Self-employed insurance: a royal decree expands the return to work

King Philippe signed a royal decree on September 6, 2026, amending the royal decree of July 20, 1971, establishing benefit insurance and maternity insurance for self-employed workers and assisting spouses. The text, referenced [2026/202264], is published in the Belgian Official Gazette of September 10, 2026, page 49466, and takes effect on September 1, 2026.

A Consolidated Legal Framework

The decree falls under the law relating to compulsory health care and benefit insurance, coordinated on July 14, 1994, in its Article 86, § 3. It was prepared on the proposal of the Minister of Social Affairs, F. Vandenbroucke, and the Minister for the Self-Employed, E. Simonet, following the opinion of the Management Committee for the Benefit Insurance of Self-Employed Workers of the RIZIV/INAMI Benefit Service (April 22, 2026), the Finance Inspector (June 16, 2026), and the agreement of the Minister of Budget (July 1, 2026). The request for an opinion addressed to the Council of State was registered on July 22, 2026, under number 79.860/2/V; the legislation section decided on July 27, 2026, not to issue an opinion within the requested timeframe.

The Expanded Role of the Multidisciplinary Team

The text expands the competencies of the medical advisor and the collaborator of the multidisciplinary team in evaluating the work potential of holders in a state of incapacity.

• In Article 25/2, § 2, the evaluation may now be requested “at the request of the medical advisor or the collaborator of the multidisciplinary team,” and where applicable after a referral referred to in Article 25/5, § 1.
• A new Article 25/4/6 allows the medical advisor or the collaborator to evaluate the work potential at any other time during the incapacity, with validation by the medical advisor in the event of classification in category 2.
• The evaluation is excluded in several situations, notably when the holder performs authorized work (Article 23bis) or when a “Return to Work Path” is underway.

Simplified Access to the “Return to Work Path”

Articles 25/4/2 to 25/4/5 are rewritten to clarify the starting conditions of the “Return to Work Path,” and a new Article 25/11/1 allows the holder to personally contact, at any time, the competent service or institution of the Regions and Communities participating in socio-professional reintegration.

• The first contact with the Return to Work Coordinator must take place no later than the sixth month of incapacity for holders classified in category 4, or within the month following the referral.
• The referral is recorded in the holder’s “Return to Work File.”
• The coordinator ensures the follow-up of the path every three months, unless the elements of the file justify a different frequency.

Scope of the Reform

By expanding the role of the multidisciplinary team and granting the policyholder the possibility to initiate a reintegration process themselves, this royal decree strengthens the social protection of self-employed persons and assisting spouses who are unable to work. It follows the royal decrees of March 12, 2023, and January 18, 2024, which structured the “Return to Work” system, and is applicable retroactively from September 1, 2026.

Official source: Belgian Official Gazette of September 10, 2026, 196th year, No. 205, page 49466 — Royal Decree of September 6, 2026, amending the Royal Decree of July 20, 1971, establishing an indemnity insurance and a maternity insurance for self-employed workers and assisting spouses, reference [2026/202264].