At a glance
- Italian National Social Security Institute (INPS) has expanded the circumstances in which social security protection for sickness absence can be recognised from the day before a medical certificate is issued.
- Previously, this exception applied only following a home visit where the doctor expressly certified the previous day as the start of the illness.
- From 4 September 2026, the same protection may also apply where the employee is examined at the treating physician's office, reflecting practical difficulties in obtaining same-day appointments.
- The illness start date may be backdated by no more than one day, and the exception does not apply where the preceding day falls on a Saturday, Sunday or public holiday covered by continuity-of-care services.
- The change does not introduce general retroactive certification; the default rule remains that sickness absence starts on the date the medical certificate is issued.
Through Circular No. 92 of 4 September 2026, the INPS has revised its approach to sickness certification, broadening the circumstances in which social security protection may be recognised for the day immediately preceding the issue of a medical certificate.
Under the previous rules, recognition of sickness absence from the preceding day was permitted only where the certificate followed a home visit and the physician specifically identified the previous day as the date on which the illness began. The same exception was not available where the employee attended an appointment at a doctor's office.
With effect from 4 September 2026, INPS has removed this distinction. Employees may now be entitled to sickness protection for the day before a certificate is issued even where the medical examination takes place at the treating physician's office. The change reflects current healthcare delivery arrangements and acknowledges that employees may face practical difficulties in securing a medical appointment on the same day that symptoms arise.
The revised guidance remains subject to strict limits. The illness start date cannot be backdated by more than one day, and the preceding day must not fall on a Saturday, Sunday or public holiday, as healthcare continuity services are available on those days.
INPS has emphasised that the new rules do not create a general right to retroactive sickness certification. The fundamental principle remains that sickness absence begins on the date the medical certificate is issued, with recognition of the preceding day continuing to operate as a limited exception that now applies equally to both home and office-based medical examinations.
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