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Temporary disability represents an estimated annual cost of €81 billion in terms of GDP

Umivale Activa and the Ivie present in Madrid the conclusions of their report on the evolution of temporary disability and accident rates in Spain

Spain ranks among the EU countries with the highest rate of absenteeism due to temporary disability and the fastest growth in this area. Between 2018 and 2023, the number of working days lost due to temporary disability under Spain’s main social security system for employed workers (known as, Régimen General) has risen from 242 million to 368.7 million, an increase of 52%. These sick leave levels, which represent 5.6% of potential working days lost in a year, are equivalent to one million workers being on sick leave every day of 2023 or, alternatively, each worker being absent 20 days a year due to temporary disability (five days more than in 2018). The potential production loss associated with sick leave days is estimated at €81.574 billion GDP, representing 5.4% of the national total. This figure is €25.9 billion higher than in 2018, marking a 47% increase.

These are some key findings from the study Evolución de la incapacidad temporal y la siniestralidad en España (Evolution of temporary disability and accident rates in Spain), carried out by the mutual insurance company Umivale Activa and Ivie. The study, presented at the headquarters of the Economic and Social Council (CES) in Madrid, was led by Ivie researchers José María Peiró and Lorenzo Serrano and carried out by the following team: Francisco J. Goerlich, Consuelo Mínguez, and Fernando Pascual from the Ivie, and Marija Davcheva and Juan Miguel Mesa from Umivale Activa.

The increase is primarily concentrated in temporary disabilities due to common contingencies (non-occupational illnesses or non-work-related accidents), rather than occupational contingencies (work-related accidents or occupational illnesses), which are mainly managed by mutual insurance companies and have remained virtually stable.

Long-term cases (lasting more than 365 days) have seen the most significant growth in recent years, doubling from 83,000 in 2018 to 167,000 in 2023. Although these cases represent only 2.4% of all the completed processes in 2023, they accounted for 34.1% of total sick leave days. The number of days lost corresponding to this period have increased by 87% over the past six years, compared to a 35% increase for cases lasting less than 12 months, totaling 110 million days of sick leave.

Another key factor contributing to the rise in temporary disability is the increase in lost working days among individuals who experience more than one episode within a 12-month period. In 2023, more than 50% of workers on active sick leave were repeat cases: a figure that continues to rise and largely explains the overall increase in absenteeism due to temporary disability over the six-year period analyzed. In fact, the percentage of repeat cases within the total protected population has increased by 55% since 2018. Although these cases represent only 16.6% of workers, they account for 69.6% of sick leave and 64.5% of lost working days, 12.6 percentage points more than in 2018, and are responsible for nearly the entire increase in temporary disability absenteeism between 2018 and 2023.

In addition, the most difficult pathologies to objectively diagnose, such as pain (neck, low back or general back pain, etc.) and mental health issues, generate more than half of temporary disability related absenteeism, and their impact continues to grow. While total lost working days increased by 52.3%, it is noteworthy that cardiovascular, oncological, and trauma-related conditions worsened at below average rates (42.9%, 39.8%, and 29.9%, respectively), while pain-related cases rose by 56.5% and mental health cases by 111.4%.

Together, these two conditions account for 51.1% of the absenteeism indicator due to temporary disability, while the remaining diagnoses make up the remaining 48.9%. Their growth represents two-thirds of the overall increase in days off due to temporary disability. Moreover, sick leave due to pain and mental health conditions are responsible for 56.1% of ongoing long-term cases. Both have gained prominence in the years following the pandemic and are among the conditions with the highest recurrence rates. In 2023, 37.7% of workers with repeat and active sick leave cases had pain (25.4%) or mental health issues (12.3%) as their primary diagnosis.

The study also analyzes differences in temporary disability due to health reasons based on demographic characteristics, occupation and environmental factors, such as sector or region.

Gender and age are key differentiators. In 2023, women had higher absenteeism rates due to temporary disability (percentage of annual working days lost out of potential working days), with 6.4%, compared to 4.8% for men. Notably, mental health issues contributed more significantly to lost working days among women (21%) than among men (15%).

The report also notes the disparity in results based on age. The temporary disability indicator stands at 3% for young people aged 16 to 29, compared to 9.6% for workers between 60 and 64 years old. In fact, 20% of the increase in the temporary disability indicator corresponds to days lost by workers approaching retirement age and 70% to those aged 50 and over. However, the authors note that the incidence rates are actually higher among young people (648 cases per 1,000 in the 20-24 age group versus 429 per 1,000 in the 60-64 age group). This index reveals a reverse trend compared to the overall temporary disability indicator: young people experience significantly more episodes (about 50% more than older workers) although their absences are shorter in terms of days off work. It is also worth noting that in all age groups, the annual incidence has increased since 2018, with increases ranging from 26% (ages 55-59) to 53% (ages 20-24).

Another indicator related to worker characteristics is educational attainment. Absenteeism and temporary disability are more frequent among individuals with lower levels of education. Workers who have only completed compulsory education are 9.5 points more likely to take sick leave than those with university degrees. Finally, the study also highlights differences based on nationality and confirms that, all other factors being equal, foreign workers are 10.3 points less likely to take sick leave than Spanish workers, which may be due to cultural differences or a greater sense of insecurity regarding available resources.

In terms of differences arising from job characteristics, the report finds a slightly higher probability of temporary disability among workers with permanent, full-time contracts. Furthermore, the probability is also higher, by up to 17 percentage points, in the case of less skilled occupations. The authors explained that: “The transformation of the productive fabric towards more skilled and higher-quality jobs appears to be a potential way to moderate temporary disability levels while simultaneously boosting productivity”. Other significant predictors of temporary disability include lack of flexibility in balancing work and family life, jobs with higher stress levels, and a lower capacity for workers to organize their tasks.

By sector, the highest rates of absenteeism due to temporary disability are found in administrative and auxiliary services (temporary employment agencies, security services, cleaning, etc.), those related to water supply and sanitation activities, and healthcare, with percentages of lost working days above 7%. In contrast, the lowest rates are seen in the information and communications sector (2.4%) and in professional, scientific, and technical activities (2.6%). Other sectors with below-average absenteeism include agriculture, financial activities, and education.

Regional differences are also significant. The highest rates of temporary disability in 2023 were recorded in the Canary Islands, the Basque Country, and Galicia, all exceeding 7% of working days lost. The lowest rates were found in the Balearic Islands, La Rioja, and the Community of Madrid, where lost working days did not exceed 5%. Long-term temporary disability cases (lasting more than 365 days) also vary by region: the Canary Islands, Galicia, and Catalonia have a higher prevalence (11 per 1,000 workers), while La Rioja and the Community of Madrid report less than 7 per 1,000 workers. At provincial level, repeat offender rates are highest in Barcelona, Álava, and Navarra (above 24% of the protected population) and lowest in Cáceres, Jaén, and Salamanca.

This report sends a clear warning: absenteeism due to temporary disability is a major strategic and economic challenge that requires an immediate, coordinated, and evidence-based response. The record-high figures, their rapid growth, and the worsening of all variables without exception highlight the urgent need for structural reforms. In the area of temporary disability, what is at stake is not only the health of workers and the proper functioning of healthcare systems, but also the sustainability of the system, the well-being of the country, and its ability to generate wealth and employment. It is therefore urgent and essential for all stakeholders to make a joint and determined effort towards a shared goal that benefits society as a whole.