Medical leave certificates can be issued at the level of the Sibiu Emergency Military Clinical Hospital for acute or chronic conditions for which consultations or medical care were provided, either in hospitalization or outpatient settings.

The individuals entitled to medical leave and health social insurance benefits, the doctors who can issue medical leave certificates, the duration, conditions, and the method of issuance are provided for in Government Emergency Ordinance (GEO) no. 158/17.11.2005, the Regulations for the implementation of GEO no. 158/2005 (part of Order no. 15/2018) hereinafter referred to as REGULATIONS, the Instructions for use and completion of medical leave certificates as of 01.07.2020 (part of Order 1192/2020) hereinafter referred to as INSTRUCTIONS, and Order no. M.66/2016 for the approval of the Regulation on the establishment, organization, functioning, and attributions of the medico-military expertise commissions, as subsequently amended and supplemented.

The issuance of medical leave certificates is done both on special forms and in electronic format, following the medical consultation, based on the employer’s certificate (issued in paper format or by remote transmission means according to the model in Annex no. 7 of the REGULATIONS), except for medical-surgical emergencies, certain types of burns, including the recovery period provided in art. 18 paragraph (5) of the REGULATIONS, quarantine, infectious-contagious diseases in group A, infectious-contagious diseases requiring isolation, care of patients over 18 years old with oncological conditions, and the issuance of follow-up medical leave certificates for the same episode of illness, by the attending physician who is required to prepare a plan to monitor the evolution of the disease (cf. art. 8 and 34 of the REGULATIONS, and art. 9, para. (1) of the INSTRUCTIONS).

In cases where certificates for temporary work incapacity are issued, family doctors and specialist doctors in ambulatory care draft, according to art. 10 of the REGULATIONS, a plan for monitoring the course of the disease, which the insured person is required to follow.

The issuance of the medical leave certificate for the care of a patient with oncological conditions is based on the agreement of the oncological patient (according to the model in Annex no. 15 of the REGULATIONS) and the certificate issued by the health insurance house under whose care the patient is, indicating the number of days of leave for the care of the oncology patient granted in the past 12 months, according to the certificate model in Annex no. 7² of the REGULATIONS, with a maximum of 45 calendar days within a 1-year interval for a patient with oncological conditions (cf. art. 11, para. (6) of the INSTRUCTIONS).

In cases of medical-surgical emergencies where the severity of the illness did not require hospitalization, medical leave certificates are usually granted on the date of the consultation by the doctor attending the emergency (family doctor, specialist outpatient doctor, emergency department) for a maximum of 5 calendar days (cf. art. 26 of the REGULATIONS). If medical leave certificates were not issued at the consultation date by the doctor attending the emergency, they may be issued within 5 days from the event by the family doctor based on the recommendation issued by the doctor who attended the emergency (cf. art. 10, para. (2) of the REGULATIONS).

The medical leave certificate must be presented to the payer no later than the 5th day of the month following the one for which the leave was granted, according to art. 60 of the REGULATIONS, or by the end of the month in which the medical certificate was issued for particular situations covered by art. 9 para. (4), art. 10 and 27 of the REGULATIONS.

The patient or, if applicable, their representative, will receive copies 1 (white) and 2 (pink) of the medical certificate; these original forms, which were transmitted by remote means, must be submitted by the insured person to the health social insurance benefit payers within 30 days from the issuance date (art. 2, para. (8) of the REGULATIONS).

For civilians, medical leave can be granted for up to 183 days within a 1-year interval, except for the conditions listed in art. 13, para. (3), letters a)-d) of GEO no. 158/2005, and art. 18 para. (3) of the REGULATIONS, for which the duration may be longer. Starting from the 91st day, medical leave can be extended by the specialist doctor up to 183 days with the approval of the social insurance expert doctor, and in duly justified cases, it can be extended beyond 183 days for a maximum of 90 days with the approval of the specialist commission within the National Institute of Medical Expertise and Recovery of Work Capacity (INEMRCM).

For active military personnel, police officers, and prison police officers, medical leave can be granted for a maximum of 180 days within a 1-year interval, of which the first 90 days by the specialist doctor, and starting from the 91st day, at the proposal of the medico-military expertise commissions. After reaching 180 days, recovery medical leave may be granted for an additional 120 days, and in duly justified cases, for a period not exceeding 550 days, at the proposal of the medico-military expertise commissions, according to art. 61, para. (4) of GEO 158/2005, and arts. 3 and 5 of M66/2016.