A medical waiver needs an assessment
A serious illness or disability may qualify you for a medical ontheffing. You must be required to integrate under Wet inburgering 2013 (Civic Integration Act 2013) or Wet inburgering 2021 (Civic Integration Act 2021). DUO (External site, opens in a new tab) decides after an Argonaut medical assessment. Applying costs €225 in 2026, refunded if DUO grants the waiver. DUO refuses the waiver if Argonaut says you can integrate within 5 years.
The three medical routes
The three routes change different things: your exam conditions, your inburgeringstermijn (integration deadline) or your integration obligation. An adapted exam gives you different conditions during the exam. Extra time for your deadline gives you longer to finish integration.
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| Your situation | Route | What changes |
|---|---|---|
| You can take an exam with different conditions. | Aangepast examen (adapted exam) | More exam time, larger letters or another format, depending on the exam and medical advice. |
| Illness delayed your studies, but you can continue. | Extra time for integration | DUO may extend your deadline if you meet all the illness conditions. |
| A serious illness or disability prevents you from integrating. | Medical ontheffing | DUO may remove the whole obligation. Only the 2021 law also allows a waiver for part of the obligation. |
Adapted exams for illness or disability
An adapted exam is for you if you can take an exam with changes to the standard conditions. Examples include larger letters or more exam time. The request differs between A2 exams and B1 or B2 exams.
A2 language exams and knowledge exams
For A2 language exams and knowledge exams, start with DUO’s adapted-exam request (External site, opens in a new tab). The Argonaut assessment for this request is free. Follow these steps:
- Request advice in Mijn Inburgering (My Integration portal). Choose Aanvraag advies aangepast examen (application for adapted-exam advice).
- Attend the Argonaut medical assessment. The doctor sends advice to DUO.
- Wait for DUO’s decision letter. If DUO approves your request, the letter explains the adaptations.
- Register with Aanmelding inburgeringsexamen (civic integration exam registration form). Adapted-exam registration uses this paper form rather than the online booking system.
If you cannot log in, use Aanvraag advies voor een aangepast examen bij ziekte of beperking (application for adapted-exam advice for illness or disability). DUO links the paper form on its adapted-exam page. For login help, see our DigiD (Dutch digital identity) setup and recovery guide.
For general booking instructions, see A2 exam registration in Mijn Inburgering.
Staatsexamen NT2 (Dutch as a Second Language state exam) at B1 or B2
The Staatsexamen NT2 adapted-exam procedure (External site, opens in a new tab) requires a medical specialist’s statement. Follow these steps:
- Select persoonlijke omstandigheden (personal circumstances) when you register.
- Discuss the adaptations and supporting document with DUO when it contacts you.
- Send the document DUO requests.
An adapted NT2 exam may take place on another date or at another location. All NT2 exam locations are wheelchair accessible. If wheelchair access is your only requirement, you can use the standard exam registration.
Extra time for your integration deadline
DUO may extend your deadline if your illness prevented you from finishing on time. You may also apply if caring for an ill family member caused the delay. DUO accepts the following relatives: your partner, child, stepchild, child-in-law, parent or parent-in-law.
You may apply only when all four conditions on DUO’s illness-extension page (External site, opens in a new tab) apply:
- The illness lasted longer than 3 months.
- The sick person received treatment from a doctor.
- The illness prevented you from finishing integration on time.
- Your integration period started at least 2.5 years ago.
DUO allows one extension for the same period. If you already received extra time for that period, you cannot apply again for it.
For example, if your illness lasted 4 months but your integration period started 2 years ago, you cannot yet use this application. You must meet the 2.5-year condition as well.
Use DUO’s form for your own illness or its form for a family member’s illness. The form requires a copy of the medical file. If the sick person used medication for the illness, also include a medication list stamped by the pharmacy. A letter from a medical specialist is optional.
Send medical documents through SecureTransfer (secure file-transfer service), using the instructions on the form. Keep your originals. DUO asks for copies and does not accept USB sticks, other storage devices or original medical files by post.
If you cannot get the evidence, DUO can request it with authorisation. Send Machtiging voor opvragen gezondheidsgegevens (authorisation to request health records) with the application. The sick person must sign this form. If the sick person is under 16, a parent or legal representative must also sign. This can add up to 3 months. DUO states an 8-week decision period when you send the evidence yourself.
Medical ontheffing for a lasting illness or disability
A medical ontheffing is for a serious illness or disability that prevents you from integrating. Psychological conditions can also qualify. You can apply only if you are inburgeringsplichtig (required to integrate) under the 2013 or 2021 law. If you are unsure, check your DUO letter or Mijn Inburgering, or read who must integrate in the Netherlands.
DUO decides after medical advice. Follow these steps to apply:
- Submit your request in Mijn Inburgering under Digitale formulieren (digital forms). Choose Aanvraag ontheffing bij ziekte (waiver application for illness).
- Pay DUO’s €225 invoice. You cannot pay this fee with a DUO integration loan.
- Attend the Argonaut assessment after payment. Take your medical documents to the Argonaut doctor. The doctor sends advice to DUO.
- Wait for DUO’s decision on your waiver. DUO refunds the €225 if it grants the waiver.
If you cannot log in, use Aanvraag ontheffing van de inburgeringsplicht om medische of psychische redenen (application for a waiver on medical or psychological grounds). DUO links the form on its medical-waiver page. Keep medical documents for Argonaut; send the initial application to DUO without them.
The form also offers payment in 3 monthly instalments of €75 in 2026. DUO processes the application after receiving the full €225.
If your illness is temporary, DUO directs you to the free extra-time route.
If you can take an exam with adaptations, compare that route before paying for a medical-waiver application.
Under the 2013 law, a medical ontheffing removes the whole integration obligation, including Oriëntatie op de Nederlandse Arbeidsmarkt (ONA, Dutch Labour Market Orientation). DUO may instead allow adapted exam conditions on the doctor’s advice. The €225 medical-waiver application under this law cannot remove ONA alone. Under the 2021 law, ONA is not required.
Ask your doctor which documents show how your condition affects study or exams.
For naturalisation or a stronger residence permit, check the rules with IND (Immigratie- en Naturalisatiedienst, the Dutch immigration service). Use IND’s naturalisation guidance (External site, opens in a new tab) or integration guidance for a stronger residence permit (External site, opens in a new tab).
ONA exemption for full inability to work
An ONA-only exemption is a separate route. You may qualify if you are volledig arbeidsongeschikt (fully unable to work). You need a beschikking (decision) from UWV (Uitvoeringsinstituut Werknemersverzekeringen, the employee insurance agency) that confirms this.
Use DUO’s form Aanvraag vrijstelling Oriëntatie op de Nederlandse Arbeidsmarkt. Include a copy of the UWV decision. Our ONA exemption guide explains this route.
The route to check before you apply
If you can take the exam with different conditions, request an adapted exam before booking. If illness delayed your studies, check all four extra-time conditions. For a lasting condition, check your law and the five-year assessment before paying €225. If full inability to work affects only ONA, use the separate ONA exemption route.
Official Sources
- DUO Inburgeren - Niet inburgeren vanwege ziekte of beperking (External site, opens in a new tab) - Eligibility, the €225 medical-waiver fee in 2026, the five-year assessment, application steps and refund on approval.
- DUO Inburgeren - Aangepast examen bij ziekte of beperking (External site, opens in a new tab) - A2 language and knowledge exam adaptations, medical assessment and registration with the paper form.
- DUO Inburgeren - Extra tijd vanwege ziekte (External site, opens in a new tab) - Eligible family members, all four illness-extension conditions, evidence, repeat-application restriction and processing times.
- DUO Inburgeren - Minder of geen examens doen (External site, opens in a new tab) - Fewer or no exams under the 2013 and 2021 laws; serious illness appears only under no exams for the 2013 law.
- Staatsexamens NT2 - Aangepast examen doen (External site, opens in a new tab) - B1 and B2 adaptations, supporting documents, possible changes of date or location and wheelchair access.
- Staatsexamens NT2 - Extra tijd bij aangepast examen (External site, opens in a new tab) - Extra time during adapted NT2 listening, speaking, reading and writing exams, rather than an extended integration deadline.
- DUO Inburgeren - Vrijstelling ONA (External site, opens in a new tab) - Separate ONA exemptions for full inability to work or full early retirement, and the application form.
- DUO Inburgeren - Aanvraag vrijstelling Oriëntatie op de Nederlandse Arbeidsmarkt (External site, opens in a new tab) - ONA exemption form: a copy of the UWV decision is required for full inability to work.
- Wet inburgering 2013, article 6 (External site, opens in a new tab) - Legal text: a medical ontheffing releases you from the whole integration obligation; the effort-based ontheffing covers separate exam parts.
- Besluit inburgering, article 2.8 (External site, opens in a new tab) - Legal text: DUO decides on the medical ontheffing after a doctor's advice, and may instead set adapted exam conditions.
- DUO: medical or psychological waiver application form (External site, opens in a new tab) - Application without medical evidence attached; payment in three monthly instalments of €75 in 2026; refunds for full or partial waivers or an approved adapted exam.
- DUO: adapted-exam advice application form (External site, opens in a new tab) - Paper alternative, larger-screen and larger-print examples, and the free Argonaut assessment for an adapted-exam request.
- DUO: illness extension application form for yourself (External site, opens in a new tab) - Required medical file and stamped medication list where applicable; optional specialist letter; SecureTransfer instructions.
- DUO: illness extension application form for a family member (External site, opens in a new tab) - Eligible relatives, medical evidence and the authorisation needed for DUO to request a relative’s records.
- Wet inburgering 2021, articles 5 and 54 (External site, opens in a new tab) - Full or partial medical waiver under the 2021 law; the previous law continues to apply to the earlier cohort.
- DUO: knowledge exams under the 2013 and 2021 laws (External site, opens in a new tab) - ONA is not required under Wet inburgering 2021.
- DUO: authorisation to request health records (External site, opens in a new tab) - Health-record authorisation, an additional parent or representative signature for a sick person under 16, and up to 3 extra months of processing.
- IND: integration for naturalisation (External site, opens in a new tab) - Separate integration requirements and medical-waiver evidence for a naturalisation application.
- IND: integration for a stronger residence permit (External site, opens in a new tab) - Separate integration requirements and medical-waiver evidence for a stronger residence-permit application.