If the doctor asks for money for the medical certificate it is corruption
Drawn up by the general practitioner, the medical certificate of illness is an official document that proves the temporary inability to carry out work activities and contains general information on the health problem, the personal data and tax code of the worker, its date of issue and the address where the medical examination can be carried out.
Well, with sentence 19409/2025 , the Court of Cassation explained that it is a crime to ask for money – even a modest sum – to issue medical certificates for abstention from work, so much so that the cause of non-punishability due to the triviality of the fact cannot be applied. Let's look at the story together and clarify what we must be careful about to avoid criminal risks.
Paid medical certificate: the caseThe case brought to the attention of the Court concerned a doctor who, as emerged from the facts of the case, had twice asked for 30 euros for the issue of a medical certificate and, on other occasions, had asked for money without indicating a specific fee.
The man had tried to take advantage of the role that the law reserves for him, that is, that of a professional with the task of carrying out a specific medical examination to justify his subsequent absence from work .
His behavior had evidently not gone unnoticed, and had in fact formed the basis for a criminal trial .
The dispute went through all levels of judgment and, in particular, the Court of Appeal reaffirmed the conclusions of the first instance court, sentencing the general practitioner, held responsible for the violation of art. 322, paragraph 3, of the Penal Code , according to which the following are punished:
the public official [or] person in charge of a public service who solicits a promise or gift of money or other benefit for the exercise of his functions or powers.
In addition to the obvious consequences on the ethical front, the man was responsible for the offence of incitement to corruption for acts contrary to the duties of his office .
In essence, the mechanism – a sort of blackmail – involved issuing the document upon payment of a “bribe” by the worker. However, the doctor did not accept the outcome of the second level of judgment and turned to the Supreme Court.
| Certificate of sick leave | |
|---|---|
| 🩺 What is it? | Medical document certifying temporary inability to work for health reasons |
| 👨⚕️ Who releases it | The general practitioner or a doctor contracted with the National Health Service |
| 📡 How it is transmitted | From the doctor to the INPS online The employer displays it via the system |
| 📌 Who requests it | The worker as soon as the illness arises |
| ⏳ Duration | Determined by the doctor It can be extended with a new certificate |
| ✅ Validity | Justifies the absence and gives the right to the INPS allowance – if applicable |
| 📞 Employee obligations | Communicate the absence and ensure availability during the scheduled hours |
| 🔍 Checks | Possible medical visits by INPS or at the request of the employer |
The correctness of the reasoning that led the territorial court to impose the criminal sanction was contested before the judges in Piazza Cavour.
The man in particular argued that the judges of merit had not taken into adequate consideration certain factors, such as to exclude the liability of the general practitioner.
But the informal and friendly tone of the requests for money, the small amount of money, and the fact that none of the patients had chosen to change their GP after this behaviour were enough to exonerate him.
At the same time, the doctor defended himself in vain by claiming that – from the testimonies collected in the criminal trial – it had not emerged that the witnesses had understood the criminal relevance of the behaviour.
None of these elements served the doctor to escape the confirmation of the conviction against him. And no possible acquittal from the charges of incitement to corruption could be had for an alleged particular triviality of the fact. The Court of Cassation refers to what is provided for by the cause of non-punishability under art. 131 bis of the Penal Code , according to which in general:
Violation of duties and tendency to commit crimesPunishability is excluded when, due to the nature of the conduct and the insignificance of the damage or danger […] also taking into account the conduct following the crime, the offence is particularly slight and the behaviour appears to be non-habitual.
Referring to the constant jurisprudential orientation (e.g. Cass. 13681/2016 , Cass. 28659/2017 , Cass. 18891/2022 ), the Court did not acquit the doctor, because he had violated the duties of correctness and loyalty in carrying out the functions of the person in charge of issuing certificates of absence from work.
In particular, the repeated incitements to corruption had trapped the man and prevented the application of the aforementioned cause of non-punishability due to the triviality of the fact. Indeed, the Court of Cassation had deduced from this a clear tendency or inclination to crime .
The Court also confirmed the correctness of the logical-legal reasoning of the appeal judges, recalling in particular its precedent 46494/2019 according to which:
The medical certificate must always be freefor the purposes of configuring the crime of incitement to corruption for an act contrary to the duties of office, the suitability of the offer must be assessed with an ex ante judgment, so that the conduct can be considered inoffensive only if the potential suitability of the offer itself to achieve the purpose pursued by the author is lacking, the insignificance of the offer being irrelevant, provided that it is not completely negligible.
By worker's illness we mean an altered health condition, which prevents the worker from normally carrying out the contractual duties .
The law and the collective bargaining agreements protect the employee, recognizing the possibility of being absent from the office without the risk of being fired and guaranteeing him adequate financial support.
At the same time, the worker is obliged to promptly communicate to the employer any absence due to illness (otherwise he risks dismissal and heavy disciplinary sanctions), to present a medical certificate, to ensure that he is at home during certain availability slots and to carry out activities that are not incompatible with a prompt recovery.
Sentence 19409/2025 reminds us that the medical certificate of illness can never be made subject to an extra payment .
It is a free right for the patient. General practitioners, as public service providers, cannot ask for any compensation for issuing it. If a doctor asks for even 10 euros for the certificate under the table, he risks a criminal conviction. Similarly, if the patient spontaneously offers money, the doctor must not accept it.
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