Key data
| Regulation | Resolution of July 22, 2026, from the General Technical Secretariat, publishing the Agreement between the INSS, the University of Alcalá and the Spanish Society of Hematology and Hemotherapy for the review of the fifth edition of the Manual of Optimal Times for Temporary Disability |
|---|---|
| BOE Publication | July 30, 2026 |
| Entry into force | July 20, 2026 |
| Affected parties | Workers on medical leave, INSS medical inspectors and companies with employees on temporary disability |
| Category | Social Security |
| Review period | 1 year from the entry into force of the agreement |
| Edition reviewed | Fifth edition of the Manual of Optimal Times for Temporary Disability |
| Copyright ownership | INSS (entirely) |
INSS medical inspectors do not decide by guesswork how long a leave should last. They use a technical manual, the Manual of Optimal Times for Temporary Disability, which sets reasonable recovery periods for each disease. If a leave exceeds those times, control and review mechanisms are activated.
Now that manual is going to be updated. The Resolution of July 22, 2026 publishes the agreement signed between the National Institute of Social Security (INSS), the University of Alcalá (UAH) and the Spanish Society of Hematology and Hemotherapy (SEHH) to review its fifth edition. The result will directly affect how medical leaves are managed and monitored in Spain.
What does this regulation establish?
The agreement assigns a specific role to each signatory party:
| Entity | Role in the agreement |
|---|---|
| National Institute of Social Security (INSS) | Project owner, copyright holder of the resulting manual and process coordinator |
| Spanish Society of Hematology and Hemotherapy (SEHH) | Review and scientific endorsement of hematology content included in the manual |
| University of Alcalá (UAH) | Methodological support to the review process |
The resulting manual will belong entirely to the INSS, which retains all copyright. The SEHH guarantees clinical rigor in the hematology specialty, while the UAH provides the methodological framework to ensure the review is systematic and reproducible.
The Manual of Optimal Times for Temporary Disability is the reference tool used by INSS medical inspectors to assess whether the duration of a work leave is reasonable from a clinical perspective. When a leave exceeds the times recorded in the manual, the inspector can summon the worker, issue a discharge proposal or initiate a permanent disability proceeding.
Economic and operational impact
For companies, the impact is not immediate: the agreement has just been signed and the review has a one-year deadline. But it is advisable to prepare in advance, because when the new manual comes into use, the criteria for monitoring leaves will have changed.
The most relevant operational consequences are:
- Change in reference times: If the new optimal times for hematological conditions are reduced or extended, the threshold from which the INSS activates monitoring of a leave will change. This can affect the planning of replacements and absenteeism management.
- Greater scientific rigor in hematology: The SEHH endorsement implies that the criteria for blood diseases (anemias, leukemias, lymphomas, coagulation disorders) will be supported by the most current clinical evidence. Inspectors will have stronger arguments for their decisions.
- Improved predictability: A more updated manual can reduce variability in inspectors' decisions, which in the long term gives more certainty to companies and workers about the expected duration of a leave.
Who does it affect?
- Companies with employees on temporary disability (TD): Any company that has or may have workers on leave will see the criteria with which the INSS evaluates these situations affected.
- HR departments and absenteeism managers: Must update their internal protocols when the new edition of the manual is published.
- Workers on medical leave for hematological conditions: The new reference times for hematology may directly affect the recognized duration of their leaves.
- INSS medical inspectors: Will work with updated clinical criteria endorsed scientifically by the SEHH.
- Mutual insurance companies collaborating with Social Security: Also use the manual as a reference for managing TD in their associated companies.
- Labor advisors and management firms: Must be aware of the new manual to correctly advise their clients on long-term leaves.
Practical example
Imagine that one of your employees goes on leave for severe anemia. With the current fifth edition of the manual, the INSS medical inspector has a determined reference time for that diagnosis. If the leave exceeds that period, the inspector can summon the worker for review.
When the new edition of the manual comes into force—within a maximum of one year from July 20, 2026—that reference time will have been reviewed and scientifically endorsed by the Spanish Society of Hematology and Hemotherapy. If the new criterion is more restrictive, monitoring could be activated earlier. If it is broader, the leave could be extended without inspector intervention.
As a company, you cannot know today what the specific result of the review will be, but you can prepare: identify which employees have active leaves for hematological conditions and maintain communication with your mutual or labor manager to act as soon as the new manual is published.
What should companies do now?
- Identify active leaves for hematological conditions: Locate which employees are currently on leave for blood diseases (anemias, leukemias, lymphomas, coagulation disorders). They will be the first affected when the manual changes.
- Inform your collaborating mutual: Consult with your mutual if it already has information about the review process and if it plans to update its own TD management protocols.
- Update internal absenteeism protocols: When the new edition of the manual is published (before July 20, 2027), review and update your internal medical leave management procedures.
- Alert your labor advisor or management firm: Ask them to notify you as soon as the new manual is available to adapt TD management to the new reference times.
- Do not make hasty decisions: The manual has not yet changed. Until the new edition is published, the current criteria of the fifth edition remain in force. Do not modify your leave management prematurely.
Frequently asked questions
When will the new manual of optimal times for temporary disability come into force?
The agreement between the INSS, the University of Alcalá and the SEHH came into force on July 20, 2026. The deadline for completing the review is one year from that date, so the new manual should be ready before July 20, 2027. Until then, INSS inspectors continue to use the current fifth edition.
What is the Manual of Optimal Times for Temporary Disability and what is it for?
It is the reference tool used by INSS medical inspectors to assess whether the duration of a work leave is reasonable. It sets the expected recovery periods for each disease. If a leave exceeds those times, the inspector can summon the worker, propose discharge or initiate a permanent disability proceeding.
What conditions are reviewed in this manual update?
This review focuses specifically on hematology content, which will be reviewed and scientifically endorsed by the Spanish Society of Hematology and Hemotherapy (SEHH). This includes blood diseases such as anemias, leukemias, lymphomas and coagulation disorders, among others.
Who owns the copyright of the new manual?
The copyright of the final document belongs entirely to the INSS, as established by the agreement published on July 30, 2026. The University of Alcalá provides methodological support and the SEHH provides scientific endorsement, but ownership is exclusive to the INSS.
Should I already change how I manage medical leaves in my company?
Not yet. The manual has not yet changed: the review has a one-year deadline from July 20, 2026. Current criteria remain in force. The recommendation is to identify active leaves for hematological conditions, alert your labor advisor and watch for the publication of the new manual to adapt your protocols when appropriate.
Official source
Consult 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-2026-16647