How to Calculate Sick Leave Benefits (Auxílio-Doença) 2025

Auxílio-doença (sick leave benefits) is one of the most requested benefits from INSS (social security), but many insured individuals still have questions about how to calculate the amount they will receive. In 2025, the rules remain the same, but it’s important to know all the details to avoid surprises.

This benefit guarantees a monthly income for those who need to take time off work for health reasons. The amount varies according to the insured’s contributions and can represent between 60% to 100% of the benefit salary.

What is auxílio-doença

Auxílio-doença is a temporary benefit paid by INSS (social security) to insured individuals who become temporarily incapacitated for work due to illness or accident. Unlike disability retirement, this benefit is temporary.

Payment is maintained while work incapacity persists, being periodically reassessed through INSS medical examinations.

Who is entitled to the benefit

All INSS insured individuals who meet the legal requirements are entitled to auxílio-doença:

• Employed workers (formal employment)
• Individual contributors (self-employed)
• Special insured (rural workers)
• MEI (Individual Microentrepreneur - a simplified business registration for small entrepreneurs)

It’s important to remember that unemployed individuals may also be entitled, as long as they maintain their insured status.

Requirements to apply

To be entitled to auxílio-doença in 2025, you must meet:

• Insured status: be up to date with contributions or within the grace period
• Qualifying period: have contributed for at least 12 months (with exceptions)
• Temporary incapacity: proven by INSS medical examination
• Inability to work: in your usual function or another activity

How the amount is calculated

The auxílio-doença calculation follows specific rules that determine the benefit salary and then apply the corresponding rate.

Benefit salary

The benefit salary is calculated based on the arithmetic average of the insured’s contributions:

• Until 28/11/1999: average of the last 36 contributions
• From 29/11/1999: average of 80% of the highest contributions since July/1994

Example: João has 60 contributions. INSS considers the 48 highest (80% of 60) to calculate the average.

Rate application

A rate of 91% is applied to the benefit salary for all auxílio-doença cases. This rule applies to both illnesses and work accidents.

Practical calculation: Benefit salary R$ 3,000 × 91% = R$ 2,730 auxílio-doença

Minimum and maximum amounts

Auxílio-doença in 2025 respects INSS limits:

• Minimum amount: R$ 1,412.00 (minimum wage)
• Maximum amount: R$ 7,786.02 (INSS ceiling)

Even if the calculation results in an amount lower than the minimum, the benefit will be R$ 1,412.00.

Required qualifying period

The qualifying period is the minimum period of contributions necessary to be entitled to the benefit.

General rules

For most cases, the qualifying period is 12 months of INSS contributions. This means you need to have:

• 12 consecutive or non-consecutive monthly contributions
• Up-to-date payments on the application date
• Maintained insured status

Exceptions to the qualifying period

Some situations waive the 12-month qualifying period:

• Work accident (any nature)
• Accident of any nature outside work
• Specific diseases listed in Ministry of Health regulations
• Special insured (under certain conditions)

Diseases that waive the qualifying period include active tuberculosis, cancer, blindness, HIV/AIDS, among others.

Required documents

To apply for auxílio-doença, you must gather the following documentation:

• Identity document with photo
• CPF (if not included in ID)
• Work card or documents proving contributions
• Medical certificates proving the illness
• Medical exams (reports, X-rays, MRIs)
• Detailed medical report from your attending physician

Keep documents organized and in chronological order to facilitate analysis.

Step-by-step application process

The auxílio-doença application process involves several mandatory steps.

INSS scheduling

The first step is to schedule the medical examination:

• Access the Meu INSS website or download the app
• Log in with your gov.br account
• Select “Schedule Medical Exam”
• Choose available date and time
• Confirm the appointment

You can also call 135 to schedule by phone.

Medical examination

On the scheduled date, you must appear at the indicated location with all documentation. The INSS medical examiner will:

• Analyze the presented medical documents
• Examine the insured physically
• Evaluate work incapacity
• Decide on benefit approval

The result is immediate, but payment may take up to 45 days to begin.

Practical calculation example

Let’s calculate the auxílio-doença for Maria, who needs time off for spinal problems:

Maria’s data:

• 5 years of contributions (60 months)
• Salaries between R$ 2,500 and R$ 4,000

Step 1: Calculate benefit salary

• Consider 80% of highest contributions: 48 contributions
• Average of 48 highest: R$ 3,500

Step 2: Apply the rate

• R$ 3,500 × 91% = R$ 3,185

Result: Maria will receive R$ 3,185 in auxílio-doença.

Use our auxílio-doença calculator to simulate your benefit with your actual data.

Frequently Asked Questions

How long does it take for auxílio-doença to be approved?

The benefit is analyzed during the medical examination itself, but the first payment may take up to 45 days. If approved, payment is retroactive to the leave date.

Can I work while receiving auxílio-doença?

No. Auxílio-doença is incompatible with work. If you return to work, you must immediately notify INSS to avoid future problems.

What happens if the medical exam denies my request?

You can appeal the decision within 30 days. It’s possible to present new medical documents and request a new evaluation.

Is auxílio-doença subject to Income Tax?

No. Auxílio-doença is exempt from Income Tax, regardless of the amount received.

How does benefit extension work?

INSS automatically schedules periodic reassessments. You must attend review examinations with updated medical documents.

Are auxílio-doença recipients entitled to a 13th salary?

Yes. Those who receive auxílio-doença for 12 months in a year are entitled to a 13th salary proportional to the months received.

Can I convert auxílio-doença to disability retirement?

Yes. If the medical exam determines that the incapacity is permanent, auxílio-doença can be automatically converted to disability retirement.