Sick leave in Italy for Nordic managers: no karensavdrag, a different certificate

A Swedish manager knows the routine. The employee reports sick, the employer pays sick pay of 80% for the first 14 calendar days, a qualifying deduction of 20% of average weekly pay is made once per period, and Försäkringskassan takes over after day 14 ( Försäkringskassan ).

Italy works on a different logic. The certificate comes first, it goes through the state, and the employer sees much less.

How the certificate works  

In Italy the doctor issues the medical certificate electronically and sends it directly to INPS, the social security institute. The employee receives a protocol number.

The employer does not receive the diagnosis. It can see that the employee is certified unfit for work and for which period. Nothing else.

So the manager’s role is narrow. You do not collect medical documents. You check that a valid certificate exists, and you plan the work.

What the employee must do  

The employee must still tell you about the absence, promptly and usually before the working day starts. Most CCNLs also expect them to share the protocol number. Put this in your onboarding material: which channel, which person. Nordic teams that are relaxed about “just post in the channel” should still name the process explicitly.

Who pays  

Sick pay in Italy is split between INPS and the employer, in proportions set by the national collective agreement (CCNL), by length of service and by type of absence. Some CCNLs require the employer to top up what INPS pays so that the employee receives close to full pay.

There is no Italian equivalent of the Swedish qualifying deduction in the standard set-up. Do not apply one by habit.

Budget this as part of the employment cost. It varies by sector, and we show it in the quote.

What a manager can ask  

• Whether the absence has been reported and through which channel.
• The certificate protocol number, so payroll can verify it.
• Whether urgent work or handovers need covering.
• The end date shown on the certificate.

And, kindly, to be told if the return date changes.

What a manager should not ask  

• The diagnosis. Health data is among the most protected categories under GDPR. You do not need it.
• Symptoms. A friendly “what do you have?” can be read as an intrusion.
• Extra proof. No further notes, photos or test results.
• Whether they are really sick. Doubts go to HR or to us, not into a chat.
• Work during sick leave. No emails, no “quick call”. It undermines the leave and creates risk.

A simple rule: if the answer would not change how you plan the work, do not ask. Most Nordic managers already work this way. The Italian rules make it formal.

Home checks  

Italy has a system of medical control visits. During set daily time bands the employee must be reachable at the declared address. The employer can request a check, and INPS can order one, with exemptions for some conditions and appointments.

Suspicion of abuse is not a reason to confront the employee. Speak to us first. A control visit follows its own formal procedure.

Practical steps  

1. Write a short sick leave note that reflects Italian practice, not the Swedish routine.
2. Brief managers on what they can and cannot ask.
3. Name one person, or your EOR, to verify certificates and keep records.
4. Keep absence records separate from any health information, and in most cases hold no health information at all.
5. Check the CCNL for top-ups and special rules.

As Employer of Record (EOR), we retrieve the certificate data, record the absence in payroll and flag anything unusual. You plan the cover.

Questions we hear from Nordic companies  

What if an employee is sick often? Do not draw conclusions from certificates. Talk about workload and wellbeing, and involve us. The CCNL sets a protected period for sickness; dismissal rules around long illness are formal and need advice.

Does sickness during holiday count as holiday? Under Italian rules, illness certified during holiday can interrupt it, so the days are not lost. The employee must follow the certificate procedure.

See the sick-pay row in Italy vs Sweden , and the cost effect in the cost calculator .