Work and Income: 1nd year of illness

Getting sick and staying sick longer

If you experience long-term symptoms following a coronavirus infection or vaccination, this will have consequences for your work. You may be able to work less or not at all. After reporting sick, you will visit various healthcare providers, such as your GP, a specialist, or a physiotherapist or occupational therapist. Your employer and colleagues want to know what is wrong and when you can return to work. You will also have to deal with legislation that is likely unfamiliar to you. Your life is turned upside down, and that takes energy—energy you want to conserve.

An aftercare advisor explains how you can deal with this situation:

If you are ill for an extended period, you fall under the Gatekeeper Improvement Act (Wet verbetering poortwachter). You are required to take various steps together with your employer. You will have to hold various conversations about work with your employer, colleagues, company doctor, case manager, or absence counselor. These conversations are important for you. Therefore, prepare for them well and bring someone along. Together, you hear and remember more than you would alone. Explain how you feel and what you can and cannot do, and that this varies from day to day. Do not pretend to feel better than you do. Write a daily log in preparation.

Ensure that you know who you are speaking with and what the purpose of the conversation is. If you are unsure, ask the person you are speaking with. The videos below explain how to conduct conversations about work and how a conversation with the company doctor proceeds. For more information, see 'Points to consider during conversations'.

To provide a clear picture of how you are doing, write a daily log. In it, you describe very precisely how your days unfold. You write down what you can and cannot do and how much energy it costs you. You use a daily log in conversations about work, for example, in the meeting with the company doctor, who uses it to accurately assess your capacity for work. The daily log fosters greater understanding of your situation and helps with your reintegration process to enable you to resume work. The daily log can also be useful in other conversations with doctors and care providers.

When you've called in sick, you and your employer will take steps to ensure you can return to work. This is called reintegration. The rules for this are outlined in the Gatekeeper Improvement Act. Together with your employer, you'll try to keep your absence as short as possible and expedite your reintegration. The image shows all the steps and who plays what role.

Please note: for temporary employees who leave employment due to illness, rights and obligations apply under the Sickness Benefits Act.

Roles within the Gatekeeper Improvement Act (reintegration):

• De employee Collaborates with all steps necessary to return to work: action plan, first-year evaluation, and discussions with the company doctor and case manager or absence counselor.
• De employer has a duty of care and must actively work on reintegration from the first day of illness.
• De working conditions service Supports employers in complying with the obligations under the Gatekeeper Improvement Act. The company doctor is usually employed by this organization.
• De occupational physician is a medical expert who assesses what the employee can (still) do despite the health complaints.
• De case manager or absence counselor monitors the reintegration process and often acts as the link between the employee, employer, and company doctor. The supervisor, an HR employee, or someone from an occupational health service can fulfill the role of case manager or absence counselor.

You want to return to work. You miss your colleagues and want to do what you enjoyed doing again. Work also offers the necessary distraction. Following the advice of your company doctor (problem analysis), you draw up a plan in consultation with your employer. a plan of action up. This states what is needed for you to be able to return to work.

In the action plan, you agree on the goal of the reintegration and the activities that will best achieve this. You also specify any necessary adjustments to your work or workplace. For example, you might agree to work a few hours a day, in a quiet workspace free from distractions. If returning to work isn't yet possible, you'll agree on how you will maintain contact during the illness. Every six weeks, you and your employer will evaluate progress and adjust the action plan as needed.

First-year evaluation ('shake-up moment')

Together with your employer, you conduct an evaluation of the reintegration process for Year 1. Together, you review whether sufficient efforts have been made regarding appropriate reintegration and whether the action plan needs to be adjusted. New agreements will be included in the first-year evaluation report.

Platform 1

In principle, you will return to your employer. We call this reintegration track 1. Adjustments to your own position or workplace may be necessary; otherwise, you must look for a position that better suits your limitations. Your employer will assist you with this. To determine what is possible for you, an occupational assessment may be conducted. Reintegration track 1 starts immediately after you report sick and runs until the end of your employment.

The Sickness Benefits Act applies to people with a temporary contract who leave employment while sick.

Sick from service

Do you have a temporary contract and are you still sick when it expires? Your employer is not required to renew your contract. You will then leave work due to illness. The Employee Insurance Agency (UWV) will be your point of contact for guidance on your reintegration and benefits. You will have an interview with a medical examiner or occupational health and safety expert. They will assess your eligibility for Sickness Benefits Act benefits and your ability to work.

Employer is self-risk-bearer for the Sickness Benefits Act

If your employer is a self-insurer under the Sickness Benefits Act, they are responsible for your reintegration and the payment of your sickness benefit. If you leave employment while ill, your former employer will assist you with your recovery and reintegration. The employer may outsource the execution of these services, for example to an occupational health and safety service or a reintegration agency.

The employer may oblige you to:

• To attend discussions with the occupational health and safety service.
• To perform suitable work if you are able to work part-time.
• To draw up a plan of action.

Ensure that you are aware of your legal obligations regarding reintegration.

First-year Sickness Benefits Act assessment (weeks 46–52)

If you have been ill for almost a year, you will receive a First-Year Sickness Benefits Act assessment. The Employee Insurance Agency (UWV) will assess whether you have made sufficient efforts to reintegrate and whether you are still entitled to a Sickness Benefits Act benefit.

How does this work?

• The insurance doctor assesses which medical limitations you have.
• If you are able to work (partly), you will have a consultation with an occupational expert.
• The occupational expert assesses whether there is suitable work that you can do with your limitations.
• You will receive a decision from the UWV stating whether you can return to work (partially) and whether your Sickness Benefits Act benefit will continue, stop, or be adjusted.

Because the UWV currently has a shortage of insurance doctors, the First-Year Sickness Benefits Act assessment is often cancelled.

To be able to resume your work, you want to work on your recovery. Because post-COVID symptoms are unpredictable and vary from person to person, this is not always easy. It requires a tailored approach. Your company doctor or insurance doctor will assist you with this. The involvement of an occupational therapist can also be helpful.

Your energy is limited due to your symptoms, while recovery actually requires a lot of your energy. Occupational physician Ernst Jurgens explains what recovery time is and what you can do to support your recovery:

Occupational therapist Edith Brocken gives tips on how to deal with the limited energy when returning to work. Make a plan and involve your environment. Make smart choices about what to spend your limited energy on.

Recognizing and guarding boundaries (PEM)

Many people with post-COVID suffer from post-exertional malaise (PEM). Symptoms worsen after physical, cognitive, and/or emotional exertion. Pacing is a technique to manage symptoms and prevent the worsening of complaints. You learn to recognize your physical and cognitive limits, so that you can lead as active a life as possible within those limits.

If you are employed and report sick, you will receive at least 70% of your salary for two years (104 weeks). The statutory minimum wage applies as the lower limit during the first 52 weeks. The employer may top up the salary to 100%. Check this in your contract or collective labor agreement. However, certain allowances, such as for travel expenses, will cease.

If it becomes apparent early in the course of the illness that your situation is so serious that returning to work is not possible, a WIA benefit can be applied for sooner. A statement from the company doctor is required for this. This 'early IVA' is possible from 3 to 68 weeks of illness.

Sickness Benefits Act benefit

You are covered by the Sickness Benefits Act if you have a temporary contract and leave employment while ill. You will receive sickness benefits from the UWV or from your employer if the latter is a self-insurer. In both situations, it is important that you during reports sick to the employment relationship. If you leave employment while sick, you apply for sickness benefits yourself.

You will receive sickness benefits for a maximum of two years (104 weeks) from the date you reported sick, unless you recover sooner or are able to return to work.

If you remain ill for an extended period, you will stay in contact with your occupational physician every six weeks. Together, you will review what is possible to resume your work step by step. Are the conversations with your occupational physician, your employer, or colleagues proving difficult? Are you encountering a lack of understanding or being put under pressure? Contact the Aftercare Advisor for support. You can also contact us for tailored advice if your situation requires it.

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