A Blood Test, a Forgotten Pan and a Cut-Off Paycheck: Spanish Court Backs Sick-Pay Suspension for DIY Therapy Exit

An employee of the city of León who stopped taking her prescribed medication while on long-term sick leave has lost her sickness benefit — and Spain's regional high court for Castilla y León has now upheld the decision.

The woman had been signed off work since 26 October 2023 for more than three months, with insomnia and anxiety listed as the reasons. The Mutua, an insurance partner of Spain's Seguridad Social social-security system responsible for paying out the benefit, then ordered a blood analysis. The lab results showed she had not taken her prescribed drugs for several weeks.

Payment was halted on that basis. The court's judges anchored the legality of the move in Article 175.2 of Spain's Ley General de la Seguridad Social (the General Social Security Act), which expressly permits financial support to be suspended when a recommended course of medical treatment is abandoned without a valid reason.

Side effects cited, but no paperwork

In court, the employee justified dropping the medication by describing serious effects on daily life. She said she had once left a pan on the hob and forgotten it, and that she had come close to an accident while driving. She also pointed out that her son, a neurologist, along with her family doctor and her psychologist, had all advised her to stop the treatment.

The high court did not accept the argument. The judges treated the recommendations from her family and treating circle as mere assertions. Because she could not produce sufficient written evidence of an official medical instruction to end the therapy, the cancellation of her wage-replacement benefit stood.

A wider pattern of abandoned prescriptions

Irregular or skipped medication is a problem across much of medical care, not just in this case. In a report dated 25 October 2026, Prof. Dr. Christiane Tiefenbacher, a board member of the German Heart Foundation (Deutsche Herzstiftung), warned of serious consequences when patients unilaterally stop long-term therapies.

With blood-pressure drugs, adherence sits below 50 percent, she noted — even though high blood pressure and cholesterol generally cause no temporary symptoms that would remind patients to keep taking them.

According to Tiefenbacher, stopping or reducing blood-pressure medication is only rarely an option, and usually requires substantial weight loss combined with lifestyle changes.

Small kilos, measurable numbers

Each kilogram lost lowers the upper blood-pressure reading by roughly 1 to 2 mmHg, so shedding 10 kilograms can bring it down by 10 to 20 mmHg. Where the upper figure sits around 100 mmHg, the dose may in some circumstances be too high.

If the reading drops to about 90 mmHg and the patient also feels dizzy, a dose adjustment should be weighed up by a doctor. Any change to medication must in principle be made in consultation with the treating physicians — to protect both the patient's health and their insurance status.