Medical discharge: who signs it and how to disagree
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The calculator starts from an INSS discharge after 365 days: enter its date and you will see the last day to lodge your disagreement.
Disagreeing with the discharge
2 November 2026
You have 4 calendar days to lodge your disagreement with your health service’s medical inspection (LGSS art. 170.3).
| The inspection can ask for a review until | 5 November 2026 |
| With no answer, the discharge takes full effect on | 9 November 2026 |
Meanwhile the leave counts as extended. Calendar days from the discharge date.
Prepared by Radif Partners · Method · Rules and agreements read in the BOE on 29 October 2026
A medical discharge ends the sick leave and means you must return to work the next day. Who can sign it depends on the cause and the stage. For an ordinary illness, up to day 365 it is signed by your health service doctor, the health service medical inspection or the INSS inspection; the mutua can only propose it. For a work accident or occupational disease covered by a mutua, the mutua's doctors can discharge you. From day 365, only the INSS can. If you disagree, the route depends on who signed it. Against a mutua discharge in an accident or occupational disease case, you have 10 working days to ask the INSS to review it. Against an INSS discharge after 365 days, you have 4 calendar days to lodge a disagreement with your health service inspection: for a discharge dated 14 December 2026, until 18 December 2026.
Who signs the discharge
Article 170 of the General Social Security Act splits authority into two stages, before and after 365 days, and Royal Decree 625/2014 governs discharge proposals by mutuas. The table sums up who can sign the discharge and what route you have to disagree. Whoever signs the discharge gives you a copy, and your employer receives its data from the INSS by the next working day.
| Situation | Who discharges | If you disagree |
|---|---|---|
| Ordinary illness, up to day 365 | Your doctor, the health service inspection or the INSS | The mutua only proposes; appeal to the labour courts |
| Accident or occupational disease with a mutua | The mutua’s doctors | Review by the INSS within 10 working days (until 28 December 2026) |
| Any cause, from day 365 | Only the INSS inspection | Disagreement within 4 calendar days (until 18 December 2026) |
An INSS discharge after 365 days
This is the only case where disagreeing does not oblige you to return while it is decided. You have 4 calendar days to lodge your disagreement with your health service medical inspection. If the inspection disagrees with the INSS, it has 7 days to ask it to reconsider, and the INSS must respond within another seven. If nobody responds within 11 days, the discharge takes full effect: for a discharge dated 14 December 2026, on 25 December 2026. Meanwhile, the leave counts as extended and the employer keeps advancing the benefit.
Your last day to disagree
Disagreeing with the discharge
2 November 2026
| The inspection can ask for a review until | 5 November 2026 |
| With no answer, the discharge takes full effect on | 9 November 2026 |
A mutua discharge after a work accident
If the mutua discharges you from a work accident or occupational disease case, you can ask the INSS to review it within ten working days of notification, under the procedure in Royal Decree 1430/2009 as rewritten by a final provision of Royal Decree 625/2014. You must provide your medical history for the case and tell your employer, on the same day or the next working day, that you have started it. The mutua has four working days to report and may accept that the discharge was wrong. Outside these procedures, discharges are challenged before the labour courts. The other deadlines are in sick leave deadlines, and the length limits in maximum length. Always keep your copy of the discharge note: its date is what starts each deadline, and you will need it for any review or appeal.