Ziektewet-uitkering (ZW)

The Dutch sickness benefit (Dutch Ziektewet, abbreviated ZW) is the statutory cash benefit paid to certain categories of insured workers who are temporarily unable to perform their job because of illness, accident, pregnancy-related complications, organ donation, or another medically certified incapacity for work. It is one of the oldest social-insurance schemes in the Netherlands, originally enacted as the Ziektewet of 1929 and consolidated several times since — most importantly through the Wet Uitbreiding Loondoorbetalingsplicht bij Ziekte (WULBZ, 1996), the Wet Verlenging Loondoorbetalingsverplichting bij Ziekte (VLZ, 2004), and the Wet Verbetering Poortwachter (2002). Each of these reforms progressively shifted the financial and reintegration burden of short-term sickness onto employers, leaving the Ziektewet itself in a narrower but still vital role: that of vangnet, the Dutch word for safety net.

The administrative authority responsible for assessing, calculating, and paying Ziektewet benefits for almost all eligible workers is the Uitvoeringsinstituut Werknemersverzekeringen (UWV), the public body that runs the employee-insurance schemes (werknemersverzekeringen) on behalf of the Ministry of Social Affairs and Employment (Ministerie van Sociale Zaken en Werkgelegenheid, SZW). UWV was created in 2002 by merging the former uitvoeringsinstellingen (Gak, Cadans, GUO, USZO, SFB) into a single nationwide carrier. For Ziektewet purposes, UWV operates a network of regional offices staffed with insurance physicians (verzekeringsartsen) and labour experts (arbeidsdeskundigen) who certify incapacity, monitor reintegration, and decide on continuation or termination of the benefit.

The legal purpose of Ziektewet, as set out in Artikel 19 of the Ziektewet, is to provide an income replacement to insured persons whose incapacity for work is medically established and who are not — or no longer — covered by an employer's two-year continued-payment obligation. The Dutch system is layered: when a regular employee falls ill, the employer is required by Artikel 7:629 of the Burgerlijk Wetboek (Dutch Civil Code) and the WULBZ/VLZ framework to continue paying at least 70 percent of wages for up to 104 weeks. Only after that period — or for workers who never had such employer cover in the first place — does the Ziektewet step in. The reform philosophy since 1996 has been clear: keep workers attached to their employer for as long as possible, because attachment improves reintegration outcomes, and reserve the public benefit for those who fall outside that attachment.

This distinction matters greatly for migrant workers, posted workers, and citizens of other EU member states working in the Netherlands. Ziektewet is an insurance entitlement earned through contributions to the werknemersverzekeringen; it is not means-tested, not subject to a household-asset test, and not classified as social assistance under the Participatiewet. EU citizens, Turkish, Bosnian, Serbian, Croatian, Polish, Romanian and Arabic-native workers with valid Dutch employment relationships are entitled to Ziektewet on identical terms to Dutch citizens, by virtue of EU Regulation 883/2004 on the coordination of social-security systems and the bilateral conventions the Netherlands maintains with several non-EU states. Posted workers covered by an A1 certificate remain insured in their home state and do not draw Dutch ZW.

Ziektewet sits inside a clearly layered Dutch income-protection system: first the employer's continued payment of wages (loondoorbetaling) under Article 7:629 BW covers up to 104 weeks of incapacity for regular employees, then — for workers without that cover, or after the 104 weeks expire — the Ziektewet acts as the vangnet, and finally, if incapacity persists beyond two years, the system hands off to the Wet werk en inkomen naar arbeidsvermogen (WIA), which is itself split into IVA for full and durable incapacity and WGA for partial incapacity. Understanding this layered structure is essential, because the same illness can move a worker through three or four different benefit regimes in a single calendar year, each with its own application form, its own decision letter, and its own UWV file number.

Eligibility for the Dutch Ziektewet is defined narrowly and is driven by one core legal concept: the worker must fall into one of the so-called vangnet groups — the categories of insured persons who are not covered, or no longer covered, by an employer's two-year continued-payment obligation under Artikel 7:629 BW and the WULBZ. Outside of these vangnet groups the Ziektewet is not the right benefit, and UWV will refuse the claim and refer the worker back to the employer's loondoorbetaling or to a different scheme entirely. The vangnet groups are listed in Artikelen 29, 29a and 29b of the Ziektewet and have been clarified through extensive case law of the Centrale Raad van Beroep, the highest social-insurance court in the Netherlands.

The largest vangnet group is composed of temporary agency workers (uitzendkrachten) who fall ill between assignments. Under a so-called uitzendovereenkomst met uitzendbeding, the employment contract typically ends automatically the moment the worker becomes incapacitated, because the assignment cannot continue. Since the temporary agency no longer has a wage obligation, the worker would otherwise be left without income; the Ziektewet therefore steps in. The same applies, with adjustments, to workers on a fixed-term contract that ends during a period of illness — once the contract ends, the employer's continued-pay obligation also ends, and UWV picks up the benefit for the remainder of the illness, up to the 104-week ceiling.

The second vangnet group is workers whose employer went bankrupt (faillissement) during their illness. In a bankruptcy, the curator (curator) is generally unable to continue paying wages beyond a short statutory wage-guarantee window administered by UWV under the Loongarantieregeling. Once that window closes, an employee who is still ill transitions to the Ziektewet. The third vangnet group is workers who are recently unemployed and fall ill within four weeks of the end of their last employment relationship — the so-called nawerking rule of Artikel 46 ZW — which preserves their ZW entitlement even though they are not, at the moment of illness, formally employed.

The fourth, and politically very important, vangnet group is women on or around maternity leave (zwangerschaps- en bevallingsverlof). The Ziektewet contains a WAZO-uitkering for the 16-week maternity period itself, and it also provides cover for pregnancy-related illness before or after maternity leave under the no-riskpolis framework. Pregnancy-related incapacity, even before the formal maternity period, is paid as ZW so that the employer is not financially penalised for hiring women of child-bearing age. The fifth vangnet group is organ donors — workers who are temporarily incapacitated because they have donated an organ, tissue, or stem cells. Their ZW is paid in full from the first day of incapacity with no waiting day, under Artikel 29 lid 2 sub e.

The sixth vangnet group, particularly relevant to employers, is the no-risk policy (no-riskpolis) workers. These are workers who are themselves classified as having a disability or chronic illness and who, under Artikel 29b of the Ziektewet, give their employer a guarantee that any sickness during the first five years of employment will be reimbursed by UWV through the Ziektewet. The purpose of this construction is to remove the financial disincentive that would otherwise discourage employers from hiring people with health conditions. Finally, certain specific groups — thuiswerkers, voluntarily insured persons, and seafarers under the maritime conventions — also draw on the Ziektewet under conditions set out in Artikel 7 ZW. Workers who do not fit any of these vangnet groups must look to their employer's loondoorbetaling, to the Werkloosheidswet (WW), or to the Participatiewet.

The Dutch Ziektewet is an earnings-related income-replacement benefit, which means that the amount you receive is calculated from your last gross daily wage (dagloon) and not from a flat-rate minimum or from your household's overall need. The rate, the ceiling, the floor, and the duration are all set by statute, with most of the detail contained in Artikelen 15 to 29 of the Ziektewet itself and the Dagloonbesluit werknemersverzekeringen, the implementing decree that defines exactly how the dagloon is computed from the worker's most recent refertejaar (reference year) of wage data drawn from the central wage register (polisadministratie) maintained by UWV.

The headline rate is 70 percent of the dagloon. This is set in Artikel 29 lid 7 ZW and applies to almost all vangnet categories. The dagloon is itself capped at the maximum dagloon, which for 2025 is €280.06 gross per day — corresponding to roughly €6,090 gross per month when annualised across the standard 21.75 working days per month. Any earnings above this ceiling do not feed into the ZW calculation. Concretely, a worker who earned €4,500 gross per month before falling ill will receive 70 percent of that wage in ZW, paid out per working day; a worker who earned €10,000 gross per month will be calculated as if they had earned the maximum dagloon and will therefore receive 70 percent of the cap, not 70 percent of their actual wage.

The benefit has an effective floor: if the 70-percent ZW amount falls below the applicable Dutch social minimum, the worker can apply for a Toeslagenwet supplement, administered by UWV in parallel with the ZW, which tops the household up to the minimum guaranteed level. The Toeslagenwet is, however, a household-tested benefit — it takes the partner's income into account and is described in detail in the section on related benefits below. For specific vangnet groups, the ZW pays at a higher percentage: organ donors and pregnancy-related illness are paid at 100 percent of the dagloon, again capped at the maximum dagloon, because in those cases the policy goal is to remove any financial deterrent to donation or to maintaining a healthy pregnancy.

The maximum duration of the Ziektewet is 104 weeks — two calendar years counted from the first day of certified incapacity. This is the same 104-week horizon as the employer's continued-pay obligation under Article 7:629 BW, by design: the Dutch legislature wanted the public safety net and the private continued-pay obligation to expire at the same point, so that all sick workers reach the same gateway to the long-term incapacity assessment under the WIA at the same moment. Within the 104 weeks the benefit can be interrupted and resumed; if the worker recovers and then falls ill again within four weeks for the same cause, the new illness is treated as a continuation under the samentellingsregel of Artikel 29c, and the clock does not restart.

At the end of the 104 weeks, the worker undergoes a WIA assessment by a UWV insurance physician and labour expert. If at that point the worker has lost more than 35 percent of their earning capacity, they transition to WIA — either to the IVA stream if their incapacity is full and durable, or to the WGA stream if their incapacity is partial or not yet durable. If the loss of earning capacity is below 35 percent, the worker is considered fit enough to work and is referred to the Werkloosheidswet (WW) or to their employer for reintegration in adapted work. There is also a small one-off ZW-cessantia payment in some niche circumstances, primarily for workers whose ZW ends and who fall outside any other benefit, but this is rarely paid in practice in the European Netherlands; it is mainly a feature of the Caribbean BES-islands sickness law.

The application procedure for the Dutch Ziektewet is centralised through UWV (the Uitvoeringsinstituut Werknemersverzekeringen) and is — in principle — entirely digital, although significant manual back-office work happens on the UWV side once a claim is filed. The starting point is the obligation to report the illness within four calendar days of the first day of incapacity. This deadline is set in Artikel 38a of the Ziektewet for the worker and in Artikel 38 for the employer (or last employer). Missing the four-day window does not automatically forfeit the benefit, but it can result in a maatregel — a partial reduction of the ZW amount — under the Maatregelenbesluit socialezekerheidswetten.

For workers in the most common vangnet situations — uitzendkrachten whose contract ends because of illness, workers on a fixed-term contract that expires during illness, and recently unemployed workers within the four-week nawerking window — the practical first step is to log in to uwv.nl with DigiD, the Dutch national digital identity. Inside the Mijn UWV environment the worker selects Ziek melden, fills in personal data, BSN (citizen service number), the date of first incapacity, contact details of their last employer, treating GP (huisarts) and any specialist, and uploads any medical certificates that are already available. The Dutch system is not built on certificates from the family doctor; the GP does not issue a sick note for ZW purposes. Instead, UWV's own insurance physicians do the medical assessment.

The employer — or in uitzend cases the temporary agency — has a parallel duty to submit a werkgeversverklaring with wage data and the contractual end-date, so that UWV can establish the dagloon from the polisadministratie. Once the claim is filed, UWV sends an acknowledgement, opens a file, and schedules a first medical consultation, typically within the first six weeks. From week six onwards, the worker and UWV jointly draft a plan van aanpak (action plan) under the Wet Verbetering Poortwachter framework: this document sets out the medical condition, the reintegration goal, any therapy, retraining, or graduated return-to-work scheme (therapeutische werkhervatting), and the responsibilities of each party. The plan is reviewed at the eerstejaarsevaluatie (first-year evaluation) and again before the WIA gateway at week 104.

Throughout the benefit period the worker has obligations: cooperate with treatment, comply with reintegration steps, accept passende arbeid (suitable work), be available for UWV examinations, and notify UWV of any change in circumstances within seven days. Failure to comply can lead to a maatregel, a temporary suspension, or, in serious cases, recovery of paid benefits. Decisions of UWV — granting, refusing, reducing, or terminating the benefit — are besluiten in the sense of the Dutch General Administrative Law Act (Algemene wet bestuursrecht) and can be challenged by bezwaar (objection) within six weeks, then by appeal to the rechtbank and, ultimately, by higher appeal to the Centrale Raad van Beroep.

Free social-law advice on Ziektewet is available through several routes. The Juridisch Loket provides free first-line advice; for serious disputes a worker can apply for subsidised legal aid (gesubsidieerde rechtsbijstand) via the Raad voor Rechtsbijstand. Trade unions (FNV, CNV, De Unie) offer in-house ZW specialists for members. Migrant workers can additionally use the multilingual support of Buronia at www.buronia.com/nl, which provides a step-by-step Ziektewet checklist in English, Dutch, Polish, Romanian, and Arabic, together with a document tracker that reminds the worker of the four-day reporting deadline and the week-six plan van aanpak milestone. The combination of Buronia's checklist with the worker's Mijn UWV dashboard is, in practice, the smoothest way for a non-Dutch-speaker to get through the full 104-week ZW journey without missing a statutory deadline.

Comparing the Dutch Ziektewet with sickness-benefit schemes in other European countries shows that the Netherlands occupies a distinctive position: it is the only major EU member state where the employer carries the full two-year continued-payment obligation as the front-line scheme, leaving the public sickness insurance in a deliberately narrow vangnet role. Most other European systems put the public scheme — paid by the social-insurance carrier — at the front of the line, with employer continued-pay either short or non-existent. This makes the Dutch system more generous to most regular employees during the first 104 weeks of illness, but more dependent on the employer's solvency and willingness to comply.

In Germany the equivalent benefit is Krankengeld, paid by the statutory sickness fund (Krankenkasse) at 70 percent of gross wages, capped at 90 percent of net, for a maximum of 78 weeks per illness within a three-year reference period, under § 47 SGB V. The first six weeks are paid by the employer at full wage under the Entgeltfortzahlungsgesetz. So a German worker gets six weeks at 100 percent, then up to 72 weeks at 70 percent; a Dutch worker gets up to 104 weeks at 70 percent from the employer, possibly topped up by collective agreement to 100 percent for the first year and 70 percent for the second.

In Belgium the comparable benefit is uitkering primaire arbeidsongeschiktheid, paid by the mutual sickness fund (mutualiteit) at 60 percent of capped gross wages for up to one year, after which the worker transitions to invaliditeit if still incapacitated. The Belgian employer's gewaarborgd loon covers only the first 30 days for white-collar workers and the first 14 days for blue-collar workers, so the public scheme kicks in much earlier than in the Netherlands. In Austria the benefit is Krankengeld, paid by the Österreichische Gesundheitskasse at 50 percent of the wage basis for the first 42 days and 60 percent thereafter, for up to 26 (or 52) weeks, under §§ 138-143b ASVG.

In France the equivalent is indemnités journalières de la Sécurité sociale, paid by the Caisse primaire d'assurance maladie (CPAM) at 50 percent of the daily reference wage, with a ceiling around €52 per day, after a three-day waiting period and for up to three years for the same illness; collective bargaining agreements very often top this up to 90 or 100 percent for the first months. Denmark sits at the other extreme: the employer pays 100 percent of wages for the first 30 days of illness, then the public sygedagpenge takes over at a flat-rate ceiling for up to 22 weeks before reassessment.

In Sweden the benefit is sjukpenning, paid by Försäkringskassan at 80 percent of the qualifying sickness income (SGI), capped at SEK 1,250 per day in 2025, for up to 364 days at the normal rate and then potentially at a lower rate for another 550 days. The employer pays the first 14 days as sjuklön at 80 percent. The Dutch headline rate of 70 percent over 104 weeks looks lower than Sweden's 80 percent or Denmark's 100 percent first-month rate, but Dutch collective agreements very frequently lift the actual paid amount to 100 percent in year one and 70 percent in year two, so the net household outcome is comparable. The key Dutch differentiator is duration: 104 weeks is, alongside Sweden's combined 364+550 days, the longest continuous protection in Europe before the long-term incapacity assessment takes over, giving Dutch workers an unusually long window to recover or reintegrate without falling onto means-tested social assistance.

The Dutch Ziektewet does not operate alone — it sits inside a constellation of related and complementary benefits, each of which can be combined with, or follow on from, the ZW depending on the worker's circumstances. Understanding these neighbouring schemes is essential, because a claim that is wrongly filed under one scheme but should be under another is regularly rejected, and the worker then has to start the process again, sometimes losing precious weeks of income in the gap.

The most important downstream benefit is the Wet werk en inkomen naar arbeidsvermogen (WIA), which takes over at the end of the 104-week ZW (or employer-loondoorbetaling) period if the worker has lost more than 35 percent of their earning capacity. WIA is split into two streams: IVA (Inkomensvoorziening Volledig Arbeidsongeschikten), for workers who are fully and durably incapacitated, paying 75 percent of the last dagloon up to the WIA cap; and WGA (Werkhervatting Gedeeltelijk Arbeidsgeschikten), for workers who are partially incapacitated or not yet durably so, paying first a wage-related phase and then a follow-up phase, the level of which depends on whether the worker is exploiting their residual earning capacity. The transition from ZW to WIA is handled administratively by UWV without the worker having to start a wholly new application, but a fresh WIA-aanvraag must be filed, usually around week 91 of the illness.

The Toeslagenwet (TW) is the means-tested top-up that ensures the household reaches the Dutch social minimum. If the ZW payment, together with any partner's income, is below the applicable minimum standard for the household type, the worker can apply to UWV for a TW supplement. The TW is not paid alongside ZW automatically; an explicit additional application is required, again via Mijn UWV with DigiD. The TW is the most important reason why the ZW floor is, in practice, the Dutch social minimum even though the statutory rate of 70 percent of dagloon could in theory fall below it for very low-earning workers.

The Werkloosheidswet (WW) — unemployment benefit — is upstream and downstream of ZW depending on the case. A worker who is unemployed and falls ill within four weeks of the end of work transitions from WW to ZW under the nawerking rule. Conversely, a worker whose ZW ends because they are deemed less than 35 percent incapacitated at the WIA gateway typically transitions onto WW, provided they meet the WW eligibility requirements (sufficient weeks worked in the reference period). The transitions are handled by UWV as a single integrated case, but they require careful timing of the aanvraag forms so that there is no payment gap.

Several other Dutch schemes round out the picture. The Wet arbeid en zorg (WAZO) covers maternity, adoption, and parental-leave payments and is administered as a ZW-variant for the 16-week maternity window. The Wajong covers young people who became incapacitated before joining the labour market and is a permanent benefit outside the ZW track. The Participatiewet — the Dutch general social-assistance law administered by the municipalities (gemeenten) — is the last safety net, available when no insurance-based benefit applies. The Wlz (Wet langdurige zorg) and the Zorgverzekeringswet (Zvw) cover medical care and long-term care alongside the income side. Finally, supplementary cover via collective labour agreements (cao) and private disability insurance (arbeidsongeschiktheidsverzekering, AOV) frequently tops up the statutory ZW rate to 100 percent of wages in year one, particularly in the public sector, healthcare, and construction CAOs.

The Dutch Ziektewet is, in volume terms, one of the largest social-insurance schemes administered by UWV. The most recent annual figures published in the UWV Jaarverslag and the Kwantitatieve Informatie dashboards show approximately 120,000 active ZW cases at any given moment in the Netherlands, with around 410,000 new cases initiated every year. The average benefit duration is around 28 weeks, although the median is shorter — typically 12 to 16 weeks — because a long tail of complex psychological and musculoskeletal cases extends the average. Annual ZW expenditure is in the order of €1.6 to €1.8 billion, financed from the Algemeen Werkloosheidsfonds (Awf) and the Sectorfondsen, with employer-paid premiums forming the bulk of the funding.

The composition of the ZW caseload has shifted markedly since the WULBZ reform of 1996. Two decades ago, the ZW carried the entire short-term sickness load — well over a million cases per year. Today, after the two-year employer continued-payment obligation has absorbed almost all regular sickness, the ZW caseload is heavily concentrated in uitzendkrachten, fixed-term workers, no-riskpolis beneficiaries, and pregnancy-related cases. Uitzendkrachten alone account for roughly one in three new ZW claims, reflecting the structural growth of the Dutch flex-labour market and the fact that the uitzendovereenkomst met uitzendbeding typically ends automatically on the day of incapacity.

By diagnosis, the dominant categories are psychological complaints — primarily burn-out, depression, and anxiety disorders — which together account for around 35 percent of ZW cases and an even larger share of long-duration cases. Musculoskeletal disorders are the second-largest group, with back pain and shoulder injuries leading the way. Pregnancy-related claims form a stable third group at around 15 percent of new cases each year. Long Covid emerged as a new category from 2021 onwards and, although its share has stabilised, it has materially lengthened average ZW duration for the affected cohort. The Centraal Bureau voor de Statistiek (CBS) and the Nederlands Centrum voor Beroepsziekten publish detailed breakdowns annually.

The outlook to 2030 is dominated by three trends. First, the ageing of the Dutch labour force: as the average worker gets older, sickness incidence rises, particularly for chronic conditions, and the relative weight of long-duration ZW cases increases. Second, the continued growth of flexible work: even as recent labour reforms attempt to push back against precarious contracts (the Wet werk en zekerheid, the proposed Wet meer zekerheid flexwerkers), the uitzend sector remains structurally large and is the main source of ZW intake. Third, sustained pressure on mental-health caseloads, with the Ministry of Social Affairs forecasting further increases in burn-out and depression cases across the decade unless preventive workplace measures expand significantly.

Policy debate in The Hague increasingly focuses on whether the 104-week loondoorbetaling framework should be shortened — for example to one year for small employers — with the ZW absorbing the second year. Successive coalition agreements have flirted with this idea without enacting it, and the Sociaal-Economische Raad (SER) has published several advisory reports recommending a more limited reform. UWV itself is investing heavily in digital case management, expanding the Mijn UWV portal, multilingual content (Dutch, English, Polish, Arabic), AI-assisted triage of incoming sickness reports, and a closer integration of the ZW file with the WIA file so that the 91-week WIA application becomes a one-click confirmation rather than a separate process. By 2030 the structure of the Ziektewet is likely to remain recognisably the same as today, but the user experience — for Dutch and migrant workers alike — should be markedly simpler, faster, and better aligned with the parallel WIA, WW, and TW schemes that surround it.