Belgium: Reintegration and Medical Absence Rules Reformed — What Changes in 2026?

On 30 December 2025, the Act of 19 December 2025 to execute a reinforced return-to-work policy and the Royal Decree of 17 December 2025 that adapts the Codex on Wellbeing at Work were published in the official journal, launching a major change in the return-to-work rules starting 1 January 2026.

Below are the key elements of this reform:

 

1) The big idea behind the reform: earlier action and clearer follow-up

RIT 3.0 is built around a simple principle: detect earlier whether returning to work is still realistically possible, and then act—instead of waiting many months before anyone takes concrete steps. The reform is part of broader measures on reintegration and prevention of long-term absence.

2) New concept: an “estimate of work potential” after 8 weeks

A key novelty is the introduction/definition of “work potential.” Basically, the presumed ability of a worker on sick leave to perform adapted work or other work.

What happens after 8 weeks?

If a worker has been unfit for work for at least 8 weeks, the employer must ask the prevention advisor–occupational physician to carry out an estimate of work potential.

That estimate is to be done using a standardised method and may rely on available information from the treating doctor, the medical advisor of the health insurer (“mutuality”), the employer and the worker; it may also involve contacting the worker using a questionnaire model to be published by the authorities.

If work potential is confirmed…

If the estimate indicates work potential, the worker and employer must be informed, and the employer then:

• Can (not mandatory!) request to the employee a pre-return-to-work visit to the Prevention-Advisor Occupational Physician, or
• Can start a formal reintegration trajectory (but this can be an obligation, see below).

3) A new “must-start” trigger for larger employers (20+ workers)

For employers with 20 workers or more, RIT 3.0 adds a stronger obligation: if work potential is confirmed, the employer must request that a formal reintegration trajectory starts no later than 6 months after the beginning of the incapacity.

Important transitional point: this particular obligation applies to incapacity periods that begin on or after 1 January 2026.

Employers who do not start the RIT procedure can be sanctioned with a level 2 sanction according to the Social Penal Code.

4) Contact during sick leave becomes more structured (and must be in the work rules)

RIT 3.0 requires employers to include, in their work rules, a procedure for staying in touch with workers who are absent due to incapacity. This procedure must specify at least:

• who will contact the worker, and
• how often contacts will take place.

This is framed as part of an “active absence policy” meant to prepare a smooth return, not to “police” the medical reasons for absence. Also, this obligation entered into force on 1 January 2026, meaning employers had 2 days (30 and 31 December 2026) to adjust their internal work rules. It is expected that the social inspection will introduce a tolerance period so employers have enough time to introduce an active absence policy in their work rules.

5) Missed RIT-invitations by employees may now have more severe consequences for benefits

In a formal reintegration trajectory, the worker is invited to an assessment by the occupational physician. These invitations must be sent by registered post. RIT 3.0 adds a new escalation step:

• if a worker does not accept the invitation after 2 invitations, the occupational physician must inform the mutuality’s medical adviser and share the invitation dates;
• after 3 invitations (with at least 14 calendar days between them), the reintegration trajectory ends and the employer and medical adviser are informed.

The invitation must also mention that the medical adviser will be informed if the invitation is not accepted and that sanctions may apply under the health insurance rules.

6) Initiation of informal and formal reintegration procedures become easier

It becomes possible for an employee and employer to start a formal reintegration procedure  from the first day of the absence with the consent of the worker. There is no longer a waiting period. However, if the worker does not consent, the employer needs to wait until the work potential assessment after 8 weeks.

The employer and employee can also request an informal procedure, which the other party can reject.

The employee can even request a preventive reintegration procedure if he/she feels that adjustment measures regarding the work are necessary to prevent a medical absence. The employer can refuse such a request but should motivate this decision.

The occupational physician will propose an employee to discuss the absence and return-to-work possibilities after one month of absence.

7) Medical force majeure: the waiting period drops to 6 months

Reintegration and ending employment due to definitive unfitness are not the same thing. Belgium has a separate procedure for ending a contract for medical force majeure.

RIT 3.0 modifies the Code so that the relevant waiting period changes from 9 to 6 (in the Code provision referenced by the reform).

On the government’s guidance, medical force majeure can be launched only after at least 6 months of incapacity and if no reintegration trajectory is ongoing for that worker.

8) More formalised communication between doctors (including via TRIO)

RIT 3.0 also targets a practical bottleneck: fragmented communication between the occupational physician, the treating doctor, and the mutuality’s medical adviser.

The new rules:

• allow/structure consultation and sharing of health data with the worker’s consent, and
• require using the TRIO platform for certain communications and updates.

This platform is still a work-in-progress.

8) Fewer “no doctor’s note for day 1” exemptions

The exemption from providing a medical certificate for the first day of incapacity is reduced from 3 days to 2 days per calendar year (so an employee can use it twice per year). Other existing conditions remain.

9) “Relapse period” for guaranteed salary extended to 8 weeks

The “relapse period” linked to the right to guaranteed salary (paid by the employer at the start of sickness) is extended from 14 days to 8 weeks.
Meaning: if an employee returns to work after a sickness period that gave a right to guaranteed salary and then becomes sick again within 8 weeks, the employer will not owe guaranteed salary again (with exceptions).

10) Main implications for employers

• You will need a documented contact procedure in your work rules (who contacts, how often).
• After 8 weeks, you must trigger an estimate of work potential.
• If you have 20+ employees and work potential is confirmed, you will face an obligation to start a formal trajectory by month 6 (for new incapacity cases from 2026).

11) Timeline and transition

• In force: 1 January 2026.
• Existing reintegration trajectories started before that date are not switched into the new rules.