In 2024 the Dutch employee insurance agency UWV granted more than 69,000 new disability benefits under the WIA, a rise of 15.8 per cent on the year before. That increase is not only a signal of long-term absence, but also of more reintegration files being looked at closely. For employers it means the risk of a wage sanction is a real financial and organisational challenge.
A wage sanction can follow when UWV judges that too little was done about reintegration during the first 104 weeks of illness. Your organisation may then have to keep paying the employee's wage for up to 52 extra weeks, with no possibility of dismissal during that period. Problems often arise from missed deadlines, suitable work investigated too late, a second track started too late, or an absence file that is insufficiently founded. Even following the occupational physician's advice does not always offer complete certainty today.
The subject is topical: psychological complaints and work stress are major causes of absence, while prevention often only gets attention after someone has dropped out. In this article we set out how to avoid a wage sanction through timely absence guidance, a clear division of roles and good file-keeping.
It starts with getting the first weeks right
Anyone who wants to avoid a wage sanction has to understand above all that UWV looks not only at the outcome of the reintegration but at the effort made. According to UWV, an employer can be required to keep paying wages for up to 52 weeks after 104 weeks of illness if too little has been done about reintegration. That assessment is made on the basis of the reintegration report at the WIA application.
The foundation is laid in the first weeks. The Gatekeeper Improvement Act calls for a tight process with clear deadlines. The sickness report has to reach the occupational health service or physician quickly, the physician draws up the problem analysis by week 6 at the latest, and employer and employee make an action plan together by week 8 at the latest. Then follow periodic reviews, in practice often every 6 weeks, the week 42 notification to UWV and the first-year evaluation around week 52.
For employers this means good intentions are not enough. You have to be able to show that you acted in time, followed advice and founded your choices. In our article on reintegration after long-term absence we set that process out in more detail.
For employees that early phase matters just as much. It is exactly then that clarity emerges about what someone can still do, what build-up is feasible and which agreements apply. For the occupational physician, the task here is to assess capacity and possibilities independently. Only the physician may determine whether someone is unfit for work and what is medically responsible in building up.
A complete and current file
One of the most common causes of problems at the UWV review is a file that is incomplete, late or too general. As an employer you therefore have to take steps and also record them well. Think of the problem analysis, the action plan, adjustments, progress conversations, the first-year evaluation and the reasoning behind choices around suitable work.
UWV assesses whether you "have done enough". Without file-keeping that is hard to make plausible, even when in practice you had a lot of contact with the employee. What is not recorded usually counts for little in an assessment.
In practice we see these points needing attention above all:
Timely documents and clear updates
An action plan drawn up once and never adjusted is risky. Reintegration is a dynamic process. Capacity can change, a return to work can go faster or slower, and sometimes suitable work turns out not to be suitable enough. So always record what was discussed, what the next step is and why.
Making arrangements about suitable work concrete
General descriptions such as "we stay in touch" or "we are looking at the options" are not strong enough. It is better to note which work was investigated, which adjustments were made, how many hours were thought feasible and what the result was.
Keeping the medical and the work-related lines separate
The occupational physician advises on capacity and possibilities. The employer then decides, within that framework, about work, organisation and offering suitable work. That division of roles has to be visible in the file too. In our article on what an occupational physician actually does you can read more about that boundary.
Steering actively on track 1 and track 2
Many wage sanctions arise because chances in track 1 or track 2 were taken too late. The starting point is always a return to one's own work, adjusted where needed. If that is not feasible, other suitable work within the organisation has to be considered. Only when that offers insufficient prospect does track 2 come into view: looking for suitable work outside the organisation.
Timing matters here. According to the Dutch government, you have to make serious work of reintegration outside the organisation by the end of the first year of illness at the latest when there is no lasting prospect internally. Waiting "because recovery might still come" is often a risk factor.
Track 1: use what is possible inside the organisation
UWV expects you to investigate whether work, workplace or tasks can be adjusted. That might be fewer hours, different tasks, an adjusted pace, aids or a temporary role. Where such possibilities exist but are not used, or used late, that can work against you at the review.
So it is wise to ask not only whether a return to one's own role is possible but also which intermediate steps are feasible. Sometimes a full return is not yet on the cards, but building up in adjusted work is.
Track 2: do not start too late
When it becomes clear that a lasting return within the organisation is not feasible, track 2 has to start in good time. In many files we see this waited on too long. That happens, for instance, when parties keep hoping for recovery while objectively little progress is visible.
A timely occupational capacity assessment and the use of second-track reintegration can help make a better case for which route fits. For employers that matters, because it shows you are not waiting but investigating which lasting solution is feasible.
It only works when responsibilities are clear
Employers sometimes think the occupational health service or physician "watches the process" and that the risk is thereby covered. In practice the employer remains ultimately responsible for the reintegration. That means mistakes or delays on the provider's side are not automatically an adequate excuse towards UWV.
For employers that calls for direction. You do not have to make the medical assessment yourself, but you do have to make sure advice arrives on time, conversations are scheduled, suitable support is arranged and deadlines do not pass. Our article on your obligations as an employer fits well alongside this.
For employees it is important to cooperate with reasonable reintegration steps. That means turning up to appointments, taking suitable work seriously and communicating openly about what does and does not work. If an employee refuses suitable work without good reason, that can have consequences for continued wage payment.
For the occupational physician, a clear, current and well-founded problem analysis matters. It also helps when advice is practically applicable: which limitations are there, which possibilities, what build-up is imaginable and when should a reassessment take place?
Psychological absence calls for extra attention
Psychological complaints play an ever larger part in long-term absence. Statistics Netherlands and TNO show that psychological complaints account for a large share of long-term drop-out, while the duration and cost of that absence are often high. That makes the risk of long files greater, and with it the importance of careful reintegration.
With psychological absence in particular, discussion sometimes arises about capacity, the pace of building up and suitable work. Employer and employee want clarity, while recovery can be uneven. In such situations a wait-and-see attitude is risky, but putting on too much pressure works against you as well.
What helps is working small and concrete:
- discuss regularly what does work rather than only what does not;
- keep capacity and limitations current through the occupational physician;
- also investigate temporary, light or adjusted duties;
- review more frequently when recovery is variable.
Prevention remains important too. The NVAB rightly points out that attention should go not only to acting after someone drops out but to preventing it. A good basic contract with an occupational health service and timely access to occupational healthcare both help.
In doubt: request an expert opinion in time
When reintegration stalls, or when doubt arises about whether your effort is enough, an expert opinion from UWV (in Dutch) can be very valuable. UWV states that employers can request one when they want to know whether they are doing enough about reintegration. That opinion can then be used to adjust in time and so help avoid a wage sanction.
That is especially wise in situations such as:
- a difference of view about suitable work;
- uncertainty about capacity and where someone can be deployed;
- doubt about whether track 2 should start;
- a build-up that stalls without a clear medical explanation;
- discussion about whether employer or employee is cooperating enough.
An expert opinion costs money, but can help prevent much larger costs if it leads to timely correction of the process.
Why this remains a point of attention in 2026
A difficult point in practice is that following the occupational physician's advice does not yet always offer complete certainty. UWV assesses the reintegration effort independently, and its insurance physician may look at capacity differently afterwards from the way the occupational physician did during the process. That can still leave employers facing a wage sanction.
Which is exactly why it is wise to work extra carefully when in doubt: have the possibilities investigated, document the choices, and do not assume too quickly that "no usable possibilities", without further reasoning, offers enough protection.
At the same time, policy is moving. According to the Dutch government on the bill making the occupational physician's advice leading at the review (in Dutch), this should give employers more certainty. The NVAB on the same bill (in Dutch) calls it a positive development. For now, though, acting carefully and recording carefully remains the safest route.
A practical checklist
For employers
- report absence to the service or physician straight away;
- keep to the deadlines at weeks 6, 8, 42, 52 and 91;
- make sure suitable work is demonstrably investigated;
- do not postpone track 2 unnecessarily;
- document every discussion, every consideration and every adjustment;
- request an expert opinion when in doubt.
For employees
- take part in conversations and support;
- talk openly about what is and is not feasible;
- take suitable work seriously when it falls within your capacity;
- keep your own record of progress and sticking points.
For occupational physicians
- deliver a clear problem analysis in time;
- describe capacity as concretely as possible;
- name not only limitations but also usable possibilities;
- advise when a reassessment or a labour expert is needed.
With timely direction and strong absence guidance you avoid wage sanctions and keep a grip on reintegration.
With timely direction, clear agreements and a well-kept file you strengthen your position as an employer and reduce the chance of unnecessary delay, argument or sanctions during reintegration.
Key takeaways
- Lay the basis for strong reintegration in the first weeks by acting quickly and recording agreements.
- Be demonstrably active in reintegration: UWV assesses above all what you did, not only the end result.
- Keep a complete and current file, so that choices, progress and the use of suitable work are well founded.
- Switch between track 1 and track 2 in good time to show that you are actively steering towards fitting, feasible solutions.
- Consider an expert opinion when in doubt, to get direction and clarity and adjust the process in time.
- Working preventively on sustainable employability reduces the chance of long-term absence and strengthens healthy work in your organisation.
By starting the conversation early together, recording choices and keeping the file in order, you build step by step towards a predictable and reliable reintegration process. That way you work with employees, HR and the occupational physician on sustainable employability, healthy work and preventing long-term drop-out.