Online disability declaration form
Use this form to send us your disability declaration digitally.
You can complete your disability declaration online using the form below.
Complete the form and attach your certificate of disability. You must first have this certificate completed by your doctor (as an employee or as a self-employed person ). Then you scan it or take a photo of it. Finally, you add the declaration as an attachment to this form.
Submit the declaration within 7 calendar days after the start of your disability, or before the end of your period of guaranteed wages . This way you avoid a reduction in your benefit or a sanction.
You do not have to provide us with the certificate intended for your employer.
Important: here you can only submit your disability declaration, not the benefits information sheet. You can complete the information sheet here .
