Around one in four people on long-term sick leave are receiving benefits to which they are not entitled, or for too long. The data comes from two surveys conducted by Riziv, the national institute for health and disability insurance, as reported by De Standaard.
The heads of the health insurance funds are due to appear before the Chamber on Monday to provide further clarification on how they monitor people with long-term illnesses. They have been summoned to do so following earlier reports that they were being too lax. Coalition parties N-VA and MR have been highly critical of the funds.
For its new surveys, Riziv examined 1,000 cases in 2025 in two groups: under-28s and people under 40 with a mental health condition. In the first group, benefits had to be terminated for 23.9 per cent of cases and reduced for a further 3.2 per cent; in the second, the figures were 25.2 per cent and 3.8 per cent.
According to Health Minister Frank Vandenbroucke of Vooruit, the figures are similar to those from 2024. “This really needs to improve,” he says. “Looking at the figures for 2025, one can only conclude that the health insurance funds are not doing enough to improve their assessment practices.”
The government also reports that in around a third of cases, another doctor had to be called in, often by Riziv, because the health insurance funds’ assessment proved insufficient.
“From 2027, part of the health insurance funds’ operating budget will be linked to the results they achieve in terms of returning to work,” Vandenbroucke said. “Those who take the reintegration of sick employees seriously and commit effectively to it will be rewarded for it. Those who lag behind will feel the consequences. The days of doing as one pleases are over.”
One can only conclude that the health insurance funds are not doing enough to improve their assessment practices
Xavier Brenez, CEO of the Independent Health Insurance Funds, disagrees with the conclusions drawn on the basis of the sample. “This is simply a variation in medical assessment,” he said. “That is well known in the healthcare sector. Ask two doctors to make a diagnosis and decide on a course of treatment, and there will be differences.”
Brenez proposes providing much more precise guidelines for difficult cases and calls for the legislation to be amended and clarified. He accepts the need for change within the health insurance funds. “But there is a great deal of tension. I think the debate needs serenity and calm so that we can discuss the solution.”