Sick Notes for Patients

Dealing with Requests for Sick Notes

The Chief Provincial Public Health Officer advised on March 12 that employers should encourage employees to stay home when ill “without facing barriers such as the requirement for sick notes” (March 12 news release).

Doctors Manitoba has produced a sample letter for patients to provide to employers regarding sick notes, which clinics can adapt to meet their needs.

Sick Note Requests from Health Care Workers

Shared Health has also issued guidance regarding medical notes from primary care providers for employee accommodation requests from health care workers. See page 3.

The full Shared Health memo to health care workers offers an overview of the position that provincial occupational health has the final say on assessing and approving exceptions from the workplace for health care providers.

Further Considerations for Sick Note Requests

As more services reopen, we have heard reports that more patients are calling for sick notes. Several physicians have raised concerns that some of these requests are arising from employees who are fearful of catching COVID-19 at work or bringing it home to their families. Physicians should consider the following when faced with sick note requests:

  • Ensure your patient has a good understanding of COVID-19, its risks and has clear and complete information from their employers about precautions.
  • If your patient reports a new condition – including anxiety or other mental health condition exacerbated by a return to the workplace – it is entirely reasonable to require an in-person or virtual visit before you can draw any conclusions, and ensure your patient has credible information about COVID-19 and has details from their employer about the precautions they are putting in place.
  • If your employee is requesting an accommodation at, or absence from, the workplace because they believe they are at increased risk, you may choose to provide a note. However, unless you are aware of your patient’s working conditions, it may be very difficult to draw a conclusion that a return to the workplace is not appropriate. You can reference the Shared Health guidance on sick notes for health care workers for some information, but you should know that different employers may require different information to understand the cause of the limitation or restriction to help assess if additional precautions or changes are needed.
  • It can also be difficult to respond to patients requesting sick notes because of other issues, such as child care or transportation challenges, or because of family members’ health concerns. These are all valid concerns, but are problematic to use as medical rationale for sick notes.