Sick leave in North Macedonia: additional checks from December 1 for extensions beyond five days

New rules on sick leave in North Macedonia will take effect on December 1. Family doctors may grant up to five days of sick leave without additional diagnostic requirements; if the leave needs to be extended, further tests or a specialist appointment will be required, depending on the illness.

According to the Health Insurance Fund, the fifth day is not a mandatory deadline for patients to return to work, and the right to sick leave remains in effect.

Family doctors’ authority to approve up to 15 days of sick leave remains unchanged. When a longer period is needed, a medical commission makes the decision. If a patient’s condition requires it, a priority referral may be issued so that a specialist examination can take place sooner.

When sick leave exceeds 60 days, an opinion from a panel of three specialists is generally required. The regulations provide exceptions for certain serious illnesses, while patients with chronic conditions may submit previous diagnostic results if they are relevant.

Doctors have sought further clarification on how the rules will be implemented, especially when patients cannot obtain a specialist appointment in time.

The Fund has announced that it will hold workshops for family doctors on November 19 and 20. A public debate on the new criteria is also planned for November 20.