Return-to-Work Recommendation (WHA): What Exactly Does the Recommendation Say?

An employee is able to return to work on a part-time basis. The (company) doctor or occupational health professional sends a recommendation specifying a percentage. A logical question: what does that mean? Does 60% mean that the employee is also 60% productive? And what does that mean for the sick leave insurance?

It's time to set the record straight.

What is a return-to-work recommendation?

The Return-to-Work Recommendation (WHA) is the recommendation issued by the (company) physician or POB regarding an employee’s fitness for work. It states:

The date on which the employee becomes available for work again, the number of hours, and the percentage of the contracted hours that this represents.

That's the crux of it. But there's more to it than just that percentage.

More than just a percentage: the entire recommendation matters

The WHA is a quantitative assessment, but the advice from the (occupational) physician or POB goes beyond that. The feedback also includes information about the employee’s limitations and capabilities, the structure of their work hours, and what you need to take into account in the workplace.

So don't just look at the percentage. Be sure to read the accompanying explanation as well. It tells you what the employee can and cannot do, and helps you work with the employee to reach appropriate agreements.

What the percentage does and does not indicate

This is where things often go wrong. The percentage in the WHA looks like a productivity figure or a wage value, but it isn't.

The percentage indicates the number of hours for which the employee is considered available for work or on call, relative to the number of contracted hours. In other words, it refers to what is theoretically possible, not to how many hours the employee actually works. After all, that can vary.

The (occupational) physician or POB therefore does not make a determination regarding:

• How productive the employee is during those hours
• What the work is worth (the wage value)
• What this means for sick leave insurance or any benefits

That is not part of the (occupational) physician’s responsibilities either. Moreover, the law does not use terms such as “partially ill” or “partial recovery.” These are concepts that have emerged in practice among employers and sick leave insurers, but they do not appear in Article 7:629 of the Civil Code.

How is the percentage calculated?

Just a simple calculation:

Percentage = (number of billable or resumed hours / number of contracted hours) × 100%

In the feedback, the (occupational) physician can specify whether the work in question is the employee’s regular work, suitable work, or modified work. This is good to know, but it does not change the percentage. That percentage remains based on the hours for which the employee is eligible to be assigned work, not on the hours the employee actually works.

What can you see in the reporting portal?

In the insurer's claims portal, you'll usually see something like this:

Recommended work capacity percentage (doctor or POB): … percent (%)
Note for the employer: Discuss with your employee which tasks are temporarily feasible. When doing so, review the doctor’s or POB’s recommendation under “Documents” in the file. Then enter the partial recovery status and the wage value of the suitable work via your reporting portal. If the partial recovery percentage differs from the recommended work capacity percentage, the insurer may request an explanation in accordance with the policy terms and conditions. In that case, briefly explain why the wage value is lower than the recommended percentage.

In short: the recommended percentage reflects what is theoretically possible. You determine the partial recovery rate—the wage value of the work the employee actually performs—yourself. These are two different things, and that’s perfectly acceptable.

Discussing wage value? Consult a case manager, employability coach, or occupational specialist

Determining wage value is not the responsibility of the (company) physician. This makes sense, since it requires a completely different set of expertise: assessing productivity, task allocation, and the value of the work.
If there is a dispute about this—for example, with the insurer or with the employee themselves—then a case manager, employability coach, or occupational health specialist is the appropriate person to advise on or assess the matter. That falls outside the scope of the (occupational) physician’s role.

How does this work with the sick leave insurer?

Insurers such as Achmea, a.s.r., and Mandaat use the WHA in their processes. Here’s how it usually works:

• The WHA is provided in a structured format, including the effective date, the percentage of work capacity, and the date of the recommendation
• You'll see the recommendation in the reporting portal and can accept it, modify it, or indicate that it wasn't met
• If you don't respond, the insurer may determine the degree of recovery or the disability percentage based on the WHA.

Important to know: Insurers often have their own calculation tool for determining wage value. This confirms the point made above. You determine the wage value yourself, together with the insurer and, if necessary, an occupational health specialist—not the (company) doctor.

Does this involve returning to work with a different employer?

This article discusses returning to work within one’s own organization (Track 1). If you’re considering reintegration with another employer, a trial placement, or a secondment (Track 2), slightly different considerations apply regarding hours and availability. We’ll be writing a separate article on that soon.

How can you, as an employer, use this advice?

There’s one thing you want to know above all else: what can you agree on with your employee regarding their return to work? A good Return-to-Work Agreement (WHA) provides you with the tools to do just that.

Therefore, please pay attention to these points in your feedback:

• When does the employee become subject to taxation, and for how many hours?
• What configuration is recommended?
• Is it your own work, suitable work, or adapted work?
• Are there any points to keep in mind regarding the work itself?

With that information, you can make specific arrangements. sorted in a snap.

Do you have questions about how this affects your sick leave insurance? You should direct those questions to your insurer or advisor. That’s not the (company) doctor’s area of expertise—and that’s a good thing: this way, the advice remains strictly medical, and responsibility for the insurance stays where it belongs.

In a nutshell

The return-to-work recommendation is merely a recommendation regarding the percentage of work capacity in hours. It is always accompanied by feedback from the absenteeism counseling process, which describes the limitations, possibilities, and points of attention regarding work. Only by considering both components together can a clear picture be formed of which tasks can be safely performed. The percentage alone, therefore, does not indicate exactly what someone can do, nor is it a measure of productivity, wage value, or a financial assessment.

Are you unsure about a recommendation, or do you want to know what to do with the results? Please contact your own Employability Coach. We’d be happy to help you figure it out.