Workers in Italy can now backdate their sick leave certificates by one day under new guidelines issued by INPS, the national social security institute, addressing widespread difficulties in securing timely medical appointments amid primary care shortages.
New INPS Rules Allow One-Day Sick Leave Backdating
According to INPS circular no. 92, issued on September 4, 2026, and developed by the Central Directorate of Social Security Measures and the General Medical-Legal Coordination, social security protection for illness can now cover the day immediately preceding a medical visit. Prior to this update, established by the agency alongside the Ministry of Labor and Social Policies, sickness benefits strictly began on the date a doctor issued the certificate, with rare exceptions previously limited to home visits.
The policy change applies when a physician conducts an in-office or home examination and certifies that the patient’s illness actually began the day before. INPS Director General Valeria Vittimberga stated in an official release that the reform adapts administrative procedures to shifting territorial healthcare conditions, noting that staff shortages among general practitioners and heavier workloads frequently prevent patients from seeing a doctor on the exact day symptoms appear.
Conditions, Exceptions, and Restrictions
The updated framework sets strict boundaries to prevent misuse while offering flexibility to ailing employees. According to the FIM-CISL trade union analysis of the circular, the retroactivity rule is subject to three core constraints:
- Maximum One-Day Limit: The certificate can only reach back a single day. If a doctor records an onset date two or more days prior to the examination, benefits will only trigger from the actual date of issuance.
- Weekend and Holiday Exclusions: Backdating is prohibited if the preceding day falls on a Saturday, Sunday, or a mid-week public holiday. INPS mandates that workers seek care through local on-call medical services, known as continuità assistenziale or guardia medica, during those periods.
- Scope of Application: The provisions cover initial illnesses, continuations, and relapses for certificates issued on or after September 4, 2026.
Practical Scenarios Under the 2026 Guidelines
To clarify how the rules apply in daily practice, official union and institutional guidance highlights specific operational outcomes. If a worker falls ill on Sunday but visits a doctor on Monday, the sick leave starts Monday because continuous coverage services were available over the weekend. Conversely, if symptoms begin on Monday and a patient cannot secure an appointment until Tuesday due to physician unavailability, the medical provider can legally validate Monday as the start of the illness.