Reintegration after illness: the employee’s obligations and when wage sanctions apply

When an employee becomes ill for a prolonged period, a process begins in which the employer and the employee are jointly responsible for the best possible return to work. That process — reintegration after illness — is largely regulated in the Netherlands by the Gatekeeper Improvement Act (Wet verbetering poortwachter) and the rules on continued payment of wages during illness set out in the Dutch Civil Code.

In practice, there is sometimes a perception that it is mainly the employer who runs risks. That picture is incomplete. The employee also has clear obligations, and anyone who fails to meet them without good reason may lose the right to wages.

In this blog we explain what reintegration involves, which obligations rest on the employee and when a wage suspension, a wage stop or other sanctions may come into play. We also address the wage sanction that the UWV (the Employee Insurance Agency) can impose on the employer, because in practice the two tracks are closely connected.

Reintegration After Illness: The Legal Framework in Brief

An employee who is unfit for work is in principle entitled to continued payment of at least 70% of their wages for 104 weeks (two years) (Article 7:629 of the Dutch Civil Code). During that period, both parties have a best-efforts obligation to reintegrate the employee. The employer must facilitate that return — for example by investigating suitable work and carefully supervising the absence — while the employee must actively cooperate. The employee’s obligations are set out in Article 7:660a of the Dutch Civil Code; the sanction options during illness are contained in Article 7:629 of the Dutch Civil Code.

The Gatekeeper Improvement Act (in force since 1 April 2002) elaborates this into a step-by-step plan with fixed milestones. The key steps are:

• Reporting sick: the employer reports the absence to the company doctor or occupational health service.
• Around week 6: the company doctor draws up a problem analysis together with the employee.
• By week 8 at the latest: the employer and employee draw up an action plan (within two weeks of the problem analysis).
• During the process: periodic progress meetings, in which the action plan is adjusted where necessary.
• In week 42: notification of long-term absence to the UWV.
• Around week 52: the first-year evaluation.
• Around weeks 91-93: the final evaluation.
• In week 104: if the employee is then still (partly) unfit for work, the WIA application usually follows.

If reintegration in the employee’s own role or in other suitable work within the organisation is not possible (the first track), it must be examined in good time whether the employee can reintegrate with another employer (the second track). That second track also remains the employer’s responsibility.

What obligations does the employee have?

The core principle is that the employee must cooperate sufficiently in a swift and responsible recovery and in their return to work. Under Article 7:660a of the Dutch Civil Code, the employee is required, among other things, to:

• cooperate with reasonable instructions and measures from the employer or an engaged expert (such as a reintegration agency) that enable them to perform suitable work;
• perform suitable work of which they are capable, both with their own employer and — in the absence of options there — possibly with another employer;
• cooperate in drawing up, evaluating and adjusting the action plan;
• not obstruct or delay their recovery.

In addition, the employee must comply with the employer’s monitoring rules. These are reasonable, written rules that enable the employer to check whether there is entitlement to wages — think of attending the company doctor’s consultation and being reachable. In doing so, the employer may not make their own medical judgment about whether someone can work; that is what the company doctor is for. Moreover, the employer may not ask about the nature or cause of the illness and may not process the employee’s medical data; the assessment of the medical situation runs via the company doctor.

Two measures that are easily confused: wage suspension and wage stop

If the employee cooperates insufficiently, the employer may suspend or even stop the wages. Legally, these are two different measures, with very different consequences. Confusing them can prove costly for the employer.

Wage suspension (Article 7:629(6) of the Dutch Civil Code)

Wage suspension is intended as a means of pressure when the employee does not enable the employer to check whether they are entitled to wages — for example because, despite being summoned, they do not attend the company doctor. The employer then withholds the wage payment. The characteristic feature of suspension is that the wages must still be paid retroactively as soon as the employee does comply with the monitoring rules and it turns out they were unfit for work. The employee therefore does not permanently lose the wages.

Wage stop: loss of the right to wages (Article 7:629(3) of the Dutch Civil Code)

The wage stop is a more far-reaching measure that is, in principle, permanent. Article 7:629(3) of the Dutch Civil Code lists a number of situations (sub a to f) in which the employee is not entitled to wages over the relevant period. Most of these relate to failure to comply with reintegration obligations, including:

• intentionally causing the incapacity for work or providing false information during a pre-employment medical examination;
• obstructing or delaying recovery;
• refusing, without proper grounds, to perform suitable work;
• refusing, without proper grounds, to cooperate with reasonable instructions or measures aimed at suitable work;
• refusing, without proper grounds, to cooperate in drawing up, evaluating or adjusting the action plan.

The difference from suspension is fundamental. With suspension, payment is temporarily withheld and back-payment follows once the employee cooperates after all. With a justified wage stop, the wages over the period of refusal are permanently lost. If the employee subsequently complies with their obligations again, they are entitled to wages from that moment on, but they do not get back the amount already withheld.

Mind the correct classification and a timely warning

The employer has a duty to warn (Article 7:629(7) of the Dutch Civil Code). They must inform the employee immediately — and preferably in writing — that and why they are going to suspend or stop the wages, so that the employee can still change course. In doing so, they must make clear whether it concerns a suspension or a stop.

In practice, this is an important point. Not every inaccuracy costs the employer their rights, but case law has accepted that unclear or incorrect communication may mean that they cannot rely on the more severe measure. If, for example, the word “suspension” is used while a wage stop is intended, the employee may rely on what they were told, and the employer may forfeit the right to permanently stop the wages. Clear and timely notification is therefore essential.

Furthermore, merely failing to attend the company doctor cannot, as a rule, immediately lead to a wage stop: a wage suspension is appropriate first. Only if the employee continues to breach their obligations over a longer period does a wage stop come into view. It is precisely on this point that careful record-keeping is of great importance.

Full or partial wage stop?

For a long time there was debate about whether, in the event of a refusal to perform suitable work, the entire wage could be stopped, or only the part relating to the refused work. On 6 June 2014, the Supreme Court (Hoge Raad) ruled that the employer may in principle stop the full wage if the employee refuses, without proper grounds, to perform suitable work — even if they could only have worked for part of their hours. The reasoning is that only a sufficiently firm incentive will move the employee to take their obligations seriously. There is, however, an exception: if a full wage stop is unacceptable according to standards of reasonableness and fairness, only part of the wage may be withheld. That exception is applied restrictively.

Other possible consequences for the employee

A wage stop is not the only consequence. Anyone who fails to meet their reintegration obligations may also face the following:

• Lapse of the prohibition on termination during illness (Article 7:670b(3) of the Dutch Civil Code). The statutory prohibition on terminating a sick employee does not apply when the employee fails to meet their reintegration obligations without proper grounds. In practice, the UWV usually requires that the employer first applied a wage stop without success; only then does termination come into view.
• Consequences for the WIA benefit. The UWV may grant a lower benefit or even decide not to process a WIA application when the employee has cooperated insufficiently in their reintegration.
• No accrual of holiday entitlement during the period that a wage stop is in force due to non-compliance with the reintegration obligations.

And the employer? The UWV’s wage sanction

The other side of the coin is the wage sanction that the UWV can impose on the employer. When the WIA application is made, the UWV assesses whether the employer and employee together made sufficient reintegration efforts (the RIV assessment). If the UWV finds that the employer fell short without good reason — for example by starting too late, deploying the second track too late, or building an incomplete file — it can extend the wage continuation obligation by up to 52 weeks. The employer then has to continue paying wages for a third year. The severity of the sanction depends on the seriousness of the shortcoming. A careful, timely and well-documented reintegration file is therefore the most important means of preventing this.

A dispute about reintegration? Request an expert opinion

If the employer and employee disagree — for example about whether offered work is actually suitable, or about the degree of incapacity for work — they can request an expert opinion (deskundigenoordeel) from the UWV. That opinion is not binding, but it carries considerable weight in any proceedings and can help break a deadlock before sanctions are deployed.

Developments to keep an eye on

The system is not standing still. At the time of writing, two proposals are pending in the Netherlands that may become relevant in practice:

• A bill that makes the company doctor’s advice on the employee’s capacity decisive in the RIV assessment by the UWV. The aim is to give employers more certainty and to prevent wage sanctions that stem from a medical difference of opinion between the company doctor and the insurance physician.
• A bill that gives small and medium-sized employers the option, from the second year of illness, to focus on reintegration in suitable work with another employer (the second track), under certain conditions.

Both proposals had not yet entered into force at the end of 2025. Anyone currently dealing with an ongoing process therefore cannot yet rely on them; it remains important to follow the applicable framework.

Frequently asked questions

In conclusion

Reintegration is a two-way process. The employee who actively cooperates and the employer who carefully supervises and documents run the least risk. If the employee cooperates insufficiently, wage suspension and — in cases of persistent non-compliance — a wage stop are powerful instruments, provided they are correctly announced. On the employer’s side, insufficient effort risks an extension of wage continuation by a full year. In both cases, the right sequence, the right wording and a complete file make the difference.

Is a reintegration process stuck, or are you in doubt about applying or challenging a wage suspension or wage stop? The employment law specialists at Law & More are happy to think along with you.