Sick leave in Portugal: how it works

This guide explains how sick leave in Portugal works, who can get Subsídio de Doença (sickness benefit), the difference between CIT and self-declaration,  how to get a sick note in Portugal, and what employers usually expect. It´s for general information only, not legal or medical advice, and rules can change, so verify details with Segurança Social,  SNS 24, or a qualified professional. 

Key takeaways

• Sick leave in Portugal usually involves two things: a document that justifies your absence (CIT or ADD) and, separately, a Social Security payment (Subsídio de Doença). Having one doesn’t automatically mean you get the other.
• CIT (Certificado de Incapacidade Temporária) is the official name for what’s commonly called a “sick note” or baixa médica; it’s the same document, issued by a doctor, and required for absences longer than 3 days.
• ADD (Autodeclaração de Doença) lets you self-declare a short illness of up to 3 consecutive days, twice a year, without seeing a doctor, but it doesn’t create a right to paid sickness benefit.
• Eligibility for sick pay depends on two tests: at least 6 months of Social Security contributions, and (for employees) 12 days worked in the relevant 4-month window; self-employed workers are exempt from the second test.
• Foreign workers who are properly insured and contributing follow the same core process as Portuguese employees, but should keep their NISS and Número de Utente easily accessible.

What sick leave means in Portugal

Sick leave (baixa medica) in Portugal means an absence from work because illness makes you unfit to do your job. In practice, you normally need formal proof of incapacity if the illness goes beyond a very short self-declared absence.

People often mix up three separate things: the absence itself, the certificate that justifies it, and the money paid during that period. In Portugal, those are linked, but they are not the same.

How sick leave works in Portugal

The system is fairly structured. You get ill, you notify your employer, you obtain the right document, and if you meet the conditions, Segurança Social processes the sickness benefit automatically from that medical certificate.

Employers do not usually keep paying your full salary as normal. In most cases, sick leave benefits in Portugal are paid through Segurança Social once you are eligible, while the employer needs valid proof of your absence.

The main terms you need to know

You will see a few Portuguese terms again and again:

• Baixa médica: the common term for sick leave or sick note.
• Certificado de Incapacidade Temporária (CIT): the formal certificate of temporary incapacity for work, issued by a doctor; this is the official name for what’s commonly called a “sick note.” It´s the document that supports a standard sickness absence and unlocks eligibility for sickness benefit.
• Subsídio de Doença: the sickness benefit paid by Social Security once you qualify, normally starting from the 4th day of incapacity for employees, later for self-employed workers.
• Autodeclaração de Doença (ADD): a self-declaration of illness that lets you justify an absence of up to 3 consecutive days, without seeing a doctor, up to twice a year (6 days total). Crucially, ADD does not carry the right to sickness benefit; those days are treated as justified absence, but unpaid by Segurança Social 

What happens when you get sick

Tell your employer as soon as possible and arrange the right kind of proof. For a very short illness, you may be able to use an ADD through SNS 24, provided you haven’t already used your two self-declarations for the year. If the illness lasts longer than 3 days, or if you’ve already used up your ADD allowance, you’ll need a CIT from a doctor instead.

Once a CIT is issued electronically, the health service sends it to Social Security automatically. You still need to share the document with your employer, either digitally or on paper, following the employer’s own process.

If you receive a paper CIT in an exceptional case, send it to Segurança Social within five business days. Late submission doesn’t automatically cancel your entitlement, but it can delay when payments start.

Who can get sick pay in Portugal

Portuguese sickness benefit (Subsídio de Doença) depends on meeting two specific contribution tests: the prazo de garantia (a qualifying period of at least 6 months of Social Security contributions) and the índice de profissionalidade (an activity requirement of at least 12 days of registered work within the first 4 months of the 6 months before your leave began). These rules apply differently depending on whether you’re an employee or self-employed, covered separately below.

Employees

Employees who pay into Portuguese Social Security can usually qualify for Subsídio de Doença. Besides a valid CIT, they normally need six months of contributions and at least 12 days of recorded work in the first four months of the last six months before the incapacity begins.

For recent arrivals, time paid into another national or foreign social protection system may still matter in some cases. That can help expats, but it is worth checking directly with Social Security if your work history spans more than one country.

Self-employed workers

Self-employed workers can also qualify for sick pay in Portugal, but the rules aren’t identical. They still need a valid CIT and six months of Social Security contributions, plus a regularized contribution position, meaning no outstanding payments owed at the time incapacity begins

Unlike employees, self-employed workers don’t use the same 12-day índice de profissionalidade test. But they face a longer waiting period before sick pay starts; this can catch freelancers off guard if they’re relying on income week to week.

Waiting periods and contribution rules

For employees, Social Security usually starts paying from the fourth day of incapacity, meaning the first three days are a waiting period. For self-employed workers, payment usually starts on the eleventh day, so there is a 10-day waiting period.

There are exceptions. Payment can start on day one in cases such as hospital admission, outpatient surgery, tuberculosis, or illness that begins during parental benefit and continues after it. Another detail that surprises people is that an ADD can help cover the initial waiting days if it runs straight into a CIT, but the ADD itself is not paid.

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How much sick pay you can receive

The amount is based on your reference remuneration, which is the earnings figure Social Security uses for the calculation. It rises as the sickness absence gets longer.

Payment bands explained

Under the current Social Security rules, sickness benefit is generally paid at:

• 55% of reference remuneration for up to 30 days
• 60% from 31 to 90 days
• 70% from 91 to 365 days
• 75% after 365 days

There can also be a 5% increase on the 55% or 60% rate in some lower-income or larger-family situations, such as a reference remuneration of €500 or less, or three or more dependent children in the household. Exact entitlement depends on Social Security’s assessment of your specific case, so treat this as a general rule rather than a guarantee.

What can affect the amount you receive

Your employment category, contribution history, and how Social Security calculates your reference remuneration can all change the final amount. If you have a mixed work history, gaps in contributions, or income from more than one system, your outcome may look different from a simple percentage estimate.

Online calculators and rough examples are only guides. Social Security calculates your actual reference remuneration case by case, based on your specific salary records, not a generic formula applied uniformly to everyone.

How long sick pay lasts

For employees, sickness benefit can usually be paid for up to 1,095 days. For self-employed workers, the normal maximum is 365 days. In tuberculosis cases, the benefit can continue without a fixed time limit.

Separate sick leaves may also be added together if less than 60 days pass between them. In practice, that means a short return to work does not always reset the clock.

How to get a sick note in Portugal

Getting a sick note in Portugal is about using the right document so your absence and any benefit claim go through smoothly.

Getting a CIT from SNS 24 or a healthcare provider

A CIT can be issued by eligible doctors in public, private, or social healthcare settings. Since March 2024, doctors in the private and social sectors can also issue these certificates for work absence, including in urgent care settings, which makes the process easier if you cannot get to an SNS clinic quickly. That said, no consultation guarantees a CIT automatically; the decision rests with the doctor after clinical assessment.

You can view, download, and print your baixa médica through the SNS 24 portal or app. The communication to Social Security is automatic in the general regime, but you are still responsible for giving the document to your employer. If you are not yet familiar with the public system, Expatica’s guide to healthcare in Portugal for expats can help you understand how access works.

What to do if you only have a self-declaration of illness

An ADD (Autodeclaração de Saúde) is useful for short illnesses, but it has limits. You can request it through SNS 24; it can justify up to three consecutive days, and you can normally use it twice per calendar year.

The key difference from a CIT is simple: an ADD does not create a right to Subsídio de Doença. It justifies the absence, but it is unpaid. If you are still sick after those three days, you need a medical consultation and, if appropriate, a CIT dated from the start of the illness period.

What your employer may ask for

Employers generally need proof that your absence is justified, but that does not mean every workplace handles paperwork in the same way. For a CIT, you usually provide the certificate itself. For an ADD, you provide the SNS 24 access code, sent to you by SMS or email when the ADD is issued,  so the employer can validate it directly through the SNS 24 portal.

An employer may also ask whether the illness has been formally certified. Under the general framework, employers can request verification of incapacity through Social Security. That is different from asking you for extra medical details. Follow your workplace policy on notification timing, but rely on official documents rather than informal messages alone.

Sick leave for expats and foreign workers

For newcomers, the confusing part is usually not the illness itself. It is knowing which system to use and which Portuguese terms matter. The core process is the same for foreign workers who are properly insured and contributing.

Keep your NISS (Social Security number), your Número de Utente (health service user number, if you have one), and your employer details easy to access. If you are newly arrived and still working out public registration, see the healthcare system in Portugal and EHIC card in Portugal so you know what short-stay public access can and cannot do.

When to use public healthcare or private insurance

For many residents, public healthcare is the default route because it connects cleanly to the CIT and Social Security system. If you are unsure about access, Is healthcare free in Portugal explains where public cover starts and where out-of-pocket costs can still appear.

Private care is also a valid route, and since eligible private and social sector doctors can now issue CITs too, a private consultation can result in a valid sick note just as a public one can. Whether private care suits you better depends on factors specific to your situation, your location, the provider, your insurance terms, and what the visit is for, not a general rule that private is faster or easier. Private insurance doesn’t replace Social Security sickness benefits either way. If you want broader private cover, compare health insurance in Portugal carefully, and look at expat-oriented options such as Cigna or Allianz Healthcare with attention to waiting periods, exclusions, and direct billing.

If you want broader private cover, compare health insurance in Portugal carefully, and look at expat-oriented options with attention to waiting periods, exclusions, and direct billing.