The impact of long-term sick employees on SMEs

Long-term illness among employees places a heavy burden on entrepreneurs, especially in small and medium-sized enterprises (SMEs). One in four companies is currently dealing with a long-term sick employee, which can lead to serious financial and personal problems. This is evident from research conducted by the RTL News Panel and De Ondernemer among more than 3,000 entrepreneurs.

Alex van Westrenen
April 17, 2026
2 min read

The impact of long-term illness on small businesses

More than half of entrepreneurs have faced long-term absenteeism due to illness in the past five years. In a quarter of companies, at least one employee is currently on sick leave for more than six weeks. The impact is particularly significant for micro and small SMEs.

  • 91% of the smallest companies experience a major impact when an employee is long-term sick

  • For larger SMEs, this figure is 67%

Guidance, reintegration, and contact with occupational health services and the UWV require a great deal of time and effort. Entrepreneurs cite high costs, loss of productivity, and regulatory pressure as key challenges.

Personal and business toll on entrepreneurs

Long-term illness has not only a business impact but also a significant personal impact on entrepreneurs. Eight out of ten entrepreneurs report stress, overtime, and emotional strain.

Entrepreneurs often feel morally obligated to do more than what is legally required, even if it harms their business. This is especially challenging for smaller companies, where personal relationships play a role.

Challenges with sickness absence legislation in the Netherlands

Nearly all SME entrepreneurs consider the current laws and regulations regarding long-term illness to be unfair and burdensome. The mandatory continuation of wage payments for two years is seen by many as a major financial risk.

  • 90% consider the legislation unfair

  • 88% experience it as burdensome

Entrepreneurs advocate for a revision of the system, such as shortening the wage continuation period or introducing a collective risk-sharing mechanism. The current system is seen as more suited to large companies and insufficiently considers the vulnerable position of small SMEs.

Conclusion

Long-term sick employees represent a significant challenge for SMEs. The costs associated with long-term illness and absenteeism call for solutions that reduce the impact on businesses. It is essential that Dutch legislation better aligns with the needs of smaller companies, so that risks are distributed more fairly and the well-being of employees can be better safeguarded.

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