Spanish Social Security now suspends employment after 545 days of sick leave. Workers face a critical review by the medical tribunal. The outcome can mean return, extension, or permanent disability.
In Spain, once an employee has been on medical leave for 545 days—about 18 months—their work contract is no longer just paused. At this point, Social Security steps in, and the case is transferred to the Instituto Nacional de la Seguridad Social for review. For thousands of workers each year, this marks a shift from waiting to facing a decision that will shape their future at work.
Up to this limit, employees on temporary incapacity receive payments, and their employer keeps up social security contributions. But after 18 months, the company stops paying in, and the worker enters a legal gray area: not fired, not fully employed, but with the employment relationship on hold. The uncertainty is immediate and real.
According to the Spanish Ministry of Inclusion, Social Security and Migration, in 2023 over 400,000 cases of temporary incapacity exceeded one year, highlighting the scale of long-term sick leave in the country.
Lucian Eduard Bighiu, director jurídico técnico at Fidelitis, explains that while contributions stop, the employment link is frozen until a final decision. During this time, the worker’s file goes to the Instituto Nacional de la Seguridad Social, where the Equipo de Valoración de Incapacidades (EVI) reviews the case.
The EVI can decide in three ways. If the tribunal finds the employee has recovered or improved, they are notified—first by SMS, then by electronic letter—to return to work the next business day. Legal advisors recommend contacting the employer right away after getting this message to avoid problems.
In some cases, the tribunal grants an extension, called ‘demora de calificación’, which can stretch medical leave to a maximum of two years. This is rare, but it gives extra time for those still recovering.
A 2022 report by El País noted that Spain has one of the highest rates of sick leave duration in the European Union, with the average temporary incapacity lasting over 40 days, compared to the EU average of 30 days. Experts from the Spanish Association of Occupational Medicine attribute this to both administrative procedures and the structure of the national health system.
The third option is for the EVI to recognize permanent incapacity. This comes in several forms: partial, total, absolute, and ‘gran invalidez’. Partial incapacity brings a lump sum equal to 24 months’ salary. Total incapacity means a pension at 55% of the regulatory base, rising to 75% after age 55. Absolute and ‘gran invalidez’ cases receive a full 100% pension, which is also exempt from income tax.
For both workers and employers, reaching 545 days is a major moment. The company’s obligations are suspended, but the employment bond is not broken. The worker keeps receiving benefits, but their future depends on the tribunal’s decision. The process is meant to protect both sides, but it often leaves employees waiting in uncertainty, unsure what comes next for their job or finances.
Spain’s system for long-term medical leave is different from other European countries, where the move to permanent disability or job loss can happen more quickly. The Spanish approach, with its formal suspension and tribunal review, tries to balance worker protection and employer flexibility. Still, as seen in recent analysis, the administrative process can be complicated, adding stress for those already dealing with health problems.
The 545-day rule highlights the tension between protecting jobs and controlling social security costs. The system avoids automatic dismissal, but it also leaves sick workers in a long period of waiting, with no guarantee about what comes next.
