The dos and don'ts of sick notes


Alexander Forbes Health Management Solutions head Myrna Sachs explains how to spot a dodgy sick note.

The validity of sick notes  is an issue that employers have been grappling with for a long time. The Health Professions Council of South Africa has guidelines for what a sick note should include. Section 23 of the Basic Conditions of Employment Act also includes the requirements. As a legal document, the sick note must also be an original and must be legible.

The Ethical and Professional Rules of the Medical and Dental Professions Board of the Health Professions Council of South Africa provides notes: Rule 15.1 A practitioner shall only grant a certificate of illness if such certificate contains the following information, namely:

  • the name, address and qualification of the practitioner;
  • the name of the patient;
  • the employment number of the patient (if applicable);
  • the date and time of the examination;
  • whether the certificate is being issued as a result of personal observations by the practitioner during an examination, or as the result of information received from the patient and which is based on acceptable medical grounds;
  • a description of the illness, with the informed consent of the patient, provided that if the patient is not prepared to give such consent, the medical practitioner or dentist shall merely specify that, in his or her opinion based on an examination of the patient, the patient is unfit to work or has a medical condition.
  • whether the patient is totally indisposed for duty or whether the patient is able to perform less strenuous duties in the work situation;
  • the exact period of recommended sick leave;
  • the date of issuing of the certificate of illness; and
  • a clear indication of the identity of the practitioner who issued the certificate which shall be personally and originally signed by him or her next to his or her initials and surname in printed or block letters.

An employer has a right to question a sick note that does not follow the above guidelines or which has been altered. If the certificate is pre-printed, then the practitioner must delete the words that are not relevant. If the patient went to the doctor after two days, and the doctor did not examine them during the initial period, the sick note would normally read, "as I was informed by the patient...etc"

An examination and sick note issued by a nurse or other person who is not qualified to carry out examination and diagnosis is not accepted. Any certificate bearing an illegible signature and a rubber stamp is unacceptable and in such cases can be questioned and treated as unpaid leave. It must be remembered though, that where an employee only takes one day or two days’ sick leave, they are not required to produce a medical certificate, those days remain classified as sick leave days and cannot be taken as unpaid leave.


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