What is a reintegration trajectory?
Returning to work after a long-term illness is often not straightforward. A reintegration trajectory (RIT) is a very strict and legally regulated procedure in which the employer, employee, and occupational physician together look for feasible ways to resume work. This can be temporary or permanent, in their own function or through different work.
Given the compelling nature of the legislation, Premed meticulously guides you through every step: from the mandatory screening to the correct drafting of the reintegration plan.
The 4 steps of the trajectory
- The Start
The trajectory starts at the employee's request (always possible) or at the employer's initiative if work capacity has been determined. For companies with more than 20 employees, this is even mandatory after 8 weeks if there is work capacity. - The Reintegration Assessment
The occupational physician examines the employee. He formally judges whether the employee:- Can resume (with adjustments);
- Is permanently unfit for the current job (but can do other work);
- Cannot yet be assessed (trajectory temporarily stops).
- The Consultation
As an employer, you consider what is concretely possible within your company. Premed can advise on this (e.g., ergonomic adjustments or adjustment of tasks). - The Reintegration Plan
You draw up a plan (tasks, hours, salary). The employee decides whether or not to accept this.
⚠️ Important: Strict procedure & registered mailings
The reintegration trajectory is bound by strict legal deadlines and obligations. Failure to comply can result in sanctions or legal consequences.
To guarantee legal certainty and avoid subsequent discussions, we strongly advise that all formal communication takes place via registered letter.
- The invitation for consultation moments;
- The delivery of the definitive reintegration plan to the employee;
- Any warnings if the employee refuses to cooperate;
- Invitations for medical examination sent by Premed.
❌ Sanctions for non-compliance
Non-compliance with reintegration obligations does not remain without consequences. The legislator has provided sanctions for both parties to underscore the importance of the trajectory:
- For the Employer:
If you fail to initiate a reintegration trajectory when it is mandatory (for example, after a positive screening or at the request of the employee), you risk administrative fines. In addition, in that case, you owe the solidarity contribution to the health insurance fund. - For the Employee:
The employee has a duty to cooperate. If he or she does not respond to invitations from the occupational physician, or refuses the reintegration plan without valid reasons, he risks loss of the sickness benefit (reduction by 5-10%). In terms of labour law, manifest unwillingness can even lead to dismissal in certain cases.
Is reintegration mandatory?
Yes, the optionality has been removed, depending on your company size:
| Company size | Obligation |
|---|---|
| From 20 employees | You are obliged to start the trajectory if the doctor sees work capacity. You must draw up a reintegration plan or provide very thorough reasons why this is not possible. |
| Less than 20 employees | You may start the trajectory, but are not obliged to do so. However, you are expected to investigate "reasonable adjustments". |
❓ Frequently asked questions about the threshold of 20 employees
From when exactly do the new obligations regarding work capacity apply to your company? The calculation of the threshold of 20 employees raises many questions in practice. Below you will find the most important answers, based on the official explanation from the FPS Employment.
Do you count per establishment or per company?
The counting always happens per legal entity, not per establishment or location. Do you have multiple branches but one legal entity? Then all employees count together.
How does a full-time employee count?
An employee who works 75% or more of a full-time equivalent (FTE) counts as 1. The calculation is based on the number of calendar days registered in the personnel register (Dimona) over the 4 preceding quarters, divided by 365.
And part-time employees?
Anyone who works less than 75% of an FTE only counts as 0.5. The number of days is then divided by 2.
How are trainees and apprentices counted?
Trainees and apprentices are calculated based on the number of hours worked over the 4 preceding quarters, divided by 1,750. Someone who works 175 hours in that period counts as 0.1.
Do temporary workers also count?
Yes — temporary workers employed by you without replacing a permanent employee count towards your company. A temporary worker who worked 73 days in the preceding 4 quarters counts as 0.2.
When should you make the calculation?
No fixed time has been determined. The calculation can be performed at any time. Because the 4 preceding quarters are always looked at, the threshold only changes in practice with a new quarter.
What are the sanctions for non-compliance?
Article 127/1 of the Social Penal Code (law of 19/12/2025) provides for a level 2 sanction. This fine can also be multiplied by the number of employees involved.
Do you doubt whether your company falls below the threshold, or do you need help with the calculation? Premed guides you step by step.
Progressive return to work
Often, a 100% return is not yet feasible. Progressive return to work (part-time work while retaining benefits) is often part of the reintegration plan. This allows the employee to build up rhythm without financial pressure.
Financial impact
From 2026, employers (> 50 employees) will pay a solidarity contribution (30% of the benefit) in the 2nd and 3rd month of illness if no action is taken.
Reintegration obligation
The employer is obliged to make efforts to provide adapted or other work for the incapacitated employee. This can range from adjustments to the workplace or flexible working hours to offering a completely different position within the organisation.
Employees are obliged to actively cooperate in the reintegration process and must seriously consider the proposals of the prevention adviser-occupational physician and the employer. This means that they must be willing to accept adapted work, within the limits of their capabilities.
The employee must therefore cooperate with this reintegration. If he is unable to do so, it is in his interest that he can prove this.
Return-to-work premium as an extra incentive
To give the reintegration of vulnerable employees a boost, employers can now apply for a one-off return-to-work premium of 1000 euros .
It goes without saying that conditions are attached to this. Read our blog about the return-to-work premium to find out what these are exactly and whether your company qualifies for it.
Progressive work resumption as an intermediate step
Progressive work resumption can play a crucial role in the reintegration process, by allowing employees to gradually return to their workplace. This approach involves a gradual increase in working hours and/or adapting tasks to the current capabilities of the employee.
Discover in our blog about progressive work resumption what the benefits are and when an employee is eligible for this.
Support via Premed
- We provide you with the required documentation for the start-up.
- We are your point of contact throughout the reintegration process and guide you every step of the way.
- For full or progressive return to work, Premed's occupational physician conducts a thorough medical examination. We provide a health assessment and formulate advice based on it for the reintegration of the employee in question.
- As a client, you can consult health assessments instantly via the Premed platform. You will also find many brochures there to improve the health of your employees.
- We facilitate dialogue with the employee and outline a feasible but powerful reintegration plan.
- We work with you to develop a policy regarding the reintegration of long-term sick employees.
Trio platform
The TRIO platform is a secure, digital communication platform intended for doctors involved in "Return to Work pathways" (RTW). The platform facilitates information exchange between advising doctors, occupational physicians, and general practitioners. The goal is to promote the reintegration of incapacitated individuals through collaboration and efficient data exchange.
Documents - Request by the employee
To be completed by the employee or the treating physician with the employee's permission or at their request:
To be completed by employer:
- 03 - Employer agreed work
Documents - Application by employer
To be completed by employer:
Upon request, you can obtain the documents in French.
To be filled in by employee:
