Romanian medical leave changed materially in 2026, and payroll teams running on last year’s rules are now underpaying — or overpaying — on almost every certificate. The first day of medical leave is no longer compensated, the employer’s own window shifted, and a follow-up amendment fixed how the unpaid day is counted when a single illness produces several certificates.
This guide sets out who pays which day under the rules now in force, the rates that apply, and the traps in the new counting method.
Key takeaways
- For certificates issued between 1 February 2026 and 31 December 2027, the first day of medical leave is unpaid — it remains protected leave, but carries no indemnity.
- The employer pays days 2–6 from its own funds. The National Health Insurance Fund (FNUASS) pays from day 7.
- The standard indemnity for ordinary illness is 75% of the calculation base; 100% applies to a defined list of serious conditions and surgical emergencies.
- Since 18 May 2026, the one-day deduction is applied once per continuous illness episode, regardless of how many certificates are issued for it.
- From 1 June 2026, maternity leave, maternal risk leave, leave to care for an oncological patient, national health programme cases and inpatient treatment are excluded from the unpaid-first-day rule.
- Eligibility requires six months of contributions in the preceding twelve, and medical leave is capped at 183 days per year in the ordinary case.
The 2026 payment split
The framework statute is Emergency Ordinance No. 158/2005 on leave and health insurance indemnities. Emergency Ordinance No. 91/2025 layered a temporary regime on top of it from 1 February 2026, and Law No. 64/2026 refined the counting rule in May.
| Day of medical leave | Who pays | Notes |
|---|---|---|
| Day 1 | Nobody — unpaid | Still suspends the contract; still insured |
| Days 2–6 | Employer, own funds | Five days of employer cost |
| Day 7 onwards | FNUASS | Paid via the employer, then reclaimed |
Before February 2026 the employer carried days 1–5 and the fund picked up from day 6. The shift looks small on paper. In practice it moved one paid day off the payroll entirely and pushed the fund’s start date back by one day, so a mechanical “employer pays the first five days” rule now produces the wrong figure on every certificate.
Isolation cases ordered by a public authority are exempt from the unpaid first day, and from 1 June 2026 the exemption list widened to cover maternity leave, maternal risk leave, leave to care for an oncological patient, treatment under a national health programme, and inpatient hospitalisation.
The one-certificate-per-episode fix
The original drafting produced an obvious unfairness: a long illness broken across several certificates lost a day of pay each time a new certificate was issued. A patient with a four-certificate recovery lost four days rather than one.
From 18 May 2026, the indemnity is calculated by deducting a single day per continuous period of illness or its related complications, however many certificates document it. The practical consequence for payroll is that you cannot treat each certificate as a fresh event. You need to know whether the incoming certificate continues an existing episode or opens a new one — a determination that lives in the certificate’s continuation coding, not in your leave calendar.
The rates
For ordinary illness the indemnity is 75% of the calculation base. The base is the average of the monthly gross income on which contributions were paid over the six months preceding the month of the certificate, subject to a statutory cap expressed as a multiple of the national minimum gross wage.
A 100% rate applies to a defined list under OUG 158/2005 — tuberculosis, AIDS, group A contagious diseases, neoplastic disease, and surgical emergencies among them. That list matters commercially, because the higher rate applies to the employer-paid days too, not only to the fund’s share.
Two boundaries catch employers out. The cap on the calculation base means high earners receive materially less than 75% of actual salary. And the rate is applied to the contributory base, not to gross contractual pay — non-contributory elements drop out before the percentage is applied.
Eligibility and duration
An employee qualifies with six months of contributions within the last twelve months. Emergency cases, surgical emergencies and certain infectious diseases are treated as qualifying regardless of contribution history — a carve-out worth knowing before you reject a new joiner’s certificate.
Ordinary medical leave is capped at 183 days within a calendar year, counted from the first day of incapacity. Beyond 90 days, continuation requires the approval of the social insurance physician. Longer entitlements exist for specific diagnoses, and cases that pass the ceiling move towards invalidity assessment rather than continuing as medical leave.
Certificate mechanics
The certificate (certificat de concediu medical) is issued by the treating physician on the standard form and must reach the employer in time for it to be entered in the month’s payroll declaration. Employers cannot pay an indemnity against a certificate that is incomplete, mis-coded, or issued outside the physician’s authority — and the fund will refuse reimbursement for the same reasons.
The employer pays the whole indemnity to the employee, including the FNUASS share, and recovers the fund’s portion by offsetting it against health insurance contributions in the monthly declaration. Where the amount due exceeds the contributions payable, the balance is claimed back from the health insurance house directly. Cash-flow planning matters here: the reimbursement lag on long absences is real.
Common employer pitfalls
1. Still paying the first day
The first day carries no indemnity for certificates issued from 1 February 2026, unless it falls within an exempt category. Paying it is not a generous gesture — it is an unreimbursable cost and a payroll-declaration mismatch.
2. Deducting a day per certificate
Since 18 May 2026 the deduction is once per illness episode. A payroll rule that fires on every certificate now over-deducts on multi-certificate recoveries.
3. Paying days 2–5 and letting the fund start at day 6
The employer window is days 2 through 6 — five days, ending one day later than the pre-2026 rule. This is the most common single error in Romanian payroll right now.
4. Applying 75% to gross contractual pay
The base is the capped average contributory income of the last six months, not this month’s gross salary. The two diverge sharply for variable pay and for earners above the cap.
5. Missing the 100% list
Applying the ordinary 75% to a tuberculosis, neoplastic or surgical-emergency case underpays the employee and understates the employer-funded days.
For how Romania compares with its neighbours, see our Europe-wide sick leave comparison; for the paid-holiday entitlement, see annual leave in Romania. Employers running payroll in several jurisdictions may also want our guide to managing leave across Europe.
Frequently asked questions
Who pays sick leave in Romania in 2026?
The first day is unpaid. The employer pays days 2–6 from its own funds. From day 7 the National Health Insurance Fund (FNUASS) pays, with the employer advancing the money and recovering it through the monthly declaration.
Is the first day of medical leave really unpaid?
Yes, for certificates issued between 1 February 2026 and 31 December 2027, unless the case is exempt. Exemptions cover isolation ordered by authority and — from 1 June 2026 — maternity leave, maternal risk leave, care for an oncological patient, national health programme treatment, and inpatient care.
How much is Romanian sick pay?
75% of the calculation base for ordinary illness, and 100% for a defined list including tuberculosis, AIDS, group A contagious diseases, neoplastic disease and surgical emergencies. The base is the capped average contributory income of the previous six months.
How long can medical leave last in Romania?
183 days within a calendar year in the ordinary case, with the social insurance physician’s approval required to continue beyond 90 days. Specific diagnoses carry longer limits.
What contribution history does an employee need?
Six months of contributions in the preceding twelve. Surgical emergencies, certain infectious diseases and emergency cases qualify without that history.
Does an employee lose a day for each certificate in a long illness?
No. Since 18 May 2026, a single day is deducted per continuous illness episode, however many certificates document it.
Putting it into practice
- Move your employer-funded window to days 2–6 and stop paying day 1 outside the exempt categories.
- Track illness episodes, not certificates, so the one-day deduction fires once.
- Maintain the exempt-category list — including the 1 June 2026 additions — as a payroll flag, not tribal knowledge.
- Calculate on the capped six-month contributory average, refreshed monthly.
- Reconcile FNUASS reimbursements against advanced indemnities each month; long absences build a receivable quickly.
A leave system that records the episode, not just the certificate, and applies the day-2-to-6 employer window automatically is the difference between a clean Romanian payroll close and a month of manual recalculation.
Sources
- Emergency Ordinance No. 158/2005 on leave and health insurance indemnities (Portal Legislativ)
- Wolf Theiss — The first unpaid day of medical leave: practical implications for Romanian employers (OUG 91/2025)
- DLA Piper — Further amendments to Romania’s medical leave framework (Law 64/2026; 18 May and 1 June 2026 changes)
Last updated: 14 July 2026. This article is general guidance, not legal advice. The 2026 medical leave regime is temporary and subject to secondary legislation — confirm current practice with a Romanian-qualified adviser before changing payroll rules.