Incapacity for work
Incapacity for work is a complex matter. Regulations change regularly.
As a general practitioner, it is not easy to stay informed of all the adjustments and side effects of disability. In addition, a structured network is created around the patient, in which the general practitioner, occupational physician and consulting physician play a role.
Declaration of disability
Patients who are incapacitated for work following an illness or accident are entitled to sickness benefits if they meet certain conditions .
To this end, they must send a certificate of incapacity for work to the advising doctor of their regional health insurance fund.
Specific certificate
The declaration must be made with the certificate of incapacity for work :
The first part is completed by the patient, the second part by the treating physician .
To determine the validity of the disability, the following information is necessary :
- start and end date of the disability;
- diagnosis or symptomatology;
- signature and date of signing.
The Riziv number should also not be missing. In addition, it is possible to provide contact details (email address) and encode the context (ICD10 and/or ICPC2).
During the first year of disability, this certificate is required to cover each period of disability. In the event of an extension , these periods must follow each other without interruption . This also applies if an incapacity for work is extended during a period of part-time resumption of work, approved by the advising doctor.
After the first year of incapacity for work, this certificate is no longer necessary .
Timely submission
The patient must submit the first declaration to the advising doctor of the regional health insurance fund within a specific period. This period varies depending on the situation.
If in doubt, it is best to advise your patient to send the certificate within two calendar days .
Extra information
- The start of incapacity for work is the first day on which work is stopped (not the first day after the period of guaranteed wages).
- During the first year of disability, benefits are stopped on the end date stated on the disability declaration.
- For self-employed persons , benefits can only start from the date on which the certificate of incapacity for work was signed . This applies to both the first certificate and to each renewal declaration.
- If you are incapacitated for work for a full week, you must state Sunday as the end date . If not, your patient will lose the benefit for Saturday.
- If your patient is insured abroad , you must use the international certificate of disability.
- If your patient is an employee, you must also prepare a certificate for the employer . Please state the start and end date of the disability. Medical information is not communicated. The report 'illness' or 'accident' is sufficient.
Information about the certificate of disability can be found on the Riziv website.
Recognition of disability
Financial consequences
If the patient is incapacitated for work, he loses a large part of his income. After all, disability benefits are lower than professional income.
Partial return to work
Professional reintegration
Since the end of 2016, a reintegration program can be started for sick people.
With this initiative, which is being introduced gradually, the government wants to facilitate the return to the labor market for some sick people through a gradual return to work, an adapted or different job, or vocational retraining.
Role of advising physician
In addition to providing information about and implementing health insurance, the advising physician is responsible for:
- the verification of disability;
- the socio-economic reintegration of persons who are disabled.
In addition, the advising physician also participates in the procedure for vocational retraining .
