What really happens after 18 months on sick leave? Social Security clarifies the rules
Many workers worry about what happens when they reach the maximum period allowed for temporary sick leave in the Canary Islands. The Social Security system has now clarified the process, confirming that once an employee reaches 545 days, around 18 months, the situation changes significantly.
Temporary incapacity (known as “baja médica”) can last up to 365 days initially, with a possible extension of a further 180 days if recovery is still expected. When that full period is reached, the National Institute of Social Security (INSS) must reassess the case and make a decision about the worker’s future.
What changes after 545 days?
At this point, sick leave is no longer considered standard temporary incapacity. Instead, the worker enters what the INSS calls a medical assessment process.
Three main outcomes are possible:
1. Medical discharge (alta médica)
If improvement is considered sufficient, the worker must return to their job, although they can legally challenge the decision if they disagree.
2. Permanent incapacity assessment
If the medical condition leaves lasting limitations, the INSS may open a file to assess whether the person qualifies for a permanent disability pension.
3. Extended evaluation period
A special extension known as a demora de calificación may be granted, allowing further medical review for up to 730 days (two years total), if there is a reasonable chance of recovery.
Does employment end automatically?
No. Although the company stops paying Social Security contributions for the worker once the 18-month period is exceeded, the employment contract is not terminated.
Instead, it remains suspended while the INSS determines the final status. The worker remains linked to their employer but does not have to attend their workplace until a decision is made.
If declared fit for work, they must return to their role, unless they file a legal objection within the permitted timeframe. If granted permanent incapacity, the type and amount of benefit will depend on the classification of their disability.
A key moment for health and employment
Crossing the 545-day threshold marks a crucial shift: the focus moves from short-term recovery to long-term capability. Legal experts stress that workers should fully understand their rights and options during this stage, especially if they disagree with the medical outcome.
For many people, this is a challenging period involving health concerns, financial uncertainty, and decisions that could affect the rest of their working life. The INSS encourages affected workers to seek proper advice to ensure they navigate the process correctly.
As the number of long-term sickness cases, particularly those linked to mental health, continues to rise in the Canary Islands, clear guidance on the 18-month rule is becoming more important than ever.
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