Written by Ömür Arslan, attorney at Arslan Advocaten, practising social security law. Registered in the Netherlands Bar’s register of legal practice areas for tenancy law and social security law.
Nederlands: Lees dit artikel in het Nederlands: Ziek tijdens de WW: van werkloosheidsuitkering naar de Ziektewet
Türkçe: Bu makaleyi Türkçe okuyun: WW sırasında hastalık: işsizlik ödeneğinden Hastalık Kanunu’na (Ziektewet) geçiş
Do you fall ill while receiving WW (unemployment benefit)? Report this to UWV, the Dutch employee insurance agency, straight away. In the usual situation, your WW continues during the first thirteen weeks of illness. If you are still ill after that, UWV assesses the transition to a benefit under the Sickness Benefits Act (Ziektewet). There are exceptions, for example where your WW ends earlier or the illness is related to pregnancy. You should therefore check your own letters and have a refusal assessed in good time.
Falling ill while unemployed often creates double uncertainty. You want to recover, but you also have to manage your income and obligations. A sickness report, an application and an objection are different steps. In this article you will read how to keep the transition manageable, which information matters and what you can do if UWV does not process your sickness report or benefit correctly.
First establish the situation in which you fell ill
The first day of illness is important. Were you already receiving WW on that date, were you also working a few hours, or was your employment contract still running? An illness that starts during employment may follow a different route from an illness that only arises during WW. In the case of partial unemployment, continued payment of wages and a benefit may apply side by side. The name of the payment on your bank statement then does not tell the whole story.
Put four dates side by side: your last working day, the end date of your employment, the start date of your WW and your first day of illness. Add the date on which you reported sick. Use your contract, dismissal letter, WW decision and the confirmation of your sickness report for this. A difference of a few days can explain why UWV applies a different scheme from the one you expected.
Are you no longer receiving WW and do you fall ill shortly after your insurance has ended? Then the so-called after-effect cover (nawerking) of the Sickness Benefits Act may be relevant. That is a separate assessment with its own conditions. Do not assume that every former employee automatically remains insured. The Dutch government describes the various situations in which a right to sickness benefit may exist.
Reporting sick to UWV and keeping evidence
For your sickness report, use the channel and follow the instructions that UWV specifies for your situation. Do not wait for a definitive diagnosis or an appointment with a specialist. A sickness report concerns your inability to work; the medical examination can follow later. State the actual first day of illness and describe any uncertainty honestly if you do not know exactly which date applies.
Keep the confirmation of your report. If you speak to UWV by telephone, note the date, the time, the arrangements discussed and, if possible, the name of the staff member. Then check whether the same details appear in Mijn UWV. A conversation in which you only ask what you should do is not always the same as a registered sickness report.
Was the report made too late? Report the illness anyway and explain why you could not report it earlier. Think of a hospital admission, serious psychological problems or a demonstrable technical problem. Enclose any documents available. An explanation for the delay must cover the entire relevant period. Merely saying that you did not know the rules does not in itself remove the possible consequences.
What happens in the first thirteen weeks?
If you fall ill during WW, in the usual situation your WW initially continues. The transition to sickness benefit therefore does not automatically take place on the first day of illness. This can be confusing: medically you are ill, but administratively you are still receiving an unemployment benefit. So check not only whether money is coming in, but also which scheme UWV refers to in its decision.
The first weeks of illness also do not mean that all arrangements lapse. Discuss with UWV which activities are still expected of you and which adjustments are needed because of your illness. If your symptoms prevent you from attending an appointment, report this in advance. Keep the reply. Deciding on your own not to respond to anything any more can create a new problem on top of the illness.
Ask for clarity in particular if your WW entitlement expires before the end of those thirteen weeks. The remaining duration of your WW and the date on which any sickness benefit starts must then be aligned. A general explanation about thirteen weeks is not enough to determine your individual end date.
The transition to sickness benefit
If the illness lasts longer, UWV can assess whether you are entitled to benefit under the Sickness Benefits Act. Check which information or forms are still required. Do not rely solely on the assumption that the various departments have arranged everything between themselves. If anything is unclear, ask in writing about the status of your case and the intended start date.
Compare the last WW payment statement with the first sickness benefit statement. Pay attention to the period covered by the payment, any set-offs, holiday pay and any income. A lower amount is not necessarily a mistake: a payment may cover fewer days. Conversely, an identical amount can conceal an incorrect scheme or start date.
A letter granting the benefit is more important than a verbal expectation. It should make clear which entitlement has been established and from what date. If there is no decision while your payments stop, ask for a written decision. That makes clear what you can legally challenge and prevents you from merely phoning about an administrative backlog.
How is it assessed whether you are ill?
A medical assessment concerns the consequences of your health for the relevant work. A diagnosis helps to understand the situation, but does not in itself prove which work you can or cannot do. So describe specifically what goes wrong when walking, sitting, lifting, concentrating, dealing with pressure or getting through a working day.
Describe a normal day and mention fluctuations as well. Can you perform an activity once but then need a long time to recover? Then mention both parts. A short walk, an errand or a conversation does not automatically mean that you can manage a full working week. At the same time, it is important to be honest about the abilities you do have.
Ask your treating practitioners above all for factual information: your symptoms, examination findings, treatment and relevant developments over time. A treating doctor does not have to draw the legal conclusion that UWV must grant a benefit. The translation into the statutory standard takes place in the insurance medical assessment and the legal assessment.
Pregnancy, part-time work and recurring illness
Illness caused by pregnancy or childbirth can affect the applicable scheme and the moment at which sickness benefit begins. You should therefore indicate when your symptoms are connected with this. Share medical details through the channel intended for that purpose. A general statement that you are pregnant does not in itself answer the question whether the illness is caused by the pregnancy.
Do you work alongside your WW? Then list, per employer, how many hours you work and what wages are paid during illness. A benefit for lost hours and wages for existing hours must be clearly distinguished. Report changes in the correct way. A payslip may be needed to check a set-off.
The timeline is also important where you recover and then report sick again. A short interruption may be treated differently for certain periods of illness than an entirely new period. Ask UWV to explain which periods have been combined and on what grounds. Do not simply count from your most recent sickness report yourself if an earlier illness already played a role.
What if UWV declares you fit for work?
UWV may decide that from a certain date you are once again fit for the relevant work. Read which assessment that decision is based on. A statement made during a consultation and the formal decision must be distinguished from each other. Ask for the medical report and check whether your symptoms and work have been described correctly.
For some decisions under the Sickness Benefits Act, the time limit for lodging an objection is only two weeks. Other decisions usually have a time limit of six weeks. The notice of legal remedies in your letter therefore deserves immediate attention. Do not wait for all the medical information before taking action; if necessary, a provisional objection can be lodged first. UWV explains the different objection periods and the pro forma objection.
Then set out specifically why you believe the assessment is incorrect. Did the doctor base the assessment on the wrong work? Was a limitation not discussed? Does a specialist have information about the date on which UWV is ruling? A targeted response to the report is easier to assess than a mere statement that you still feel ill.
Applying for WW again after sickness benefit
If your sickness benefit ends and you are unemployed, a new or revived entitlement to WW may come into play. That does not follow solely from the fact that you received WW before your illness. UWV must assess which entitlements remain and which conditions you meet. Also check what you need to apply for or report yourself.
If you disagree with the termination of your sickness benefit, you can meanwhile ask about a possible WW application. Record your medical position carefully when doing so. Applying for another form of income support and disputing the medical assessment are separate matters. Discuss how to prevent your statements from unintentionally appearing contradictory.
Ask in good time which job-seeking and availability obligations apply. Keep track of appointments and report any obstacles. The information on WW benefits can help you distinguish between the entitlement to WW, its duration and any dispute with UWV.
No income because of a mistake in the transition
An interruption in payment can have various causes: a missing form, a refused entitlement, a set-off or a decision that has not yet been made. First ask which cause UWV has recorded. With that information you can choose the appropriate next step. An objection to a refusal does not automatically resolve an application that is still missing.
In addition, map out your financial situation. List your essential monthly expenses, available income, bank balances and specific payment arrears. Ask UWV which temporary solution is possible. If necessary, find out from your municipality whether you qualify for social assistance benefit. Mention pending claims and expected back payments to prevent double payment later on.
Where objection or appeal proceedings are pending, interim relief (a voorlopige voorziening) can be requested in an urgent situation. The court assesses, among other things, why you cannot await the outcome of the ordinary procedure. A low income alone does not give an automatic entitlement. The documents, other options and the substance of the dispute also play a role.
Practical example: illness shortly before the end of WW
Suppose someone has only a few weeks of WW left and during that period is unable to work because of serious back problems. The person reports sick, but assumes that the WW always continues for thirteen weeks. After the original end date, no payment arrives. It turns out that there is uncertainty about the transition and about a form that is still required.
A useful approach starts with the WW decision, the sickness report and the first day of illness. Next, it is checked whether UWV has already taken a decision under the Sickness Benefits Act and which information is missing. If the entitlement has been refused, the reason for the refusal must be challenged. If no decision has yet been taken, the first issue is progress and possibly the failure to decide on time.
This fictitious example shows why a complete timeline is important. The solution does not follow from the general thirteen-week rule, but from the combination of insurance, remaining WW duration, illness and decision-making. The example does not predict the outcome in any individual case.
A file that allows your question to be assessed quickly
Collect the WW award, any termination letter, the confirmation of your sickness report and all decisions under the Sickness Benefits Act. Add payment statements for the last few months. Note which documents you have already sent and on what date. A short table of contents saves explanation and makes missing documents visible.
In addition, prepare a single page with your questions. For example: which first day of illness does UWV use, why does sickness benefit start on this date and why is a payment missing? Separate medical questions from questions about money and administration. This makes it clear which department or expert needs to respond on each point.
Keep the originals and work with copies. Send medical documents only through an appropriate channel and do not hand over a complete medical file to a general contact person if targeted information is sufficient. Do tell your legal representative which relevant documents exist, so that nothing important is overlooked.
Check the first payment after the transition
When moving from WW to sickness benefit, it is wise not only to compare the net amount received. The composition of the payment may differ. UWV states, for example, that with sickness benefit holiday pay is usually included directly in the payment, whereas with WW it is paid out at a different time. A higher or lower amount in your bank account therefore does not necessarily mean that there is a mistake in the entitlement. See UWV on illness during WW.
Compare the statements on the same items: the period, the daily wage, the benefit percentage, any income and deductions. Note missing days separately. A payment may also include a correction for an earlier period, which makes a comparison with a single ordinary month misleading.
Keep submitting the income statements requested for as long as UWV asks for them. Also keep a statement reporting no income and the confirmation that it was sent. If payment is not made, you can then ask specifically whether a missing form, an administrative transition or a substantive decision is the cause.
Illness and part-time work alongside WW
If you still work a few hours alongside your WW, map out both parts of your situation. Note which employer you work for, how many hours are involved and for which work you are reporting sick. Reporting sick to your employer does not automatically mean that all the information also reaches UWV.
Keep your payslips and any arrangements about hours worked. If you continue to work part-time during your illness, it must be clear which income is being paid and to which period it relates. Report changes through the channels intended for that purpose.
Where you receive different letters, ask who is responsible for which part of your income. With an overview of your employer, WW and any sickness benefit, you prevent a missing payment from being attributed to the wrong scheme.
Frequently asked questions about being ill during WW
Do I receive sickness benefit from the first day of illness?
Not always. During WW, in the usual situation the WW continues first. Exceptions may apply, for example if the WW ends earlier or in the case of specific causes of illness. Have the first day of illness and the remaining WW duration assessed together.
Do I have to wait for a diagnosis before I report sick?
No. Report your illness in good time in accordance with UWV’s instructions. The medical substantiation can be added later. Keep the confirmation and note which symptoms you had at the time of the report. A later diagnosis can help to explain earlier symptoms.
Can I lodge an objection without all the medical documents?
That is usually possible with a timely pro forma objection, after which you supplement the grounds within the period given to remedy this. First check whether two or six weeks applies in your case. A request for medical information does not in itself extend the objection period.
Does my benefit continue during the objection?
Lodging an objection does not, in principle, suspend the decision. A termination can therefore take effect while the objection is pending. So discuss straight away how you can bridge the gap in income and whether temporary relief is necessary and feasible.
Do I automatically get my old WW back after recovery?
That must be assessed separately. Remaining entitlements, any new work and the conditions for WW may be relevant. Ask UWV which application or change is needed and check the new decision carefully.
What can a lawyer do in this situation?
A lawyer can assess the timeline, insurance, medical standard and decisions, determine the correct procedure and substantiate an objection. For an initial assessment, the most recent decision and the final date for responding are particularly important. Discuss the costs and possible legal aid in advance.
Have the transition and the decision assessed
Illness during WW requires attention to both recovery and administration. Check the sickness report, the first day of illness, the end of the WW and any decision under the Sickness Benefits Act. Act quickly in particular if UWV refuses or terminates the entitlement: the time limit may be short.
You can put your situation to Arslan Advocaten via the contact page. Send the decision with it and state when you received it. You can read more about the legal route under objecting to UWV decisions and in the explanation of sickness benefit and your rights.
Read also
UWV decides too late on your WIA or objection: what can you do?
Sickness benefit stopped after the first-year assessment: objecting to the EZWb
Benefit stopped and no income during the objection: interim relief against UWV
