How to get a sick note in Spain: Expat Guide

Understanding the rules around time off work for health reasons is essential for anyone employed in Spain, whether you are a local worker or an expat. It is especially important to consider the legal and financial implications of taking medical leave, as employment or visa regulations, combined with remuneration details, are valid concerns for expats working abroad.   

This blog post explains medical leave documents and how to get a sick note in Spain, providing expats a step-by-step guide about the role of public and private healthcare providers, and other important factors. It also highlights how providers like Caser Expat Insurance can support access to healthcare and simplify the overall process.  

Differences between medical leave, sick note & medical certificate of attendance

In Spain, there are three related but distinct concepts that are often confused: the sick note, medical leave, and the medical certificate of attendance.

• A sick note (parte de baja) is an official document issued by a doctor in the public healthcare system confirming that you are unfit to work due to illness or injury. This document legally initiates medical leave, which is the period during which you are authorized to be absent from work.
• Medical leave (Incapacidad Temporal) is not a document but a status. It begins when the sick note is issued and continues until a doctor provides a discharge note (alta médica) confirming that you are fit to return to work.
• A medical certificate of attendance (justificante) is a simpler document confirming that you attended a medical appointment at a specific date and time. It is typically used to justify short absences, such as arriving late or leaving work early for a doctor’s visit.

Understanding these distinctions is essential when learning how to get a sick note in Spain, as not all medical documents carry the same legal or professional weight.  

Can a private doctor give me a sick note for my company?  

Medical documentation in Spain can come from both the public healthcare system and the private sector, but their roles are not identical. If you are looking for a private doctor to give you a sick note, it may not be enough. Read more below:  

1. 1. Public healthcare system (Seguridad Social)

The public healthcare system is the only authority that can issue an official sick note for legally recognized medical leave.

Through your public doctor (médico de cabecera), you can obtain:

• Sick notes (parte de baja)
• Follow-up reports (partes de confirmación)
• Medical discharge (alta médica)
• Medical certificates of attendance (justificantes)

These documents are automatically integrated into the social security system and are fully valid for employment and benefits purposes.

1. 2. Private healthcare providers

Private doctors, including those accessed through Caser Expat Insurance health insurance policies, can provide high-quality care and documentation, but with some limitations.

What they can do:

• Issue medical certificates of attendance
• Issue medical reports and diagnoses

What they cannot do:

• Issue official sick notes recognized by social security
• Their documentation usually needs to be confirmed by a public doctor for formal medical leave
  

What steps do I need to take to get a doctor's sick note if I'm ill in Spain?  

If you need to take time off work due to illness, the steps for getting a sick note in Spain are very easy to follow:

1. 1.Recognize that you are unfit to work:

1. 2. Book a medical appointment:

1. 3. Attend the consultation: Clearly explain your symptoms and how they impact your ability to work.
2. 4. Receive the sick note (parte de baja): If the doctor determines that you cannot work, they will issue the official document.
3. 5. Submit or confirm notification: In most cases, the system automatically informs your employer, but it is good practice to communicate directly as well.
4. 6. Attend follow-up appointments if required: For ongoing conditions, you may receive periodic confirmations.
5. 7. Obtain medical discharge (alta médica): When you are fit to return, the doctor will issue your discharge note.
6. 8. Book regular doctor’s visits: An annual health checkup and regular doctor visits help you to be proactive about your health and potentially minimize certain medical conditions or illnesses before they get too serious.
   1.  

   For short medical visits where you remain fit to work, you may instead request a medical certificate of attendance rather than initiating full medical leave.

Legal, financial & work-related implications of medical leave in Spain

Medical leave in Spain is highly regulated and comes with specific obligations and protections.

1. 1. Legal responsibilities

Employees are expected to:

• Inform their employer as soon as possible
• Follow medical advice and attend required check-ups
• Ensure proper documentation is issued and recorded

Failure to comply with these requirements may affect your employment status or benefits.

1. 2. Salary during medical leave

Compensation during medical leave typically follows this structure:

• Days 1–3: Usually unpaid (unless covered by a collective agreement)
• Days 4–20: Approximately 60% of your salary
• From day 21 onwards: Approximately 75% of your salary

Payments may be managed by your employer or directly through social security.

1. 3. Job protection

Spanish labor law generally protects employees during medical leave. While dismissal solely due to illness is restricted, there are exceptions in cases involving long-term absence or organizational needs. Discover explanations regarding working hours, leave and holidays on Spain’s government website.

How Private Health Insurance helps you manage sick leave

​​​​Oftentimes, public healthcare access is not enough to return to work in a timely manner, due to waiting times, language barriers, or specialist access. ​​​

​​​For example, e​​xpats working in Spain should be aware of several ​ ​factors​ when dealing with the public healthcare system​:

• Registration matters: Access to public sick leave benefits requires registration with Social Security
• Language differences: Medical documentation is typically issued in Spanish
• Employer expectations: International employers may not be familiar with Spanish procedures, so make sure all documents are validated and authorized within the Spanish system. 
• Faster access to doctors and specialists
• Multilingual support, including English-speaking professionals
• Flexible healthcare options across Spain
• Guidance in navigating the healthcare system

Using both public and private healthcare systems strategically can help streamline the process.

Health Insurance for Expats supports international residents in Spain by offering access to private healthcare services tailored to their needs.

Key advantages include:

Although Caser does not replace the public system for issuing official sick notes, it can significantly reduce waiting times and improve access to care. Many expats use private consultations to receive quick diagnoses and then follow up with the public system to formalize their medical leave.

Discover all Caser’s health insurance plans. Top plans include the Adapta for Residency Permit plan that’s specific for visa and residency requirements and Integral family health insurance.  

By understanding medical leave and documentation in Spain, you can protect your employment rights, access the appropriate financial support, and focus on recovery. Combining public healthcare with services like Caser health insurance can further simplify the process, particularly for expats navigating the system for the first time.