Belgium’s Long-Term Sick Top Half Million, Data Lags Behind

Belgium has crossed a troubling threshold: more than half a million citizens are now classified as long-term sick, with official figures from the RIZIV recording 576,643 people on invalidity benefits at the end of 2025. But as Het Laatste Nieuws revealed in an investigative report published Wednesday, the true figure is significantly higher — and the government itself has no idea how many of its own permanent civil servants are among the long-term sick.

The Hidden Half Million

The official RIZIV statistics exclude approximately half a million permanent (“vastbenoemde”) civil servants — roughly half of Belgium’s nearly one million public sector employees. This group includes teachers, police officers, military personnel, train conductors, magistrates, and tax officials. Unlike private sector workers, these employees are not tracked in the national long-term sickness database.

When civil servants on “sickness pension” (ziektepensioen) are included, the total rises to at least 663,554. As of January 2026, 86,911 civil servants were in this system, though a new pension law voted on June 1 has formally ended the practice.

A Kafkaesque Data Hunt

Journalist Fleur Mees of HLN embarked on an exhaustive investigation to determine how many permanent civil servants have been sick for more than one year. The result, she wrote, was “pure Kafka.” Each government department uses its own calculation method — some measure absence over 30 days, others over six months, still others over one year. Some express data only in percentages, making aggregation impossible.

“Trying to determine how many permanent civil servants in Belgium are ‘long-term sick’ is pure Kafka,” Mees wrote. “Each government department uses its own calculation method.”

The fragmented picture that emerged reveals:

• Federal government: 583 permanent staff sick for over one year (end of 2024)
• Police: 291 personnel absent for more than one year (end of April)
• Defense: 119 ongoing cases, though measured at six months rather than one year
• Walloon government: 181 staff sick for over one year in 2025, only 57 of whom were permanent
• Brussels region: No recent data available; officials declined to share figures, citing “very sensitive information”
• Flemish government: Only knows who is sick for more than 30 days — 3.99% of permanent staff, or roughly 780 people — but cannot say how many exceed one year
• Education: An estimated 2,750 staff in Flemish education, but the threshold is six months, not one year; 1,582 in French-language education who missed an entire school year
• Local governments: No central data exists; each of Belgium’s 565 municipalities would need to be contacted individually

The Two-Tier System

Belgium operates fundamentally different systems for private and public sector workers. Private sector employees and contractual civil servants fall under health insurance funds after one month of sickness and are classified as “invalide” after 12 months — these are the 576,643 counted by RIZIV. Permanent civil servants, by contrast, continue receiving full pay while using accumulated sick days. Once those are exhausted, the employer could request Medex to place them on sickness pension — historically a dead-end with no reintegration mechanism.

As VRT NWS reported, the system was designed under the 1994 Sickness Insurance Law and has struggled to keep pace with rising caseloads.

Broader Crisis

The long-term sickness crisis extends well beyond the civil service. The 576,643 figure represents an increase of over 105,000 in five years and more than 26,600 additional cases compared to the end of 2024. Demographics show that 77% of long-term sick employees are aged 45 or older, women account for 60.3% of cases, and the most common causes are psychological disorders (38.28%) and musculoskeletal conditions (26.94%).

A RIZIV audit found that approximately one in four long-term sick individuals received unjustified or overly extended benefits, intensifying political debate. Health Minister Frank Vandenbroucke (Vooruit) has declared that “the era of non-commitment is over,” announcing that from 2027, health insurance funds will receive performance-based funding tied to return-to-work outcomes.

Political Fallout

The data gap has become a politically charged issue. The N-VA argues there are too many long-term sick and wants to cut costs, while health insurance funds say they are being unfairly scapegoated. Professor Lutgart Braeckman of Ghent University, an expert in occupational medicine, warned: “It’s good that there is a safety net, but it should not become a hammock.”

The central finding of the HLN investigation — that the government cannot monitor its own employees while demanding transparency from the private sector — has raised fundamental questions about accountability. As Mees concluded: “This search mainly shows something else: even the government itself does not know exactly how many permanent civil servants have been sick for more than one year. Nowhere are these figures centrally recorded. And that is an uncomfortable truth.”

What Comes Next

The new pension law ending the sickness pension system for civil servants took effect on June 1, introducing a minimum two-year waiting period and a focus on reintegration. However, 86,911 civil servants remain in the legacy system. Calls are growing for a centralized database to track long-term sickness across all levels of government, though no concrete proposals have been announced.

With labor shortages across multiple sectors and social security budgets under strain, the pressure to address both the data gap and the underlying drivers of long-term sickness — an aging population, rising psychological disorders, and work intensification — is only expected to grow.