Key data
| Regulation | Resolution of September 28, 2026, from the General Technical Secretariat, which publishes the Agreement between the INSS, the University of Alcalá and SEIMC for the review of the Manual of Optimal Times for Temporary Incapacity. Fifth Edition. |
|---|---|
| BOE Publication | October 5, 2026 |
| Entry into force | September 24, 2026 |
| Affected parties | Workers on work leave, medical inspectors of the INSS and companies with employees on temporary incapacity |
| Category | Social Security |
| Review period | 1 year from the entry into force of the agreement (until September 24, 2027) |
| Previous version | Fourth edition, published in 2018 |
| Manual ownership | The INSS retains all copyright and distribution rights |
Medical inspectors at the INSS use a manual to decide whether a work leave lasts as long as it should. That manual has not been updated since 2018. As of September 24, 2026, the INSS has formalized an agreement with the University of Alcalá (UAH) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) to publish the fifth edition of the Manual of Optimal Times for Temporary Incapacity.
The result will directly affect how IT benefits are managed for millions of workers in Spain, and by extension, the companies that bear part of those costs and manage absences.
What does this regulation establish?
The Resolution publishes the agreement signed between three organizations with distinct and complementary roles:
| Organization | Role in the agreement |
|---|---|
| INSS (National Institute of Social Security) | Promoter of the manual. Retains all copyright and distribution rights. Coordinates the process. |
| University of Alcalá (UAH) | Provides methodological support and strengthens the scientific rigor of the document. |
| SEIMC (Spanish Society of Infectious Diseases and Clinical Microbiology) | Reviews and scientifically endorses the contents related to its specialty (infectious diseases). |
The resulting manual is a guidance tool for INSS medical inspectors. It is not binding in the strict sense, but in practice it sets the reference times that are applied when reviewing the duration of work leave. A leave that exceeds the times in the manual can trigger reviews or proposals for discharge.
The incorporation of SEIMC is especially relevant: following the COVID-19 pandemic and the rise of infectious diseases in the workplace, the 2018 criteria have become outdated. The new edition will specifically update the standard times for this type of pathology.
Economic and operational impact
For companies, the IT manual is not an external technical document: it is the reference that determines whether an employee's leave is considered "within normal limits" or whether the INSS can propose medical discharge before expected.
The specific operational effects are:
- Planning of absences: Updated standard times will change expectations about the duration of leave for infectious diseases, which are the most frequent in many sectors.
- Cost of replacements: If standard times are reduced for certain pathologies, companies can better plan temporary replacements.
- Management of long-term IT: HR departments and labor advisors will need to review their internal criteria for managing leave once the fifth edition is published.
- Collaborating mutual insurance companies: Mutual insurance companies, which also use this manual as a reference, will adapt their follow-up protocols and discharge proposals.
The impact is not immediate: the period to complete the review is one year from September 24, 2026, so the new edition will not be available before the third quarter of 2027. But the process has already begun and companies must anticipate it.
Who does it affect?
- Companies with employees on temporary incapacity: Any company that manages work leave will see the reference criteria applied by the INSS modified.
- HR departments and labor advisors: Will need to update their internal IT management protocols when the fifth edition is published.
- Medical inspectors at the INSS: They are the direct users of the manual. The new edition will change their evaluation criteria.
- Mutual insurance companies collaborating with Social Security: Use the manual as a reference for their own discharge proposals and leave monitoring.
- Workers on work leave: Updated standard times will directly affect reviews of their IT process, especially in infectious diseases.
- Primary care physicians: Although not direct recipients, the manual influences the context in which leave certificates are issued and reviewed.
Practical example
A company in the services sector has an employee on leave due to an infectious disease. With the fourth edition of the manual (2018), the INSS medical inspector applies the standard times from that document to assess whether the duration of the leave is reasonable.
When the fifth edition is published (likely before the third quarter of 2027), that same inspector will apply the new times reviewed and endorsed by SEIMC. If the new criteria update upward or downward the times for that specific pathology, the company will see how the planning horizon for that absence changes and when the INSS can propose discharge.
The HR department that today manages leave for infectious diseases with 2018 criteria is working with outdated information. Anticipating the new edition is a competitive advantage in absence management.
What should companies do now?
- Review internal IT management protocols: Identify what leave duration criteria are currently being applied and whether they are based on the fourth edition of the manual (2018).
- Alert the HR department and labor advisors: Inform them that over the next 12 months (before September 24, 2027) a new edition of the manual will be published with updated criteria, especially for infectious diseases.
- Coordinate with the collaborating mutual insurance company: Ask the mutual how it plans to adapt its IT monitoring protocols to the new edition when available.
- Monitor the publication of the fifth edition: The INSS will publish the updated manual once the review is complete. Being aware of its publication allows you to adapt internal processes without delay.
- Review active IT cases for infectious diseases: These are the ones most likely to see changes in standard reference times with the new edition.
Frequently asked questions
When will the fifth edition of the Manual of Optimal Times for IT be available?
The agreement signed on September 24, 2026 establishes a period of one year to complete the review and obtain scientific endorsement from SEIMC. Therefore, the new edition will not be available before September 24, 2027. The INSS retains distribution rights and will be the one to publish it officially.
Is it mandatory for companies to follow the Manual of Optimal Times for IT?
Not directly. The manual is a guidance tool for INSS medical inspectors, not a binding regulation for companies. However, it sets the reference criteria applied by the INSS when reviewing the duration of leave, so it directly influences discharge proposals and the management of IT benefits for workers.
What changes compared to the previous edition of the manual?
The fourth edition dates from 2018, more than 8 years ago. The fifth edition will incorporate the review and scientific endorsement of SEIMC in contents related to infectious diseases, with methodological support from UAH. The specific changes in standard times will not be known until the new edition is published.
What is SEIMC's role in updating the manual?
The Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) is responsible for reviewing and scientifically endorsing the contents of the manual related to its specialty. Its participation ensures that standard times for infectious diseases are updated with the most recent scientific evidence, something especially relevant following the COVID-19 pandemic.
How does this update affect active work leave in my company?
Active leave at this time is still governed by the criteria of the fourth edition (2018). The impact of the new edition will occur once published, likely before the third quarter of 2027. Leave for infectious diseases is most likely to see changes in standard reference times.
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-2026-20727
