Employees must exchange medical certificates within 30 days


Through Resolution No. 485-GG-ESSALUD-2022, the Peruvian Healthcare System (EsSalud) eliminated the possibility for employees to present private medical certificates that will be exchanged for a Temporary Occupational Disability Certificate (CITT) after the 30 business days following their issuance. Such possibility, which was temporary and exceptional, applied to medical certificates issued within the 30 business days prior to the Health Emergency declared due to the COVID-19 pandemic, as well as to those issued during such period.

The most significant aspects of this resolution are explained below:

1. What is a CITT?

A Temporary Occupational Disability Certificate (Certificado de Incapacidad Temporal para el Trabajo or CITT in Spanish) is an official document required by employers to start the refund process of the payments made to insured employees. It is obtained after exchanging a private medical certificate according to the deadlines and conditions provided for by applicable regulations.

2. Regarding the regular 30-day period

All private medical certificates must be exchanged for a CITT within a maximum period of 30 business days; however, certain documents are exempted from this requirement:

  • Medical certificates from insured employees who cannot opportunely present them due to long distances.
  • Medical certificates from insured employees who are hospitalized or bedridden.
  • Medical certificates for maternity leave.
  • Medical certificates issued abroad.

3. Is the maximum period of 30 business days applicable to all procedures?

No. The dossiers submitted before March 25, 2022 will continue to be exempt from the maximum period of 30 business days.


In the case of medical certificates issued to an employee by a private physician, the employer must ensure that such certificate is exchanged for a CITT as soon as possible, and must verify the content of such document once it has been exchanged. However, please note that the personnel of EsSalud is authorized to apply an “OUT-OF-DATE” stamp on the certificate presented and to return it to the employee in case it is presented after the referred 30-day period.


Carina Dávila, Legal Manager, Business Services & Outsourcing