You will only need to fill in this form if you have received a letter from us asking you to do so. The form only applies to people living abroad who are entitled to receive a sickness or WIA benefit (‘Ziektewet- of WIA-uitkering’). However, you will only need to fill it in if 1 of the following situations also applies to you:

• you have notified us of your illness and have requested a sickness benefit (‘Ziektewet-uitkering’)
• you have asked us to reassess your WIA-benefit (‘herbeoordeling WIA-uitkering’)

Let us know where you would like to have the medical examination by completing the form Preference for medical examination in your country of residence or in the Netherlands. You will need a DigiD account to do this.

• If you would prefer to have a medical examination in your country of residence, the benefits organisation in that country will contact you directly.
• If you would prefer to have a medical examination in the Netherlands, we will send you an invitation for an appointment as well as information about how to claim travel and accommodation costs.