From reintegration to litigation
When an employee is long-term sick, the employer and employee may disagree about the progress of reintegration. In such cases, a UWV (Employee Insurance Agency) expert opinion can help. This article explains what an expert opinion involves, in which situations it can be requested, what role it plays in proceedings, and the possible consequences of not obtaining one.
What is an expert opinion?
A UWV expert opinion is an independent assessment by a doctor or expert on the reintegration of a sick employee. Both the employer and the employee can request such an opinion from the UWV. This often happens when there is a difference of opinion about the progress of the employee’s reintegration.
An expert opinion can be requested for the following five situations:
whether the employee can work fully again, without adjustments;
whether the work the employee must or wants to do is suitable;
whether the employee or the employer has done enough for reintegration;
whether the employee is entitled to continued payment of wages due to incapacity for work;
regarding frequent sick leave by the employee.
The UWV does not provide an expert opinion in all cases. In particular for situations 1 and 3, an opinion is only issued if the employee cooperates with the medical examination.
Although the law prescribes that the UWV must issue an opinion within two weeks of receiving the request, the UWV internally applies a processing time of four weeks. In practice, it often takes longer.
The expert opinion is non-binding. This means the employee and employer cannot lodge an objection or appeal against it.
There are costs attached to requesting an expert opinion. When the employee requests the opinion, the cost is EUR 100. When the employer requests it, the cost is EUR 400, unless the expert opinion is requested in the context of a dissolution request, in which case the request is free of charge.
Purpose of the expert opinion
The expert opinion was created to clarify disputes about illness and reintegration at an early stage, with the aim of avoiding unnecessary burden on the courts and offering parties fast, expert advice. The expert opinion is often seen as a precursor to court proceedings.
Expert opinion as protection against a wage sanction
For employers, it is advisable to request an expert opinion on their own reintegration efforts after one year of incapacity for work. This provides insight into the quality of the reintegration process and, if the opinion is positive, significantly reduces the chance of a wage sanction from the UWV.
Wage sanction
A wage sanction is a measure the UWV can impose on an employer when it has made insufficient reintegration efforts for a sick employee. The sanction requires the employer to continue paying the employee’s wages for up to one additional year, on top of the usual 104-week period of continued payment during illness.
Case law shows that an employer may rely on a positive expert opinion on reintegration efforts issued around the end of the first year of illness. The UWV cannot, in principle, revisit this in its final assessment after two years, unless the employer made insufficient efforts in the intervening period. If the initial opinion is negative, the expert opinion offers the opportunity to remedy shortcomings in good time.
It remains crucial that the employer stays alert to changes in the employee’s situation throughout the reintegration process and responds to them adequately. This limits the risk of a wage sanction.
Expert opinion in court proceedings
An expert opinion does not always resolve a dispute. If the dispute is not resolved by it, the parties can still go to court. In certain proceedings, submitting an expert opinion is mandatory. For example, employers must submit an expert opinion in dissolution requests based on frequent sick leave or failure to meet reintegration obligations. Employees are required to do so for wage claims or claims to enforce reintegration obligations. If an expert opinion is missing, the request or claim is, in principle, rejected.
In exceptional cases, submitting an expert opinion is not required, for example where this cannot reasonably be expected of the employee or employer. Case law shows this can be the case in summary proceedings, where there is insufficient time to request an opinion, or where the UWV refuses to process the request. An expert opinion can also be dispensed with if already-submitted medical documents provide sufficient substantiation for the claimed incapacity for work.
Conclusion
The UWV’s expert opinion can be a valuable tool in disputes about illness, reintegration, and continued payment of wages. Both employers and employees can use it to gain clarity about their rights and obligations.
Make sure you act in good time, document your reintegration efforts properly, and stay alert to changes in circumstances. Also be prepared for the possibility that legal proceedings may still be necessary, and take the procedural requirement of the expert opinion into account.
Do you have questions or doubts about the importance of an expert opinion? Our employment lawyers are ready to help.
