Who pays your sick leave (baja médica) depends on two things: why you are off sick and which day of the leave you are on. For ordinary illness, the first stretch is paid by your employer and the rest by Social Security or a mutua. After a work accident the split changes from day one. Knowing it tells you whom to chase if money does not reach your account.
For ordinary illness, your employer pays days 4 to 15
Article 173.1 of the Ley General de la Seguridad Social (LGSS, the General Social Security Law) says it plainly: for ordinary illness or a non-work accident, the benefit is paid from the fourth day of leave, and from the fourth to the fifteenth day inclusive it is the employer’s responsibility. That is 12 days of benefit paid by the company. Days 1, 2 and 3 carry no public benefit.
From day 16 the benefit stops being the employer’s. It passes to the body that manages your temporary incapacity: the INSS (Instituto Nacional de la Seguridad Social) or the mutua colaboradora con la Seguridad Social your employer has chosen (art. 83.1 LGSS).
| Cause of the sick leave | Days 1 to 3 | Days 4 to 15 | From day 16 |
|---|---|---|---|
| Ordinary illness or non-work accident | No benefit | Employer | INSS or mutua |
| Work accident or occupational illness | Wage for the day of the accident paid by the employer | INSS or mutua | INSS or mutua |
From day 16 the INSS or your mutua pays, even if it arrives on your payslip
Receiving the money on your payslip from day 16 does not mean the company pays it from its own pocket. Article 102 LGSS lets companies cooperate in managing Social Security by paying their workers, “at the expense of the managing body or mutua”, the temporary incapacity benefits. In practice the employer pays you and offsets the amount against the contributions it hands over to Social Security. This is called pago delegado (delegated payment).
For you the effect is simple: the money may come through your usual payslip, but from day 16 the insurer, not your boss, is liable for it. While the compulsory cooperation lasts, the employer keeps paying until you are notified of the discharge, or until the 545-day maximum (art. 170.2 LGSS).
After a work accident or occupational illness, the split is different
Here the law is more favourable. Under article 173.1 LGSS, the benefit is paid from the day after the leave begins, and the employer pays the full wage for the day of the accident. There are no three waiting days and no 12 days paid by the employer. No minimum previous contribution is required either (art. 172.b LGSS).
Whether the cause is work-related is first decided by the mutua, although the competent managing body can review or reclassify it later (art. 82.2 LGSS). If your employer covers accidents with a mutua, that mutua pays you from the next day.
An example with 30 days of ordinary sick leave
Take a 30-day leave for ordinary illness with a daily base of €65. We use the percentages published by Social Security, explained in how much sick leave pays: 60% from day 4 to day 20 and 75% from day 21.
| Stretch | Days | Calculation | Amount | Who pays |
|---|---|---|---|---|
| Days 1 to 3 | 3 | No benefit | €0.00 | Nobody |
| Days 4 to 15 | 12 | 12 × €65 × 60% | €468.00 | Employer |
| Days 16 to 20 | 5 | 5 × €65 × 60% | €195.00 | INSS or mutua |
| Days 21 to 30 | 10 | 10 × €65 × 75% | €487.50 | INSS or mutua |
| Total | 30 | €1,150.50 |
The employer bears €468 and the INSS or mutua €682.50. You receive €1,150.50 in total. If your collective agreement (convenio) improves the benefit, the top-up is paid by the employer on top.
A mutua is not your employer
A mutua colaboradora is a non-profit association of employers authorised to help manage Social Security (art. 80 LGSS). Your employer joins one when registering its workers, and can choose whether it manages only work accidents and occupational illnesses or also ordinary-illness sick leave.
This matters to you because the mutua can summon you to medical examinations. If you fail to attend without justification, article 175.3 LGSS provides for a precautionary suspension of the benefit while it checks whether your absence was justified. And any decision by the mutua granting or removing rights must be reasoned, in writing and notified to you (art. 82.2).
Why your case may be different
- Your convenio improves the benefit. Many collective agreements oblige the employer to pay a top-up or the first three days. The employer pays that, and the law does not require it; check yours.
- You do not meet the minimum contributions. For ordinary illness you need 180 days of contributions in the last five years (art. 172.a LGSS). Without them nobody pays the benefit.
- Special situations. From week 39 of pregnancy, after an interruption of pregnancy, with disabling secondary menstruation and for organ donation, the split in article 173.1 is different and a minimum contribution period is not always required.
- Your employer fails to pay contributions or disappears. Article 167 LGSS shares out responsibility and lets the managing body or mutua advance payment in the cases set by regulation.
The first three days have their own rules and collective-agreement exceptions: see the first three days of sick leave.
What to do if the money does not arrive
- Check your payslip for the breakdown: a “IT” line (temporary incapacity) for days 4 to 15 and the insurer’s share from day 16.
- Ask HR in writing which days the company pays and which the insurer pays.
- If you are not paid, ask the mutua or the INSS directly: a written decision is your proof.
- If the leave is due to a work accident and nobody pays, claim from the mutua from the next day.
Your payslip for the month before the leave shows the base used for the calculation. If the leave drags on or you are discharged without being cured, see what to do if you disagree with a medical discharge. And if you worry about being dismissed while receiving it, read dismissal while on sick leave.
This information is general guidance. When deadlines or money are at stake, speak to an employment lawyer (abogado laboralista) or a union.