Tool Incapacity for Work and 'Return To Work' journey

Möbius supported the development of a tool for general practitioners in the dialogue with incapacitated patients, both in the recovery phase and during reintegration at work.

Logo FPS Social Security

In December 2016, on the initiative of the Minister of Social Affairs and Public Health, the National Board of Social Insurance Medicine on Disability was established. With this initiative, the minister confirmed the willingness to support incapacitated people. After all, all citizens have the right to participate actively in society, according to their capabilities.

In this context, every person must be able to develop their own talents on the labour market. This opportunity should be offered equally to incapacitated persons. However, such an inclusive labour market is far from a reality in Belgium. In spite of their limitations, people who are incapacitated for work often still have a lot of residual capacity, also in the occupational field. When they are no longer able to carry out certain activities, many other activities are often possible for them.


Strategic challenge

The National Board has set up a specific working group (WG 3) with the task of developing a tool for general practitioners in their dialogue with incapacitated patients, both in the phase of recovery of their health condition and in the possible simultaneous phase of reintegration at the work through a custom journey.

Möbius supported the WG 3 of the National Board in developing this tool.

It was not easy to make this project successful. The ambition was great and prone to arousing resistance. Later came Covid. Many elements required numerous reorientations in Möbius' process guidance. However, the pathology sheets are well published, the result of cooperation between all actors. The dynamising support from Möbius was indispensable in this.

Dr. Alex Peltier President WG 3, National Board of Social Insurance Medicine on Disability


A vision has been developed and a general scheme indicating how the recovery process and the return to work process should be considered together, as well as 9 pathology sheets, namely for the following pathologies: burnout (ICD-10 code: Z73.0), adjustment disorders (F43.2), mild depressive episode (F32.0), carpal tunnel syndrome (G56.0), torn rotator cuff (M75.1), knee prothesis (Z96.6), non-specific low back pain (M54.5), breast cancer (C50) and acute myocardial infarction (I21).

The development took place in three phases, with regular coordination with the Steering Committee.


Phase 1: Mapping the existing situation / known factors

First, the existing situation and known factors were mapped out, via three steps:

  1. Studying existing information and guidelines from abroad (e.g. France, Sweden etc.) via desk research;

  2. Conducting exploratory interviews with 16 experts in occupational medicine, insurance medicine, general practice medicine and the relevant medical domains (face to face);

  3. Organising a feedback round with 22 medical specialists within the relevant clusters (via e-mail).

This led to a first version of the vision and a sheet per pathology.


Phase 2: Reorientation with a focus on the ‘Return To Work' (RTW) journey

In 2021, the new government, together with Minister Vandenbroucke, wished to seize the ongoing process to make the link with the ‘Return To Work’ (RTW) coordination. The tool was revised and expanded where necessary. The vision and the sheets were revised with a focus on the ‘Return To Work' journey. Work has also been done on the elaboration of a general scheme regarding the parallel consideration of recovery and the return to work journey, and appendices on the range of participation opportunities and tips to facilitate the return to work.

Möbius also collected input from associations of general practitioners (Domus Medica and SSMG) and patient associations (Vlaams Patiëntenplatform and LUSS) and integrated it into the tool.

This led to an adapted version of the vision and sheets, and a general scheme.


Phase 3: Pilot process for testing and evaluating the tool

In order to maximise the usefulness of the tool and to ensure support for the tool, a pilot process was organised with both Dutch-speaking and French-speaking general practitioners and patient representatives (in collaboration with GP associations and patient associations). This process consisted of three steps:

  1. Organising an online event to present the developed tool and to explain the pilot process (an event was organised in Dutch and the same event in French);

  2. During three months: usage of the tool during consultations by general practitioners and evaluation of the tool (by both groups), supported by an online community (organised via a digital platform);

  3. Collecting feedback and suggestions in a structured way to further optimise the material and maximise its implementation rate, via an online survey of the participants in the pilot process.

There were several consultation/coordination moments with the members of the WG 3 and the GP associations, to triage the collected feedback and to integrate the relevant feedback. This led to a final version of the vision, the general scheme and the pathology sheets.



The result is a clear tool with recommendations to improve the use of absence certificates due to illness as part of the therapeutic approach and reintegration at work, in the form of:

  • A vision consisting of an introduction, three pillars and three appendices with relevant additional information;

  • A general scheme to make the link between recovery and the journey back to work;

  • A sheet for each of the 9 pathologies, which is built up according to a fixed structure, with basic medical information, information regarding recovery and return to work, indicative durations for incapacity for work and factors that are important to determine the patient's situation to be assessed 'in concrete terms'.