The 24-month permanent disability review: what you need to know

Updated on 27 September 2026. Since 1 September 2026 the National Social Security Institute (Instituto Nacional de la Seguridad Social, INSS) has served notice of permanent disability reviews electronically, and in May 2025 Law 2/2025 changed what happens to your employment contract and renamed gran invalidez as gran incapacidad. We also make clear that partial permanent disability can be reviewed too and that, since December 2024, working with an absolute or gran incapacidad disability suspends payment of the pension rather than being barred.

Many people think a permanent disability (incapacidad permanente) is for life, but Social Security can review it until you reach retirement age. The review that raises most questions is the one usually set two years after the decision. Understanding how it works helps you keep your pension, ask for a higher degree if your condition has worsened and avoid losing employment rights along the way.

What it means for your disability to be "reviewable at 24 months"

Every decision that grants a permanent disability, or confirms the degree after a review, must state the date from which a review can be requested on the grounds of deterioration or improvement (art. 200.2 of the General Social Security Act, Ley General de la Seguridad Social, LGSS). Two years is common, but the INSS may set a different period depending on your diagnosis.

Bear three things in mind:

• It is not an automatic appointment. It is the point from which the INSS, you or other interested parties can open the review. It may come then, much later or never.
• The period binds everyone, including you: as a general rule, nobody can initiate the review before that date.
• There can be more than one. Each decision that keeps your degree sets a new period (art. 19 of the Order of 18 January 1996). A review is possible up to the retirement age in art. 205.1.a) LGSS: in 2026, 65 if you have 38 years and 3 months of contributions or more; otherwise, 66 years and 10 months. Separately, the pension is renamed a retirement pension, without any change to its conditions, when you turn 66 years and 10 months in 2026, however long you have contributed (art. 200.4 and last paragraph of the seventh transitional provision LGSS).

There are exceptions to the period. If you work, the INSS can review your degree at any time, and a diagnostic error can always be corrected before retirement age (art. 200.2 LGSS). In its official guidance, Social Security also accepts bringing the review forward if new conditions appear.

If your disability stems from an occupational disease (enfermedad profesional), the rules are more flexible: Social Security can arrange periodic medical examinations without waiting for the general period, at least six months apart, and review your degree as a result (art. 44 of the Order of 15 April 1969). According to its official guidance, in that case a review is possible even after retirement age.

Partial permanent disability can also be reviewed

Partial permanent disability (incapacidad permanente parcial) does not give you a monthly pension but a one-off lump sum (art. 196.1 LGSS). That does not exclude it: the law allows disability to be reviewed "in any of its degrees", and it is usually reviewed for deterioration, to move up to total permanent disability or higher. In that case, the new pension is not paid until the part of the lump sum corresponding to months that have not yet elapsed has been deducted; and if a review concludes that you no longer have any disability, you do not have to repay anything (art. 40 of the Order of 15 April 1969).

Who can open the review and who decides

Only the INSS declares and reviews permanent disability (art. 200.1 LGSS and art. 1 of Royal Decree 1300/1995). A review can be requested by the INSS itself, on its own initiative; by you, if your condition has deteriorated; and by the mutual insurance society (mutua) or the employer responsible for the benefit, which is common when the disability stems from an accident at work or an occupational disease (art. 4 of Royal Decree 1300/1995). So the mutua can request a review, but it does not decide.

The usual reasons are: the period having elapsed, reports pointing to an improvement, work that the INSS considers incompatible or doubts about the diagnosis.

If you are thinking of asking for a higher degree, bear in mind that the INSS is not bound by what you ask for: it can grant a higher or lower degree than you had (art. 6.1 of Royal Decree 1300/1995). Before applying, check that your reports show a clear worsening.

The procedure, step by step

1. Notice of the start of the review, now electronic. Since 1 September 2026, INSS notices on permanent disability have, as a general rule, been served electronically (art. 4.1.c of Order ISM/903/2020, as amended by Order ISM/541/2026): on the Social Security electronic office (sede electrónica), Mi Carpeta Ciudadana (the Government's online citizen folder) or the single enabled electronic address (Dirección Electrónica Habilitada única, DEHú). If you do not open the notice within 10 calendar days, it is deemed rejected, the step is treated as completed and the procedure continues (art. 8.1 of that Order and art. 41.5 of Law 39/2015).
2. 15 days to submit representations. When the review starts, a 15-working-day evidence period opens for you to submit written representations (alegaciones) and reports (art. 18 of the Order of 18 January 1996). It is not compulsory, but it is your best chance to show that your limitations persist.
3. Examination by the EVI. The Disability Assessment Team (Equipo de Valoración de Incapacidades, EVI), popularly known as the "medical tribunal", examines you, studies your records and issues a proposed opinion (dictamen-propuesta) that does not bind the INSS (arts. 3 and 5 of Royal Decree 1300/1995).
4. Hearing. Before a decision is taken, you are normally given 10 working days to respond to that opinion (art. 11 of the 1996 Order), and you can ask for a copy of the file (art. 53.1.a of Law 39/2015).
5. Decision. It is issued by the INSS provincial director within a maximum of 135 days (art. 14 of the 1996 Order). If you asked for the review and receive no answer within that period, you can treat it as rejected and challenge it.

To avoid missing anything, register a mobile number and an email address on the sede electrónica: the INSS will use them to alert you to each notice, although a missing alert does not invalidate it (art. 8.2 of Order ISM/903/2020). If the INSS does not have your contact details, it may notify you on paper and ask you to provide them (art. 5.2.d of that Order).

According to the Social Security sede electrónica, notices containing health data, such as these, can only be opened with an electronic certificate or Cl@ve permanente (the permanent password of the Government's Cl@ve digital identity system; Cl@ve Móvil is not enough). Get one before the review starts: you can register for Cl@ve online or in person at a registration office. Social Security information and advice centres (Centros de Atención e Información de la Seguridad Social, CAISS) can help you access the system, and you can also authorise a trusted person or your lawyer to receive notices on your behalf.

How to prepare your representations and the medical appointment

• Think in terms of comparison. A review for improvement requires your condition to have changed compared with the one assessed when your disability was granted: your reports should show that the limitations are still there.
• Provide recent reports from your specialists, objective tests and your current treatment, with its side effects.
• Explain what you cannot do in your usual occupation (if you have total permanent disability) or in any job (if you have absolute permanent disability), with specific examples. Do not exaggerate, but do not play down what is happening to you either.
• Do not miss the appointment. If you cannot attend, give your reasons and ask for another date. If you fail to attend the medical tests the INSS calls you to without a justified reason, it can treat you as having lost your right to that step and decide on what is already in the file, because the procedure moves forward even if you do not appear (arts. 6 and 8.2 of the 1996 Order and art. 73.3 of Law 39/2015).

Working with a permanent disability

Working is not prohibited, but it allows the INSS to review your degree at any time (art. 200.2 LGSS). The rules depend on the degree (art. 198 LGSS):

• Total: the pension is compatible with a salary as long as your duties do not coincide with those that led to the disability. If you receive the additional 20% of "qualified" total disability, that increase is suspended while you are employed (art. 6 of Decree 1646/1972).
• Absolute and gran incapacidad (severe disability): you can carry out activities compatible with your condition that do not amount to a change in your capacity. Since 22 December 2024, if an activity requires you to be registered with Social Security, the INSS suspends payment of the pension for as long as it lasts and resumes it when it ends, without prejudice to reviewing your degree (art. 198.2 LGSS, as amended by Law 7/2024). The gran incapacidad supplement for paying the person who cares for you is not suspended.

If you receive the pension when it should have been suspended, the INSS can claim back the amounts unduly received (art. 55 LGSS). Law 2/2025 asked the Government to put forward a proposal to reform these compatibility rules, but as at 27 September 2026 no change has been approved.

Your job: two-year job protection and Law 2/2025

If you were declared to have a total, absolute or gran incapacidad disability at the end of a period of sick leave and the decision anticipates a review for improvement that would allow you to return, your contract is suspended with your job held open for two years from the date of the decision (art. 48.2 of the Workers' Statute, Estatuto de los Trabajadores, ET). For this, the initial decision must set a period for review for expected improvement of two years or less (art. 7 of Royal Decree 1300/1995). The two years run from the decision, not from the review: if the INSS reviews later, the job protection will already have ended.

In addition, since 1 May 2025 total or absolute permanent disability and gran incapacidad no longer automatically terminate the contract (Law 2/2025 of 29 April). You have 10 calendar days from notification to tell your employer in writing that you wish to stay on, and the employer has 3 months to adapt your job or move you to a compatible vacancy. It can only terminate the contract, in writing and with reasons, if the adaptation would be an excessive burden, if there is no suitable vacancy or if you turn down the change (art. 49.1.n ET). In the meantime, the contract remains suspended with your job held open. If the employer terminates the contract on this ground, you can challenge it as a dismissal within 20 working days; the proceedings are urgent and handled as a priority (arts. 120.2 and 121 of the Social Jurisdiction Act, Ley reguladora de la jurisdicción social, LRJS, and art. 59.3 ET).

If the review removes or lowers your disability

• If you are still within the protection period, ask in writing to return to work as soon as you receive the decision (art. 48.1 ET). If the employer refuses, it may be a dismissal: you have 20 working days to challenge it, starting with the request for conciliation, which in Madrid is filed with the Servicio de Mediación, Arbitraje y Conciliación (SMAC, the Madrid regional conciliation service) (art. 59.3 ET and art. 103 LRJS).
• If your contract has already ended, you may have priority to return to your last employer, although the rule links this to having received vocational rehabilitation benefits. If you fully recover your capacity, the priority is for the first vacancy in your category or professional group; if the review leaves you with a partial disability, for the first vacancy suited to your capacity. To use it, tell the employer and the workers' representatives within one month of the decision recognising your recovery, preferably in writing (arts. 2 and 3 of Royal Decree 1451/1983).

If the INSS withdraws or reduces your pension

The decision is immediately enforceable (art. 6.4 of Royal Decree 1300/1995): the change applies from the day after the decision, even if you challenge it (art. 40 of the Order of 15 April 1969). You do not have to repay what you received before, unless it was undue.

To defend yourself:

1. Prior administrative claim (reclamación previa) to the INSS within 30 working days of notification (art. 71.2 LRJS).
2. The INSS has 45 days to reply; if it does not, the claim is deemed rejected (art. 71.5 LRJS).
3. Court claim before the Social Court (Juzgado de lo Social) within 30 working days of the rejection or the deemed rejection (art. 71.6 LRJS). For the court claim, August and the days from 24 December to 6 January do not count in this area (art. 43.4 LRJS).

Prepare the prior claim carefully: in court you will not be able to introduce substantial changes to what you raised in it, except for new facts (art. 72 LRJS). An expert medical report comparing your current condition with the one assessed when your disability was granted is often decisive. At first instance you do not have to be represented by a lawyer (art. 21.1 LRJS), although it is advisable to have advice.

Common mistakes

• Assuming you will be reviewed exactly at 24 months, or that you will not be reviewed after that.
• Not checking the sede electrónica, or not having an electronic certificate or Cl@ve permanente to open notices: after 10 days the notice is treated as served.
• Starting work without checking whether it is compatible with your degree.
• Missing the 30-day deadline for the prior claim or not asking to return to work in time.

If you have received notice of a review, are considering asking for a higher degree or the INSS has withdrawn your pension, we can look at your case and the deadlines that are running: book a consultation. You may also be interested in what happens after 18 months of sick leave or whether you can receive a disability pension and unemployment benefit at the same time.

Legislation and sources

• General Social Security Act (consolidated text), arts. 196, 198 and 200
• Workers' Statute (consolidated text), arts. 48 and 49
• Royal Decree 1300/1995 on Social Security work disabilities (consolidated text)
• Order of 18 January 1996 implementing Royal Decree 1300/1995
• Order of 15 April 1969 on disability benefits (art. 40)
• Order ISM/903/2020 on Social Security electronic notifications (consolidated text)
• Order ISM/541/2026 of 27 May, extending electronic notifications to permanent disability
• Law 2/2025 of 29 April (art. 49.1.n ET, art. 120.2 LRJS and gran incapacidad)
• Law 7/2024 of 20 December (thirteenth final provision, art. 198.2 LGSS)
• Law 39/2015 on Common Administrative Procedure (consolidated text)
• Royal Decree 1451/1983 on selective employment (arts. 2 and 3)
• Decree 1646/1972 on General Scheme benefits (art. 6)
• Social Jurisdiction Act (consolidated text), arts. 71 and 120
• Social Security: assessment and review of permanent disability