Sick leave and the medical certificate in Italy

When ill and unable to work call your employer the same day, before work begins if possible, in the agreed way, and say you are ill and an estimated date of return, without stating your diagnosis.

• Then ask for an urgent appointment with the family doctor, who examines you and issues the medical certificate (certificato di malattia) electronically with the set duration of absence, which arrives directly at INPS and the employer, and you do not need to hand over paper (you are given a copy with a protocol number).
• If you cannot go the doctor can visit you or write after a call.
• Give the employer the protocol number if requested.
• And on extension the doctor issues a continuation certificate (continuazione).

For the first three days (carenza) INPS often does not pay, and many collective agreements oblige the employer to compensate it. From the fourth to the twentieth day INPS pays about 50 per cent of the average daily wage, and from the twenty-first day about 66.66 per cent, and the employer often tops up according to the CCNL up to 100 per cent or less.

• For workers in commercial and industrial companies the employer pays directly on behalf of INPS then deducts from contributions, while for some categories (such as seasonal workers and agriculture and tourism on temporary contracts) INPS pays directly.
• Check your contract and agreement.
• And prior contributions are required (about 30 working days in 12 months for some categories).
• And compensation appears on the payslip (busta paga).

You must be present at your residence address reported to the doctor during leave in the fasce di reperibilità to receive an inspection visit (visita fiscale) from INPS: in the private sector from ten to twelve and from four to seven in the evening every day including holidays, and in the public sector from nine to thirteen and from fifteen to eighteen.

• There are exceptions for cases such as serious illness, accidents or disability.
• If you must go out for a medical exam or serious circumstance inform INPS and the company.
• Absence from the inspection without justification leads to deduction from compensation or disciplinary sanctions.
• And if your temporary residence is another address tell the doctor to include it in the certificate.

The CCNL sets the protection period (periodo di comporto) during which you may not be dismissed because of illness, often between six and eighteen months depending on category, with the possibility of extra unpaid leave (aspettativa).

• If you exceed the period the company may end the contract with notice.
• During leave your contract remains and days count towards contributions.
• On return a visit to the company doctor (medico competente) may be requested to assess fitness, and you have the right to adjust your tasks when there are health restrictions.
• And keep all your certificates.
• For chronic or serious illnesses some days may be excluded from the count (giorni di ricovero).
• And in disability there are legal facilitations for work.
• And keep a friendly contact with the employer.

For mothers there is compulsory maternity leave (congedo di maternità) of five months at about 80 per cent pay from INPS (two months before birth and three after or flexibility or one month before and four after), and for a parent paternity leave, and optional parental leave (congedo parentale).

• Dismissal of a pregnant woman is forbidden until the child reaches one year.
• For the self-employed and those without a contract, if you are self-employed (partita IVA) you may not be entitled to sickness benefits except under conditions, and many workers without a contract get nothing, so ask for your contract to be registered.
• For work without a contract report to the labour inspectorate (Ispettorato del Lavoro) or the union (CGIL, CISL and UIL) or a patronato free of charge.
• And do not hide your illness for fear of dismissal.

Who sends the certificate to INPS?