How Sick Leave Works in Spain — What Expats and Tourists Need to Know
Spain's sick leave system has two distinct tracks. Understanding the difference helps you know what this service can and cannot provide.
Public system sick leave (Incapacidad Temporal — IT)
Official sick leave certification in Spain's public system is issued by a doctor contracted with the SNS. It is automatically communicated to Social Security and the employer. Workers may be entitled to economic benefit from INSS from day four of sick leave. Access requires registration with a public GP — which many expats and international residents do not have.
Global Health does not issue public system IT certificates. These require a doctor contracted with the Spanish public health system.
Private medical certificate
A private medical certificate issued by an OMC-registered doctor is a clinical document that certifies the patient was assessed and presents a health condition incompatible with work activity on the date of consultation. This certificate:
- Is issued exclusively at the doctor's clinical discretion following full assessment
- Is accepted by most Spanish employers to justify short-term absences
- Is particularly useful for self-employed workers and freelancers
- Can serve as clinical documentation if you later pursue formal IT certification through the public system
- Is legally valid as a clinical document issued by a registered physician
Who This Service Is For
Employees without a registered Spanish GP
You are ill and need documentation for your employer today — but you are not registered with a public GP. Most employers accept private medical certificates for short-term absences, particularly when you have not yet been able to get a public system appointment.
Expats and international residents
You are registered in Spain but either have not yet been assigned a public GP or cannot get an appointment quickly enough. Your employer requires documentation and you need it today.
Self-employed workers and freelancers
As a self-employed worker in Spain, your sick leave pathway differs from employed workers. A private medical certificate documents your health situation and can support claims through your mutua colaboradora. Your doctor advises on the appropriate pathway for your specific situation.
Tourists and short-stay visitors
You have fallen ill during your visit to Spain and need clinical documentation — for your employer at home, your travel insurance, or other purposes. Our doctors assess your symptoms and issue a medical certificate where clinically justified.
What Your Consultation Includes
Full clinical assessment
Your doctor takes a complete history of your symptoms — onset, duration, severity, associated symptoms, relevant medical history, current medications, and the nature of your work activity. The assessment is clinical and structured — not an administrative formality.
Assessment of incapacity for work
Your doctor assesses whether your clinical presentation is compatible or incompatible with your work activity, what type of documentation is clinically appropriate for your situation, and whether you should pursue formal IT certification through the public system or your mutua.
Private medical certificate — at the doctor's clinical discretion
If your doctor determines that your clinical situation justifies issuing a certificate of temporary incapacity for work, this is issued the same day. The certificate documents the date of assessment, symptoms, clinical assessment, and incompatibility with work activity — without specifying diagnosis if you prefer this for privacy reasons.
Additional clinical documentation — at the doctor's discretion
If your illness requires treatment — including management of infections where clinically indicated — your doctor issues the appropriate clinical documentation the same day.
Guidance on the public system pathway
If your clinical situation suggests you need formal IT certification through the public system or your mutua, your doctor advises clearly on the steps to take.
What This Service Cannot Do
Transparency is part of clinical quality. Some things this service cannot provide:
- We do not issue public system IT certificates — these require a doctor contracted with the Spanish public health system
- We do not issue documentation without clinical assessment — the medical certificate is issued exclusively at the doctor's discretion following full assessment of your symptoms
- We do not issue retroactive certificates — our doctors cannot clinically certify a period of illness they did not assess at the time
- We do not guarantee the certificate — the decision is exclusively clinical, based on the medical assessment
