Sick Leave in Belgium: Your Rights at Work in 2026

If you become ill and cannot work in Belgium, you may be entitled to paid sick leave. However, the rules depend on your employment contract, how long you have worked for your employer and how long you are unable to work.

Employees must also follow certain rules when reporting an illness, submitting a medical certificate and applying for sickness benefits.

Belgian law changed several times in recent years. In 2026, one important change is that most employees can take the first day of sick leave without a medical certificate twice per calendar year, subject to specific conditions.

Here is what workers in Belgium need to know about sick leave, guaranteed pay and time off to care for a sick family member.

1. Do you need a doctor’s note for sick leave in Belgium?

In Belgium, employees generally have to provide a medical certificate if their employer requires one under the workplace rules or a collective labor agreement.

However, an exception allows employees to be absent on the first day of illness without submitting a medical certificate twice per calendar year.

This exemption applies both when an employee is sick for just one day and when the illness lasts longer. It does not remove the obligation to notify the employer immediately.

What changed in 2026?

Until the end of 2025, the exemption generally applied three times per calendar year. Since January 1, 2026, it has been reduced to twice per year.

The exemption also has an important limitation: companies with fewer than 50 employees can opt out of this arrangement through an applicable collective labor agreement or their workplace regulations.

If your employer has validly opted out, you may still need to provide a medical certificate for the first day of illness.

How quickly must you submit a medical certificate?

You must inform your employer as soon as possible that you are unable to work because of illness.

If a medical certificate is required, you must submit it within the deadline set by your workplace rules or collective labor agreement. If no deadline is specified, the general legal deadline is two working days, counted from the start of the incapacity or receipt of the employer’s request, as applicable.

The certificate must state how long you are expected to be unable to work and whether you can travel for a medical check.

Failing to notify your employer or submit a required certificate on time can affect your right to guaranteed pay.

2. What happens if you become sick at work?

If you become ill during your shift and have to go home, you should inform your supervisor and follow your employer’s reporting procedure.

You do not automatically need a medical certificate simply because you leave work during the day. The usual certificate rules still apply, depending on the circumstances and your employer’s requirements.

There is also a difference between the pay you receive for the part of the day you have already worked or were scheduled to work and the guaranteed sick pay that follows.

Under Belgian rules, an employee who becomes ill during the working day may qualify for guaranteed daily pay for that interrupted day. The normal guaranteed sick-pay period then starts on the following day.

If your illness continues, you must follow the usual notification and medical certificate requirements.

3. How much sick pay can you receive in Belgium?

Many workers in Belgium are entitled to guaranteed pay when illness or an accident prevents them from working. The amount and duration depend on the type of employment contract and the employee’s status.

Employees with standard contracts

Employees with an indefinite contract, or a qualifying fixed-term contract of at least three months, generally receive 100% of their normal pay from their employer during the first 30 calendar days of ordinary sickness-related incapacity.

From the 31st day, sickness benefits may be paid by the health insurance fund, known in Belgium as the mutuality or mutualité.

The amount is not necessarily the same as your regular salary.

Manual workers

Manual workers generally need at least one month of uninterrupted service with their employer to qualify for guaranteed pay for ordinary sickness.

For eligible workers, the payment schedule is different from that of standard employees. During the first 30 calendar days, the employer and, for part of the period, the health insurance system contribute according to the applicable rules.

The amount may therefore change as the absence continues.

What if you are sick for several months?

For longer periods of incapacity, your health insurance fund normally becomes responsible for sickness benefits once the guaranteed-pay period ends.

For many employees, the initial sickness benefit is calculated at 60% of their gross daily salary, subject to the applicable salary ceiling and other legal rules. The amount you actually receive can vary depending on your situation.

You should contact your mutuality to confirm your entitlement and the documents required.

4. What if you become sick again after returning to work?

Returning to work does not always mean that a later period of illness will automatically qualify for a new period of full guaranteed pay.

Since January 1, 2026, a new period of incapacity caused by the same illness or condition generally does not trigger a new full guaranteed-pay period if it begins within eight weeks after the previous period for which guaranteed pay was paid.

Different rules may apply if the new incapacity is caused by a different illness or accident, or if part of the original entitlement remains unused.

This change is important for employees who return to work and then become ill again within a relatively short period.

If this happens to you, ask your employer’s HR department or payroll service to explain how the rules apply to your situation.

5. What if your child or partner becomes sick?

If your child, partner or another family member suddenly becomes ill and needs your urgent assistance, you may be able to take leave for compelling reasons, sometimes called family emergency leave.

Belgian employees can generally take up to 10 working days per calendar year for qualifying urgent circumstances.

This leave is normally unpaid unless a collective labor agreement, your employer or another applicable arrangement provides for payment.

You must notify your employer as soon as possible and may be asked to provide evidence of the reason for your absence.

The illness of a family member does not automatically entitle you to paid leave. The circumstances must meet the legal conditions for this type of leave.

6. Can you take care leave for a seriously ill family member?

Belgian employees may also use up to five working days per calendar year as care leave to provide personal care or support to a family member or household member who needs substantial care for serious medical reasons.

These five days are included within the broader allowance of up to 10 working days of leave for compelling reasons. They are not an additional five days on top of that allowance.

Care leave is generally unpaid unless a more favorable arrangement applies.

If a family member needs long-term care, you may also qualify for other leave arrangements, depending on the circumstances. These can include formal leave for medical assistance or career-break arrangements, subject to their own conditions and application procedures.

7. What if you become sick during your annual holiday?

If you become unable to work because of illness or an accident during your annual holiday, the affected days do not automatically have to count as vacation days.

Since 2024, Belgian rules have allowed qualifying sick days during annual leave to be taken later instead.

However, you must follow specific procedures. These include informing your employer immediately, providing a medical certificate and communicating your location if you are staying somewhere other than your usual residence.

Your holiday is not automatically extended. You must notify your employer if you want to take the unused vacation days later.

8. What should you do if you are too sick to work?

If illness prevents you from working in Belgium, follow these steps to protect your rights.

1. Notify your employer immediately, following your workplace’s reporting procedure.
2. Check whether a medical certificate is required.
3. If necessary, arrange a medical appointment and submit the certificate within the applicable deadline.
4. Keep copies of relevant documents and messages.
5. If the illness continues, contact your mutuality to find out when to submit your incapacity declaration and how to claim sickness benefits.
6. If your employer disputes your entitlement to guaranteed pay, ask HR or your payroll service for a written explanation.

You should also follow any applicable medical examination or control procedure. Employers may arrange a medical check by a qualified control doctor, and employees are generally required to cooperate with that check.

What workers in Belgium should remember?

Sick leave in Belgium can provide important financial protection, but it does not mean that every employee receives their full salary for the entire period of illness.

The rules for medical certificates, guaranteed pay and sickness benefits depend on your contract, length of service and circumstances. The 2026 changes also mean that employees should check how often they can use the first-day certificate exemption and what happens if an illness returns within eight weeks.

If you are unsure about your rights, contact your employer’s HR department, payroll service or mutuality before assuming that a particular absence will be paid.