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The era when work incapacity was a mere administrative box managed by the health insurance fund is over. Faced with an exponential curve in long-term absenteeism, the Belgian federal government has executed a major legislative shift.Under the impetus of Social Affairs Minister Frank Vandenbroucke, Belgium is moving from a passive compensation logic to an active accountability logic.
This decoding analyzes the mechanisms of this reform, the urgency of the 2026 figures, and the new financial sanctions that now directly threaten the cash flow of companies.
To understand the severity of the new measures, one must face reality: the Belgian social security system is on the brink of asphyxiation.For a long time, unemployment was the n°1 national concern. Today, the curve has reversed. Belgium now has significantly more long-term sick people (more than one year of absence) than job seekers. The observation is clear: Belgium is now the European country with the highest rate of inactive people due to illness or disability. Official figures from INAMI, RTBF, and the latest analyses from SD Worx (January 2026) paint an alarming picture:
The number of sick people continues to grow. Facing this, the government no longer wants to just compensate, it wants to hold employers accountable.
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This severity serves a quantified national ambition: to reach an employment rate of 80% by 2029. For Minister Vandenbroucke, this objective is mathematically impossible to hold without reactivating a significant part of the 500,000 long-term sick people.
This is the measure that changes everything since January 1st, 2026. Until now, once the first month of guaranteed salary passed, the employer no longer had any immediate direct cost.From now on, for companies of 50 workers and more, the State imposes active participation during the critical period of absence (the 2nd and 3rd month).
This device aims to replace the logic of late sanction with immediate accountability.Until now, the "Responsibility Contribution" mechanism (in force since 2022) penalized companies generating an excessive flow of long-term sick people (> 1 year).With the reform, for large companies, the financial effort is brought forward: by paying a solidarity contribution for the 2nd and 3rd months, the employer is financially encouraged to act while the link with the worker is still strong, rather than waiting for invalidity.
Beyond the financial aspect, the reform hardens the procedural framework for all actors. It is no longer just about paying, but about acting. Here are the 4 new obligations you must know.
If you employ 20 workers or more (lower threshold than for the financial contribution!), you now have a strict procedural obligation.If a worker has been absent for 6 months and occupational medicine considers that they have "work potential", you must start a reintegration path.→ The sanction: A fine is provided if no process is launched despite the detected potential.
This is a major novelty for prevention. A worker who is not yet sick but feels that they can no longer hold their position (e.g.: onset of back pain, intense stress) can request a "preventive reintegration path".The impact: The company must examine the possibilities of position adaptation before the sick leave falls.
Accountability is not just one-way. The sick worker now risks more if they do not play the game:
Faced with this legislative hardening, the landscape of Belgian companies will split into two camps as of 2026:
The "Return to Work" reform highlights an often underestimated accounting reality: absenteeism costs a fortune, long before the federal sanctions fall.According to reference analyses from SD Worx, an average Belgian company loses nearly €1,600 per employee per year solely for unperformed hours.Do the math: for a company of 100 employees, that's €160,000 in direct salary costs spent in pure loss each year.And be careful, this amount is a floor cost. It only takes into account salaries paid without any service in return. It says nothing about indirect costs that explode as soon as the absence prolongs:
The observation is mathematical: reducing your absenteeism rate by only 10% is enough to fully self-finance a solution like eBloom. Any result beyond that is net profit for your cash flow.
To act effectively, one must understand what is really playing out in the heads of your collaborators before they fall ill.If INAMI statistics confirm that psychosocial disorders are the n°1 cause of invalidity (37%), academic research gives us a valuable reading key to anticipate them.The work of KU Leuven (via the Burnout Assessment Tool) has highlighted a major precursor signal: mental distancing.Before the physical collapse (burnout), there is always a phase of psychological withdrawal. The collaborator is physically present, but their mind has already "resigned". They become cynical, distance themselves emotionally from their work and their colleagues.It is this invisible disengagement that managers do not always see with the naked eye, but which constitutes the anteroom of long-term sick leave. Detecting this mental distance before it becomes physical distance is a real way to avoid the sanctions of the reform.
The "Return to Work" reform is not a simple administrative update. It is a societal change desired by the government to reach the 80% employment rate in 2029.The new financial contributions (months 2 and 3) and results obligations no longer leave room for improvisation. Your cash flow will now be directly impacted by the mental and physical health of your teams.You have the choice:
The best reintegration strategy? It's to never have to do it. Transform your absenteeism risks into a performance lever today. Book your 1-to-1 to discuss your talent management strategy and discover eBloom.
From HR digitalization to AI integration and new employee expectations, the human resources sector is rapidly changing. Based on responses from over 450 Belgian companies, our report gives you a head start to prepare your teams and strategy for the realities of tomorrow.
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