is acknowledged that employers tend to lose interest in their patients once the one-month guaranteed salary period has ended. It would therefore be a matter of making them more financially responsible.
Note that Les Engagés also propose the implementation of prevention plans against musculoskeletal disorders and burnout, which are the two main causes of long-term illnesses.
The first medical certificate limited to 15 days
The MR’s overall approach is different. Following a more individualistic logic, the party believes that it is primarily up to the patient to make the effort to return to work.
The MR also proposes to strengthen controls and sanctions in the event of fraud; to limit to 15 days the duration of the first medical certificate given by the general practitioner; or to only allow the certificate to be extended after two months by a specialist or a psychiatrist in the event of musculoskeletal or mental illness.
The Liberals also propose to facilitate sectoral mobility for disabled workers, which should enable them to find a suitable position more easily; to strengthen the role of prevention services; or, as expressed in La Libre , to transfer the management of work incapacity from mutual insurance companies to Inami (health and disability insurance).
The budget negotiations are expected to conclude early next week.
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