Starting in 2026, pending the final technical steps, it will be possible in Italy to obtain the sick leave certificate not only in person but also through telemedicine, all from the comfort of home.
This represents a true revolution in the relationship between citizens, healthcare institutions, and the world of work, introduced by Law 182/2025, which for the first time equates the remotely issued digital sick leave certificate with the traditional certificate issued after an in-person visit.
The goal is to simplify access to care, reduce unnecessary travel, and provide workers with a faster and more efficient service without compromising clinical quality.
However, full implementation will depend on the State–Regions agreement, which will define in detail the specific procedures, tools, and limitations.
The timeline of this turning point: change begins in 2026
Law 182/2025 came into effect on December 18, 2025. However, the actual implementation of this procedure is tied to crucial technical steps: its practical application — including the ability to issue the INPS sick leave certificate via telemedicine — is expected to begin in 2026.
Important: The essential requirement for full operability is the establishment of a State–Regions Agreement. This agreement will define the key parameters:
- Operational procedures: how the telemedicine consultation must be conducted in order to be considered valid.
- Specific use cases: which conditions or pathologies will be eligible for this remote modality.
- Authorized tools: the technological platforms that may be used to ensure security and legal validity.
The full digitalization of the process aims to simplify the procedure for both the worker and the physician, while maintaining diagnostic accuracy and the legal validity of the document.
Sick leave certificate via telemedicine: what Law 182/2025 provides
Law 182/2025 introduces a clear principle:
The sick leave certification issued through telemedicine has the same validity as the certificate issued after an in-person visit.
The regulation will formally come into effect on December 18, 2025, but the actual ability to request an online sick leave certificate will only begin once the State–Regions agreement is finalized. This agreement will define:
- which conditions and situations can be certified remotely;
- which digital tools will be authorized (platforms, identification systems, electronic health records);
- security, traceability, and privacy requirements;
- any limitations for cases that necessarily require an in-person visit.
Why this reform is considered a turning point
The new system modernizes the model of community-based healthcare and aligns Italy with what is already happening in many European countries.
The main expected benefits include:
1. Reduction of unnecessary travel
Those who are ill will no longer be forced to leave home to obtain an INPS sick leave certificate, avoiding discomfort, risks, and additional costs.
2. Faster access to the certificate
Thanks to telemedicine, the physician can confirm the clinical condition and send the digital sick leave certificate directly to INPS within minutes.
3. Improved healthcare efficiency
In-person visits will be reserved for cases that genuinely require them, reducing wait times and easing the workload of outpatient clinics.
4. Greater accessibility for vulnerable individuals, the elderly, and people with limited mobility
Remote certification is particularly beneficial for those who struggle with mobility or live in areas with limited access to healthcare providers.
How the sick leave certificate will work through telemedicine
While awaiting the State–Regions agreement, the most likely operational scenario will be as follows:
1. Booking the telemedicine consultation
The citizen will be able to request a telemedicine visit through:
- regional digital healthcare platforms,
- authorized general practitioners,
- affiliated healthcare services.
2. Identification and video consultation
The patient will need to identify themselves using:
- SPID / CIE,
- or certified identification systems.
During the telemedicine visit, the physician will assess:
- symptoms,
- overall condition,
- any available test results,
- medical history.
3. Issuance of the digital sick leave certificate
If the conditions allow, the physician will be able to:
- fill out the electronic certificate,
- send it directly to INPS,
- provide the patient with the protocol number.
4. Communication to the employer
As is already the case today, the employee will not need to submit anything: the employer will view the certificate on the INPS portal using the identification code.
When it will NOT be possible to obtain the sick leave certificate online
There will be situations in which a traditional in-person visit will remain mandatory.
For example:
- symptoms requiring a physical examination (auscultation, palpation, instrumental measurements);
- potentially serious conditions or those with a rapidly evolving risk;
- accidents or work-related injuries that require structured medical reports;
- the need for certifications other than the INPS sick leave certificate (e.g., sports fitness clearance, medico-legal certifications).
Digital sick leave certificate: what remains unchanged
Even with telemedicine:
- the certificate will be sent to INPS electronically;
- the worker will receive the certificate number to provide if needed;
- employer medical checks will remain possible and unpredictable;
- clinical responsibility will continue to rest with the certifying physician.
Which digital tools will be authorized?
The framework will be defined by the State–Regions agreement, but the reform outlines several requirements:
- secure and certified healthcare platforms;
- end-to-end encryption for video calls;
- integration with the Electronic Health Record;
- traceability of all operations;
- strong identification systems (SPID, CIE, CNS)
It is possible that regional platforms and tools already used during the health emergency will be accredited.
What changes with the online sick leave certificate for workers and companies
For workers
- greater convenience and no need to travel;
- quicker access to the certificate;
- reduced risk of worsening symptoms by leaving home while sick.
For companies
- increased traceability;
- fewer absences caused by queues or travel;
- immediate verification of the certificate status through the INPS portal.
For physicians
Optimized time management, the ability to assist more patients, and improved efficiency in handling sick leave certificates.
For the healthcare system
Reduced pressure on outpatient clinics and emergency departments for non-urgent cases, and a significant boost to digital healthcare and telemedicine.
For further information:
- INPS regulations and updates: https://www.inps.it
- Electronic Health Record: https://www.fascicolosanitario.gov.it
- Ministry of Health – Telemedicine
Essential FAQs about the sick leave certificate via telemedicine
No. Law 182/2025 has been in effect since December 18, 2025, but the actual implementation of telemedicine for certification purposes depends on a State–Regions Agreement. Barring technical steps, full application is expected from 2026.
No. The telemedicine consultation must be carried out through platforms that ensure privacy compliance, secure patient identification, and healthcare safety standards, as established by the State–Regions Agreement.
A simple video call or WhatsApp message will not be sufficient.
No. The possibility of using telemedicine depends on the type of condition. It is up to the doctor to assess whether the patient’s health status can be verified remotely or whether an in-person visit is necessary, according to defined clinical protocols.
Absolutely not. Once the State–Regions Agreement becomes operational, the digital sick leave certificate issued after a telemedicine visit will have the same legal and evidentiary value as a certificate issued in person.
The sick leave certificate may be issued following a telemedicine consultation by general practitioners, pediatricians, or physicians working in healthcare facilities that fall within the agreements of the National Health Service, in compliance with INPS regulations.
Until the State–Regions Agreement is fully implemented and facilities are equipped, the traditional procedure will continue to apply (in-person visit or out-of-hours medical service). The transition will be gradual.
No. The method used to issue the sick leave certificate does not affect the worker’s obligation to be reachable for INPS medical checks. The time slots (currently 10–12 and 17–19) remain unchanged.
Yes. Law 182/2025 introduces a general reform of healthcare certification procedures that applies to both private and public sector employees, since the final recipient of the digital sick leave certificate is the INPS.
Yes. Law 182/2025 equates remote certification with in-person certification.
Most likely yes: digital identification will be one of the mandatory requirements.
No. For situations requiring a physical examination, an in-person visit will still be necessary.ame fisico, sarà comunque necessaria la visita in presenza.
This will depend on the services made available by the Regions (digital out-of-hours medical service, telemedicine clinics, etc.).
If performed through your general practitioner, it may be free; for private services, a fee may be applied depending on the facility.
