Partena - Business & Expats

→ Work disability

If you are ill, a victim of an accident or hospitalised, you will temporarily lose your income. After the period in which you receive a guaranteed salary or sick pay, the health insurance organisation will take over and pay you a replacement income called a ‘work disability allowance’.

To benefit from this, you need to meet certain conditions and carry out certain procedures. As a newly registered policy holder (not applicable if you transferred from one Belgian health insurance provider to another) you can only benefit from allowances, in case of illness or pregnancy, if you have been contributing to the Belgian social security system for at least 6 months.

Did you just graduate or were you employed in another European country? You can then, under certain circumstances, cancel this waiting period and immediately benefit from allowances in case of illness or pregnancy. For more information, contact your mutuality.

 

How do the indemnities work?

1) Employee, blue-collar worker or a job seeker receiving unemployment benefit.

Give your employer a medical certificate within two days. Unemployed people should complete their control card.

Send the original ‘medical certificate of work disability’ to the medical advisor of your health insurance company. This should be completed by your general practitioner and mention the diagnosis, the date your work disability started, your details, the details of the doctor, his/her signature and the date.

What document do you need ?
Send Partena Business & Expats the medical certificate or a document completed by your doctor, indicating the start date of your incapacity to work and the medical reason. It should be sent, as quickly as possible, and absolutely by mail (Be careful ! You may not drop it off in one of our letter boxes).


The normal time allowed to send in your certificate, starting on the 1st day of your inability to work :

  • 28 days, if you have an employee contract
  • 14 days, if you have an blue collar worker's contract.
  • 3 days, if you are a job-seeker receiving unemployment benefit, a temp worker or if you are following a professional training course.

What are the indemnities ?

The calculation is done based on information provided by your employer or the office paying your unemployment benefit and yourself. During the first 12 months (primary incapacity), the indemnities vary between 55% and 60% of your capped gross remuneration. The first day of the 13th month of incapacity marks the beginning of the incapacity period where the indemnities vary between 40% and 65%.

2) Self-employed

There is a special medical certificate for the self-employed. It is available from Partena Business & Expats and must be sent within a period of 29 days (starting on the 1st day of your inability to work).

During their first month of work disability, self-employed people will not receive any compensation. After this period, compensation is paid by your health insurance provider if certain conditions are met.

Notify your health insurance provider as soon as possible. In addition to the medical certificate, the medical advisor also needs a questionnaire about your professional self-employed activity.

 

Timing

It is imperative to send your medical certificate of work disability within the following deadlines:

  • unemployed: 3 days
  • worker: 14 days
  • employee: 28 days
  • self-employed: 29 days

Failure to do this will result in a fine for every day of delay (-10% of the daily amount of your work disability allowance). After receipt of your medical certificate, we will send you all the necessary documents, including the ‘information sheet’ to be completed by yourself.

As soon as we have received this document, we will be able to calculate the work disability allowance that you are entitled to.

 

Conditions

To be recognised as occupationally disabled, you must satisfy three statutory conditions:

  • you have ceased all professional activity for at least 1 working day; odd jobs are therefore not permitted. If you are unemployed, you should no longer be available for the labour market.
  • you have a disorder, which means officially that this must be the occurrence or worsening of injuries or functional impairments.
  • the disorder reduces your capacity to earn an income from work to one third of what someone can earn with the same profession or with the same education and professional career (in other words: you are at least 66% occupationally disabled).

Primary work disability

The legislator divides work disability into two periods. The period of 'primary work disability' lasts no longer than one year and starts at the commencement of the work disability. As soon as you return to work, the period of primary work disability stops.

Invalidity

After the first year of work disability (called primary work disability), you enter the phase of ‘invalidity’: you continue to receive allowances from your health insurance provider, but the amounts may vary and be higher or lower depending on your family situation.

 

Allowance of work disability

To be entitled to allowance payments, you must first be a member with a health insurance organisation or with the Belgian Assistance fund for sickness and disability allowance.  In addition, you must be entitled to allowance payments. This is the case for the majority of working or unemployed employees, or self-employed people in main occupation. Please contact your mutuality to ask about these allowances.

Employee

Your work disability allowance is equal to 60% of your gross salary, depending on the duration of the work disability and your status. However, a monthly ceiling applies. If your gross salary exceeds this amount, the allowance will be calculated based on this ceiling.

Unemployed

During the first 6 months of work disability, you will receive a disability allowance equal to your unemployment benefit. As of the 7th month, the disability allowance will either be based on your initial unemployment category or on a fixed amount linked to your experience. The disability allowance will, as a result, not automatically correspond with the unemployment benefit.

Self-employed

You will benefit from a fixed allowance starting from the 2nd month of your work disability.

 

What to do in case of an accident?

Every victim of an accident, with or without the responsibility of a third party, has to notify this accident to the health insurance company. The person then has to complete an accident declaration form. If necessary, we will recover the reimbursed costs from the responsible third party in accordance with the legal provisions.

 

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