What is temporary disability or medical leave, how much is charged and what is its maximum duration

What is temporary disability or medical leave, how much is charged and what is its maximum duration

The temporary disability or medical leave is the situation by which a working person suffers an illness or accident that prevents them from carrying out their work activity. When you take sick leave, you have the right to request temporary disability benefit, which is managed by the National Social Security Institute (INSS). This is an economic benefit that tries to cover the loss of income due to not being able to work, whether due to a common or professional illness, work-related or non-work accident, and is recognized in the Workers’ Statute.

While on sick leave, the worker must attend medical check-ups, so that professionals can see and assess how the temporary disability is evolving and whether they can be incorporated into their work or not. Are Reviews will last seven days maximum. when the losses are of short or medium duration and of a maximum of 14 days when these are expected to be long lasting.

What are the causes that generate temporary disability?

Social Security understands that temporary disability can occur due to two situations: whether it is due to work or not. The first occurs when the cause of the leave is directly related to work, that is, when it is a work accident or an occupational disease. In these cases, the worker does not need to have completed any minimum contribution period to access the benefit. In addition, the collection of the subsidy begins from the first day of the medical leave.

On the other hand, if the temporary disability is caused by a common illness or non-work accidentthe affected person must prove at least 180 days of contributions in the last five years. In this modality, the benefit is not received from the first day, but from the fourth day of sick leave. Thus, in a more schematic way, the causes of temporary disability would be the following:

Work accident or occupational disease:

  • In these cases, the worker does not need to have completed any minimum contribution period to be able to request temporary disability.
  • The financial benefit begins from the first day of the medical leave.

Common illness or non-work accident:

  • To qualify for temporary disability, the affected person must prove at least 180 days of contributions in the last five years.
  • In these cases, the subsidy is collected from the fourth day of sick leave.

For example, if a worker who is a truck driver falls from a trailer and fractures his foot, that would be sick leave due to professional accident. On the other hand, if it is a cold or an accident that has occurred outside of our work environment, the leave will be due to a common illness or non-work accident.

What types of temporary disability exist?

There are two types of temporary disability: by common contingency, which arises from a non-work accident or a common illness, and by professional contingency, which arises from a work accident or an occupational disease.

Temporary disability due to common contingencies is disability that encompasses medical leave whose cause is not directly related to work activity. These can be of two types:

  • Non-temporary accident: that occurs in an area of ​​life that is related to work (for example, those that can occur at home or while playing sports, among others).
  • common disease: (a cold, back pain, etc.) that do not arise from work.

On the other hand, there is the temporary disability due to professional contingencieswhich covers those cases in which the origin of the leave is directly associated with work. In this type of contingencies, both accidents that occur in the place where work activity is carried out like those that happen during the trip to or from work (as long as this movement occurs within the working day).

Thus, we can say that the main difference between both modalities is in the origin of the health problem: whether or not it is a result of the work activity itself.

Requirements to request temporary disability

To request temporary disability, the worker must be in a discharge situation or assimilated to discharge at the time of the contingency. Furthermore, if the cause of the sick leave is a common illness or non-work accidentit is necessary have at least 180 days of contributions in the last five years.

This contribution requirement is not required when the temporary disability is due to a work accident or an occupational disease, in which case the benefit can be accessed without the need to prove a minimum contribution period.

How long does temporary disability benefit last?

The maximum duration of a temporary disability is 365 days, although this can be extended for another additional 180 daysreaching a maximum of 545 days, as long as it is considered that the worker can recover and obtain a medical discharge within that period.

If after those 545 total days, the worker does not show improvement, Social Security must assess whether or not to propose permanent disability. Now, in the in the event that the leave was due to professional illnessl, it will be possible to be on leave up to 180 more days, that is, 725 days. If more time is needed to study and diagnose the disease, this leave can be extended for another 180 days.

The maximum duration of temporary disability is included in article 169 of Chapter V of the General Social Security Law. This article explains these assumptions and what the maximum duration is in the case of being under temporary disability.

Article 169 of the General Social Security Law (LGSS) | Photo: BOE

How much do you charge while on temporary disability?

While on medical leave, the worker has the right to receive a temporary disability benefit. The amount depends on the duration of the leave and the reason for it, being the following:

  • In cases of common illness or non-work accidentbetween days 4 and 15, the 60% of the regulatory baseand payment is borne by the company. Starting on the 16th, it is Social Security that assumes the payment and, starting on the 21st, the worker receives the 75% of the regulatory base.
  • If the disability is a consequence of a professional illness or work accidentthe worker receives the 75% of its regulatory base from the day after the leave, and it is the company that pays the benefit.

This is in general terms, so any collective agreement may improve their amounts. In cases of secondary disabling menstruation, 60% of the regulatory base is collected during the first 20 days, and, from day 21, 75% is charged.

When the leave occurs due to termination of pregnancy or from the first day of the thirty-ninth week of gestation, the full salary is received during the first day of the leave. From the second to the twentieth day, 60% of the regulatory base is charged, and from the 21st day onwards, 75% is charged.

How do you pay for temporary disability?

While on leave due to temporary disability, both the worker and the employer must continue contributing to Social Security. The worker must contribute 6.35% on the regulatory base, of which 4.7% is allocated to common contingencies, 1.55% for unemployment and 0.10% for vocational training. In the case of the employer, it will contribute 23.60% for common contingencies, 5.50% for unemployment, 0.60% for vocational training and 0.20% for the Salary Guarantee Fund (Fogasa).

In the following tables you can see how it is quoted:

Concept Company Worker Total
Common contingencies 23.6 4.7 28.3
Work accidents and occupational diseases
Concept Company Worker Total
Unemployment – General type 5.5 1.55 7.05
Unemployment – Fixed-term contract Full time 6.7 1.6 8.3
Unemployment – Fixed-term contract Part-time 6.7 1.6 8.3
Salary Guarantee Fund 0.2 0.2
Vocational Training 0.6 0.1 0.7
Overtime quote Company Worker Total
Overtime force majeure 12 2 14
Rest overtime 23.6 4.7 28.3

When does temporary disability leave begin to be collected?

When the temporary disability has its origin in a common contingency, the worker begins to receive the benefit from the fourth day of sick leave (nothing is charged during the first three days). In the event that the leave was due to a professional contingency, it will not be necessary to wait any day, since the benefit is paid from the first day of disability. Social Security pays the benefit on the last business day of each month.

Reasons why the temporary disability benefit stops being collected

The reasons why the temporary disability benefit is no longer collected go beyond the end of the maximum period of 365 days (extendable for another 180). Social Security contemplates the following cases for which it can be terminated:

  • Issuance of medical dischargeeven before the 365-day period is up.
  • Failure to appear for medical examinationswhen the beneficiary does not attend the pertinent reviews.
  • Retirement.
  • Death.

Likewise, the right to benefit can suspend in situations like:

  • Fraudulent action to obtain or maintain temporary disability.
  • Performance of a work activityboth on their own and on behalf of others.
  • Treatment abandonment without justification.
  • Failure to appear for medical examinations summoned by the competent body.