How many days of medical certificate before INSS takes over? The 15-day rule explained
For employees with a signed work card (carteira assinada), the employer pays the first 15 consecutive days of absence. From day 16, payment may pass to INSS, if the benefit is requested and granted.
To work out how many days of medical certificate (atestado) you need before INSS (Instituto Nacional do Seguro Social, Brazil's social security institute) takes over, start with art. 59 of Lei 8.213/1991 (the Social Security Benefits Act): the auxílio por incapacidade temporária (temporary incapacity benefit, formerly auxílio-doença) requires incapacity for more than 15 consecutive days, on top of the other requirements. For the segurado empregado (insured employee), the employer pays the salary for the first 15 consecutive days of absence, and the benefit, if granted, is due from day 16 (art. 60, caput and §3). Those days do not have to be on a single certificate. Other categories follow a different rule, and the decision always rests with INSS.
Who pays each period
How many days of certificate before INSS: the rule by category
Does a 15-day certificate go to INSS? No: the absence has to exceed 15 days. Who pays for the start of the absence depends on the category.
- Employee with a signed work card, under the CLT (Brazil's labour code), except domestic workers: the employer pays the first 15 consecutive days; the benefit is due from day 16.
- Domestic employee, contribuinte individual (self-employed contributor, including the MEI, the individual microentrepreneur), voluntary contributor (facultativo), casual worker (trabalhador avulso) and segurado especial (special insured, such as small rural producers): there are no 15 days paid by an employer; once the absence exceeds 15 days, the benefit is due from the start of the incapacity.
- Unemployed person in the grace period: keeps the qualidade de segurado (insured status) under art. 15 of Lei 8.213 and follows the rule for the other categories.
A 10-day certificate followed by an 8-day one, with no return to work in between, adds up to 18 consecutive days. A 20-day certificate, however, does not guarantee the benefit: INSS still assesses incapacity, carência (minimum contribution period) and insured status.
Lei 8.213/1991, arts. 15, 59 and 60, caput and §3 and Decreto 3.048/1999 (Social Security Regulation), art. 72, I and II, and art. 75. Accessed 17 September 2026.
Do not miss it
How to apply to INSS with a certificate of 30 days or more
You apply through Meu INSS (the INSS app and website) or by calling 135. The request date matters.
Under Lei 8.213/1991 (art. 60, §1) and Decreto 3.048/1999 (art. 72, III), when the request is made after day 30 of the absence, the benefit is due from the date the request is filed. The right is not lost; the start date changes. Someone who applies on day 45 is not paid for the period from day 16 until the request.
- Log in to Meu INSS with your CPF (taxpayer number) and gov.br password.
- Under "Do que você precisa?" (What do you need?), type "Benefício por incapacidade" (incapacity benefit).
- Choose "Pedir Novo Benefício" (Request a new benefit) and follow the steps, attaching the medical document.
- Without internet access, call 135, Monday to Saturday, 7 am to 10 pm (Brasília time).
gov.br — Request the benefit, Lei 8.213/1991, art. 60, §1 and Decreto 3.048/1999, art. 72, III.
Repeated absences
Absences for the same illness within 60 days: when they count together
Not every certificate within 60 days adds up. Decreto 3.048/1999 sets out three situations, all for the same cause of incapacity.
- Employee off for 15 days who returns on day 16 and is off again for the same cause within 60 days of returning: the benefit is due from the new absence, with no new 15 days paid by the employer (art. 75, §4).
- Same situation, but returning before the 15 days are complete: the absences are counted together, and the benefit is due from the day after the 15 days are reached (art. 75, §5).
- New benefit for the same cause within 60 days of the previous one ending: the previous benefit is extended, minus the days worked, and the employer does not pay a new 15 days (art. 75, §3).
These rules concern the employer's obligation towards the employee. Different causes, or a gap of more than 60 days, fall outside the count, and INSS checks whether the cause is the same, so the illness or the CID (ICD code) on the document matters.
Contributions and calculation
INSS sick leave: requirements, amount and duration
Having more than 15 days of certificate is not enough. INSS checks insured status, carência and incapacity.
- Carência: as a general rule, 12 monthly contributions (art. 25, I).
- No carência required: accidents of any kind, occupational or work-related illness, and illnesses such as malignant neoplasm, severe heart disease, active tuberculosis or multiple sclerosis, when they arise after joining the system (arts. 26, II, and 151). The segurado especial proves rural activity instead (art. 26, III).
- Anyone who lost insured status and started contributing again: needs half the carência, 6 contributions, counted from the new affiliation (art. 27-A).
- Illness that predates affiliation: does not give rise to the benefit, unless it worsens (art. 59, §1).
- Amount: 91% of the salário de benefício (benefit calculation base; art. 61), which is an average of the salários de contribuição (contribution salaries; EC 103/2019, art. 26), not the last salary. The result cannot exceed the average of the last 12 contribution salaries (art. 29, §10) and stays between the minimum wage and the INSS ceiling (art. 33).
- Duration: whenever possible, the grant sets an estimated period. Only when no period is set does the benefit end after 120 days, and an extension can still be requested (art. 60, §§8 and 9).
Lei 8.213/1991, arts. 25, 26, 27-A, 29 §10, 33, 59 §1, 60 §§8 and 9, 61 and 151.
Atestmed and medical assessment
Atestmed and the medical document: what applies today
Assessment based on documents alone, without an in-person medical examination (perícia), has limits that depend on the law and the normative acts in force.
Lei 8.213/1991 limits a benefit granted by document analysis alone (Atestmed, the INSS document-based route) to 30 days (art. 60, §11-F, added by Lei 15.265/2025) and allows exceptions by act of the Executive, for a fixed period (§11-I). Portaria Conjunta MPS/INSS 14/2026 (a joint ordinance of the Ministry of Social Security and INSS), published on 24 March 2026, raised the limit to 90 days in total, on a transitional basis, for 180 days, that is, until around 20 September 2026. After that, whatever act is in force applies: check Meu INSS on the date you apply. Above the limit, there is a medical examination in person or by telemedicine (§11-G).
For document analysis, gov.br asks for the patient's full name, date of issue, estimated rest period, the professional's signature and stamp with CRM (regional medical council), CRO (dental council) or RMS registration, and information on the illness or the CID. The signature may be electronic; the page does not require ICP-Brasil (Brazil's public-key infrastructure for digital signatures).
Issuance through telemedicine, on the other hand, follows CFM (Federal Council of Medicine) Resolution 2.314/2022 (art. 13): a doctor identified by CRM number and address, the patient's details, date, time, an indication that it was telemedicine, and a digital signature to the ICP-Brasil standard or another legally accepted standard. At Global Health, the online medical certificate is issued after the online GP consultation, with the rest period set by the doctor after assessing you. See how it differs from an attendance certificate.
gov.br — required documents, Lei 8.213/1991, art. 60, §§11-F, 11-G and 11-I, Portaria Conjunta MPS/INSS 14/2026 (via LegisWeb) and CFM Resolution 2.314/2022, art. 13.
Global Health Brazil
Next steps
The doctor assesses and documents the incapacity. Granting the benefit is a decision for INSS.
- Online medical certificate
- Online GP consultation
- Online medical certificate: validity and rules
- Doctors in Brazil
- Contact Global Health
Need a medical assessment with a valid document?
A consultation with a CRM-registered doctor and, if there is incapacity, a certificate with a rest period and an ICP-Brasil digital signature.
Official sources
Sources for this guide
Federal legislation, the gov.br portal, the joint MPS/INSS act and the Federal Council of Medicine, consulted on 17 September 2026.
The limits on document analysis depend on the law and on ordinances with a set period of validity. Check the rule in force on Meu INSS before you apply.
Frequently asked questions
Questions about medical certificates and INSS
Does a 14-day certificate go to INSS?
Not on its own. If another certificate continues the absence with no return to work, the days count together; a new absence for the same cause within 60 days may count, under the conditions of art. 75 of Decreto 3.048/1999.
I applied after day 30. Have I lost my entitlement?
No. The benefit becomes due from the date of the request (Lei 8.213, art. 60, §1). Only the days before the request are left out.
Is a certificate from an online consultation accepted by INSS?
It can be submitted if it contains the details gov.br asks for. The ICP-Brasil signature (or another accepted standard) is a CFM rule for issuing documents through telemedicine, not an item on the INSS list. The decision on the benefit always rests with INSS.
