CCSS Medical Leave (Sick Leave): Requirements, Timeframes, and Payment

Sick leave (*incapacidad*) is the medical rest order issued by a CCSS physician (or one authorized by the CCSS) when a common illness prevents you from working. It is not automatic: in addition to being granted the leave, you must meet separate contribution requirements to be eligible for the **subsidy** (the cash payment during your leave) — Reglamento del Seguro de Salud de la CCSS.

**Contribution requirement (Art. 34)**: To be eligible for the subsidy, you must have paid social security contributions during the month prior to the medical leave **and** have contributed at least **6 monthly payments within the 12 months prior** to the date the leave begins. The subsidy is paid for up to a maximum of **52 weeks**; if you contributed 9 monthly payments or more in those 12 months, it can be extended for an **additional 26 weeks**. If you contributed only 1–2 payments, you are not entitled to the full subsidy, but rather a smaller financial aid for up to 12 weeks (or 26 weeks if you made 3 consecutive payments followed by fewer than 6 in total).

**From which day is it paid? (Art. 35)**: The CCSS subsidy applies **starting on the fourth day** of medical leave — the first three days are covered by the employer (an obligation established by the Código de Trabajo and confirmed by criteria from the Ministerio de Trabajo, commonly cited as 50% of the salary for those three days, although for the exact amount it is best to confirm with Human Resources or the MTSS). If you are granted a new medical leave within 30 days of the previous one, CCSS payment begins on the first day, not the fourth.

**How much does the CCSS pay? (Art. 36)**: It is calculated based on the average salary or income reported in the **three months prior** to the medical leave — the regulatory formula is technical (up to four times the total contributory contribution), and in practice the resulting amount usually hovers around 60% of that average salary, though it is best not to assume it is fixed: **confirm the exact amount in the Oficina Virtual de la CCSS**, where it is calculated on a case-by-case basis. For **independent workers**, the law does set exact percentages based on how long you have been contributing: 50% if you contributed from 3 to less than 6 months, 75% if you contributed from 6 to less than 9 months, and 100% if you contributed 9 months or more.

**How to receive payment**: The payment is deposited directly into your bank account — you must have it registered in the Oficina Virtual de la CCSS. You can check the status of a medical leave using the voucher number (*número de boleta*) at aissfa.ccss.sa.cr.

**Important rules while on medical leave**: You cannot work (neither at that job nor any other, paid or unpaid) 24 hours a day during the duration of the medical leave, nor leave the country without express medical authorization — doing so may cause your subsidy to be suspended.