Getting Sick Leave (La Baja Médica) in Madrid

If you are legally employed in Spain or registered as an autónomo (freelancer), you have the right to take paid sick leave when you are unable to work due to illness or injury.

In Spain, this official sick leave is called Incapacidad Temporal (IT), but everyone colloquially refers to it as "La Baja" or "La Baja Médica".

Getting a baja is not just about calling your boss and saying you have a fever. It is a strictly regulated bureaucratic process involving the public healthcare system and the Social Security administration.

The Golden Rule: Only Public Doctors Can Issue a "Baja"

This is the most common mistake expats make. A doctor from a private health insurance clinic (like Sanitas, Adeslas, or Quiron) cannot issue an official baja médica for Social Security purposes.

If you go to a private doctor, they can give you a medical report (informe médico) recommending rest, but that document has no legal standing with your employer or the government for paid leave.

To get an official baja, you must go through the public healthcare system (SERMAS in Madrid).

How to Get the Baja

Step 1: See a Public Doctor

• For common illnesses (flu, gastroenteritis, minor injuries): You need an appointment with your assigned family doctor (médico de cabecera) at your local public health center (Centro de Salud). If it's urgent and you can't get a same-day appointment, you can go to the health center's emergency room (Urgencias de Atención Primaria).
• For severe emergencies: If you are taken to a public hospital emergency room, the hospital doctors can issue the baja directly (thanks to a recent system update in Madrid), or they will give you a clinical report that you must take to your médico de cabecera within 72 hours for them to issue the official baja.

Step 2: The Doctor Issues the Document

If the doctor determines you cannot work, they will issue a digital document called the Parte de Baja.

Historically, you were given physical paper copies that you had to physically hand to your company's HR department within 3 days. As of April 2023, this is no longer your responsibility.

The public health system now communicates directly with the National Social Security Institute (INSS), which automatically notifies your employer. You are only required to communicate to your boss/HR that you are sick, but you do not need to deliver the paperwork.

Types of Baja and How You Get Paid

Your pay during sick leave depends on why you are sick.

1. Contingencias Comunes (Common Illness or Non-Work Injury)

This covers things like the flu, a broken leg from skiing, or anxiety.

• Days 1 to 3: You receive 0% of your salary by law. (However, many modern collective bargaining agreements—Convenios Colectivos—or company policies mandate that the company tops this up to 100%. Check your contract!)
• Days 4 to 20: You receive 60% of your regulatory base salary.
• Day 21 onwards: You receive 75% of your regulatory base salary.

2. Contingencias Profesionales (Workplace Accident or Occupational Disease)

This covers injuries sustained at work or illnesses directly caused by your job.

• Day 1 onwards: You receive 75% of your salary from the very first day. (Again, many company convenios top this up to 100%).

The Follow-Up (Partes de Confirmación)

A baja is not open-ended. The doctor will specify an estimated duration based on your illness (e.g., 5 days for a severe cold).

• Short Bajas (under 5 days): The doctor will issue the baja and the alta (the discharge document allowing you to return to work) at the same time.
• Longer Bajas: You will be given dates for follow-up appointments. You must attend these appointments. If you are still not well, the doctor will issue a Parte de Confirmación (extension). If you miss these appointments, your baja can be suspended, and you will lose your sick pay.

Returning to Work (El Alta)

When you are recovered, the doctor will issue a Parte de Alta. This means you are legally fit to work. You must return to your job the following working day. You cannot legally work while on a baja, and you cannot refuse to return to work once an alta has been issued.