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# The sick-leave certificate for non-occupational illness (Decrees 1427 of 2022 and 2126 of 2023)

- Law

Sick leave is issued by the treating doctor after examining the patient, for up to 30 days at a time, with true data and no backdating except in set cases.

Updated Nov 13, 2026

## Key points

- Issued by the treating doctor or dentist (ReTHUS or compulsory social service), after examining and recording.
- At most 30 days per certificate, extendable 30 at a time on clinical judgement.
- Backdated only for emergency, admission, mental disturbance or catastrophe; at most 30 days; never outpatient.
- Certifying without a clinical basis = false certificate, serious breach (Law 23, art. 52).
- Sick leave for work ≠ the forensic expert's medico-legal incapacity.

## What it is

The sick-leave certificate is a medical certificate stating that a person cannot work for a period because of a non-occupational illness or accident. Like any certificate, it must be clear, true and state its purpose (Law 23 of 1981, arts. 50 to 52). Its rules are in Title 3 of Part 2 of Book 2 of Decree 780 of 2016: Decree 1427 of 2022 replaced that title, and Decree 2126 of 2023 replaced its chapters 1 to 4 again. It is issued by the treating doctor or dentist registered in ReTHUS (the national health workforce register), or by someone doing compulsory social service, attached to an accredited provider. It covers at most 30 days, extendable in periods of up to 30 days, and it cannot be backdated except for emergency care or admission, mental disturbances that prevented consulting, or catastrophic events, never by more than 30 days and never in outpatient care. Sick leave for work is not the medico-legal incapacity that a forensic expert sets in a criminal case.

## Key articles

- Art. 2.2.3.1.4 (Decree 2126 of 2023 wording): certificates are issued by treating doctors or dentists registered in ReTHUS and by those doing compulsory social service, attached to an accredited provider; the act is subject to medical ethics and to the duty to record true facts in the medical record.
- Art. 2.2.3.3.2: minimum content: provider and insurer details, place and date, the member's identification, service group and modality, ICD diagnoses, presumed origin, start and end dates, extension yes or no, backdating ground and the professional's signature.
- Art. 2.2.3.3.2: at most 30 days per certificate, extendable on clinical judgement in periods of up to 30 days; an extension is the same or a related illness with no gap longer than 30 days.
- Art. 2.2.3.3.2: at the member's request and in the professional's judgement, sick leave may be ended early if the person has recovered and it has not been paid, with a justified record.
- Art. 2.2.3.3.4: backdating only for emergency care or admission, memory or consciousness disorders and other disturbances, or catastrophic and terrorist events; up to 30 days and never in outpatient care.
- Art. 2.2.3.3.3: sick leave from a professional outside the insurer's network is validated if submitted within 15 days with the discharge summary or care summary; the insurer may request a peer evaluation.
- Art. 2.2.3.5.2 (Decree 1427 of 2022): before day 120 the insurer issues the rehabilitation opinion (Law 100 of 1993, art. 41).
- Art. 2.2.3.7.1 (Decree 1427 of 2022): abuse of rights includes, among other conduct, fraud in granting the certificate; such cases are reported to the Attorney General's Office.

## What it covers

- Who issues it and with what ethical responsibility (art. 2.2.3.1.4).
- What the certificate must contain (art. 2.2.3.3.2).
- Length, extensions, backdating and a later start date (arts. 2.2.3.3.2, 2.2.3.3.4 and 2.2.3.3.5).
- Validation by the insurer, periodic review, rehabilitation opinion and abuse of rights (arts. 2.2.3.3.3, 2.2.3.5.1, 2.2.3.5.2 and 2.2.3.7.1).

## Step by step

- Examine the patient and record in the medical record the findings that justify the sick leave.
- Decide the days from the clinical condition and the activity the person cannot do, not from the request of the patient or employer.
- Complete every field of the certificate, with ICD diagnosis, presumed origin and exact dates.
- Do not backdate except in the legal exceptions (emergency, admission, mental disturbance, catastrophe).
- If sick leave goes on, review at a follow-up before it ends and extend it only if justified.
- Sign with name and ID, and guide the patient on the procedure with the insurer.

## In clinical practice

- A patient asks for three days «because I have to travel»: certifying something that does not match the state of health is a false certificate, a serious ethical breach (Law 23, art. 52).
- A patient consults on Monday for Friday's gastroenteritis, now resolved: no backdated sick leave is issued in outpatient care.
- An inpatient asks for proof: the provider issues a certificate of admission within two days of the request.
- Sick leave from a teleconsultation is valid if it meets the rules in force; tele-guidance cannot issue it (Res. 1644 of 2026, arts. 10 and 21).

## Status and official text

- Official text verified on 2026-11-13 on funcionpublica.gov.co (Decree 1427 of 2022, Decree 2126 of 2023 and Law 23 of 1981) and on minsalud.gov.co (Resolution 1644 of 2026).
- Decree 1427 of 2022 (29 July) replaced Title 3 of Part 2 of Book 2 of Decree 780 of 2016; Decree 2126 of 2023 (12 December) replaced its chapters 1 to 4. Chapters 5 to 7 (periodic review, sick leave over 540 days and abuse of rights) keep, according to the texts consulted, the Decree 1427 wording.
- Law 23 of 1981, arts. 50 to 52: a medical certificate is truthful, and issuing a false one is a serious breach.
- This page does not summarise who pays each stretch of sick leave or the amounts of the benefit; check the rules in force.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the maximum length of one sick-leave certificate for non-occupational illness?

Up to 30 days, extendable on the treating doctor's clinical judgement in periods of up to 30 days each (Decree 780 of 2016, art. 2.2.3.3.2).

## When is backdated sick leave allowed?

For emergency care or admission, for memory, consciousness or other disturbances that prevented consulting, or for catastrophic and terrorist events; up to 30 days and never in outpatient care.

## Which decree replaced chapters 1 to 4 of the sick-leave rules in 2023?

Decree 2126 of 2023, which replaced chapters 1 to 4 of Title 3 of Part 2 of Book 2 of Decree 780 of 2016, previously worded by Decree 1427 of 2022.

## What breach does a doctor commit who issues sick leave as a favour?

Issuing a certificate that is not true: a serious ethical breach (Law 23, arts. 51 and 52), without prejudice to criminal action; fraud in certification is reported to the Attorney General's Office.

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## Elsewhere in DurgiPedia

- [Incapacidad médico-legal: what it is and how it is set](https://durgical.com/en/forensic-medicine/incapacidad-medico-legal-what-it-is-and-how-it-is-set/)

## Connections

## Related 4

- [Medical certificates: sick leave, death and medico-legal reports](https://durgical.com/en/medical-ethics/medical-certificates-sick-leave-death-and-medico-legal-reports/)
- [Ley 23 de 1981: the Colombian medical ethics law](https://durgical.com/en/medical-ethics/ley-23-de-1981-the-colombian-medical-ethics-law/)
- [Resolución 1995 de 1999: the medical record](https://durgical.com/en/medical-ethics/resolucion-1995-de-1999-the-medical-record/)
- [Telehealth and telemedicine in Colombia: Law 1419 of 2010 and Resolution 1644 of 2026](https://durgical.com/en/medical-ethics/telehealth-and-telemedicine-in-colombia-law-1419-of-2010-and-resolution-1644-of/)

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Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.

Sources: [Decreto 2126 de 2023, replaces chapters 1 to 4 of Title 3, Part 2, Book 2 of Decree 780 of 2016](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=226790) (Función Pública, Gestor Normativo, 2023); [Decreto 1427 de 2022, cash benefits of the General Social Security Health System](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=191146) (Función Pública, Gestor Normativo, 2022); [Ley 23 de 1981, arts. 50 to 52: medical certificate](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=68760) (Función Pública, Gestor Normativo, 1981); [Resolución 1644 de 2026, arts. 10 and 21: sick leave in telehealth and telemedicine](https://www.minsalud.gov.co/Normatividad_Nuevo/Resoluci%C3%B3n%20No%201644%20de%202026.pdf) (Ministerio de Salud y Protección Social, 2026).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/medical-ethics/the-sick-leave-certificate-for-non-occupational-illness/