Work leave 2026: INSS updates optimal IT timeframes with psychiatry experts

Key data

INSS medical inspectors do not decide the duration of work leave arbitrarily: they rely on the Manual of Optimal Timeframes for Temporary Disability, a technical tool that establishes how many days it is reasonable to be on leave according to each condition. This manual will be updated, and the changes will directly affect how leave is managed and controlled throughout Spain.

The Resolution of July 20, 2026 publishes the agreement signed between the INSS, the University of Alcalá (UAH) and the Spanish Society of Psychiatry and Mental Health (SEPSM) to review the fifth edition of this manual. It is the first time that SEPSM formally participates in its development, which reinforces the specific weight that psychiatric criteria will have in the new version.

What does this regulation establish?

The agreement precisely defines the role of each signatory body:

The result will be an updated version of the manual that INSS medical inspectors use in their assessments. When a worker has been on leave longer than the manual considers "optimal" for their condition, the inspector can summon the worker, issue a medical discharge, or propose control measures. The criteria that are updated will determine, in practice, which leaves are considered prolonged and which are not.

The incorporation of SEPSM is especially relevant because leaves due to mental health reasons—anxiety, depression, burnout—are today one of the main causes of temporary disability in Spain and, historically, the most difficult to objectively verify medically.

Economic and operational impact

Work leave has direct and indirect costs for companies. Although Social Security pays the economic benefit from the fourth day onwards (the first three days are covered by the employer in most agreements), companies bear substitution costs, loss of productivity, and administrative management.

An update to the manual could have two opposite effects depending on how the criteria evolve:

• Stricter criteria: the INSS could shorten recognized timeframes for certain conditions, which would increase pressure on workers on leave and could generate more premature medical discharges, with the resulting risk of labor conflicts or relapses.
• Broader or more nuanced criteria: especially in mental health, SEPSM's endorsement could support longer durations for certain diagnoses, which would extend the recognized IT period and reduce inspection pressure on those workers.

In any case, companies with high incidence of leave due to mental health should pay attention: the new psychiatric criteria, once published, will be the standard applied by INSS inspectors throughout the national territory.

Who does it affect?

• Companies with employees on temporary disability: especially those managing long-term leave or with high turnover due to mental health reasons.
• HR departments and payroll managers: will need to update their IT monitoring protocols when the new version of the manual is published.
• Mutual insurance companies collaborating with Social Security: use the manual as a reference for their own assessments and discharge proposals.
• INSS medical inspectors: are the direct users of the manual in their control assessments.
• Workers on work leave: especially those on leave due to psychiatric conditions, as the new criteria will determine whether their duration is considered appropriate or excessive.
• Labor advisors and management firms: will need to know the new timeframes to correctly advise their clients on the risk of control or forced discharge.

Practical example

A services sector company has an employee on leave for a moderate depressive episode for four months. The INSS medical inspector summons the worker to assess whether the duration is appropriate according to the Manual of Optimal Timeframes for IT (fifth edition, currently in force).

With the review underway, SEPSM is evaluating whether the recognized timeframes for this type of condition correctly reflect current scientific evidence. If the new manual—scientifically endorsed by SEPSM and with methodological support from UAH—establishes a different optimal timeframe than the current one for moderate depression, the inspector will apply this new criterion in future assessments.

For the company, this means that the threshold from which the INSS can pressure for discharge may change. Knowing the new timeframes, as soon as they are published, will be key to anticipating the worker's return and planning position coverage.

What should companies do now?

1. Identify employees on active temporary disability, especially those who have been on leave for more than 60 days due to psychiatric reasons (anxiety, depression, burnout), as they will be most directly affected by the new criteria.
2. Review internal IT monitoring protocols with the HR department or labor advisory, to be prepared when the new version of the manual is published.
3. Coordinate with the collaborating mutual: mutual insurance companies also use the manual as a reference; it is advisable to know if they are already adapting their assessment criteria in anticipation of the update.
4. Stay alert to the publication of the updated manual: the review timeline is one year from the signing of the agreement (July 2026). The new version could be available during 2027.
5. Consult a labor advisor if you have employees with prolonged leave due to mental health: the new criteria can affect both the risk of forced discharge and the planning of return to work.

Official source

Consult complete regulation at official source

Notice: This article is purely informational in nature 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-2026-16432