Sick Leave in the Netherlands: A Practical Guide for Expats

Falling ill in a new country is stressful enough without worrying about your job or your paycheck. The good news: Dutch law protects your salary during illness for up to 104 weeks (two years), and your employer cannot fire you for being sick during that time. This guide explains what you need to do when you call in sick, what happens to your pay, and how the reintegration process works.

What Counts as Sick Leave in the Netherlands

Sick leave (ziekteverzuim) covers any period where you are physically or mentally unable to do your job due to illness, injury or recovery. Two things make the Dutch approach different from many other countries:

• You do not need to hand in a doctor's note on day one. Dutch privacy rules mean your GP is not allowed to share your diagnosis with your employer in the first place.
• The focus is on getting you back to work safely, through structured medical guidance, rather than on policing your absence.

Who Is Covered

• Permanent and temporary employees are both covered under standard Dutch labor law for as long as their contract runs. If a temporary contract ends while you are still sick, responsibility for your benefit shifts to the UWV (the national employee insurance agency).
• Agency and on-call workers are covered through their collective labor agreement (CAO) or directly via the UWV.
• Self-employed people (ZZP'ers) are not automatically covered by employer-paid sick leave. If you work for yourself, you need to arrange your own disability insurance (arbeidsongeschiktheidsverzekering, or AOV) or join a mutual support fund (broodfonds) if you want income protection during illness.

How to Report Sick (Ziekmelden)

Every employer has its own illness protocol (ziekteverzuimprotocol), but the general process looks like this:

1. Notify your employer promptly, usually before a set time such as 9:00 on your first day of illness, by phone or email to your manager or HR. 2. Share only what is needed: that you are sick and, if you can estimate it, when you expect to return. Under Dutch privacy law (AVG/GDPR), you are not required to disclose your diagnosis or symptoms to your employer. 3. If illness continues beyond a week or two, your employer will typically ask you to see the company doctor (bedrijfsarts) through their occupational health service (arbodienst).

What Happens to Your Salary

Dutch law requires your employer to keep paying you during illness, for up to two years in total:

Some contracts or CAOs include up to two unpaid waiting days (wachtdagen) at the start of an illness, but these cannot usually be imposed on you unless they are explicitly agreed in your contract or CAO, and they generally do not apply if you fall sick again within four weeks of a previous absence. Check your own contract to see whether waiting days apply to you.

The Role of the Company Doctor and Case Manager

Employers work with an independent occupational health provider to support your recovery, as required under the Gatekeeper Improvement Act (Wet verbetering poortwachter):

• **The company doctor (bedrijfsarts)** assesses what you can and cannot do. Everything you discuss with them is medically confidential: they report functional limitations to your employer (for example, "cannot sit for long periods" or "can work reduced hours"), never your diagnosis.
• **The case manager (casemanager)**, appointed by your employer or the occupational health service, tracks the practical steps of your reintegration plan.

The Reintegration Timeline (Poortwachter Process)

For longer absences, Dutch law sets out a structured timeline that both you and your employer must follow:

• Week 6: The company doctor prepares a Problem Analysis (Probleemanalyse) covering your limitations and recovery outlook.
• Week 8: You and your employer agree a formal Action Plan (Plan van Aanpak) with concrete steps toward returning to work.
• Every 6 weeks: You, your employer and the occupational health service review progress together.
• Week 52: A mandatory First-Year Evaluation (Eerstejaarsevaluatie) looks at your long-term outlook and next steps.

You are expected to cooperate reasonably with this process, such as attending appointments and following the agreed plan. Refusing reasonable light duties or not cooperating with reintegration can lead to your sick pay being reduced or suspended.

Returning to Work

You can return in one of two ways:

• Full recovery: once you are fully fit, you notify your manager and HR that you are reporting back as recovered (betermelden).
• **Gradual reintegration (therapeutisch werken):** for longer illnesses or burnout, the company doctor may recommend building back up gradually, for example starting with a few short shifts a week and increasing hours over time.

A Few Things Worth Knowing as an Expat

• Burnout and work-related stress are recognized as medical conditions under Dutch occupational health practice, and the company doctor can recommend a reduced workload or professional support as part of your recovery.
• Sick while on holiday: if you fall ill during a pre-planned trip, notify your employer on the day it happens and get a written medical note locally. Depending on your employer's policy, days you were sick during a holiday can sometimes be credited back as holiday allowance rather than counted as vacation days, if reported correctly.
• The 30% ruling continues to apply during paid sick leave, as long as you keep receiving taxable wages above the threshold the ruling requires.

The Bottom Line

Dutch sick leave law is built around support rather than suspicion: your employer has to keep paying you and help you recover, and you are expected to cooperate with a clear, time-bound reintegration plan. If a dispute comes up over pay, waiting days, or reintegration steps, the Juridisch Loket offers free initial advice, and the UWV can step in as an independent assessor once things reach 104 weeks.

This guide connects closely with our articles on employee rights in the Netherlands and Dutch pensions, since your contract type and salary during illness both affect your longer-term benefits.

References

• Rules and pay during sick leave (Government of the Netherlands)
• Loon bij ziekte: wachtdagen en percentage 70-100% (Arbeidsrechter.nl)
• Information on illness and reintegration (UWV)
• Free legal advice on Dutch labor rights (Juridisch Loket)