Dirk Cuypers, the top official at Belgium’s health ministry, is sick of sick leave. Belgians, like many Europeans, are entitled to extensive or even unlimited sick leave—and they tend to stretch the definition of the word. One study showed government employees in droves were calling in sick to pack before vacations and to sleep off holiday hangovers.
Some government departments were averaging 35 days of paid sick leave per employee each year, more than twice the national rate and seven times the U.S. average.
Dr. Cuypers and the minister for civil service set up a network of doctor-inspectors around the nation to smoke out malingerers. . .. Once, says Dr. Quoidbach, he discovered that a man taking time off was really working a black-market job, given away by the paint on his hands. Another man answered his door with an undone belt as a woman hurried out the door. Others, faking backs, go to the door too fast.

1. Prosecute the cheaters. They are causing Belgian companies to be inefficient, thereby increasing costs.
2. Push for national legislation aimed at reducing the number of sick days that people are allowed to take.
3. There is nothing you can do because people just find other ways to cheat.
4. Continue the doctor-inspectors, and do not pay people found to be lying about being sick.
5. Invent other options.