Key data
| Regulation | Resolution of July 22, 2026, from the General Technical Secretariat, publishing the Agreement between the INSS, the University of Alcalá and SECOT for the review of the fifth edition of the Manual of Optimal Times for Temporary Disability |
|---|---|
| Publication | July 30, 2026 |
| Entry into force | July 30, 2026 |
| Affected parties | Workers on sick leave, INSS medical inspectors and companies with employees on temporary disability |
| Category | Social Security |
| Year | 2026 |
| Review period | One year from the entry into force of the agreement |
| Revised edition | Fifth edition of the Manual of Optimal Times for Temporary Disability |
| Copyright | Exclusively held by the INSS |
INSS medical inspectors use the Manual of Optimal Times for Temporary Disability as the main reference to assess whether the duration of a sick leave is appropriate or whether its extension or termination is warranted. That manual is going to be thoroughly reviewed, and the changes can directly affect how your employees' sick leave is managed.
The Resolution of July 22, 2026 publishes the agreement between the INSS, the University of Alcalá (UAH) and SECOT to review the fifth edition of the manual. The deadline to complete that review is one year from the entry into force of the agreement.
What does this regulation establish?
The agreement defines the role of each participating entity in the manual review:
| Entity | Role in the agreement |
|---|---|
| INSS (National Institute of Social Security) | Coordinates the review process and exclusively holds the copyright of the manual |
| University of Alcalá (UAH) | Provides methodological and scientific rigor to the review process |
| SECOT (Spanish Society of Orthopedic and Traumatological Surgery) | Provides specialized scientific endorsement in traumatological and orthopedic matters |
The resulting manual will continue to be an advisory and non-binding tool. However, in practice it decisively influences the resolutions adopted by INSS medical inspectors regarding the duration of sick leave, especially for injuries to the musculoskeletal system: fractures, sprains, herniated discs, orthopedic surgical interventions and similar conditions.
The review focuses specifically on the traumatological and orthopedic section of the manual, which is precisely the one that concentrates the largest volume of temporary disability processes in Spain.
Economic and operational impact
For companies, the cost of sick leave is not limited to Social Security contributions. It also includes loss of productivity, the need to cover the position and, in many cases, payment of salary supplements during temporary disability. Any change in the reference times in the manual can have two opposite effects:
- If times are extended: sick leaves could be prolonged longer without the medical inspector questioning them, increasing costs for the company and the system.
- If times are reduced or adjusted to updated scientific evidence: the INSS could activate controls earlier and propose discharge or review of processes that are lasting longer than medically justified.
The actual impact will depend on the specific content of the new edition of the manual, which will not be known until it is published within the one-year period. What is certain is that INSS medical inspectors will have updated criteria backed by the most recent scientific evidence in traumatology.
Who does it affect?
- Companies with employees on temporary disability due to traumatological or orthopedic injuries (fractures, sprains, hernias, spine, knee, shoulder surgeries, etc.).
- HR departments and absenteeism managers who manage temporary disability processes and their monitoring.
- Mutual insurance companies collaborating with Social Security, which also use the manual as a reference in their assessments.
- Workers on sick leave due to traumatological conditions, whose benefits may be reviewed with the new criteria.
- INSS medical inspectors, who are the direct users of the manual in their resolutions.
- Labor advisors and management firms that accompany companies and workers in temporary disability processes.
Practical example
Imagine that one of your employees suffers a wrist fracture and is on sick leave. The INSS medical inspector, when reviewing the process, consults the Manual of Optimal Times to check whether the duration of the sick leave complies with the usual recovery times for that type of injury.
With the current fifth edition, the inspector applies the reference times in force. With the new edition reviewed by SECOT and UAH, those times could change by incorporating updated scientific evidence in traumatology. If the new manual sets a different recovery time for that injury, the inspector will apply it in future resolutions: they could propose discharge earlier, or conversely, consider a longer sick leave reasonable if scientific evidence justifies it.
For the company, this translates into a longer or shorter duration of the temporary disability process and, therefore, a direct impact on absenteeism costs and workforce planning.
What should companies do now?
- Identify active temporary disability processes due to traumatological or orthopedic injuries in your workforce. These are the ones that will be directly affected by the new edition of the manual.
- Review internal absenteeism monitoring procedures to be prepared for possible changes in the reference times applied by the INSS in its inspections.
- Inform HR managers that the INSS reference manual is undergoing updates and that the criteria for assessing traumatological sick leave may change within one year.
- Coordinate with your company's collaborating mutual insurance company to understand how the new edition of the manual will affect the temporary disability processes it manages on your behalf.
- Stay alert for the publication of the new edition of the manual, which must be completed before July 30, 2027. When it is published, it will be time to review in detail the new reference times for the most frequent injuries in your sector.
Frequently asked questions
What is the INSS Manual of Optimal Times for Temporary Disability?
It is the tool used by INSS medical inspectors to assess whether the duration of a sick leave is reasonable. Although it is advisory and not binding, in practice it decisively influences the resolutions on extension or termination of temporary disability benefits. The copyright of the manual is exclusively held by the INSS.
When will the new edition of the manual be ready?
The agreement signed on July 22, 2026 establishes a one-year period to complete the review. Therefore, the new edition must be ready before July 30, 2027.
What types of sick leave will be affected by this review?
The review focuses on the traumatological and orthopedic section of the manual, with the scientific endorsement of SECOT (Spanish Society of Orthopedic and Traumatological Surgery). It will affect sick leave for fractures, sprains, herniated discs, orthopedic surgical interventions and other musculoskeletal injuries.
What role does the University of Alcalá play in this review?
The University of Alcalá (UAH) provides methodological rigor to the review process. SECOT provides specialized scientific endorsement in traumatology and orthopedics, and the INSS coordinates the process and exclusively holds the copyright of the manual.
Can the INSS medical inspector close a sick leave based on this manual?
The manual is advisory and not binding, but in practice INSS medical inspectors use it as the main reference for their resolutions. If the duration of a sick leave exceeds the reference times in the manual without additional medical justification, the inspector can propose discharge or termination of the temporary disability benefit.
Official source
View complete regulation in official source
Notice: This article is for informational purposes only and does not constitute legal advice. For specific decisions, consult a qualified professional. Source: https://www.boe.es/diario_boe/txt.php?id=BOE-A-2026-16648