Reintegration in 2018: legal framework assessed by key actors

There are currently 405,000 Belgian workers on long-term incapacity for work. In order to get them back to work in a sustainable way, the government set up a new procedure in December 2016 to stimulate reintegration. As shown by the conclusions of several key actors, there is still room for improvement and nuance, however.

On 16 October 2018, various stakeholders in the reintegration process gathered in Brussels for a roundtable discussion. The purpose of this debate? Produce an interim evaluation of the legislation and identify possible bottlenecks. The external prevention services, the Belgian National Institute for Disease and Invalidity Insurance (INAMI/RIZIV) and the independent health insurance funds also took part in the evaluation. So did Voka, occupational physicians and the reintegration managers of a few large Belgian companies.

According to them there are three main areas of concern:

1. The figures on reintegration have been distorted

2 out of 3 reintegration processes lead to permanent incapacity for work, without the possibility to perform other or adapted work at the same employer. However, the figures need to be viewed in a broader context, for two reasons:

  • A reintegration process comes with a high administrative burden. Among other things, medical exams and discussions, the corresponding consultations between the parties involved and a possible reintegration plan take a great deal of time and resources. That is why quite a few employers and employees opt for a preliminary medical exam before the resumption of work or a return-to-work medical exam. These are a bit more accessible and ideal when a consensus is reached about resuming work.
  • In certain cases, a general practitioner declares the employee permanently incapacitated for the agreed work even though a reintegration procedure has not been started. It is impossible for the employee to go back to the same employer. However, in order to terminate the employment contract due to medical force majeure, the employer is obliged to go through a reintegration process, even if the outcome is bound to be negative. Failing that, the employer will have to pay the worker severance pay.

2. An evaluation of health surveillance is required

The legislation on the compulsory health surveillance of healthy employees needs an update. The – often routine – annual checks take up valuable time and resources. By amending the law and focusing health surveillance on certain profiles, occupational physicians will be able to free some of their capacity.

They will then be able to invest it in the timely detection of employees at risk of getting ill because of mental health issues. These problems play a part in 25% of all benefits for incapacity for work. By focusing more on the prevention of mental health problems, occupational physicians can identify those problems early in the workplace, which in turn will reduce the risk of long-term absenteeism among sufferers.

3. The consultation between the parties involved must be more efficient

Many parties are involved in a reintegration procedure, which leads to a time-intensive process. Two measures make the consultation easier:

  • The medical file must be available to all the physicians involved. At present, the health insurance funds, among other players, do not have access to the medical records of an employee who goes through a reintegration process. This makes it difficult to get a complete picture. Giving access to the physicians involved removes that problem. Yet, the shared professional secrecy and the privacy laws must first be amended.
  • Each reintegration process must have a Disability Manager, who coordinates the reintegration and monitors its progress. Various players in the process can take up this role, such as the external prevention advisor or the health insurance fund's advisory physician. A Disability Manager has mastered the legal framework and maps out the person's individual needs and working conditions. He/she also encourages cooperation and consultation between the parties involved, as this dramatically improves the efficiency of the reintegration process.

Conclusion: amendments needed

A reintegration process, as enshrined in the legal framework, constitutes a major first step in getting employees on long-term absence due to illness back to work. Almost two years on, amendments seem necessary: the high administrative burden, the inefficiencies in the consultation process, and the compulsory health surveillance of healthy employees are still hampering the smooth return to work of workers on long-term sick leave.

How can Mensura help you?

Mensura can offer you practical and policy-related assistance in the reintegration of employees on long-term sick leave.

More information? We will be happy to help: email us or call +32 2 549 71 00.