Work and study
The largest recovery from the effects of a stroke occurs within 3-6 months. Further recovery may occur up to about 2 years after the stroke.
After 3 months of absence from work, the chance of returning to work slowly decreases. If you still have severe physical or mental disabilities after 3-6 months, it is important to discuss targeted rehabilitation with your medical team.
It is also important that rehabilitation is aimed at improving the skills needed for your own work.
Denkhulp (information tool)
The Denkhulp Werk en Chronisch ziek (information tool on work and chronically illness, in Dutch) gives useful information about your rights and obligations. It also provides possible choices for people with a chronic disorder, who are employed and are on long-term sick leave. The Denkhulp (information tool) also provides insight into the effects that different scenarios may have on your income.
- The Wet Poortwachter (gatekeeper improvement act) applies. More information on the website of the UWV (Employee Insurance Agency)(in Dutch).
- In principle you have 2 years to reintegrate. After 1 year, it often has already switched to reintegration into other work (at one's own work or with another employer).
- Your employer is obliged to continue to pay the salary for 2 years.
- Your employer is obliged to make an effort to have you reintegrate into suitable work for 2 years.
- You are obliged to cooperate fully.
- Things that influence the chance of successful reintegration into work are: cooperation and support from the work environment (manager and colleagues), and possibilities and willingness to adapt the work if necessary.
- Keep as much contact as possible with your work from the start.
- In principle you have 2 years to reintegrate. After 1 year, it often has already switched to reintegration into other work (at one's own work or with another employer). The chances of successful reintegration into your own workplace will already be greatly reduced at that point. After 2 years, the UWV (Employee Insurance Agency) will carry out an inspection to assess the ability to work and the entitlement to benefits (WIA). In principle, the Poortwachter program will then end and the employer's obligations will also end.
- Make the best use of the possibilities, 2 years seems a long time, but is also goes by quickly. Do not waste any time.
- The chance of receiving a full, permanent disability benefit is small. The WIA is a kind of insurance with insurance conditions, like most others. The UWV’s (Employee Insurance Agency) assessment is not about the severity of your condition, but about the extent to which you are still able to earn your own income according to the insurance terms and conditions. If, theoretically, you can still earn income (in full or partially) in suitable work and it has not been possible to start working in the first 2 years, you will not receive disability benefit for work for that part, but a (temporary) unemployment benefit.
Permanent or temporary employmentIf you have a temporary contract (“fixed term”), it is possible that the contract may end while you are still sick.
If you have a temporary employment contract and you have not yet been able to resume all or part of the work at the time that your employment contract ends, the employer's obligations end at that moment and you “have departed your post due to illness” as it is called. Your reintegration file will then be transferred to the UWV (Employee Insurance Agency) and from that moment on the Sickness Benefits Act will apply, you will receive a sickness benefit from the UWV (Employee Insurance Agency), and the UWV will be responsible for supervising your reintegration.
Not yet back to work
Your focus is probably not on work during the initial period after the stroke. On the other hand, you may soon be worried about what to do with work and income.
In this phase there is still great uncertainty about how the recovery will proceed and whether you will completely return to your old self. As long as you are not able to work (fully), you are entitled to continued payment of your wages. This applies at least for the first 2 years.
If possible, it is important to maintain contact with your employer and colleagues. For example, if you can, stop by every now and then for a cup of coffee and a chat. That will make it much easier to start again later. Whether, and when, you can progressively return to work depends on the mental and physical consequences of the stroke. However, it also relies on the nature of your work and the possibilities for adapting your work.
Your employer is obliged to call in a company doctor in order to map this out with you and to advise you on the approach to reintegration. The company doctor must do this within 6 weeks of you becoming ill. They will then create a “problem analysis”. For you and your employer, this problem analysis is the basis for drawing up a plan of action for the return to work. Of course, you may still not able to go to work after 6 weeks. This will then be the conclusion of the company doctor and will be the recommendation to you and your employer.
One year of illness
After a year of illness, you and your employer must conduct the first-year evaluation. You will receive a letter from the UWV (Employee Insurance Agency) with information about this.
The evaluation focuses on the approach to further reintegration in the second year of illness. Your company doctor will draw up an employability profile or functional possibilities list (FML) for this purpose. Is it possible to achieve a complete return to work? If not, an employment expert must be called in to use the FML to investigate which work is suitable and whether your own employer has suitable work for you. If this is not the case, the employer must accompany you to suitable work with another employer. The employer often hires a reintegration agency for this purpose.
Two years of illnessIf you have still not fully returned to work after 2 years, your employer's obligation to continue payment of wages will cease. You can then apply for disability benefit (WIA) from the UWV (Employee Insurance Agency). You have to do this three months before having been sick for two years.
If the temporary employment agency/payroll company is responsible as a risk bearer and for the rights and obligations of the wet Verbeterde Poortwachter (gatekeeper improvement act), then everything is the same as when you are employed by an employer.
If this is not the case, the vangnetbepaling (safety net provision) applies. You will then enter the Sickness Benefits Act and the UWV (Employee Insurance Agency) is responsible for the continued payment of your (average) salary and for your assistance in finding suitable employment. The situation is the same as if you were an employee with a temporary contract, after the contract has ended.
In this case, whether or not you have taken out disability insurance is important. Even if you are insured for work disability, the conditions in the insurance policy can be very different. Please consult the terms and conditions of your insurer.
Employed before the strokeIf you are unemployed following your time as an employee, you are entitled to unemployment benefits for a certain period. These benefits are generally WW-uitkering (unemployment benefits), paid by the UWV (Employee Insurance Agency). The duration of the right to WW benefits depends on your employment history. If you become ill while receiving unemployment benefits, it is important that you report your illness to the UWV. The Ziektewet (sickness benefits act) will apply and you will receive sickness benefits from the UWV. In that case, the rules of the Wet Poortwachter (gatekeeper improvement act) that are relevant when you work for an employer will largely apply as well. You would then be in the same situation as someone who becomes ill during a temporary contract and falls under the Sickness Benefits Act at the end of the contract (see salaried employee).
Not employed before the strokeIf you were not a salaried employee before the stroke, you are not entitled to unemployment benefits. It may turn out that you despite not being employed, you will not receive any unemployment benefits either. This is usually the case if the unemployment benefits (WW) have ended or because you were self-employed or studying before you became a job seeker. In that case you normally have the right to social welfare benefits. If you become ill while receiving social welfare benefits, there will be little or no change. You will continue to have the right to social welfare benefits. However, it is important that you report your illness to the municipality. You must be exempted from the obligation to search for jobs if this applies. If there are permanent health problems and limitations in this situation, the municipality is responsible for providing support in the search for suitable employment. The Participatiewet (participation act) then applies. This has only been the case since 2015 and many municipalities have little experience with it. This is mostly the case for smaller municipalities. If you want to be supported well, you must often insist on it yourself and demand the support to which you are entitled. For example, this can also be any form of education, training, or targeted rehabilitation, which is necessary in order to have a chance of finding suitable work again with the limitations.
Unfortunately, you can also suffer a stroke at a young age, while you are still studying. It is important to know that there are special facilities in regards to rehabilitation and counselling that you can use. Breinsupport (brain support, site is in Dutch) is an organization that knows everything about the rights you have to to study facilities and to adjust your studies. They offer specialized support to young people in an educational situation with a brain disorder.
If you have had a stroke, you may suffer from symptoms that limit your independence. It may then be easy to use aids for certain actions. Below are some websites that can help you find the right aids. You may also be eligible, via the municipality, for the purchase of aids or support in this regard. This is done via the WMO (Social Support Act) point of contact of your municipality. This can vary from one municipality to another.
- Regelhulp (care and support help): WMO (Social Support Act) (Dutch)
- Medipoint (Dutch)
- Thuisleefgids (home life guide, in Dutch)
- Hulpmiddelenwijzer (aids guide, in Dutch)
- Hulpmiddelen via Bol.com (aids on Bol.com)
- Hersenletseluitleg (brain injury explanation, in Dutch)
- In eigen hand (in our own hands, in Dutch): baby and toddler care for functional one-handed people
- Weerhandig: advice on aids, in Dutch.
Do you wonder what opportunities there are in the area for disability sports? Are you looking for
advice about looking for a buddy or, for example, aids? Unique Sporten helps with finding a suitable sport or exercise option. You can look in the sports locator yourself, but the coordinator for adapted sports can also provide you with personalized advice.
- Check out the website of Uniek Sporten (in Dutch) for more information, tips, and sports possibilities in your area.
- Meet me at the gym (in Dutch) offers a customized sports program for people with brain injury.
Fees: You pay the costs for practicing a sport yourself. There are no fees for this.
SexualityA stroke is a major event for you and your partner. It can have both physical and mental consequences. The consequences of a stroke depend on several factors, including the type of stroke (infarction or hemorrhage) and the location of the stroke.
After a stroke, a lot changes in your life. Your relationship and sex life may also change. Many people do not feel like having intimate contact and intercourse after a stroke as much as they did before the stroke.
Do you have questions about intimacy and sexuality after a stroke, but do you find it difficult to talk about it? This applies to many patients and their partners. After all, these are subjects that we regard as private and prefer to keep to ourselves. But it can help to discuss the changes in your sexual relationship with each other or to ask for help from a doctor or other specialist.
This brochure offers support in this respect (in Dutch).
Life insurance for the chronically ill
Read more information about this:
- Choice of advice (in Dutch)
- ICZ (in Dutch)
Childcare with socio-medical care assessmentWhen people suffer a stroke at a young age, there often is a young family too. Due to the consequences of a cerebral infarction or hemorrhage, this can lead to problems because of the limited strength (fatigue), sensitivity to irritation, and problems with dual-tasking. Sometimes a person can no longer work after a stroke and the partner starts working full time to avoid financial problems.
This can lead to problems in the care of your children. You may then be eligible for a contribution towards the costs of childcare. Unfortunately, this is not known to everyone. For more information, please contact your municipality. Read more information here:
- VNG (in Dutch).