Stress-related cases double, long-term absences climb, and doctors warn lack of oversight fuels fraud
The number of workers on medical leave in Alicante has reached record levels, straining the public health system and inspection services. Most cases are linked to work-related stress and musculoskeletal conditions, which together account for more than half of all sick leave.
According to the Spanish General Council of Psychology, these conditions represent 65.7% of absences in 2024, both among salaried employees and the self-employed.
Doctors Warn of Collapsed Oversight
Medical inspectors acknowledge they are overwhelmed by the volume of cases.
“Temporary incapacity is skyrocketing, and we can’t keep it under control—there simply aren’t enough inspectors. Long-term cases pile up, and many turn into permanent disability once workers exceed 18 months on leave,” said one Social Security medical inspector.
He added that “there are countless very long sick leaves that no one monitors. This creates fertile ground for fraud, made worse by staff shortages in the public health system.”
Delays and Legal Changes Add Pressure
The lack of resources leads to delays in medical tests, consultations, and return-to-work assessments, further prolonging absences. Inspectors also face heavier workloads after recent legal changes that expanded their responsibilities without increasing staff.
Permanent disability cases are surging nationwide—from 13,000 monthly in 2016 to 24,000 today.
Rising Trend in Alicante
The figures in Alicante are alarming: between January and April 2025, 84,339 new medical leave cases were registered among 775,000 insured workers—an 11% rate and 4,378 more than the same period in 2024. The number of new cases is growing by roughly 1,000 per month compared with last year.
If the trend continues, 2025 could end with over 337,000 sick leaves in Alicante, compared with 225,766 in 2024.
Absenteeism Hits Record Levels
Workplace absenteeism due to illness has grown by 40% in the Valencian Community, climbing from 3.8% in 2018 to 5.3% in 2023—the highest levels ever recorded. In Alicante, the rate rose from 3.6% to 5% in the same period, a 32% increase.
According to Umivale Activa, a mutual insurer collaborating with Social Security, the sharpest rise is in long-term cases (over 365 days), which have doubled nationally in the past five years. In the Valencian Community, long-term cases grew even faster, multiplying by 2.2 to reach 15,800 in 2023.
Recurrent Cases Drive the Crisis
A key factor is the rise of “repeaters”—workers with multiple sick leaves in a single year. Nationwide, they now make up 16.6% of all workers, up 55% since 2018. This group is responsible for nearly 70% of all medical leave and almost two-thirds of lost workdays.
In the Valencian Community, repeaters represent 12.9% of workers, but their numbers have grown 72% since 2018. Among them, mental health problems and chronic pain are the leading causes of long absences.
Employers and Doctors Caught in the Middle
Business groups argue companies are under pressure to do more with fewer staff, while workers suffer increased stress and burnout. Meanwhile, psychiatrists often refuse to classify work-related stress as psychiatric illness, complicating treatment.
Some experts fear that turning medical leave into an administrative process controlled by private mutual insurers would erode worker rights.
“Since the pandemic, mental health problems have grown in the general population, with socio-economic pressures filtering into the workplace,” said Dr. María Ángeles Medina, president of the Valencian Society of Family and Community Medicine. “This is a multidimensional problem that affects not just workers, but society as a whole.”
Call for Action
Umivale Activa, in partnership with the Valencian Institute of Economic Research, will present a study in Elche on September 11, urging measures to improve worker health and ensure more efficient management of sick leave.
The report stresses the need to improve diagnoses, treatment monitoring, and early interventions to prevent long-term disability. It also warns that absenteeism is at historic highs in Spain, largely driven by repeat cases, and that urgent action from employers, health services, inspectors, and government is essential to preserve the system’s sustainability.
“There are many mental health problems in the general population, along with numerous socioeconomic factors affecting health, and these have an impact on the workplace environment.”
— María Ángeles Medina, President of the Valencian Society of Family and Community Medicine
Image courtesy Pexels
