New sick-leave rules: family doctor to approve only 5 days without a specialist; Fund board seeks further clarifications

From December 1, new sick-leave rules are planned to take effect in North Macedonia. The main change, as the MKinformer portal reported today, is shortening the period within which the family doctor can open a sick leave alone — from the current 7 days to only 5 days, without the need for additional diagnostics. The criteria currently in force date mainly from the 2012 regulation.

However, the plan has not yet received the green light. According to today’s reporting by the 24 Vesti portal, the governing board of the HIF has not yet approved the proposal of HIF director Zlatko Perinski to change the sick-leave control criteria — board members requested further clarifications on how the changes would work concretely in practice.

Silvana Andov, director of the control sector at the HIF, spoke about the process so far on TV24’s “24 Analiza” show. She said the final version of the regulation has already been sent for approval and, once the board gives its opinion, the regulation must receive the consent of the Health Ministry and be published in the Official Gazette — with the aim of starting implementation from December 1. Under the proposal, for some diagnoses — acute respiratory infections, influenza, viral enteritis and some gynecological conditions — the family doctor could manage the patient for up to 15 days with medical documentation, but not necessarily with a specialist examination.

Behind the reform stand worrying figures: in the 2021–2025 period the number of patients grew by 6.7%, while the number of opened sick leaves grew by 33.4%. This year alone, 326 requests for extraordinary controls were registered — 110 from the public sector and 56 from the private sector, alongside group requests affecting 84 people from the Interior Ministry (MPB) and 51 from the Defense Ministry. Employers report cases where employees post photos on social media from trips or parties while officially on sick leave.

The Fund rejects fears of “police raids” on homes. According to the HIF, control of sick leave does not imply police searches of homes — the Fund already had the legal possibility of field controls following an employer’s report. One of the measures under discussion is the electronic exchange of data with other institutions, for example verifying whether a person with active sick leave has left the country.

The changes have sparked reactions. Ivan Peševski, vice president of the Confederation of Trade Unions (SSM), says the new rules must not punish genuinely ill workers — responsibility should fall on those who concretely abuse the system, not on suspicion cast over all employees. He also warned of a possible clash with collective agreements, which provide for 7-day periods. Meanwhile, the president of the Family Doctors Association, Dr. Dragan Georgievski, warned that shortening the deadline could overload specialist clinics, adding that family doctors already face great pressure from patients.