New rules for sick leave: The first day will be paid for chronic patients and emergency cases

New legislation significantly changes the rules for granting and paying sick leave for all employees in Romania. Law 64/2026, published in the Official Gazette and applicable from 1 June 2026, introduces important clarifications regarding the categories of patients who will receive full payment of sick leave.

Categories exempt from the unpaid first day

The new regulation establishes that the first day of sick leave will be paid in full for certain vulnerable categories of patients. These include chronic patients, those enrolled in national health programmes, patients receiving day hospitalisation, and cases involving medical or surgical emergencies.

Also exempt from this measure are maternity sick leave, sick leave for the care of patients with oncological conditions, and maternal risk allowances granted to pregnant women working in at-risk conditions.

Payment mechanism and responsibilities

For all other categories of employees, the system operates as follows: employers cover days 2–6 of sick leave allowance payments, whilst the National Unique Fund for Social Health Insurance (FNUASS) takes on costs from day 7 onwards until recovery. For sick leave funded entirely from the FNUASS budget, the first day is not paid at all.

Monitoring and verification measures

The law introduces a complex three-tier system for monitoring sick leave. The Health Insurance Houses will carry out checks on the legality and validity of sick leave granted, examining medical documents and verifying compliance with legal requirements regarding their duration.

A second level of verification is conducted through occupational capacity assessment offices, which may be notified where fraud is suspected. The third tier involves the Disciplinary Commission of the Romanian College of Physicians, which may impose sanctions on doctors who issue certificates without complying with the relevant legal provisions.

Impact on patients

These legislative changes aim to combat fraudulent practices in the area of sick leave, whilst at the same time protecting vulnerable categories of patients. For older people with chronic illnesses or those requiring ongoing medical care, the new provisions ensure that their entitlements to full allowances are maintained.

The measures are temporary, applying between 1 February 2026 and 31 December 2027, during which time the authorities will monitor the effects of these changes on the healthcare system and on sick leave fraud.