EPS Disability/Sick Leave Application Colombia (Solicitud de Incapacidad ante la EPS)

An EPS Disability/Sick Leave Application Colombia (Solicitud de Incapacidad ante la EPS) is a formal written notification submitted by a worker to the employer — or by the employer to the Entidad Promotora de Salud (EPS) — documenting a temporary disability (incapacidad temporal) certified by a physician and requesting the corresponding salary subsidy established under Article 206 of Ley 100 de 1993 and the Codigo Sustantivo del Trabajo (CST). The incapacidad temporal arises when a worker is medically unable to perform job duties due to illness (enfermedad comun), non-occupational injury, or a condition requiring medical treatment and recovery time.

The legal framework for sick leave in Colombia operates through the Sistema General de Seguridad Social en Salud established by Ley 100 de 1993, as regulated by Decreto 780 de 2016 (Decreto Unico Reglamentario del Sector Salud). Article 206 of Ley 100 establishes the economic benefit (prestacion economica) of the incapacidad por enfermedad general: the EPS pays a subsidy equivalent to two-thirds (66.67%) of the worker's base salary for the first 90 days of disability and 50% of the base salary from day 91 through day 180. The employer is directly responsible for paying the first two days of disability at 66.67% of the salary — the EPS assumes payment from the third day onward.

The Corte Constitucional has extensively developed the constitutional protection of workers during temporary disability. Sentencia T-920 de 2009 established that dismissal of a worker during an active incapacidad constitutes a violation of the right to health (Article 49 of the Constitucion Politica de 1991) and the right to minimum living wage (minimo vital) under Article 53 of the Constitution. The Corte has applied the principio de estabilidad laboral reforzada (reinforced job stability) to workers with active disabilities through Sentencia T-468 de 2010, requiring prior authorization from the Ministerio del Trabajo or a labour inspector before dismissing a worker on medical leave.

Decree 1072 de 2015 — the Decreto Unico Reglamentario del Sector Trabajo — consolidates the regulatory framework for disability management in the workplace. Chapter 2 of Title 4 of Part 2 of Decreto 1072 addresses the employer's obligations regarding the Sistema de Gestion de Seguridad y Salud en el Trabajo (SG-SST), which includes protocols for managing worker disabilities, tracking recovery progress, and coordinating with the EPS and ARL (Administradora de Riesgos Laborales) for occupational versus non-occupational classifications.

The disability certification process begins when the worker visits a physician within the EPS network. The attending physician issues a certificado de incapacidad specifying the diagnosis (coded under the CIE-10 International Classification of Diseases), the number of days of disability, and the recommended treatment. Under Resolucion 2266 de 1998 of the Ministerio de Salud, the initial disability certificate may cover up to 30 days, with extensions (prorrogas) requiring review by the EPS medical committee. Disabilities exceeding 180 days are referred to the Junta de Calificacion de Invalidez under Ley 962 de 2005 Article 41, which determines whether the condition qualifies for permanent disability pension under the Sistema General de Pensiones.

The Planilla Integrada de Liquidacion de Aportes (PILA) reporting system tracks disability periods for social security contribution purposes. During temporary disability, the employer must continue paying social security contributions (EPS, AFP/Colpensiones, and ARL) on the salary base applicable before the disability commenced, per Decreto 1406 de 1999. The worker's contributions (4% EPS and 4% AFP) are deducted from the disability subsidy paid by the EPS.

The Ministerio del Trabajo (MinTrabajo) enforces disability-related employment protections through workplace inspections under CST Articles 485 through 487. Employers who dismiss workers during active disabilities without MinTrabajo authorization face reinstatement orders, back pay obligations, and administrative fines of up to 5,000 SMLMV under Ley 1610 de 2013 Article 7. The Superintendencia Nacional de Salud oversees EPS compliance with timely recognition and payment of disability subsidies under Ley 1122 de 2007.

Where the disability arises from a workplace accident (accidente de trabajo) or occupational disease (enfermedad laboral) rather than general illness, the ARL — not the EPS — assumes financial responsibility under Ley 1562 de 2012 and Decreto 1295 de 1994. The classification between general illness and occupational origin is determined by the EPS physician, with appeals to the Junta Regional de Calificacion de Invalidez and ultimately to the Junta Nacional de Calificacion de Invalidez under Decreto 1072 de 2015.

An EPS Disability/Sick Leave Application Colombia is needed when a worker covered by the Sistema General de Seguridad Social en Salud under Ley 100 de 1993 receives a certificado de incapacidad (disability certificate) from a physician within the EPS network and must formally notify the employer to activate the salary subsidy mechanism and job protection rights. The application creates a documented record linking the medical certification to the employment relationship and triggers the employer's obligations under the Codigo Sustantivo del Trabajo and Decreto 1072 de 2015.

The Solicitud de Incapacidad is required when the EPS physician determines that a worker cannot perform job duties due to enfermedad general (non-occupational illness or injury). Common situations include hospitalization, surgical procedures, acute illness requiring bed rest, chronic condition flare-ups, and mental health conditions requiring treatment — all classified under the CIE-10 coding system used by Colombian health providers. The worker must present the certificado de incapacidad to the employer within the timeframes established by the company's Reglamento Interno de Trabajo under CST Articles 104 through 125.

A formal application is necessary when the disability extends beyond two days, triggering the EPS payment obligation under Article 206 of Ley 100 de 1993. For the first two days of disability, the employer pays directly at 66.67% of the worker's base salary — the EPS assumes payment from day three onward. Without the formal application and the attached certificado de incapacidad, the employer cannot process the EPS reimbursement claim through the Planilla Integrada de Liquidacion de Aportes (PILA) system.

The application is needed when a worker experiences multiple consecutive disabilities (incapacidades sucesivas) arising from the same diagnosis. Under Decreto 780 de 2016, consecutive disabilities from the same condition are counted cumulatively toward the 180-day maximum established in Ley 100 de 1993 Article 206. After 180 days, the case must be referred to the Administradora de Fondos de Pensiones (AFP) or Colpensiones for evaluation of permanent disability pension under the Sistema General de Pensiones.

Workers under any type of employment contract — contrato a termino indefinido (CST Article 45), contrato a termino fijo (CST Article 46), or contrato por obra o labor determinada — must file the application to preserve job protection rights. The Corte Constitucional's estabilidad laboral reforzada doctrine, established in Sentencia T-468 de 2010, protects workers on medical leave from dismissal without prior MinTrabajo authorization, regardless of contract type.

Foreign nationals working in Colombia under a visa de trabajo issued by Migracion Colombia per Decreto 1067 de 2015 hold identical sick leave rights, provided they are affiliated to an EPS under the Regimen Contributivo and their employer has reported contributions through the PILA during the period preceding the disability.

The application is also needed when a worker experiences a mental health condition — including depression, anxiety disorders, or burnout — requiring medical treatment and absence from work. The Ministerio de Salud y Proteccion Social recognizes mental health conditions as valid grounds for incapacidad temporal under the CIE-10 classification system, and Ley 1616 de 2013 (Ley de Salud Mental) reinforces the worker's right to treatment and job protection during mental health-related disabilities. The Resolucion 2764 de 2022 (Bateria de Riesgo Psicosocial) requires employers to assess and mitigate psychosocial risk factors contributing to worker mental health conditions, and the EPS disability application documents the connection between the worker's condition and the need for protected absence.

A valid EPS Disability/Sick Leave Application Colombia under Article 206 of Ley 100 de 1993 and Decreto 1072 de 2015 must contain the following elements to activate the salary subsidy, job protection, and EPS reimbursement mechanisms.

Employee Identification: Full legal name of the worker, cedula de ciudadania number (for Colombian nationals) or cedula de extranjeria (for foreign residents), job title (cargo), department, and contact information. The identification must match the data registered in the Planilla Integrada de Liquidacion de Aportes (PILA) to allow the EPS to verify contribution history and process the disability subsidy.

Employer Information: Legal name (razon social) of the company, NIT (Numero de Identificacion Tributaria) assigned by the DIAN, and the name and title of the human resources representative or direct supervisor receiving the application. The employer's PILA operator code should be available for cross-referencing the disability claim with social security contribution records.

EPS Affiliation Details: Name of the Entidad Promotora de Salud (EPS) — such as Sura EPS, Nueva EPS, Sanitas, Compensar, Famisanar, or Coomeva — the affiliation number, and confirmation that contributions have been current during the period preceding the disability. Under Decreto 780 de 2016, the EPS may deny the disability subsidy where the employer has failed to report or pay contributions during the relevant period, though the worker retains the right to medical attention regardless of the employer's payment status.

Disability Certificate Reference: The number, date, and issuing institution of the certificado de incapacidad issued by the EPS physician, including the CIE-10 diagnosis code, the number of days of disability authorized, and the start and end dates of the disability period. Where the disability is a prorroga (extension) of a previous incapacidad, the application should reference the original certificate number and the cumulative days of disability to track progress toward the 180-day threshold established in Ley 100 de 1993 Article 206.

Type of Disability: Specification of whether the disability arises from enfermedad general (non-occupational illness covered by the EPS under Ley 100 de 1993), accidente de trabajo (workplace accident covered by the ARL under Ley 1562 de 2012), or enfermedad laboral (occupational disease covered by the ARL under Decreto 1295 de 1994). The classification determines which entity — EPS or ARL — bears financial responsibility for the disability subsidy and which regulatory framework applies.

Salary and Subsidy Calculation: The worker's monthly base salary (Ingreso Base de Cotizacion — IBC) reported in the most recent PILA, which serves as the basis for calculating the disability subsidy. Under Article 206 of Ley 100 de 1993: days 1-2 are paid by the employer at 66.67% of the IBC; days 3-90 are paid by the EPS at 66.67% of the IBC; days 91-180 are paid by the EPS at 50% of the IBC. The subsidy may not be less than the proportional SMLMV (salario minimo mensual legal vigente) per CST Article 227.

Disability Period Dates: Specific start and end dates of the disability period as certified by the EPS physician, the expected date of return to work, and any restrictions on duties upon reincorporation. Where the disability involves a gradual return (reincorporacion gradual), the application should specify any recommended accommodations under the SG-SST framework of Decreto 1072 de 2015.

Forms-legal.com provides this EPS Disability/Sick Leave Application Colombia template as a practical tool for documenting temporary disabilities and activating the salary subsidy under Colombian law. Each application should be coordinated with the specific EPS's administrative procedures and the employer's SG-SST protocols. The Ministerio del Trabajo, the Superintendencia Nacional de Salud, and the UGPP (Unidad de Gestion Pensional y Parafiscales) each oversee different aspects of disability management compliance.