Being ill when living and working abroad can be particularly unpleasant, especially if you’re far from your family and are still getting to grips with a foreign healthcare system.

For those working in Italy as freelancers, illness may also come with uncertainty around your right to paid time off work and the bureaucracy around claiming sick pay.

Contrary to what many people believe, you may be entitled to l‘indennità di malattia (statutory sick pay) if you have a Partita Iva (VAT number).

However, there are various restrictions to be aware of.

Which self-employed workers are eligible?

Statutory sick pay is available to workers on a Partita Iva who are classed as being under ‘separate management’ (gestione separata), according to Italy’s social security agency INPS.

‘Separate management’ applies to those who are not signed up for health insurance through a professional organisation (for example, architects and engineers may have paid for registration with Inarcassa through their industry association).

Sick pay is not available to those with other types of Partita Iva registration.

As a Partita Iva holder under gestione separata you’ll be eligible for statutory sick pay, but only from the fourth day of absence from work.

This is paid from social security, and while for employees the amount is equivalent to half your average daily wage, for self-employed workers instead the amount depends on how many months’ worth of social security contributions you’ve made.

According to INPS, the daily amount of sick pay is:

• €22.58 if you have made up to 4 months’ payments.
• €33.88 if you have made 5 to 8 months’ payments.
• €45.17 if you have made 9 to 12 months’ payments.

The following conditions also apply:

• you must have made at least one month’s worth of INPS contributions in the 12 months preceding the date of onset of the illness;
• self-employed work is ongoing when the illness begins;
• you do not work during the period of paid absence.

The state may cover paid sick leave for up to a maximum or 61 days.

You’ll need a sick note (certificato di malattia) issued by your doctor (medico di base), which must be shared with the National Institute for Social Security (INPS). Usually the doctor can do this for you electronically, but double check: if not, you’ll be responsible for posting the paper copy to the INPS within two days.

You’ll also need to file a request yourself by via the INPS website.

It’s also important to know that if you’re on paid sick leave, you may be subject to checks at home.

Every day you’re not working, you’re supposed to be available at your registered address between the hours of 10am to 12pm and 5pm to 7pm, awaiting the visit of what’s sometimes known as a medico spia, or ‘spy doctor’. 

If they find you not at home, or think you appear fit to work, you can be denied your sick pay.

If you struggle to work out your entitlement or how to apply for sick pay, you can seek advice from your commercialista (accountant) or from a CAF (tax assistance centre), where help with filling out tax forms is free of charge.

Useful Italian vocabulary:

L‘indennità di malattia – statutory sick pay

Partita Iva – An Italian VAT number, required to set up as self-employed.

INPS – ‘Istituto nazionale della previdenza sociale’, Italy’s social security and pensions agency.

CAF – centro assistenza fiscale, or tax assistance centre