Work

Retroactive sick leave, greater protection for workers

Now, the first day of absence coincides with the start of the waiting period. Previously, doctors would often backdate the start, but INPS would correct this

by Giuseppe Maccarone and Mauro Pizzin

17 September 2026

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3' min read

Translated by AI

Versione italiana

3' min read

Translated by AI

Versione italiana

The INPS’s decision to backdate the sick noteto the previous day, subject to certain conditions, in reality simply confirms a practice followed by many doctors. In fact, it is common for workers to receive a certificate on which the doctor has also completed the section stating ‘declares to have been unwell since…’.

INPS checks

This is a modus operandi that, for a long time, had no particular impact, as the certificates were probably subject to less thorough checks. Since the INPS has improved the quality and quantity of checks on electronic certificates – cross-referencing them with the attendance records compiled by the employer and submitted via the Uniemens system – the number of notifications rejecting the sick day preceding the certificate’s issue date has risen. With this correction, the institution effectively amended the start date of the sick leave, bringing it forward by one day.

The result was that the period of absence (the first three days of which were paid in full by the employer) was shifted forwards, effectively ‘eating into’ the first day whilst still retaining its full duration.

Consider a case of illness with a certificate issued on Tuesday 25 August, with a prognosis until 27 August. The doctor had completed the section ‘the employee declares that they have been unwell since…’, entering 24 August (i.e. Monday). The consultation took place at the outpatient clinic.

The company regarded the 24th, 25th and 26th as a waiting period and the fourth day (27 August) as sick leave covered by INPS (provided, of course, that the conditions were met). When the social security body examined the electronic certificate, verifying that it concerned a outpatient appointment, it did not recognise the first day of sickness, and therefore the entire period of illness became a waiting period to be borne by the employer.

The compensation relating to the fourth day, which had initially been paid to the employee and borne by INPS, was to be recovered and repaid to the institution through the adjustment of contributions, given that, amongst other things, a specific code for the Uniemens (E775) that had enabled the payment; the repeal – according to INPS – was necessary to prevent companies from simply returning the sum without making any other changes. All this could only have been avoided if the visit had been carried out at the employee’s home.

Il certificato di malattia ora si può retrodatare

News and updates

With effect from 4 September, in a situation similar to that in the example, regardless of the type of visit (outpatient or home visit), the day preceding the date of issue of the certificate is considered sick leave. However, it is confirmed that retroactive application is not possible when the preceding day is a midweek public holiday, a Saturday or a Sunday.

The rules on certification also apply in the event of continuation of illness. A few years ago, INPS, in a notice issued to doctors, stated that ‘a worker whose first medical certificate expires on a Friday must, if they have not recovered, contact their GP on that same Friday or, in the GP’s absence, the out-of-hours medical service (on-call doctor, ed.) who will issue a certificate covering Saturday and Sunday. The certificate issued at the surgery by the attending doctor on the following Monday cannot cover either Saturday or Sunday’. It is understood that this situation has not been altered by the social security institution’s current decision.