Belgium Requires Annual Doctor Visits for Long-Term Sick

Belgium has introduced sweeping new rules requiring individuals on long-term sick leave to visit their doctor annually for a reassessment of their work incapacity status. The measure, approved in second reading by the federal Council of Ministers on June 12 and announced on June 16, 2026, is part of Health Minister Frank Vandenbroucke’s broader “Terug Naar Werk” (Return to Work) package aimed at reducing the country’s growing long-term sickness crisis.

Under the new rules, long-term sick individuals must undergo an annual evaluation by their treating physician to renew their invalidity benefit certificate. Failure to comply results in the loss of the benefit. The policy applies to the more than 570,000 Belgians currently on long-term sick leave, a number that has risen to 576,643 as of May 2026 according to RIZIV figures cited by the Federal Institute for Human Rights (FIRM).

Context and Background

Belgium has been grappling with a mounting long-term sickness crisis. Over 570,000 people were on invalidity leave last year, prompting the federal government to target €1.9 billion in savings on long-term sickness by 2030. The government aims to reduce the number of long-term sick by 100,000 — bringing the total below 470,000 — through a combination of stricter evaluation measures and expanded reintegration support.

This is the fourth wave of measures within Vandenbroucke’s Return to Work program. Previous steps included limiting initial sickness certificates to three months during the first year of incapacity, various reintegration programs, and a burn-out prevention plan. The latest measures also shorten the duration of the first sickness certificate to just three weeks to ensure rapid follow-up.

Key Developments

According to VRT NWS, Minister Vandenbroucke explained the rationale behind the policy in an interview on Radio 1’s “De Ochtend.” “There is today a large group of people who sometimes go years without new contact with a doctor, without the question being asked again: ‘What can you actually still do?’” he said.

“As a rule, after a year you will have to have a thorough conversation with your treating doctor about what you can still do in society. That doctor will then have to submit a new application for your invalidity benefit. If you don’t do that, it will lapse,” Vandenbroucke added.

The minister emphasized that the goal is not to penalize the sick but to ensure they remain connected to the healthcare system. “We really no longer want people who are at home sick to be left to their fate,” he stated.

Exceptions for Severe Illnesses

The annual evaluation requirement does not apply to patients with very severe conditions. “It concerns, for example, people who are hospitalized or people with a progressive disease. We are not going to ask someone with Parkinson’s disease to prove every year that they are sick,” Vandenbroucke clarified.

Expanded Employer Obligations

The measures also expand employer obligations. Companies with more than 50 employees must now pay 30% of the sickness benefit for workers aged 18 to 55. Employers who successfully reintegrate long-term sick workers receive a higher work resumption premium. Additionally, the value of “Return to Work” vouchers — currently capped at €1,800 — will be increased and their target group expanded. These vouchers can be used for professional career guidance.

Sickness funds (ziekenfondsen) are expected to review approximately 218,000 dossiers of long-term sick individuals by 2029, with an anticipated 17% outflow from work incapacity in this group.

Analysis and Implications

The policy has sparked significant debate, with human rights organizations raising concerns about the potential erosion of social protections. Martien Schotsmans, Director of the Federal Institute for Human Rights (FIRM), warned in the organization’s 2025 annual report that “social rights are also human rights. The current reforms affect hundreds of thousands of people. Measures that entail a deterioration of their rights cannot simply be implemented.”

FIRM has cited Article 23 of the Belgian Constitution, which guarantees social rights including the right to work, social security, and health, as well as the “standstill principle” — which requires that the government cannot lower the level of protection of social rights without sufficient justification. The institute has also criticized the lack of impact assessments before adopting the reforms and the use of urgency procedures in Parliament, which limited debate and expert consultation.

Public reaction has been mixed. While some commentators support the principle of regular checks — noting that “it seems only logical that long-term sick should be checked at least every 12 months” — others have raised practical concerns. Questions have been asked about whether there are enough doctors to handle an estimated 220,000 additional evaluations per year, and how patients with fluctuating conditions such as epilepsy, Crohn’s disease, multiple sclerosis, and chronic fatigue syndrome will be assessed fairly.

Economic Context

The federal budget agreement targets €1.9 billion in savings related to long-term sickness by 2030, as part of broader fiscal consolidation efforts by Prime Minister Bart De Wever’s government. Vandenbroucke noted that the government has already demonstrated progress: “We have proven in recent months that change is possible. For the first time in years, short and medium-term absenteeism is declining. We continue that line without slackening.”

What’s Next

The measures are now set to be implemented, with sickness funds beginning the review of 218,000 dossiers. Several outstanding questions remain, including which specific medical conditions will be exempt from the annual evaluation, how the government will ensure sufficient doctor capacity for the additional evaluations, and whether the measures will withstand potential legal challenges based on human rights law.

Patients with fluctuating or invisible illnesses face particular uncertainty about how their conditions will be assessed fairly under the new framework. The coming months will reveal whether the government’s ambitious targets for reducing long-term sickness can be achieved without compromising the social protections enshrined in Belgian law.