INPS sickness benefits: new guidance on the start date of the period covered by medical certificates

In Circular No. 92 of 4 September 2026, INPS provided new guidance on the start date of the certified period of sickness for the purposes of entitlement to the corresponding social security benefits.

As a general rule, for social security purposes, a period of sickness starts on the date on which the medical certificate confirming temporary incapacity for work is issued.

However, until the publication of Circular No. 92, INPS exceptionally allowed sickness to be recognised from the day before the certificate was issued only where a home visit had taken place, so as not to penalise employees whose attending physician was unable to visit them on the day the visit was requested.

With the above circular, INPS revised this approach, extending entitlement to social security benefits from the day before the certificate is issued to cases involving a consultation at the doctor’s surgery.

This recognition is, however, subject to limitations. Specifically, it does not apply where the day immediately preceding the date of issue of the medical certificate is a weekday public holiday, a Saturday or a Sunday, when out-of-hours medical services are available.

The new guidance therefore broadens employee protection in INPS’s determination of the first day of sickness, taking greater account of the practical arrangements for accessing medical care. In particular, it addresses cases where, for organisational or patient-care reasons, the physician cannot make a home visit or see the employee at the surgery on the day the illness begins, also considering the now widespread use of appointment-based access to medical practices.