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Fit notes

When an employee is off work, they may need to provide proof of sickness. Depending on how long the employee has been sick, their sickness absence can either be self-certified or certified by a medical professional using a fit note. Read this guide to find out more.

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A fit note (also known as a ‘statement of fitness for work’, a ‘doctor's note’ and a ‘medical statement’) is a formal written statement by a healthcare professional stating their medical opinion on someone’s fitness for work. A fit note was formerly known as a ‘sick note’.

Whether or not an employee needs a fit note depends on how long they’ve been sick:

Sickness absences for 7 days or less

A sick note is not needed for sickness absences of 7 days or less. The 7 days include any days not typically worked by the employee, like weekends and bank holidays. Instead of requiring medical evidence, employers can ask the employee to confirm that they have been sick. They can use a Self-certification form to self-certify that they have been ill.

Sickness absences for more than 7 days

If an employee has been sick for more than 7 days (including any days they typically don’t work), employers can ask them to provide medical evidence in the form of a fit note. Fit notes for absences of more than 7 days are provided free of charge.

In certain situations, employers may ask employees to provide a medical certificate. For example, employers may request this if employers are concerned about the reason for absence or if an employee’s short-term absence is frequent. A fit note should not be used in such circumstances. Instead, a healthcare professional may charge for a private medical certificate. 

The employer’s Sickness policy should set out when a private medical certificate may be needed and who will cover the costs.

If someone needs a fit note, they should contact the healthcare professional who is treating them. The healthcare professionals that can provide a fit note are:

  • doctors

  • nurses

  • occupational therapists

  • pharmacists, and

  • physiotherapists

The healthcare professional will assess the individual’s health and whether it affects their fitness for work (eg how the sickness affects their stamina and concentration).

A fit note will either state that an employee is not fit for work or that they may be fit for work.

The employee is not fit for work

This means that, in the healthcare professional’s medical opinion, someone is currently not able to work. 

If someone is not fit for work, the fit note should be shown to the employer and sick pay should be arranged accordingly. Employers are allowed to make a copy of a fit note, but the employee should keep the original.

The employee may be fit for work

This means that, in the healthcare professional’s medical opinion, someone may be able to work. Generally, the fit not will set out what level of work the healthcare professional believes the employee is capable of. This will often mean that the healthcare professional believes that they can do some work with the help of their employer. For example, a factory worker with an injured back may be able to return to work to carry out light tasks which do not involve any heavy lifting.

Fit notes may also set out possible changes, to enable the employee to return to work. These may include:

  • a gradual return to the workplace (eg by coming back part-time or working reduced hours)

  • flexible working

  • working from home

  • performing different duties or tasks

  • making changes to your workstation or working pattern

  • providing extra training or supervision

Employers and employees should discuss the fit note recommendations to help them return to work as quickly as possible. If employers are not able to implement any of the fit note recommendations, the fit note will automatically change to 'not fit for work' (ie without the employee getting a new fit note).

Note that, if an employee is disabled, employers are required to make reasonable adjustments under the Equality Act 2010.

If an employee has been off sick for more than 7 days and fails or refuses to provide a fit note, employers can consider treating the situation as a disciplinary matter. However, employers should only do this if the employee doesn’t have a good reason for not providing the fit note. When considering disciplinary action, care must be taken to follow the employer’s Disciplinary procedure. If you’re unsure about disciplining an employee, it’s best to Ask a lawyer for advice.

For more information on fit notes, see the Government’s guidance. For more information on sickness absences, read Managing sickness absence and Sick pay.

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