Illness at work: wages, privacy, the occupational physician and your contract

Illness at work: wages, privacy, the occupational physician and your contract

If illness prevents you from working, you need to combine room for recovery with arrangements about work and income. Your employer, occupational physician and sometimes UWV each have their own role. Recording the first sick day, contract and arrangements carefully helps prevent a practical misunderstanding turning into a wage dispute. Medical symptoms also call for a different person to speak to than payroll.

Follow the reporting procedure and discuss medical information with the occupational physician.

The statutory starting point is generally up to 104 weeks of continued wages, with important exceptions.

A fixed-term contract can expire on its agreed end date while you are ill.

1. Report sickness and keep confirmation

Follow the absence protocol: for example, call before a set time and remain reachable at agreed times. If unable to report yourself, explain what happened as soon as possible. Record the first sick day and ask where the arrangements are recorded. Reporting sickness is not an ordinary holiday request; use the correct procedure so your absence is registered properly.

Provide practical information about availability and ongoing work where possible. You do not need to give your manager a detailed account of your diagnosis or medication. Discuss capacity for work with the occupational physician. If the protocol is unclear, ask in writing how contact and support will be organised.

2. How much pay must continue?

The statutory main rule is at least 70% wages for up to two years of sickness, subject to statutory limits. In the first year, wages must in principle reach the applicable minimum wage; that top-up requirement does not apply in the second year. A cao or contract may provide a higher percentage, for example full pay initially and partial pay later. Compare the statutory basis with your own arrangements. If household income falls below the social minimum in the second year, ask UWV whether you can apply for a supplement. This requires a separate assessment; the absence of an employer top-up duty does not automatically establish entitlement to a UWV supplement.

Check fixed supplements, variable remuneration and any unpaid waiting days separately. Lower net pay need not result only from the sickness percentage: deductions and supplements can also change. Ask for a clear calculation. Special schemes apply to illness caused by pregnancy, childbirth or organ donation. Employees at state-pension age and some flexible contracts also need a different assessment from the usual two-year route.

3. The occupational physician assesses work possibilities

The occupational physician assesses your medical ability and the restrictions or adjustments relevant to work. Your treating practitioner treats symptoms; the occupational physician translates health into work capacity. Prepare for the appointment with your duties, physical or mental demands, recovery and questions. Describe specifically what happens after a task or working day so the assessment considers workload as well as attendance.

Ask for understandable feedback on capacity, hours and the next review. The employer should receive functional information needed for reintegration, without your complete medical record. Ask the physician to clarify unclear advice. HR or a case manager can coordinate arrangements but does not replace the medical assessment.

4. Reintegration starts with what is possible

Employer and employee must cooperate on returning to work. If prolonged absence is expected, the occupational physician prepares a problem analysis around week six; a plan of action generally follows within two weeks. This can include different tasks, adjusted hours, training or workplace adaptations. A phased build-up should fit what is medically responsible and practically feasible.

Make arrangements measurable: which tasks, how many hours, which rest breaks and when to review? Report promptly if a step fails and request adjustment. The plan does not prove you have fully recovered. Conversely, illness does not make every form of suitable work impossible. Careful records help distinguish unwillingness, unclear arrangements and genuinely excessive demands.

5. Disagreement about work, recovery or wages

First record the actual disagreement. Is it about the physician’s medical assessment, suitability of offered work or insufficient employer effort? A second opinion from another occupational physician addresses doubts about advice. A UWV expert opinion can address specific questions about fitness for work, suitable work or reintegration efforts.

An application does not automatically suspend existing arrangements. Continue cooperating insofar as this can responsibly be expected, and record objections specifically. If suspension of wages or loss of wage entitlement is threatened, ask for the legal basis and conditions for payments to resume. Do not wait several pay periods. The correct next step may depend on the difference between verification information and cooperation with suitable work.

6. Illness and the end of your contract

A prohibition on giving notice generally applies during the first two years of sickness, but it does not protect against every form of ending employment. A fixed-term contract can expire on its agreed date. Valid probation or summary dismissal follows different rules. The timing of sickness relative to a dismissal application can also matter. Have the actual route assessed rather than only asking whether ill employees can be dismissed.

Sickness benefit may apply when you leave employment while ill. Ask about the notification and, where needed, reintegration report. Do not sign a settlement agreement to “continue the sickness through UWV” without advice. You may surrender continued wages while benefit is refused. A payment in the agreement does not automatically compensate for that risk.

Example: illness under a one-year contract

You become ill in month nine and the contract expires after twelve months. Wage entitlement during employment and possible sickness benefit afterwards are separate processes. Illness does not automatically move the agreed end date.

7. Approaching two years of sickness

Keep all documents for the reintegration report and follow UWV messages about a possible WIA disability benefit application. Not everyone still ill after two years receives WIA; UWV assesses incapacity under its own rules. An application does not automatically change your employment contract either. The end of continued wages, the benefit decision and any dismissal are separate events.

If the employer has done too little on reintegration, UWV may impose a wage sanction: up to another year of continued pay. Further protection applies during that extension. Do not make final income arrangements based only on the calendar. Where adjusted work continues, also ask what work has now been agreed, because this may matter on a later sickness report.

Keep the first sick day and confirmation of your report.

Check cao, wage percentage and waiting days.

Prepare questions for the occupational physician.

Record tasks, increasing hours and reviews in writing.

Have termination during sickness assessed beforehand.

Must I tell my manager my diagnosis?

Discuss medical details with the occupational physician. The employer needs practical and functional information to organise work and support. With an extensive form, ask why the data are needed and who may see them.

Am I automatically dismissed after two years?

No. The end of the ordinary wage continuation period does not itself end employment. Benefit assessment, a wage sanction or a separate dismissal procedure may be relevant. Check decisions and contract status separately.

May I take holiday while ill?

Discuss holiday beforehand and check that it does not obstruct recovery or reintegration. Record which days count as leave and the applicable pay. Illness does not mean every trip is prohibited.

What if I do not trust the occupational physician?

First ask for an explanation of the specific advice and discuss a second opinion if you doubt its accuracy. For disputes over suitable work or efforts, a UWV expert opinion may fit better. The routes have different purposes.

Sources and editorial notes
Sources current as of: October 17, 2026
1. Rijksoverheid: wage levels during illness
Publisher: Rijksoverheid
https://www.rijksoverheid.nl/themas/werk/vakantiedagen-en-vakantiegeld/vakantiedagen/vraag-en-antwoord/ziekteverzuim-van-het-werk/hoeveel-loon-krijg-ik-doorbetaald-als-ik-ziek-ben
2. UWV: problem analysis and medical information
Publisher: UWV
https://www.uwv.nl/nl/ziek/loondoorbetaling/probleemanalyse
3. UWV: expert opinion on reintegration
Publisher: UWV
https://www.uwv.nl/nl/ziek/re-integratie/deskundigenoordeel
4. Rijksoverheid: fixed-term contracts and illness
Publisher: Rijksoverheid
https://www.rijksoverheid.nl/themas/werk/arbeidsovereenkomst-en-cao/vraag-en-antwoord/ziekteverzuim-van-het-werk/krijg-ik-met-een-tijdelijk-contract-ook-loon-doorbetaald-als-ik-ziek-ben
5. UWV: assessing reintegration reports and wage sanctions
Publisher: UWV
https://www.uwv.nl/nl/ziek/re-integratie/beoordeling-re-integratieverslag
The source publications are in Dutch. All language editions cover Dutch law.