Getting sick is stressful enough without wondering whether you filled out the right paperwork. If you work in Italy , whether you're an employee, a remote contractor, or an expat still learning the system , you've probably heard the term certificato di malattia tossed around by colleagues or your HR department. This document, along with its INPS submission process, decides whether your sick days are protected, paid, and legally recognized. Get it wrong, and you could face a docked paycheck or, in rare cases, disciplinary action. Get it right, and the whole thing takes just a few minutes of your doctor's time.
This guide walks through what a certificato di malattia actually is, how the INPS submission workflow works step by step, what changed under Law 182/2025, and what to do if you're sick abroad or can't get to a clinic. We'll also cover fast, compliant ways to get a certificate remotely.
What Is the Certificato di Malattia? Certificato vs. Attestato Explained
The certificato di malattia is the official medical certificate a doctor issues when you're too ill to work. It states your diagnosis, expected recovery time, and the address where you'll be reachable during sick leave. Your medico curante (treating physician, often your medico di base or family doctor) creates this certificate directly in the INPS online system , not on paper, and not something you personally hand to your boss.
Here's where many people get confused, and where most guides fall short: there are actually two documents involved, and they serve different purposes.
| Document | What It Contains | Who Sees It |
|---|---|---|
| Certificato di malattia | Diagnosis, clinical details, full medical information | INPS and the doctor only |
| Attestato di malattia | Only the dates of absence , no diagnosis | Your employer (datore di lavoro) |
This split exists for a good reason: privacy. Your employer has no legal right to know why you're sick, only that you are and for how long. The attestato is the version that gets forwarded automatically to your workplace, while the certificato with your medical details stays between you, your doctor, and INPS. If someone at work asks what illness you have, you're not obligated to say , the system was designed specifically so you wouldn't have to.
How INPS Submission Works: The End-to-End Workflow
This is the part most official sources explain in dense bureaucratic language. Here's the plain-English version of what actually happens, from the moment you feel sick to the moment your absence is logged.
- You see a doctor. This can be your medico di base, a hospital doctor, a telemedicine physician (more on that below), or an emergency room doctor.
- The doctor issues the certificate digitally. Instead of writing a paper note, the physician logs into the INPS portal and enters your diagnosis, start date, and expected end date directly online. This is often called the malattia telematica system.
- INPS generates a protocol number. Once submitted, the system assigns a unique protocollo number to your sick leave certificate. Keep this number , it's your proof the certificate was filed correctly and the date it happened.
- The attestato is sent to your employer automatically. You typically don't need to personally notify HR with paperwork, though most workplaces still expect a quick heads-up call or message the same day you're unable to work.
- INPS calculates your illness allowance. Depending on your contract and sector, INPS and your employer split the cost of statutory sick pay for a set number of days, following rules set by your collective labor agreement (CCNL).
You can check the status of your certificate and protocol number anytime through your personal INPS online account (using SPID, CIE, or CNS credentials), so you're never left guessing whether the paperwork went through.
Law 182/2025 and the New Telemedicine Sick Leave Certificate
For years, one of the biggest gaps in Italy's sick leave system was clarity around telemedicine. Could a doctor issue a valid certificato di malattia over a video call, without ever seeing you in person? Law 182/2025 answered that question directly, formally recognizing telemedicine consultations as a legitimate route to a fully valid sick leave certificate, provided the consulting physician is licensed in Italy and follows the same INPS submission steps as an in-person visit.
In practice, this means a remote medical certificate Italy carries the same legal weight as one from a walk-in clinic. For employees who work from home, travel frequently, or live far from their family doctor, this closes a gap that used to force people to choose between waiting days for an appointment or going to work sick. The certificate still needs a real, licensed medico curante behind it , the law does not open the door to informal or unlicensed online forms , but it does mean a proper telemedicine sick certificate now satisfies INPS requirements without an office visit.
The reform also reinforced expectations around documentation quality: the certificate must include verifiable clinician credentials, a clear diagnosis code, and dates, as an in-person certificate would. This matters if you're an expat or remote worker used to more informal doctor's notes elsewhere , Italy's standard is stricter, and a GDPR-compliant medical certificate from a properly licensed platform is the safest way to stay covered.
Employee Obligations: Fascia di Reperibilità and Your Rights
Once your certificate is filed, you're not entirely free to disappear for the day. Italian law sets specific hours, known as the fascia di reperibilità (availability hours), during which you must be home in case INPS sends a doctor to verify your illness.
- Standard hours: 10:00–12:00 and 17:00–19:00, every day including weekends and holidays, unless your CCNL specifies otherwise.
- Who can be exempt: Certain categories, including some cases tied to recognized disabilities or specific serious illnesses, may be excused from reperibilità checks.
- What happens if you're not home: A missed inspection visit without a valid reason can result in a reduction or full loss of your illness allowance for that day, and repeated violations can lead to disciplinary consequences from your employer.
If you need to step out during those hours for a medical reason , say, a pharmacy run or a follow-up appointment , keep documentation. INPS inspectors generally understand that sick people still need to see doctors or pick up prescriptions.
On the flip side, you have real protections too. Employers cannot demand to know your diagnosis, cannot require you to reveal the contents of the certificato (only the attestato), and cannot terminate you simply for being sick within the legally protected period known as the "comporto" (the maximum cumulative sick days your contract allows before employment protections change).
Illness Abroad: Cross-Border and Posted Worker Scenarios
If you fall ill while traveling or working outside Italy, the process shifts slightly, and this is where a lot of employees and posted workers get tripped up.
- Illness in another EU country: A local doctor there can issue a certificate, but it typically won't feed automatically into the INPS malattia online system the way an Italian-issued one does. You'll likely need to submit the foreign certificate to INPS yourself, sometimes with a certified translation, within a set deadline (usually two days from issue).
- Sick leave for posted workers: If you're a posted worker under an EU assignment, your Italian employer generally still handles INPS coordination, but you remain responsible for getting documentation to them quickly , don't assume it happens automatically like it would domestically.
- Sick note translation Italy: INPS may require an official or certified translation of a foreign doctor's certificate. Google Translate printouts won't cut it; use a certified translator or a service familiar with Italian medical documentation standards.
- Timing matters: Even with the extra travel complication, INPS deadlines don't pause. Submit as soon as you're able, and notify your employer directly in parallel so there's no gap in communication.
If you're an expat unsure whether your foreign certificate will be accepted, the safest move is a quick call to your employer's HR team or INPS directly, before the deadline window closes.
Fast, Remote Alternatives: Telemedicine Certificates for Sick Leave and More
Not everyone can get a same-day appointment with their medico di base, especially in bigger cities or if you're new to the country and not yet registered with a family doctor. This is the gap that a licensed online doctor consultation Italy service is built to close.
Through a service like Get Medical Certificate, you can complete a video consultation with a licensed Italian physician, get evaluated for your symptoms, and , if appropriate , receive a properly filed digital sick certificate Italy that goes through the same INPS submission process as an in-person visit, protocol number included. The same kind of platform can also issue:
- Fit-to-fly certificates for travelers with upcoming flights
- Sports fitness certificates for amateur or competitive athletes
- General wellness or return-to-work certificates for students and job applicants
Every certificate is GDPR compliant, issued by a licensed clinician, and delivered without the wait of a physical clinic visit , a real advantage if you're too unwell to leave the house, working remotely, or simply need documentation fast.
Frequently Asked Questions
Do I need to submit my certificato di malattia to my employer myself?
No. Once your doctor files it through INPS, an attestato (without diagnosis details) is sent to your employer automatically. You should still notify your employer that you're out sick, typically by phone or message, on the first day.
What is the protocol number for a sick leave certificate?
The protocol number (numero di protocollo) is a unique code INPS assigns when your certificate is filed. It confirms the certificate was submitted correctly and lets you or your employer verify it in the INPS system.
Can I get a valid sick leave certificate through telemedicine in Italy?
Yes. Under Law 182/2025, a licensed doctor can issue a fully valid certificato di malattia through a telemedicine consultation, and it's submitted to INPS the same way an in-person certificate would be.
What are fascia di reperibilità hours?
These are mandatory availability hours (typically 10:00–12:00 and 17:00–19:00 daily) when you must be home in case INPS sends a doctor to verify your illness.
What happens if I get sick while traveling in another EU country?
A local doctor can issue a certificate, but you'll usually need to send it to INPS yourself, sometimes with a certified translation, within a short deadline after issuance.
Getting It Right the First Time
The certificato di malattia and INPS submission system in Italy is more logical than it first appears once you know the moving parts: your doctor files digitally, INPS assigns a protocol number, your employer only receives the dates, and you stay reachable during set hours. Law 182/2025 now makes telemedicine a fully valid path to that certificate, which matters if you're remote, traveling, or simply can't get a quick appointment.
If you need a fast, licensed, GDPR-compliant certificate , sick leave, fitness, fit-to-fly, or sports , you can get one online through Get Medical Certificate without an in-person visit, filed correctly from the start.