Sick leave: employee rights and employer obligations
Monday morning, quarter to eight. Your phone rings. One of your staff calls: "I'm ill, I can't come in to work." And so it begins. What exactly does that employee have to do? And you, as the employer? What about their pay, the medical certificate, and what if you doubt whether the illness is genuine?
In practice, this turns out to be one of the topics employers stumble over most often. Not because the rules are so complicated, but because there are so many different situations. Short illness, long illness, a relapse, illness during leave, illness during the notice period. And the legislation has changed significantly of late, especially from 2026 onwards.
This article gives you a complete overview of your obligations as an employer when an employee falls ill. Practical, up to date, and with a close eye on the new rules.
The employee's obligations when off sick
Let's start with the basics. What does your employee have to do when he or she falls ill?
Notify you immediately
The employee must inform you as quickly as possible. Most work rules state that this has to happen before the shift starts, or within the first hour of the working day. Check your own work rules for the exact requirements.
Provide their address of stay
If the employee is not staying at their usual home address during the illness, that address must be communicated immediately. This matters for a possible check.
Submit a medical certificate
In many cases, the employee has to hand in a medical certificate. But the rules here have changed recently. More on that in a moment.
When is a medical certificate required?
This is one of the most frequently asked questions. And the answer is more nuanced than you might think.
The main rule since 2022
An employee does not have to submit a medical certificate for the first day of an incapacity for work. This applies for a maximum of three times per calendar year. From the fourth time onwards, a certificate is required, even for a single day.
Change from 2026
From 1 January 2026, the exemption is limited to twice per calendar year instead of three times. So your employee may still be absent for one day without a certificate a maximum of twice per year.
Exception for small companies
Do you have fewer than 50 employees on 1 January of the calendar year? Then you can deviate from this rule. You may require a certificate for every sick day, but only if you set this out in your work rules or in a collective labour agreement (CLA). Without that formal arrangement, the general rule applies.
In practice
Many smaller employers choose to always ask for a certificate. That's understandable, because it keeps everything clear. But don't forget that this has to be stated in your work rules.
Guaranteed salary: the 30-day rule
This is where it gets a little legal. Not boring-legal, but definitely important for your wallet.
As an employer, you are required to keep paying your sick employee for a set period. This is what we call guaranteed salary.
For white-collar workers
A white-collar worker is entitled to 30 calendar days of guaranteed salary at 100% of gross salary. This applies regardless of seniority, unless the contract runs for less than three months.
For blue-collar workers
For blue-collar workers, the calculation is more complex:
- Days 1 to 7: 100% of gross salary
- Days 8 to 14: 85.88% of gross salary
- Days 15 to 30: 25.88% of the capped gross salary, plus 85.88% of the portion above the cap
Note: a blue-collar worker must have at least one month of seniority to qualify for guaranteed salary. Without that seniority, the employee goes straight to the health insurance fund.
White-collar workers on short contracts
For white-collar workers on a fixed-term contract of less than three months, the same rules apply as for blue-collar workers, including the seniority condition.
After 30 days
Once the guaranteed salary period ends, the health insurance fund takes over. The employee then receives a sickness benefit of roughly 60% of the capped gross salary.
In our experience with thousands of sickness notifications, we see that many employers underestimate the guaranteed salary calculation. The difference between blue-collar and white-collar workers, the seniority conditions, the percentages per period. With Recruit, this is calculated automatically based on your employee's status and situation.
Relapse within 8 weeks: the new rules
This is an important change since 1 January 2026. And it can make a real difference to your costs.
The old rule
Until 2026, the rule was: if an employee fell ill again for the same reason within 14 days of returning to work, this counted as a relapse. You then did not have to pay new guaranteed salary.
The new rule
From 2026, this period has been extended to 8 weeks. In concrete terms: if your employee falls ill again for the same medical reason within 8 weeks of returning to work, there is no new entitlement to guaranteed salary.
Has the balance of the previous period not yet been used up? Then you only pay the remaining part. Has the 30-day period already elapsed? Then the employee falls back directly on the health insurance fund.
Exception
If a medical certificate shows that the new illness stems from a different cause, then a new period of guaranteed salary does begin.
Example
Your employee was off sick for two weeks in January with back problems. After returning to work, they relapse in February with the same back problems. You then pay at most the remainder of the original 30 days, not a full new period.
Sending a controlling doctor: when and how
You have the right to send a controlling doctor. This is not about mistrust, but a legal tool to prevent abuse.
When can you send a controlling doctor?
From the first day of absence. You do not have to wait for a medical certificate. You also do not have to give a reason. The expected length of the absence plays no role.
How often?
As often as you consider necessary. Each time the certificate is extended, you may send a controlling doctor again. Even during the period when the health insurance fund is paying, you can still arrange checks.
The timing
The check may take place between 7 a.m. and 9 p.m., including on Sundays and public holidays. Your work rules can require the employee to remain available for a maximum of 4 consecutive hours, for example between 2 p.m. and 6 p.m.
What if the employee isn't home?
The controlling doctor then leaves a message with a summons. The employee must then report to the controlling doctor on their own initiative, unless the certificate states that travel is not allowed. The travel costs are for your account.
Does the employee deliberately avoid the check? Then you may refuse the guaranteed salary for the entire period covered by the certificate.
Dispute between doctors
What if the controlling doctor judges that the employee is fit to work, but the treating doctor says otherwise? An arbitrating doctor can then be called in. They decide within three working days. The losing party pays the costs: around 185 euros (2024 amounts).
What you may not do
You may not ask what is wrong with the employee. That falls under medical confidentiality. You are only allowed to know whether someone is unfit for work or not, and for how long.
Long-term illness: reintegration duties
Long-term illness brings extra obligations into play. The legislation on this has been tightened considerably from 2026.
After 8 weeks: assessing work capacity
As an employer, you are required to have an assessment of work capacity carried out after 8 weeks of incapacity for work, by your prevention advisor-occupational physician. This is new since 2026.
After 6 months: mandatory reintegration process
Do you have 20 or more employees? Then you must start a reintegration process no later than 6 months if it turns out there is work capacity. If you fail to do so, you risk sanctions: a criminal fine of 400 to 4,000 euros, or an administrative fine of 200 to 2,000 euros per employee concerned.
Keeping in contact
Since 2026, you are required to include a procedure for keeping in contact with employees who are unfit for work in your work rules. The occupational physician contacts the sick employee as early as after one month.
Progressive return to work
Can your employee partly resume work? Then a progressive return to work can be started in consultation with the occupational physician. Note: if the employee relapses during this progressive return to work, no guaranteed salary has been due since 2026. The employee then falls back directly on the health insurance fund.
Solidarity contribution for larger companies
Do you have 50 or more employees? Then, from 2026, you pay a solidarity contribution of 30% of the sickness benefit during the second and third month of incapacity for work. This applies to employees aged between 18 and 54. The cost can run up to around 1,700 euros per employee.
In our experience with thousands of cases, we see that keeping track of sick days and reintegration deadlines is a challenge. With Recruit, these periods are tracked automatically, so you can take action in good time.
Falling ill during annual leave
Since 2024, new rules apply when an employee falls ill during their leave.
The employee can keep their leave days
If your employee falls ill during their annual leave, the leave days are converted into sick days. The employee can then take these leave days later.
Conditions
The employee must:
- Notify you of the illness immediately
- Provide their address of stay if it differs from home
- Submit a medical certificate within two working days
- Explicitly request to take the leave days later
Guaranteed salary
You owe guaranteed salary for the sick days. The leave days are effectively converted.
Carry-over possible
Can the employee no longer take the postponed leave days within the holiday year? Then they may be carried over for up to 24 months after the end of the holiday year. However, you pay the holiday pay no later than 31 December of the holiday year.
This applies only to statutory leave days, not to extra-legal leave days or ADV days (working time reduction days).
Falling ill during the notice period
A situation that comes up regularly and leads to discussion.
Dismissal by the employer: the notice period is suspended
Have you, as the employer, terminated the employment contract? Then the notice period is suspended during the illness. The notice period is extended by the number of sick days. This can mean a considerable extra financial cost in the case of long-term illness.
Resignation by the employee: no suspension
Has the employee resigned themselves? Then the notice period simply continues to run during the illness. There is no extension.
Example
You dismiss an employee with a notice period of 13 weeks. After 4 weeks, the employee falls ill for 3 weeks. The notice period is then extended by 3 weeks. Instead of 13 weeks, the notice period now lasts 16 weeks.
Alternative: severance pay
Do you want certainty about the end date? Then you can terminate the employment contract with payment of severance pay. From this amount, you may deduct the guaranteed salary already paid.
Want to know more about notice periods? Read our article on notice periods with payroll.
Can you dismiss an employee who is off sick?
The honest truth? Yes, you can. But not for just any reason.
No protection against dismissal
An employee who is off sick does not enjoy statutory protection against dismissal. You can lawfully end the employment contract during the incapacity for work.
But protection against discrimination
You may never dismiss an employee because of the illness itself. That is discrimination on the grounds of health status, prohibited by the Anti-Discrimination Act of 10 May 2007.
When is it allowed?
You must be able to cite a valid reason for dismissal that is entirely unrelated to the health status:
- Poor performance or behavioural problems (documented)
- Economic or organisational reasons
- Serious disruption to business operations caused by the absence
Burden of proof
In the event of a dispute, you as the employer must prove that the dismissal was not discriminatory. So build a solid file with objective arguments.
Sanction for discrimination
Is the dismissal classed as discriminatory? Then you must pay compensation of six months' gross salary.
Medical force majeure: shorter deadline
Since 2026, you can start the procedure for dismissal on the grounds of medical force majeure after just 6 months of uninterrupted incapacity for work (previously this was 9 months). This is, however, subject to strict conditions.
Frequently asked questions
Do I have to pay salary if the employee doesn't submit a medical certificate?
If the medical certificate is required and the employee does not hand it in on time, you can suspend the guaranteed salary for the days on which the certificate is missing. As soon as the certificate arrives, payment resumes.
Can I ask what is wrong with the employee?
No. The nature of the illness falls under medical confidentiality. You are only allowed to know whether someone is unfit for work and for how long.
How much does a controlling doctor cost?
The costs vary, but count on 50 to 150 euros per check. In a dispute procedure with an arbitrating doctor, add costs of around 185 euros. You, as the employer, pay for the check; the losing party pays for the arbitrator.
Does illness at the weekend count towards guaranteed salary?
Yes. Guaranteed salary is calculated in calendar days, not in working days. So a weekend during the illness does count towards the 30 days.
Do I have to pay guaranteed salary in the case of an occupational accident?
Yes, the same rules apply. After the guaranteed salary, the occupational accident insurance takes over instead of the health insurance fund.
In short
As an employer, you have clear obligations when an employee falls ill. You pay up to 30 days of guaranteed salary, you respect the rules around the medical certificate, and you can bring in a controlling doctor if you feel it's necessary.
Since 2026, the rules have been tightened. The relapse period has been extended to 8 weeks, the exemption for the medical certificate is limited to twice per year, and in the case of long-term illness you have to work actively on reintegration.
The most important lesson? Document things well, act in good time, and bring in an expert when in doubt. Absence through illness is part of running a business. With the right knowledge and tools, you keep it manageable.
How Recruit helps you
Calculating guaranteed salary correctly and keeping track of sick days? On our platform, it happens automatically.
With Recruit:
- Contracts in under 60 seconds: create trial and temporary contracts without the hassle
- Automatic salary calculation: correct pay in line with current legislation and your Joint Committee
- Dimona (immediate employment declaration) and social documents: we handle all declarations, you focus on your business
- 24/7 personal support: always a dedicated contact who knows your company
- No fixed monthly costs: pay only for what you use
Try Recruit or get in touch with our HR experts for tailored advice.
The information in this article is purely informative and does not replace professional legal or accounting advice. Employment legislation changes regularly. Always consult the current legislation or get in touch with an HR expert for advice tailored to your situation. The rules can differ per Joint Committee and sector.