Growing number of long covid patients declared unfit for work
The number of people in the Netherlands declared partially or fully unfit for work due to long Covid has risen sharply in recent years. According to figures from the Employee Insurance Agency (UWV), more than 12,000 people have been granted a WIA disability benefit after being ill for more than two years. That figure stood at just 3,000 two years ago.
Patient organizations warn that the real number is much higher. PostCovid NL estimates that 90,000 people in the Netherlands suffer from severe long Covid symptoms. Many of them are struggling to return to work but do not qualify for disability benefits.
Suzanne van de Nes fell ill in July 2021, shortly after her daughter attended a "Dancing with Janssen" weekend, an event for young people who had received the Janssen Covid-19 vaccine. Van de Nes was severely ill for months, and it took years before she could return to work.
“My husband and I ran a practice helping people with muscle tension issues. The lockdowns cost us a lot of money, and because I never fully recovered, we had to close our business in March 2023,” she said.
Her condition improved gradually, allowing her to take up volunteer work and begin a career coaching program. Eventually, she secured a job as a social worker, working 24 hours a week. “It went well until late October, when I got sick again with Covid-like symptoms,” Van de Nes said. She is now working 15 to 18 hours per week as she reintegrates into the workforce.
Initially, doctors treated long Covid like burnout or chronic stress, advising patients to push their limits. “But we quickly realized that recovery worsened with that approach,” said Charlotte de Bruin, an occupational physician and internist-nephrologist at Arbo Unie in Nijmegen.
Experts now recommend a slow and gradual return to work. “It works in some cases,” said Iris Homeijer, medical director at HumanCapitalCare. “But unlike other illnesses, we cannot predict recovery timelines for long Covid. Patients may relapse unexpectedly.”
Homeijer has worked with about ten long Covid patients in recent years. “A few never returned to work. Those are tragic cases where people also struggle with daily life at home.”
Charlotte Nelck, a former deputy public prosecutor, fell ill in the summer of 2021. After years of trying to reintegrate, she was declared fully unfit for work and now receives a WIA benefit. As a volunteer with Long Covid Nederland, she focuses on employment issues for patients.
“Many long Covid sufferers don’t appear in the WIA statistics,” Nelck said. Some reduce their working hours without applying for benefits, while others retire early. “And not everyone qualifies for WIA. Self-employed workers without private disability insurance, for example, receive no support.”
Young people who contract long Covid before entering the workforce also face difficulties. They often do not qualify for WIA and must apply for the Wajong disability benefit. However, Wajong is only granted to individuals deemed permanently unable to work. “Insurance doctors hesitate to make that determination, leaving many young, sick people in serious financial trouble,” Nelck said.
The UWV acknowledges that the strict criteria create difficult situations and states it provides guidance to young people who do not qualify for Wajong benefits.
Reintegration outcomes often depend on the occupational physician assigned to a case, Nelck said. Some doctors are unfamiliar with post-exertional malaise (PEM), a worsening of symptoms due to physical or mental exertion. “Avoiding overexertion is critical. If an occupational physician lacks knowledge of PEM, they may give harmful advice,” she said.
Joost van Bekum, an occupational physician at Arbo Unie in Eindhoven, believes that knowledge gaps have narrowed over the years. “Initially, no one knew about PEM. Now, most occupational physicians are aware of it.” Still, long Covid remains a new disease. “We’re still learning,” Van Bekum added.
