More than 1.5 million self-employed individuals without employees postpone treatments for fear of losing income. UPTA reports that the RETA fee continues to be charged during the first 60 days of leave and calls for legal reform.
The Union of Professionals and Self-Employed Workers (UPTA) has highlighted a reality affecting over 1.5 million self-employed individuals without employees: they delay their medical leave for fear of losing income. The organisation has analysed data on temporary incapacity between the first quarter of 2024 and the same period in 2026, and the results are revealing.
While the number of protected self-employed individuals grew by 2.5% (from 3,310,323 to 3,391,709), the number of initiated temporary incapacity cases fell by 10.1%. It’s not that self-employed individuals are getting sick less often; rather, many cannot afford to stop working. The monthly RETA fee continues to be charged even during the first 60 days of leave, adding pressure to a business that is already losing revenue.
The trap of the 60 days: you pay even if you don’t earn
Currently, the exemption from paying the fee of the Special Regime for Self-Employed Workers (RETA) during a temporary incapacity does not start until the 61st day of leave. For the first two months, the self-employed individual pays the full contribution while their activity suffers or comes to a complete halt. For those who work alone, without employees, this is a double blow: zero income and the same fixed monthly Social Security expense.
The study’s data reveals that leaves last longer than before: the average duration of completed cases reaches 101.5 days, ten days longer than two years ago. Specialists deduce that by delaying the visit to the doctor, the illness worsens and requires longer treatments. The chronicity of conditions that could have been addressed in time is one of the consequences of this economic vulnerability.
What UPTA proposes: erase the economic penalty
The Union of Professionals and Self-Employed Workers calls for a legal reform so that the exemption from the RETA fee starts the day after any temporary incapacity begins, without waiting for the 61st day. UPTA president Eduardo Abad summarises it in a phrase that has been repeated for years: “Self-employed individuals do not get sick less; they simply cannot afford to be ill.”
“Self-employed individuals do not get sick less; they simply cannot afford to be ill.”
If approved, the measure would eliminate one of the main disincentives to taking care of health. By stopping the fee from the first day, the self-employed individual would not have to choose between continuing to work while sick or jeopardising the business's finances. Short-term leaves, which are almost invisible in the statistics today, would start to be processed without fear, and recoveries would be quicker.
A problem that chronicises illness and burdens the business
The vicious circle is well identified: a self-employed individual delays the visit to the doctor because they cannot stop; when they finally do, the condition is more advanced and the leave lasts longer; this prolongs the period without billing and without the exemption coming into effect. Small businesses, especially in services and trades, are exposed to losing clients and not fully recovering after the leave.
UPTA's figures indicate that over 1.5 million self-employed individuals without employees are the biggest victims. For them, a temporary incapacity often equates to closing the shutters. In addition to rent, utilities, and taxes, there is the RETA fee, which in lower brackets is around 225 euros per month, and in higher brackets exceeds 500.
Detecting an illness in its early stages facilitates recovery and reduces complications. If the law allowed for stopping without the cost of contributions, thousands of prolonged leaves would be avoided, and the continuity of businesses would be protected. The health of the self-employed would no longer be a luxury that is only addressed when there is no other option.
The UPTA proposal is now on the table of the Ministry of Social Security. In the meantime, self-employed individuals facing a leave must know that the exemption only begins from the 61st day, and it is mandatory to inform Social Security of the situation to avoid losing rights. The reform, if it comes, could change the rules of the game for millions of self-employed workers.
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