[REVISION HISTORY]

Italian INPS sick leave, Law 104, and disability reforms

Updated 7 times since CLSTR started tracking revisions of this situation.

What changed

2026-10-16 09:02 UTC → 2026-10-26 05:43 UTC · added ~~removed~~

In September 2026, the Italian social security institute (INPS), in coordination with the Ministry of Labour, implemented reforms regarding sick leave certification. Under circular no. 92, medical certificates can now be requested retroactively for the single day immediately preceding an outpatient visit at a general practitioner’s office. To be valid, physicians must include a specific electronic declaration stating, ‘Dichiara di essere ammalato dal…’ followed by the correct date. This reform addresses previous practices where INPS often invalidated certificates that indicated illness began the day before a medical visit, a situation that frequently caused economic penalties for workers and employers during the initial three-day deficiency period. However, retroactivity is strictly limited to one day and cannot be applied to weekends or holidays. Additionally, INPS has clarified regulations regarding Law 104, which governs leave for assisting family members with severe disabilities. While multiple workers can now be authorized to assist the same individual, the total available days must be organized according to established legal limits. New clarifications specify that exceeding the collective monthly threshold for a single person can result in salary deductions. Furthermore, workers assisting two different people with severe disabilities may be eligible to accumulate up to six days of leave per month. By October 2026, INPS introduced new digital procedures for disability applications. Through the integration of the Docsan system and the Intermediary Platform, citizens can use a single digital mandate to allow patronati to submit health documentation, removing the need for paper delegations. Furthermore, the Corte di Cassazione clarified that recognition of severe disability under Law 104/1992 does not automatically grant the ‘indennità di accompagnamento’ (attendance allowance), which requires specific medical criteria and an explicit request. In mid-October 2026, the implementation of reforms regarding Legislative Decree 62 began, adopting a ‘biopsychosocial approach.’ This reform shifts the focus from solely measuring invalidity to evaluating disability by considering an individual’s environment and relationship with the external world. This approach is currently being tested experimentally in 60 provinces, with a nationwide rollout planned for January 1, 2027.

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