Sick leave by country / Italy
Sick leave and sick pay in Italy
Who pays when someone is ill, how much, for how long, and what the certificate rules are — in plain English, whether you run a team in Italy or work on one.
In Italy sick pay is shared between INPS and the employer. For most private-sector employees INPS pays 50% of average daily pay from the fourth to the twentieth day and 66.66% from the twenty-first to the 180th day in a calendar year; the first three days (carenza) and the top-up to full salary are paid by the employer under the collective agreement, which also sets the protected period (comporto) during which the employee cannot be dismissed. The doctor sends the certificate to INPS electronically from day one.
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How it works
Article 2110 of the Civil Code guarantees pay and job protection during illness, leaving the amounts and the maximum protected period to collective agreements. INPS pays the indennità di malattia for manual workers in all sectors and for white-collar staff in commerce and some other sectors — white-collar employees in industry are paid entirely by the employer under their CCNL. The INPS benefit covers up to 180 days a year at 50% for days 4–20 and 66.66% from day 21, and the employer advances it through payroll. Nearly every CCNL requires the employer to pay the three carenza days and to integrate the INPS amount to 100% for a period, often 180 days, and fixes the comporto — typically 180 days — after which dismissal becomes possible. Employees must be at home during the reperibilità windows (10–12 and 17–19) for possible INPS checks.
Worth knowing: The 180-day INPS limit is per calendar year, and the CCNL comporto period is what determines when your job is at risk — they are different clocks.
If you run a team in Italy
Retrieve the electronic certificate from INPS using the protocol number the employee gives you, apply the CCNL's rates and comporto, advance the INPS indennità in payroll and recover it through the UniEmens contributions. You may request an INPS medical check (visita fiscale). Sick leave does not reduce annual leave, and leave keeps accruing up to the CCNL limit.
If you work in Italy
See your doctor on the first day; the certificate goes to INPS electronically and you give your employer the protocol number. Stay at home during the check windows (10–12 and 17–19) unless you have a justified reason. Your CCNL decides how much of your pay is topped up and for how long — most give full pay for months.
Sickness and annual leave
Illness during annual leave suspends the leave if it prevents rest and is certified; the days are recovered later. Annual leave continues to accrue during sickness within the comporto period under most CCNLs.
The annual leave entitlement itself is covered on our Italy annual leave page — 20 working days minimum.
Keeping the record straight
Sick pay rules turn on dates: the day the illness started, the day the certificate was due, the day the employer's obligation ends and the benefit takes over. In Italy those dates decide who pays and how much, and they have to be provable months later — to a payroll auditor, an insurer, or the employee. A shared spreadsheet rarely survives that; a tracker like Leavo records each absence with its dates and approvals alongside annual leave, so the record exists before anyone asks for it. We compare the options in our leave management software guide, and the policy side — carryover, payout, accrual — in our guides.
Sick leave in Italy: common questions
Who pays the first three days?
INPS never does. Almost all collective agreements require the employer to pay them at full salary; without a CCNL provision they are unpaid.
What is the 'comporto'?
The maximum period of protected sickness set by the collective agreement — commonly 180 days in a year or over a rolling period — after which the employer may dismiss for exceeding it.
Are white-collar employees in industry covered by INPS sick pay?
No. Their sick pay comes entirely from the employer under the CCNL; INPS covers manual workers in all sectors and white-collar workers in commerce, credit and some other sectors.
What happens if I fall ill during my annual leave in Italy?
Illness during annual leave suspends the leave if it prevents rest and is certified; the days are recovered later. Annual leave continues to accrue during sickness within the comporto period under most CCNLs.
Source
Primary source: Codice Civile art. 2110; Legge 638/1983 (indennità di malattia INPS); collective agreements (CCNL). Rates and caps change — often every January or April — and collective agreements frequently improve on the statutory scheme. Confirm against the current text before acting. See our methodology.