Are you ill and receiving Sickness Benefits Act (ZW) benefit from the UWV? A UWV decision can then have far-reaching consequences. You may be told that your benefit is being stopped, is not being granted, or that in the UWV’s view you are able to work again. Many people then ask themselves: What are my rights? And what can I do about a UWV decision?
Short answer: With a decision under the Sickness Benefits Act you must check the decision letter carefully. The objection procedure, the requirements and the deadline depend on the decision; the date and deadline in the letter govern.
This article sets out what you need to know about the Sickness Benefits Act: when you are entitled to it, how the UWV decides, and what you can do if you disagree with a decision.
What is the Sickness Benefits Act?
The Sickness Benefits Act is a UWV scheme for people who are ill and have no permanent job, or who are receiving benefit. Sometimes someone who does have an employer can receive it too. Whether the scheme applies in your situation depends on your employment, your benefit situation and the reason for your illness.
See the current explanation from the UWV on Sickness Benefits Act benefit.
How is the level of the benefit determined?
The benefit is usually 70% of the daily wage and includes holiday allowance. In principle it lasts a maximum of two years, but exceptions and different calculations can apply — for pregnancy, organ donation, income alongside the benefit, or a no-risk policy, for instance.
The UWV sets the daily wage and states the personal outcome in Mijn UWV. See the UWV on the level and duration of the benefit.
How do you apply for the benefit?
How you report sick or arrange the benefit differs from case to case. Follow the instructions given by the UWV or your employer, and use Mijn UWV where that is indicated for your situation. If you fall ill while receiving unemployment benefit, report sick to the UWV by the second day at the latest.
Keep the confirmations and messages from the UWV. If you are unsure about your situation, you can consult the UWV or an independent support organisation.
May you work alongside the benefit?
Work, income and your capacity to work can affect the benefit. Which details you must report and which arrangements apply depend on your personal situation. Follow the UWV’s instructions and check your messages in Mijn UWV.
See the UWV on Sickness Benefits Act benefit.
What happens if you fall ill while receiving unemployment benefit?
If you fall ill during or after unemployment benefit, report sick to the UWV by the second day at the latest. In many situations you keep your unemployment benefit for the first 13 weeks; after that the UWV can grant Sickness Benefits Act benefit. There are exceptions, including for pregnancy, organ donation, or the end of the unemployment benefit.
See the current instructions from the UWV: falling ill while receiving unemployment benefit.
What should you do when you are ill?
Report your illness in line with the instructions that apply to your situation, keep the UWV’s messages and decisions, and stick to arrangements about contact or reintegration. For illness during unemployment benefit, specific instructions apply from UWV.
Sickness Benefits Act benefit with an employer: how does that work?
Someone who does have an employer can also receive the benefit in certain situations: pregnancy, childbirth, organ donation or a no-risk policy, for example. The administration, continued pay and reintegration differ from case to case. The UWV and the employer will tell you which arrangements apply to you.
See the UWV on the benefit with or without an employer.
What does ‘self-insured employer’ mean for the Sickness Benefits Act?
With a self-insured employer, the administration of the Act and the reintegration may be organised differently. Which party is your contact and which steps you must take will appear from the information provided by your employer, the administrator and the UWV. Always check the correspondence you receive.
What steps apply when an employee falls ill?
In case of illness, employer and employee have obligations that depend on the employment situation, the length of the absence and the scheme involved. This page does not give a fixed, universal set of steps. Follow the current information from your employer, occupational health service and the UWV.
Working together on reintegration during illness
Reintegration arrangements differ from case to case. The UWV, the employer, the occupational health service and the employee can each have a role. Read the messages you receive carefully and ask for an explanation if you do not understand which arrangement or obligation applies to you.
How does the UWV decide on the benefit?
The UWV looks at:
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Whether you are unfit for the work you did before you fell ill.
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The reports of an insurance physician and a labour expert.
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Your medical details and your limitations.
On that basis the UWV decides whether you are entitled to benefit, or whether the benefit stops.
What is a no-risk policy and when does it apply to an employee?
A no-risk policy can be relevant to an employer in certain situations. Whether the scheme applies, and what that means for your benefit, depends on your personal situation. Consult the UWV or the employer for the current explanation.
What if you fall ill because of organ donation?
For illness caused by organ donation a special arrangement under the Act can apply. The conditions and the calculation depend on the situation. Consult the UWV for the current instructions and your personal position.
How do you report recovery while receiving the benefit?
Report a recovery or a change in your capacity in line with the instructions from the UWV or your employer. The way of reporting and the consequences differ from case to case. Keep the confirmation of your report.
What does an assessment after 1 year of illness involve?
If you have been receiving the benefit for about a year and have no employer, you may be given an assessment under the Act. The UWV then assesses your capacity to work and what you could earn with it. Which assessment follows, and what it means, depends on your situation.
The UWV states that a labour expert can assess whether you are able to earn more than 65% of your pre-illness pay. Read the current conditions and consequences at the UWV: assessment under the Act after one year of illness.
How does the reintegration action plan work during Sickness Benefits Act benefit?
An action plan and reintegration arrangements are not the same in every situation under the Act. Which steps apply depends, among other things, on whether you have an employer and on the scheme you fall under. Follow the instructions from the UWV, your employer or the occupational health service.
Common UWV decisions
The UWV can take decisions on entitlement to benefit, its continuation, the assessment of your capacity, or a recovery of overpayment. The decision letter states which decision was taken, why, and what deadline applies for lodging an objection.
What can you do about an adverse decision?
Read the decision letter carefully. It states whether, and within what period, you can lodge an objection. The procedure, the deadline and the requirements depend on the decision. Gather the relevant documents and, if necessary, take advice on the content of your objection.
Objection and appeal
A decision on objection states which next step is possible. Always keep to the deadline in the UWV letter; that is what governs your situation.
Examples from practice
A UWV assessment always depends on the personal situation, the medical information and the specific decision. For that reason no unverifiable practical examples are used here as a yardstick.
Checklist: what to do if your benefit stops
- Read the decision letter carefully.
- Note the deadline stated in the letter.
- Keep the relevant documents and correspondence.
- Seek an explanation or advice about your options in good time if needed.
Specialist UWV lawyers at Arslan Advocaten
With a decision under the Act, legal assistance can help in assessing the letter, the deadline and the relevant file documents. Whether costs are covered depends on the help you choose and on your situation. Ask about the options and conditions in advance.
Frequently asked questions (FAQ)
Who is the benefit intended for?
The benefit is intended, among others, for people who are ill and have no permanent job, or who are receiving benefit. Sometimes someone who does have an employer can receive it too. The UWV assesses the personal situation.
How high is the benefit?
The benefit is usually 70% of the daily wage and includes holiday allowance. Exceptions and different calculations can apply. The UWV calculates the personal outcome.
What happens in an assessment under the Act?
After about a year of illness the UWV can assess your capacity to work and what you could earn with it. Whether and when that happens depends on your situation.
Can I object to a UWV decision?
If you disagree with a decision, the decision letter states whether, and within what period, you can lodge an objection. That letter governs your situation.
What happens after 2 years of illness?
The benefit usually lasts a maximum of two years. When you have been ill for almost two years, you may be able to discuss with the UWV whether a WIA application is appropriate. The conditions and the timing of an application are personal; follow the UWV’s messages.
See the UWV on the duration of the benefit.
Can you go abroad while receiving the benefit?
Travelling to or staying abroad can affect your benefit or your arrangements. Before you leave, check the UWV’s current instructions and the messages that apply to your situation.
Why Arslan Advocaten?
A legal assessment starts with the specific UWV decision, the deadline and the relevant file documents. Get in touch in good time with any questions, so that the letter and possible next steps can be assessed carefully.
Conclusion
The Sickness Benefits Act has various routes and exceptions. The UWV’s messages and decisions govern your personal situation. Read a decision carefully, keep to the deadline it states, and seek an explanation or advice in good time if you do not understand it.
Steps to take after a UWV decision
- Note the date of the decision and the final date for lodging an objection.
- Request the file and the medical or occupational reasoning if needed.
- Lodge your objection in good time and state which decision you are objecting to.
- Add the relevant medical and factual information, or announce that you will.
The general rule is usually six weeks, but always check the specific UWV letter.
