Published in Spain's Official State Bulletin on July 18 and effective September 1, Royal Decree 625/2014 introduces significant changes to procedures relating to temporary incapacity, or sick leave, benefits during the first 365 days of a worker's incapacity. The Royal Decree is designed to prevent fraud, reduce bureaucratic procedures, and allow for more individualized monitoring of each worker on leave for temporary incapacity.

The most relevant changes include the elimination of the weekly confirmation of sick leave and adjustments to the monitoring of sick leave relative to the estimated duration of the particular condition that necessitates the leave. Various conditions related to sick leave are evaluated with tables designed to estimate the condition's duration (and that account for age and occupational factors), and those conditions receive appropriate monitoring schedules:

  • For a sick leave with an estimated duration of less than five calendar days, the doctor will issue a sick note and a fit-for-work note at the same time.
  • For a sick leave with an estimated duration of five to 30 calendar days, a review will be conducted seven days from the date the sick leave commenced. At that point, the doctor can confirm the sick leave, and a second review will take place during the following 14 calendar days.
  • For sick leave with an estimated duration of 31 to 60 calendar days, a review will be conducted seven days from the date the sick leave commenced. The doctor can confirm the sick leave, and a second review will take place during the following 28 calendar days.
  • For sick leave with an estimated duration of more than 61 calendar days, a review will be conducted within 14 days from the date the sick leave commenced. If the condition and sick leave are confirmed, a second review will take place within the following 35 calendar days.

The Royal Decree also introduces changes to the communication of sick leave and medical-discharge notes between the employee and the company. As of September 1, the worker is obliged to send these notes to the company within 24 hours of issue. In addition, a new obligation is imposed on the company with regard to sick notes and confirmation or fit-to-work notes, which now must be sent to the managing entity, the National Institute of Social Security ("INSS"), or the mutual insurance company, within three working days of receipt. 

The new regulation also supports the proposal of medical discharges formulated by the mutual insurance companies in common illness cases. When the mutual insurance company considers the worker fit to return to work according to the medical information available and the worker does not comply, the mutual insurance company can make a reasoned proposal for the medical discharge of the worker to the medical inspection units of the public health service. 

The Royal Decree also establishes a procedure to address nonattendance of workers at medical examinations requested by the INSS or the mutual insurance companies. If a worker does not attend a medical examination that is set four days in advance, the managing entity or the mutual insurance companies can provisionally suspend benefits, starting from the date of the scheduled examination, and grant the worker a period of 10 working days to justify the nonattendance. If justification is not received within the period granted, the decision will be made to terminate the allowance. 

Finally, the Royal Decree encourages mutual insurance companies, management agencies, and companies to use the online INSS systems to communicate information relative to sick leaves, confirmations, medical discharges, and suspensions or terminations of benefits. This will be possible through cooperation and coordination agreements, which can make the monitoring and control of temporary incapacity cases more efficient. 

This Royal Decree will be supplementary to the Draft Law of Mutual Insurance Companies that collaborate with the INSS, for which the parliamentary procedure is currently underway. The draft law forms part of a comprehensive plan carried out by the Spanish government that changes the legal regime of the mutual insurance companies relative to occupational accidents and occupational illnesses covered by INSS.