In the fourth quarter of 2025, sickness absence stood at 5.6 per cent. That means 56 of every 1,000 working days were lost to illness. For you as an employer or HR professional that is much more than a statistic; it has a direct impact on your planning, the strain on your team, wage costs and the sustainable employability of your people. An employee who is ill costs an average of €405 a day, and psychological complaints still play a large part in long-term absence.
Which is why it matters to know your obligations around working conditions and absence well. The Working Conditions Act asks more of employers than simply reacting to a sickness report. You have to map risks in a risk inventory and evaluation, appoint a prevention officer, give employees access to the occupational physician and arrange a proper basic contract with an occupational health service. On top of that, your responsibility under the Gatekeeper Improvement Act starts immediately after a sickness report, with specific steps for absence guidance and reintegration that have to be taken in time and in full.
If you neglect this, you run not only health risks for your people but financial and legal risks as well, such as a possible wage sanction from UWV. In this article we explore what the law asks of you, where employers often run into trouble, and how to organise working conditions and absence more intelligently with a focus on prevention and people-centred employership.
What you have to arrange by law
The basis of an employer's working-conditions obligations is clear: you have to provide a safe and healthy working environment. That follows from the Working Conditions Act, the Working Conditions Decree and the Working Conditions Regulation. That legislation does not prescribe that every organisation takes exactly the same measures, but it does require you to map risks and take fitting action.
A first compulsory part is the risk inventory and evaluation (RI&E). In it you record which risks employees run, for instance through physical strain, screen work, hazardous substances, noise or work pressure. An action plan belongs with the inventory, setting out which measures you are taking, who is responsible and by when you will arrange them. According to the Dutch government on the employer's duty of care under the Act (in Dutch) and Arboportaal on the obligations of employers and employees (in Dutch), this is a fixed part of good working-conditions policy.
Every employer also has to appoint at least one prevention officer. They support the drawing up and carrying out of the risk inventory and contribute to measures for improving healthy and safe work. In small organisations the employer may sometimes fill that role, but even then it matters that the task gets real substance.
You also have to give employees access to an occupational physician. That is relevant not only during illness but exactly in order to help prevent health complaints and drop-out. Employees may also visit the physician without the employer's permission. That right is laid down in the Act and is emphasised by the NVAB on hiring an occupational physician (in Dutch).
The basic contract with the occupational physician
An important part of your obligations is concluding a basic contract with an occupational health service or physician. Without such an agreement you do not meet the legal requirements. In that contract you record how the occupational health services are arranged and for which statutory tasks you get expert support.
According to Arboportaal on the basic contract (in Dutch) and Arboportaal on its content (in Dutch), it has to arrange, among other things:
- guidance during sickness absence and reintegration
- testing of and advice on the risk inventory
- offering a periodic occupational health examination
- the possibility for employees to request a second opinion
- a complaints procedure
- access for the occupational physician to the workplace
- cooperation with the prevention officer and the works council or staff representation
For you as an employer that means an occupational physician should not be a separate call-out service you only engage when someone is ill for a long time. Good working-conditions policy calls for structural cooperation. That fits our view of engaging an occupational physician: prevention, timely spotting and clear guidance work better than reacting only once problems have grown large.
What this means in practice for employer, employee and physician
For the employer, the basic contract means thinking in advance about processes, responsibilities and availability. For employees it means access to independent medical guidance. For the occupational physician it means getting enough room to carry out their statutory tasks well, including workplace visits and preventive advice.
That independent character matters. The physician advises on capacity, resuming work and prevention, but shares no medical details with the employer. That keeps medical confidentiality protected while you as an employer still know what is needed for a return to work, without gaining sight of the diagnosis.
Your obligations from the first day of illness
As soon as an employee reports sick, attention shifts from prevention to absence guidance and reintegration. Clear obligations belong there too. The Gatekeeper Improvement Act requires employer and employee to work together, with support from the occupational physician or service, on a return to work.
Important steps are:
- passing the sickness report to the service or physician in good time
- having a problem analysis drawn up by the physician within six weeks
- making an action plan together by week eight at the latest
- reviewing and recording progress regularly
- reporting the absence to UWV in week 42
- delivering a complete reintegration report towards the end of the waiting period
This way of working is based on Arboportaal on the Gatekeeper Improvement Act (in Dutch), the NVAB on what the Act involves (in Dutch) and UWV on assessing the reintegration report (in Dutch).
Continued wage payment during illness
One of the best-known obligations is continued wage payment during illness. By law you keep paying wages for up to two years during illness, that is 104 weeks. In that period you work with the employee on reintegration. That follows from UWV on continued wage payment during illness (in Dutch).
In practice that means absence is not only an HR subject but a financial risk. Not only the direct wage costs play a part but cover, reduced productivity and extra pressure on colleagues. That risk is anything but theoretical. According to Statistics Netherlands on sickness absence (in Dutch), absence stood at 5.6 per cent in the fourth quarter of 2025. And TNO and Statistics Netherlands data show that work pressure and work stress play a large part in work-related absence, as can be seen at TNO on psychosocial workload (in Dutch).
Psychosocial workload
An employer's working-conditions obligations go further than physical safety. You also have a statutory task to prevent or limit psychosocial workload. That covers work pressure, work stress, bullying, aggression, violence, discrimination and sexual harassment, among other things.
According to Arboportaal on psychosocial workload (in Dutch) and the Social and Economic Council on the same subject (in Dutch), psychosocial workload has to be part of your risk inventory and action plan. So a general remark along the lines of "we keep an eye on work pressure" is not enough. You have to inventory risks concretely and take measures.
Putting the policy into practice
Think for instance of:
- clear arrangements about availability outside working hours
- realistic division of tasks and staff planning
- training for managers in recognising overload
- a confidential adviser or clear reporting route for unwanted behaviour
- periodic conversations about work pressure, recovery and capacity
- analysis of absence patterns per team or role
For employees that means they may expect signals to be taken seriously. For you as an employer it means preventing work stress belongs in normal policy. For the occupational physician it means being able to advise on signals, risks and fitting measures at the level of the organisation.
Health examinations, the walk-in clinic and prevention
A subject that sometimes gets less attention, but does belong to your obligations, is the periodic occupational health examination. You are required to offer employees the possibility of such an examination where there are work-related health risks. Employees are not obliged to take part, but you do have to make the offer.
The examination matters because it helps spot health problems early. Think of complaints from screen work, physical strain, shift work or exposure to substances or noise. The outcomes can be a reason to adjust the work, the workplace or the policy.
The walk-in clinic with the occupational physician belongs here too. Employees may contact the physician without the employer's permission when they have questions about health and work. That can help prevent absence before someone actually drops out. Employers who bring this actively to people's attention show that they take prevention seriously.
Prevention gets stronger when you connect it to sustainable employability. Cooperation with various experts can be useful there, such as the prevention officer, managers and where needed labour experts and second-track reintegration when a return to one's own role or organisation turns out no longer to be feasible.
Turning obligations into a workable approach
In practice, working-conditions policy only works well when it does not stay stuck in separate documents. A workable approach usually consists of a fixed cycle:
- inventory risks in the risk inventory
- plan measures in the action plan
- assign responsibilities to managers, HR and the prevention officer
- give employees access to the occupational physician
- carry out absence guidance and the Gatekeeper steps in time
- review on the basis of absence figures, signals from teams and expert advice
For you as an employer it matters to connect those parts. A case of absence rarely stands on its own. Long processes regularly show that signals were visible earlier: high work pressure, insufficient recovery, unclear tasks or a workplace that was not set up well.
For employees such an approach gives clarity: who can they turn to, what may they expect and how are health and privacy handled? For the occupational physician it makes the difference between reactive and effective cooperation. When the physician is only involved late, the possibilities are often more limited than when prevention, workplace visits and early consultation are already well arranged.
Tackle absence in a people-centred way and in time: that way you protect your team, your planning and your costs.
With a considered approach to working conditions you make healthy and safe work concrete, predictable and easier to manage. That way you lower the risk of absence and drop-out and increase the sustainable employability of your people.
Key takeaways
- Make sure your risk inventory, action plan and prevention officer are not only formally arranged but visible and workable in daily practice.
- Record in a clear basic contract how you work with the occupational physician, including arrangements about prevention, clinics and absence guidance.
- From the first day of illness, follow the right steps under the Gatekeeper Improvement Act to keep a grip on reintegration and prevent argument afterwards.
- Take psychosocial workload seriously by including work pressure, unwanted behaviour and recovery structurally in your policy and your conversation cycle.
- Invest actively in health examinations, easy access to the occupational physician and early spotting, so as to stay ahead of complaints and long-term drop-out.
- Involve managers and employees in your approach, so that safe and healthy work becomes a shared responsibility.
By investing today in prevention and well-organised working-conditions policy, you build step by step towards an organisation where people can keep working with confidence, energy and enjoyment. You, your people and your organisation benefit from that every day.