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Sick Note Rules (Do You Need a Fit Note?)

  • 10 minute read
  • Last updated: 27th October 2019


If you are ill, you are by law permitted to take time off work to recover. To return to work after sickness absence, specific rules will apply depending on how long you have been absent from work. The following guide sets out the purpose of the sick note, now known as the ‘fit note’, including the rules on self-certifying and when a fit note is needed, as well as the requirements on employers to make changes to support employees with the return to work.

This article covers:


When do I need a sick note?

If you are absent from work for seven or less days consecutive days, including non-working days such as weekends and bank holidays, you are not required to give your employer a sick note.

Instead, on your return to work, where you are asked by your employer to confirm that you have been off sick, you can provide what is known as ‘self-certification’.

The process by which you notify your employer of your absence, return to work and reason of absence should be detailed in the organisation’s absence policy. For example, the employer may have a form that they use, or they may simply ask you to put details of your absence in writing, via email or letter. You can also use the employee’s statement of sickness (SC2) form on GOV.UK.

There are some circumstances in which you will not be able to self-certify and where you will need to provide official evidence that you are, or have been, poorly, and are now fit and able to return to work.

This means, where you have been ill for more than seven consecutive days and have taken sick leave, you are under an obligation to provide your employer with a fit note.

GPs are expected to issue a fit note free of charge for anyone for whom they provide clinical care where that person has been ill for more than seven days in a row and have as a result been absent from work. They are not, however, obliged to do so unless the patient has been ill for more than the required period, or in some cases, GPs may charge a fee for a private medical certificate if requested earlier than seven days of illness.

What is a sick note?

A sick note is an official document or form from a GP or hospital doctor to certify whether an employee is either ‘not fit for work’ or ‘may be fit for work’.

The sick note will also set out the nature of the condition for which the patient has been absent from work.

Where you are certified as ‘may be fit for work’, the medical practitioner completing the form may indicate what changes need to be made to help you return to work. The note will also specify the prognosis period of your illness, and whether or not a further assessment of your fitness for work will need to be made at the end of this period.

Employers should consider the recommendations on the fit note to facilitate the employee’s return to work.

If you have a disability, under the Equality Act 2010 your employer is required to make reasonable adjustments to ensure you are not substantially disadvantaged when doing your job.

Where it is not possible to implement or work to the recommendations, the fit note will change from ‘might be fit for work’ to ‘not fit for work’. The employee will not then be required to obtain a new fit note.

In some circumstances, you may be able to obtain a document akin to a sick note from a different professional, such as a physiotherapist or occupational therapist. This is known as an Allied Health Professionals (AHP) report. Your employer, however, will need to agree to accepting an AHP report by way of alternative to a sick note from your GP or hospital doctor.


Returning to work after illness

The fit note does not cover a ‘fit for work’ option, as such you do not need a fit note to confirm you can return to work after illness.

However, you should not return to work before the date on the fit note if your GP has advised you to remain off for the full period as noted on the fit note and the doctor has stated they want to see you again.

You do not need to be fully recovered to return to work and in many cases, employees can feel ready and able to return to work before the date on the fit note.

In such instances, you will first need to discuss with your employer if it is possible to return to work before the date on the fit note.

Your employer may stipulate in its absence policy that professional medical advice is needed in writing to verify that you are fit and able to resume work. This would not be covered by a standard fit note, and instead, you may need a private medical certificate or your employer may require that you attend an occupational therapist for a professional opinion.

Your employer would also be expected to carry out a risk assessment to determine if an early return could be accommodated as this may require changes to be made. For example, whether a phased return to work would be appropriate, varying working hours temporarily or giving support to do the job, such as avoiding heavy lifting.

In some circumstances, the employer may request a doctor’s report to find out more about the employee’s condition and health, for example, to assess whether the employee is fit to carry out their work, to prevent health and safety risks and prevent disability discrimination. The employer must have the employee’s consent for such a report. In agreeing to a medical report, the employee can ask their doctor not to give information they think could be damaging or is not relevant, ask to see the doctor’s report first and not agree to the doctor’s report being shared with their employer if they disagree with what it says.

If the employee does not wish the employer to see their medical information, the employer must base their decision on the information they have.

If your employer does not agree to an early return, perhaps due to the risk assessment or issues with any adjustments that may need to be made, you would need to stay off until the date on the fit note.

What changes should be made to support my return to work?

The premise of the fit note is that employees may not need to be at 100% health to return to work, and that resuming duties may in some circumstances support recovery.

Where a sick note indicates that an employee ‘may be fit for work’, your employer should explore any changes that may need to be made to support you in your return to work.

Where a GP or doctor has certified that you may be able to return to work, as previously indicated, the sick note will often indicate what type of changes may need to be made. These include the following:

  • A phased return to work, for example, part-time to full-time
  • Altered hours, for example, fewer hours or flexible working hours
  • Amended duties, for example, nothing involving physical activity
  • Workplace adaptations, for example, the provision of specialised equipment, such as an ergonomically designed chair where you have been off sick with back problems

The sick note can also include detailed comments on the functional effects of your condition and how any suggested changes will help. However, in the event that no agreement can be reached with your employer as to any suitable changes, you should continue to be treated as unfit for work.


What reasonable adjustments should be made where I have a disability?

Where there is a delay in returning to work is related to a disability, by law your employer is required to make reasonable adjustments in the workplace to ensure that you are not substantially disadvantaged when carrying out your job.

You will be treated as having a disability where you have a physical or mental impairment, and that impairment has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities. The impairment is long-term if it has lasted for at least 12 months, or is likely to last for at least 12 months, or is recurring.

Where you have a disability, any failure by your employer to make reasonable adjustments to support your return to work could amount to disability discrimination for which you can make a claim to an employment tribunal. That said, prior to taking any legal action, it is always best to discuss any alternative solutions directly with your employer.

What constitutes reasonable adjustments will depend on a number of factors, including the nature of the work you perform, the type of workplace environment where you work and the size of the organisation and the resources it has available to make the reasonable adjustments. Your employer is not, however, required to change the basic nature of your job.

Examples of reasonable adjustments could include installing a disability ramp for wheelchair users, providing specialised equipment or modifying performance targets, for example, due to disability-related fatigue.

Employees should not be asked to pay for the adjustments to be made. You may, however, be eligible for a government grant to help cover the costs of practical support in the workplace under the Access to Work scheme. A grant through this scheme can be used to fund special equipment, adaptations or support worker services to help you return to work.

Am I entitled to sick pay?

Statutory sick pay (SSP) may be payable if you are too ill to work and you have been off work for four or more consecutive days, including non-working days. SSP starts on the fourth day.

To qualify for SSP you will need to be earning an average of least £118 per week. You must also have notified your employer of your illness within any specified timeframe under the terms of your contract, or within seven days.

SSP is paid at a rate of £94.25 for a maximum of 28 weeks. It is payable in line with the employee’s standard working pattern, known as ‘qualifying days’ and payable on the employee’s usual payday, and is subject to the usual deductions for tax and national insurance.

You should look at your employment contract to determine your rights to any enhanced sick pay.

What about my holiday entitlement?

In the event that you are off work sick, your statutory holiday entitlement will still accrue, regardless of how long you are absent.

In circumstances where you fall ill just prior to or during any period of annual leave, you are entitled to take this as sick leave instead. Your employer cannot force you to take annual leave where you are eligible for sick leave.

However, you may be able to take paid holiday for any time that you are off work sick, for example, where you do not qualify for sick pay.

Need assistance?

DavidsonMorris are experienced employment law specialists offering guidance and support to employees facing difficulties at work due to ill-health and sickness absence.

We have particular expertise in advising employees with disabilities facing unfavourable treatment and discrimination at work due to their employer’s failure to make reasonable adjustments and remove disadvantage in the workplace. We can help you understand your legal options and the steps you can take to resolve issues with your employer in light of your health condition and discussions about returning to work.

If you have a question about your employment rights in relation to sickness absence or disability discrimination, contact us.

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