Who pays for sick leave? A guide for employers and employees

When an employee goes on sick leave, the first question that arises for the company (and for the employee themselves) is always the same: who pays for sick leave? The answer is not simply “Social Security and that’s it”. The cost is split into stages between the employee, the employer and the managing body, and that split changes depending on the type of contingency. If you run an SME, it’s worth being clear about this so you don’t overpay or throw your payroll out of balance. Here we explain it in a simple way, with the figures in force in 2026.

What is sick leave?

Sick leave (technically, incapacidad temporal or IT — temporary disability) is the situation in which an employee is unable to carry out their duties due to a health problem and needs medical care. While it lasts, the contract is suspended: the employee does not come to work, but keeps their employment relationship and receives a financial benefit that replaces their salary.

There are two broad types of contingency, and who pays and how much depends on them:

Common contingencies: common illness (a bout of flu, an infection, lower back pain) or a non-work-related accident. This is the most frequent case.
Professional contingencies: an occupational illness arising from work or a workplace accident, including those occurring in itinere (on the way to work).

This distinction is crucial, because leave for professional contingencies has more generous cover from day one.

Who pays for sick leave?

For leave due to common illness or a non-work-related accident, payment of the benefit is split into three stages:

Days 1 to 3: no Social Security benefit is paid. This stage is borne by the employee (unless the collective agreement requires the employer to top it up, which is very common).
Days 4 to 15: the employer pays, out of its own resources.
From day 16 onwards: the Social Security system or the collaborating mutual insurer pays, although the amount is paid through payroll under a pago delegado (delegated payment) arrangement (the company advances it and is later reimbursed).

As for how much is received in a common contingency:

From day 4 to day 20: 60% of the regulatory base.
From day 21 onwards: 75% of the regulatory base.

Many collective agreements improve on these figures and require the employer to top up the benefit to 100% of salary for a number of days. That’s why, before calculating a sick-leave payslip, the first thing to do is check the applicable collective agreement.

Who pays the first 3 days of sick leave?

This is the most frequently asked question. In leave due to a common contingency, the first three days generate no Social Security benefit: in principle, that cost falls on the employee, who would go unpaid for those days.

In practice, however, two very common things happen:

The collective agreement requires the employer to pay them. A large number of agreements include the obligation to top up the benefit from the first day, so that the employee does not lose income.
The employer covers it voluntarily as part of its employment terms.

The situation changes completely for professional contingencies (a workplace accident or occupational illness):

Benefit is paid from the day after the leave begins.
The benefit is 75% of the regulatory base from the first day.
The day the leave begins is paid in full by the employer as if it were a working day.

In these cases there is no “gap” of the first three days: cover starts earlier and at a higher percentage.

And what about self-employed workers?

Self-employed workers (RETA) are also entitled to temporary disability (IT) benefit, provided they are up to date with their contributions and have the contingency covered. For common illness, they are paid from the fourth day of leave, and payment is made by the mutual insurer or managing body with which they have the contingency covered. For professional contingencies, from the following day.

How to manage absences in the company?

Beyond knowing who pays each stage, the real challenge for an SME is managing the paperwork and the impact on payroll without errors. A poorly recorded sick leave can lead to an incorrect calculation, a discrepancy in contributions or a problem with the Inspección de Trabajo (Labour Inspectorate).

To keep this in order, it’s a good idea to:

Record the exact start and end dates of leave for each employee, along with the type of contingency.
Keep the medical certificates (leave, confirmation and discharge) centralised and accessible.
Apply the agreement top-up automatically, instead of calculating it by hand every month.
Reflect the absence in the working-time record, so that time tracking matches what the workforce has actually worked.

This is where HR software makes the difference. With LapsoWork you can record sick leave, link it to time tracking and store medical certificates in the document manager, so that every absence is documented and its effect on payroll is calculated automatically. Fewer spreadsheets, fewer errors and all the traceability the Labour Inspectorate might ask you for.

In summary

For common illness, the split is: days 1-3 the employee (unless the agreement says otherwise), days 4-15 the employer and from day 16 onwards Social Security.
60% of the regulatory base is paid from day 4 to day 20, and 75% from day 21 onwards.
For professional contingencies (a workplace accident or occupational illness), 75% is paid from the day after the leave begins.
Always check the collective agreement: it determines whether those first days are paid and whether there’s a top-up to 100%.

Having this process automated saves you time, avoids payroll errors and gives you the peace of mind of complying with the regulations in force.