I was doing my morning media briefing today and I found a very positive news on Brussels Times (here) about how "Flanders reintegrated over 10,000 long-term sick into labor market". For a region of just 6.5 million people, this is not a small number – so surely worth appreciating.
However, what left me speechless for quite a while is reading the next paragraph, namely that "Belgium is estimated to have 585,000 people who have been unable to work for over twelve months due to illness".
I actually thought for a second that there was a typo, and it is actually 58.500 but nope – more than 5% of the entire Belgian population, and almost 10% of working age population (20-60 years old) is long-term sick. Not one in 100, not even one in 20 – almost 1 in 10 working age people in Belgium are long-term sick.
To me, this number is striking – as someone coming from Eastern Europe (now fully Belgian citizen) with background in statistics, I know data for the country I was born in is more than twice lower.
Does anyone know why it is so common? Is there some form of systemic abuse, where it is simply very easy to grant long-term sick leave? Is there little to no control of it? I really could not find any reliable explanation, other than Belgium has very generous policy regarding sick leaves. Furthermore, Belgium actually has very "normal" data regarding regular sick leaves of couple of days (see). So it seems majority of workers actually do not use much of sick leaves – but there is also a sizeable minority that use them to an extreme extent.
I am really curious what is the cause – loopholes in the system? Cultural? Are there maybe specific regional differences regarding over-representation of long-term sick?
The number of long term sick in Belgium just blew my mind
byu/Quiet_Illustrator410 inbelgium
Posted by Quiet_Illustrator410
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Simply cultural I’m afraid. Just as it is cultural to do tax fraud or other types of “legal” loopholes to abuse the social welfare system. It comes to a point where it would be dumb not to do it.
“Het zijn de gekken die werken” is a common saying.
it is mostly fraud. people try to explain this with a straight face that belgium is somehow simply more injurious than all out surrounding countries. but especially among francophones social fraud is commonplace
unfortunately while party affiliated institutions decide who gets money from a common national pot, nothing will get fixed here
e: the subsidariaat has arrived
Someone remind me where Belgium ranks in the mental health and suicide statistics? Not all long term illness is physical.
That said, there probably is a reasonable amount of fraud. And while fraud should be eliminated, hunting down all of it is also probably more expensive than it’s worth.
Good and expensive social benefits allowing this to happen forever, plus doctors that can easily pass some “sick note” for the most stupid reasons. My doctor wanted to give me more time than I needed. Some people will abuse the system, just because they benefit without much loss (especially people living at minimum wage level). I know a person who is on long term sickness, with something she already cured, but still stays due to her doctor note. And the company can’t fire her, because she is protected. Meanwhile, the company can’t hire anyone, because she is still considered one headcount….
And as someone said, it became cultural. Once you open the door to it, it’s very hard for people to let it go.
Do you have any statistics for the rest of Europe? I cannot find much to compare with myself, so any links may be welcome. I highly doubt it would be much different in other western european countries – if anything, the Flemish tend to “live to work” rather than “work to live”, in my experience.
I find this topic to be one especially prone to be propagandized in our political climate, so thorough numbers should really come up in discussions like these – and why those numbers are the way they are rather than lump all long term sick people in as “profiteurs”.
I’d argue it comes down to a combination of factors. The system is relatively generous and accessible. Doctors, historically, may have been too quick to write long-term sick notes. And employers, for a large part, are less than entousiastic to make accommodations for re-integration.
Now, all of those things are changing, but there’s a long way to go still…
I’m Flemish born and was on sick leave (mix of burn out and depression) for 8 months around 2007. I felt i had the choice between struggling with long term sick leaves for the rest of my life or leave Belgium. I left and 20 years later my conclusion is that Flemish society chokes people whose brain is wired a little differently.
>Is there some form of systemic abuse, where it is simply very easy to grant long-term sick leave?
It’s not actually easy at all. A doctor has to analyze you and the conclusion of that analysis has to be “this person cannot work anymore”. This can be checked again if required.
Something has to have happened. The doctor is the gateway. And many parties can ask for extra checks.
These people are checked again over time as well, as per their specific condition, how they are progressing(some things take months to heal, some less, some longer, so checks are naturally fitted onto that knowledge).
Those claiming abuse of the system is massive, are doing so for purely political reasons. The populace is already frustrated at how hard they have to work, it’s easy to spin them a story of people trying to get out from under work.
Directing people’s anger is how the rich and powerful distract the people from the fact that the real abusers, are the rich and powerful.
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Yeah you cannot just base yourself on a number and Eastern European experiences. If the situation was so great there, there would not be so many Romanians, Bulgarians, Polish, et cetera here.
There are so many reasons: people have to work until 67 now and as of 50, the health issues start increasing and could be linked to lifestyle: lots of obese people in this country, high number of people use legal or illegal stimulants or medicine, have a very bad eating pattern of junk food and processed foods.
Burn-outs: it is not uncommon that people are repeatedly out or out for several years even. People in Belgium are extremely reluctant to seek help or to change jobs but it is hard to get access to professional, affordable, help as well.
I have seen proof that my employer for example needs to re-integrate people on sick leaves but in reality, nothing is happening. No idea why. I have also seen that employees can be extremely creative in staying at home as much as possible.
My bet is that due to a good and available sick leave network, we have faster, more diagnosis, more psychological support and even physical problems are identified much quicker.
Like during covid we had higher numbers than neighbouring countries, but we had an “overreport” of cases compared to other nations.
As for systemic abuse, I have no clue. But certain work ethics do incentivize burnout quicker, like I have a friend who works IT who seems permanently near burnout
Everyone I know that has been or is on it has had a long painful path full of checks and balances to get it. Most of them desperately want to go back to work.
This country has a strong welfare state and we all should be proud.
As a kind reminder, people on sick leave still pay their taxes, as their subsidies are considered revenue.
I’m technically one of these, I think? Or is disability separate?
I’ve been through reinsertion stages, failed every single of them. While I do fine work, I rapidly crash out, burn out, because I can’t hold the work *and* my household. I do good work because I completely drop housework, and I’m incapable of doing both.
I do help in any way I can, still, mostly through through volunteering. Aren’t volunteer works just works that aren’t valued enough to be paid, anyway? But it’s far from a full schedule, because else, well, I’d not be holding up.
One reason not mentioned, and applicable especially for blue collar workers, could be that employers are not prone to let employees start their job again unless they are absolutely sure there is no risk of relapse, because that would be a financial punishment for the employer( that system just changed in 2026)
Also an employer wants you to be 100% fit to work, with optimal efficiency, safety and ecomic return. This will be checked by an independent Doctor. As long as the doctor’s findings are that you are not 100% fit to do a full-time fysical job they will be hesisant to employ you and they will be send back to ‘long term sick’. All of the involved parties must be on the same line : employee and his doctor, the employer and the independent doctor, the doctor of the health fund.
Also employers do not like blue collar workers working x % off a fultime job. Labor is expensive and y’r employee not working fulltime can decreases efficiency and is harder organize. So it’s just less off a hasle to replace the worker and let the employee on sick leave.
It’s a system where there is little encouragement to reactivate people in ‘long term sick leave’. New laws and measures are being taken in 2026, so we will have to wait and see how that affects the curve.
This is an opinion formed out of own experience. I have no idea how this would impact the numbers. I’m just leaving it here 😉
A major problem is that it’s very hard to get back on the labor market.
Employers will at best consider you a relapse risk, at worst consider you a freeloader and imposter who has only one goal, to screw them over. In addition, there’s a very hierarchical view of employment where the boss says what they want, and the employee says “yes boss”. But for people who return from long term sickness, they’ll need accommodations in schedule or workload before they can perform at 100% again, and that just shortcircuits something in the minds of employers: they are not supposed to accommodate employees, it’s the other way around!! So they avoid that.
Then from the side of the government, the same attitude from rightwing parties results in an official distrust towards the long term sick: they just *know* that every long term sick person who isn’t bleeding is an imposter, they just haven’t managed to catch them yet. So every time someone like that tries to work for a while and concludes they can’t handle it yet, they jump up and say “Aha! You have worked for a week! That proves my prejudice that you’re just a *profiteur* using up *my* money! No more sick leave!” So the system conditions people to certainly not to try to work, as it will just be used against you to cut support.
Anecdotally, i had never come across someone on a long sick leave due to mental health before I moved to Belgium. I’ve worked in Germany, the UK and Eastern Europe. Here in Belgium I’ve had people drop off for many months at every job I worked.
It’s true though that Belgians are socially isolated and depressed. In Eastern Europe life sucks in general but people have strong social bonds so are perhaps less susceptible to depression. Also, if you request long term sick leave due to burnout you’ll be laughed out of the room.
It’s fraud and for whatever reason encouraged by the medical field. Even in this thread you will read that when people experience even the slightest discomfort in their work life they are put on long term leave. It’s madness
Op I am sorry you became a Belgian citizen without being unable to shed your unempathethic eastern european mindset as your proposition isn’t just based on a lie you didn’t create but seem to support, but also you lean into your bias of drawing the worst possible conclusion extrapolated from the least of data.
Instead if talking to you which clearly seems would be a waste of time, I will talk to natives unfamiliar with the former Soviet bloc.
In Belgium as most of us seem to be aware we pay dues and taxes so if the need arises we can benefit from it. In Eastern Europe there is not a vast network of social workers, Healthcare professionals whose job is to assist the chronically ill. A miniscule side tangent here in Belgium compared to Hungary I need to take a lot more antidepressants as sunlight and good weather are in the premium package.
So here in Belgium if you have an insured but chronically ill relative, health insurance offers various services to make life easier since you do pay for them. In Eastern Europe almost everything is pay to play, but it gets worse.
As health insurance doesn’t offer these services, the state pretty much expects you to drop out of work indefinitely with a pension for old people who never worked. In addition you are also barred from working.
What this means? That you have a few hundred euros at best a month to support yourself and pay the medical costs out of pocket for your chronically ill relative who because they themselves do not receive support also not go into the statistics.
So basically op bemoans that Belgium has a working social contract.
Regional differences could play a part, but I also think the hyperfocus on getting people back to work while not addressing the underlying issues is part of the problem.
I will focus on long-term sick for mental health reasons: I’m off work because I couldn’t do it anymore mentally. I immediately searched for help, and found it in a therapy group which I do fulltime now. Ofcourse I’m thinking about what after, so I contacted VDAB. As a result of the bureaucratic whirlwind I was sent through – and still am in, I ended up with three different job coaches suddenly, while I contacted only one, and I’m not even off sick-leave until July.
I mean, that’s all great, and I will need the help, but it shows how people are treated as beings that have to work, get forced to try, didn’t have enough time to resolve underlying issues and just end up on sick-leave again, sometimes even worse than before.
The limiting unemployment benefits to two years also fucks over people that actively use VDAB to reschool themselves by getting their bachelors. I don’t understand how these people can’t be an exception when they’ve proven that they’re doing their best and are succeeding. It makes zero sense to me that you can finish 2 years of a bachelor and for the third and last one it’s “suit yourself”. If you didn’t follow the “model trajectory” (finish highschool at 18, finish college/uni by max 25) it’s being made tougher to catch up.
Therapy should be much, much more state-supported and the taboo should be actively removed through policy. Mental health deserves so, so, so much more emphasis in the workspace as a whole, but with the current government, focus on that is very low. We’re now in a time where the only thing that matters seems to be the economy and not spending money, but I predict it will lead to more drop-out, except in companies that actually have a big focus on it.
In any case, in the future, a question I’ll always ask a potentially new employer is how many people quit working there over a year and how long they work there on average. If the “verloop” is big you know you won’t be treated as a human being, even if it appears so at first.
I worked for 17 years full time and had a massive burnout and panic attack crash 2 years ago. I never tought i would got something like this.
Was out of 6 months and worked 50, 60 and 80% from 2024 till 2026.
Now…things are going much better.
I feel like a lot of these people would benefit from having a parttime job, but there are very few of those in Flanders.
you cant have this discussion without adding that we also have one of the highest suicide rates in Europe. Just for those people that are talking about “systemic abuse”. 15th place worldwide.
[https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate](https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate)
just right above kiribati and zimbabwe.
This is your sixth recent thread about how Belgium sucks. At least this time you didn’t add that we have to become more like the Netherlands. You don’t have to live here, you know? There are issues, but your fixation is weird.
I worked in a University and I’ve seen plenty of people who went into long term sick leave.
Most of those people were made sick by a hierarchy that bullied and humiliated them into depression. Once those people were destroyed they were useless to the university so the sick-leave was actually desired by the employer too. Because eventually they could fire the employees.
Most of those employees were good workers. But they were destroyed by a toxic work environment. When those people become unemployed they are likely to be long-term unemployed too because they have been crushed. Sometime repeatedly at different jobs.
I’m genuinely very grateful that Belgium has this kind of social safety net. I’m the mother of an autistic son, and within two years my entire life changed completely.
My son wasn’t able to attend regular school, and I constantly had to call in sick from work because there was simply no other option. At the same time, he developed severe sleeping problems and would stay awake throughout the night, while I still had to somehow function the next day. The chronic exhaustion, stress, and grief became overwhelming.
The future I thought I would have (a successful career in real estate and a healthy, stable family life) suddenly disappeared. I became deeply depressed and cried almost every day from exhaustion and heartbreak.
During that same period, I also discovered I had a thyroid tumor. Thankfully, after surgery, it turned out to be benign. But emotionally and physically, it was one of the hardest periods of my life.
That’s why I’m incredibly thankful I had the possibility to go on sick leave for two years. I can honestly say that having that support probably saved my family. Without it, I don’t know how we would have survived that period.
Today, I’m working part-time at a school, something completely different from the career path I originally imagined for myself, but I’m working again, rebuilding my life step by step, and mentally I’m in a much better place now.