Health & well-being
The anti-discrimination law and the Welfare Act oblige employers to provide reasonable accommodations for employees with disabilities. The reintegration procedures also provide a framework for adapted work.
For some professions (e.g., healthcare or laboratories), specific vaccination obligations apply. The employer must inform employees about the risks and any mandatory vaccines.
No. The employer may request no diagnoses or medical details. The occupational physician is the designated person to assess medical fitness and work possibilities.
Yes. From 2026, the employer can themselves request the return-to-work visit from the prevention service. That helps to find solutions more quickly without immediately starting a formal procedure.
There is no fixed number of first-aiders for all companies, but it depends on the size and risks of the undertaking. The employer must determine, through risk assessment, how many first-aiders are needed. The Committee for Prevention and Protection at Work (CPBW) or, in its absence, the employee representation must be consulted. The labour inspectorate can check if this is sufficient.
Set achievable goals; if someone has been absent for a long time:
- provide the necessary training or retraining again;
- if there are still conflicts in the way (which were the reason for absence or which arose because colleagues had to step in, ...), address them before the employee returns to work.
Premed guides the employer and employee in finding feasible solutions, advises on the legal framework, conducts an independent medical examination, and helps in drawing up a reintegration plan.
The employer plays an important role in occupational accidents and incapacity for work. He must ensure a safe working environment, prevent risks and inform employees about safety rules. In the event of an accident, he is obliged to report it and support the necessary medical and administrative steps. In addition, he offers guidance on re-integration.
After the application, Premed invites the employee for a medical examination. The occupational physician assesses definitive unsuitability. The procedure must be completed within three months and respects the steps of registration and consultation.
Employers can provide healthy food, offer exercise opportunities (such as sit-stand workplaces or sports activities) and schedule information sessions on health. The policy should integrate health into the well-being plan.
No, medication generally does not belong in a first aid kit. This is an important guideline within Belgian legislation and good first aid practices.
First aid responders are not authorized to administer medication. Even a seemingly harmless painkiller can cause severe reactions in some individuals.
The employee is legally obliged to cooperate in determining the work capacity. If the employee does not respond to our first invitation, we will send reminders. If we ultimately receive no input, we cannot assess the work capacity. This will be noted in the file and passed on to the advising physician (health insurance fund/RIZIV) for further follow-up.
You need a fitness to drive certificate if you professionally drive certain vehicles for which a medical driving fitness examination is legally required.
This applies especially to drivers with a driving licence category C, C+E, D or D+E (such as truck and bus drivers) and to holders of a category B driving licence who use it for professional activities such as taxi services, driving school lessons, rental services with chauffeur, paid student transport or ambulance transport. The certificate is intended to confirm that the driver is medically fit to safely operate such vehicles.
No, there is an important distinction here. For ordinary illness, the assessment of work capacity starts after 8 weeks. Is the incapacity for work the result of an industrial accident or occupational disease? Then the work capacity can only be assessed once the injuries are 'consolidated' (permanent/stable), and therefore not automatically after 8 weeks.
Healthy employees feel better, perform better and contribute to a positive work atmosphere. Premed stimulates health at work and at home by giving employees tips for a healthier lifestyle and organizing workshops.
Good preparation ensures a safe and healthy trip. You need to know which vaccinations you need and what health risks there are at your destination.
A reintegration process helps an employee return to work after long-term illness. It must be carefully prepared because the causes of absence are diverse.
An occupational disease arises when employees are exposed to harmful substances or other risks at work for an extended period. Premed emphasizes that it is crucial to identify and manage these hazards early, as such exposures can lead to illness and ultimately disability.
The medical force majeure procedure allows an employer or employee to terminate an employment contract when an employee is definitively unable to perform their work for medical reasons.
The medical force majeure procedure can be started from January 1, 2026, after only 6 months of uninterrupted incapacity for work (instead of 9 months), when return to work is medically impossible.
The procedure can be started when the employee has been continuously incapacitated for work for at least 6 months and no re-integration process is ongoing. This is requested via registered letter to the other party and to Premed
For employers with 20 or more employees, a formal reintegration process becomes the standard route when after 8 weeks it appears that effective work capacity is present.
It is advisable that the employee reports her pregnancy as early as possible so that the employer can immediately take appropriate protective measures.
The material must be adapted to the company's activities. Examples include plasters, sterile compresses, disinfectants, bandages, scissors, gloves, and resuscitation aids.
Check the contents regularly and record incidents in a first aid register.
A travel first aid kit contains your personal medication (with medical certificate), disinfectants, sterile compresses, bandages, thermometer, pain and fever reducers, remedies for diarrhea and motion sickness, ointment for insect bites, sunscreen and antihistamines.
Then return to work is often still possible through a partial restart, a temporarily adjusted schedule, or other tasks. By building up the workload in achievable steps, you increase the chance of a sustainable return.
After completing a basic training, the first responder must annually follow a 4-hour refresher course. If the first responder misses this refresher course, then he must attend another refresher session within 12 months following the originally scheduled refresher course.
If the first responder misses this refresher course 2 times, a basic training must be followed again. Otherwise, he will be deemed to no longer possess the necessary knowledge and skills in first aid.
Work capacity refers to the extent to which someone is able to perform work — both physically and mentally — within a specific context, such as a job or work environment. It is an assessment of what a person can do, regardless of what they are currently doing.
It is an important pillar of federal reintegration policy.
The **assessment of work capacity** is a mandatory "pre-phase" or screening after 8 weeks of illness. Here, a questionnaire is used to easily check if there are any possibilities at all. The Reintegration Trajectory (RIT) is the effective follow-up with a medical examination and a reintegration plan. Important: From 2026, as an employer, you may not simply start an RIT if a positive **work capacity** has not first been established (unless the employee spontaneously agrees).
A medical examination by the occupational physician aims to protect the well-being and health of employees in relation to their work. Objectives of the medical examination are;
- To check if an employee is physically and mentally fit to perform certain tasks, especially for high-risk positions such as safety functions or positions requiring increased vigilance.
- Early detection of occupational diseases or work-related conditions.
- Advice and guidance.
The employee must cooperate with the medical examination and can appeal the decision of definitive unsuitability. The employee can also initiate the procedure themselves if returning to the workplace no longer seems possible.
The employer has an important responsibility regarding safety and well-being at work.
He must ensure a safe working environment by identifying risks and taking appropriate measures to limit them. If an occupational accident still occurs, the employer is obliged to report it correctly to the insurer.
In addition, the employer monitors the absenteeism of his employees. In the event of long-term incapacity for work, he also plays a role in guiding the employee, for example by examining the possibilities for reintegration into the workplace.
Employers must make efforts to provide adapted or alternative work. Employees are obliged to actively cooperate and seriously consider proposals.
The medical force majeure procedure is the only legally valid way to achieve dismissal for medical reasons. After a minimum of six months of continuous incapacity, the appointed occupational physician can determine the employee's definitive incapacity. Medical dismissal is subsequently the termination of the employment contract based on this established medical force majeure, when the procedure shows that the employee is definitively incapacitated and no adapted work is available.
A return-to-work visit is an informal and voluntary step to discuss return possibilities. A reintegration process is a more formal process that is initiated when structural agreements or official advice are needed.
The core legislation on maternity protection in Belgium consists of the Labour Act (1971), the Employment Contracts Act (1978), the Royal Decree of 3 May 1999 (Codex on Well-being at Work), and the RIZIV regulation on maternity leave. These together ensure the protection of the health of mother and child, the retention of rights during pregnancy and after childbirth, and protection against dismissal.
The Legislation on the well-being of employees and the Codex on Well-being at Work obliges employers to prevent occupational diseases. In addition, Fedris provides for the regulation for recognition and compensation of occupational diseases.
Since 28 November 2022, an adapted legal framework for medical force majeure applies. The royal decree sets out the conditions and steps of the procedure.
Periodic health surveillance is prescribed by the Codex on Well-being at Work (Book I, Title 4). Employers are responsible for enrolling employees in the correct medical program.
A first aid procedure begins by remaining calm and ensuring one's own safety, followed by notifying emergency services, providing essential information (who, where, what happened and the victim's condition), initiating necessary aid and possibly evacuation. The step-by-step plan must be visibly present at the workplace.
Every employer conducts a risk assessment to assess whether the work remains suitable during pregnancy. The risk assessment must show whether there are elements at work that could be detrimental to the health and safety of the expectant mother, the breastfeeding mother, or the child.
Even if there are currently no female employees, this analysis remains mandatory.
As soon as an employee announces that she is pregnant or breastfeeding, the appropriate measures from this analysis will be applied.
The employer must, according to the Code on Well-being at Work:
- perform a risk assessment,
- provide first-aid resources and possibly a room,
- designate sufficient and trained first responders,
- organize procedures and information,
- keep records.
Premed organizes workshops and awareness sessions on nutrition, exercise, sleep, and vitality. Prevention advisers provide practical tips to stimulate health-promoting behaviour.
For employers, as of January 1, 2026, a fixed timeline applies with a notification after 4 weeks and a screening after 8 weeks of incapacity for work. If you do not follow this, you expose yourself to various financial risks:
- Administrative sanctions (Direct risk):
If the screening — or at a later time — shows that there is positive work capacity, you as an employer are obliged to consider a reintegration process (RIT). If you do not do this and no reintegration plan is drawn up, you risk administrative or criminal fines (sanction level 2). - New Solidarity Contribution (Replaces the old responsabilisation contribution):
The 'old' responsabilisation contribution will be abolished but replaced by a more direct system. Companies (>50 employees) with an excessive influx into disability will pay a solidarity contribution from 2026 (approx. 30% of the sickness benefit). A timely assessment of work capacity is necessary to avoid this "fine". - Missed premiums (Opportunity cost):
Without a correct procedure and screening, you cannot claim the increased work resumption premium (€ 1,000 – € 3,000) for employment in adapted or other work.
A timely assessment therefore not only protects you against fines, but especially against the high costs of long-term disability.
Who should or should not be examined is determined by the different tasks you perform during work.
The legislation stipulates for Employees who perform a safety function (such as machine operators), work with dangerous substances, or are exposed to noise, radiation, intense stress or shift work, are obliged to undergo a regular medical examination.
Psychosocial risks
An effective absence management policy includes clear reporting procedures, maintains contact with sick employees, detects risks early, and offers appropriate support. The policy must be developed in collaboration with doctors and prevention advisers.
Premed supports by drawing up a psychosocial policy, conducting open conversations, and guiding reintegration processes. They offer consultations with a psychosocial prevention adviser, training, mediation, and advice during and after a burnout.
Five core symptoms are exhaustion, loss of cognitive control, loss of emotional control, depressive symptoms, and an increasing distance from work.
Absence means that an employee is not at work. This can be short-term (for example, due to a cold) or long-term (for example, due to a serious illness or burnout). Sometimes there is unlawful absence.
Premed offers both organisational and individual support: they help develop a policy, conduct risk analyses, coach managers and employees, facilitate reintegration processes, and advise on medical force majeure.
The Bradford Factor is a formula used to measure the impact of absenteeism in the workplace, with particular attention to frequent short-term absenteeism. The idea behind it is that many short absences are more disruptive to an organisation than a single long-term absence.
The main causes of work stress are related to an imbalance between carrying capacity (energy givers) and burden (energy takers). When the burden becomes too heavy in relation to the carrying capacity, overload and stress arise.
Premed emphasizes that stress is not a personal shortcoming, but often stems from an inefficient psychosocial work environment.
There can be both physical and psychological consequences when the body is under long-term stress without sufficient recovery. Stress in itself is not always problematic, as long as sufficient recovery follows. The danger arises when stress persists for a long time and the body does not get a chance to recuperate.
Occupational hygiene
Ventilate regularly by opening windows or using mechanical systems, keep the temperature stable to avoid condensation, perform frequent air quality measurements, and prevent moisture and mold formation. Avoid bothersome drafts by limiting air currents to below 0.16 m/s in winter and 0.19 m/s in summer.
An employer must systematically include the risks of exposure to artificial optical radiation (such as UV lamps, lasers, infrared sources, and welding arcs) in the risk assessment in accordance with the Code on Well-being at Work and check whether the exposure limit values are respected according to the guidelines of the Federal Public Service Employment, Labour and Social Dialogue.
If there are risks, he must take preventive measures according to the prevention hierarchy. In addition, the employer must inform and train employees about the dangers, provide warning signage where necessary, and organize health surveillance when the risk assessment shows that this is required.
It concerns environmental factors such as bright screens, humming computer noise, and electromagnetic radiation from devices that can affect comfort and health.
Biological agents in the workplace are understood to be micro-organisms or their toxic products that can be harmful to the health of employees. This includes bacteria, viruses, fungi, parasites or toxins that may be present in the air, on surfaces or in materials with which employees come into contact.
Examples include: salmonella bacteria in food processing, hepatitis B or C viruses in healthcare, fungi in damp buildings, or Legionella bacteria in cooling and spraying systems.
Employers in Belgium must comply with the Codex on Well-being at Work, which imposes strict rules regarding the identification, inventory, and control of asbestos in the workplace. They are obliged to draw up and keep an asbestos inventory up to date, take preventive measures, inform and train employees, and, if necessary, cooperate with recognized asbestos removers according to the guidelines of the Federal Public Service Employment, Labour and Social Dialogue. In addition, they must prevent or limit exposure as much as possible, provide appropriate protective equipment, and organize health surveillance for employees who may be exposed to asbestos.
To determine whether you comply with the Code on Well-being at Work concerning chemical agents, you must verify whether a written and up-to-date risk assessment has been carried out, including all hazardous substances and exposure scenarios. In addition, you must check whether appropriate preventive measures have been implemented according to the prevention hierarchy (substitution, technical measures, collective protection, personal protective equipment), and whether labelling and safety data sheets are available and correctly applied in accordance with regulations. Finally, you must be able to demonstrate that employees are informed and trained and that, where required, health surveillance is organised in accordance with the guidelines of the Federal Public Service Employment, Labour and Social Dialogue.
Occupational Safety
At least one evacuation drill must be organized annually. Evacuation plans must be clearly visible, and larger locations may require multiple plans.
An investigation by the prevention adviser is necessary to systematically analyse the causes of a (serious) accident, so that recurrence can be prevented and workplace safety is improved. This investigation must take place immediately or as soon as possible after the accident, as soon as the situation is safe and first aid has been completed, so that testimonies are fresh and the accident can be accurately reconstructed.
A workplace accident is an accident that occurs during or because of work and causes harm to an employee. The employer must report this to the insurer in a timely manner.
A fire prevention file contains the result of the risk assessment, organisation of the fire-fighting service, intervention plans, results of evacuation drills, fire protection measures, inspections and deviations.
Besides providing first aid, the employer must register and report the accident. Premed emphasizes that investigating the cause is crucial to prevent recurrence.
It concerns machines, devices, installations, and personal protective equipment (PPE) that employees use to perform their tasks.
A fire risk assessment must identify the circumstances. General measures include clear emergency exits, fire extinguishers and no smoking signs; all employees must know the evacuation procedures.
The employer must analyse risks and provide the necessary protective equipment, while employees are obliged to use it correctly.
Ergonomics
Yes. Every company with VDU workers must carry out a risk assessment at least every five years, evaluating physical and mental strain and taking appropriate measures.
Yes. An ergonomic risk assessment is also mandatory when designing workstations (art. VIII.1-1, §2 of the codex).
Prolonged sitting slows blood circulation and can lead to varicose veins, swollen ankles, and reduced concentration. Stand up every 30 minutes and alternate sitting with standing; get extra exercise by, for example, walking while on the phone.
Ergonomics is crucial in the design of workplaces because it directly contributes to the health, safety, and efficiency of employees. In Belgium, this is even legally enshrined in the Codex on Well-being at Work.
For industrial workplaces in Belgium, clear guidelines apply, which are laid down in the Codex on well-being at work. These guidelines are intended to guarantee the safety, health, and comfort of employees.
There are basic requirements concerning safety and functionality, lighting, ventilation, temperature, working height and reach, freedom of movement, and noise level.
For detailed information, please visit the website of the Federal Public Service Employment.
General
Yes, every employer in Belgium is obliged to appoint a prevention adviser, but the type and organisation depend on the size and sector of the company.
Yes, in Belgium, every employer must be affiliated with an External Service for Prevention and Protection at Work (ESPPW) or an internal prevention and protection service if the company itself has the required internal structure.
The purpose of an ESPPW is to assist the employer in fulfilling legal obligations regarding well-being at work, such as risk assessment, preventive measures, training, and medical examinations.
The task of an ESPPW (External Service for Prevention and Protection at Work) is to support the employer with the legal obligations regarding well-being at work. This includes, among others:
- Risk assessment and prevention plan – assisting with identifying risks and drawing up the Global Prevention Plan (GPP) and Annual Action Plan (AAP).
- Advice and guidance – advising on organisational, technical, and individual measures to prevent accidents and occupational diseases.
- Medical follow-up and health surveillance – organizing preventive medical examinations and driving fitness tests if necessary.
- Training and information – informing and training employees and employers about safety, health, and well-being.
- Investigations – in the event of (serious) accidents, near misses, or exposure risks, providing support for investigation and reporting.
Premed fulfills this by offering a complete package that includes both preventive and medical services. They provide the medical examinations, such as driving fitness certificates (RGA) and health surveillance, and support employers with risk analyses, prevention planning, training, and audits. In this way, Premed functions as an integrated partner that helps fulfill both practical and legal obligations.
The employer is responsible for both the Global Prevention Plan (GPP) and the Annual Action Plan (AAP).
The Global Prevention Plan describes the company's complete policy regarding well-being at work and contains the risk assessment and long-term strategic objectives.
The Annual Action Plan specifies which concrete measures and actions will be carried out within one year to achieve the objectives of the GPP. The employer must draw this up in consultation with the internal or external prevention adviser and employee representatives, but ultimately remains legally liable for the implementation.