Ontario Employer Guide: Creating a Fair Sick Note Policy (2026)

Ontario Employer Guide: Creating a Fair Sick Note Policy

As an Ontario employer, the Working for Workers Act has changed what you can require from employees regarding sick notes. Here's how to stay compliant.

What Ontario Law Says (2026)

You CANNOT:

• Require a medical certificate for the 3 ESA sick days


• Require a note from a specific type of practitioner


• Ask for a specific diagnosis


• Contact an employee's doctor without consent


• Penalize employees for using their legal sick day entitlements

• Request a note for absences beyond the 3 ESA days (if in your policy)


• Ask for confirmation of inability to work


• Request an estimated return date


• Require a fitness-to-return note for safety-sensitive roles


• Have a policy requiring notes for paid sick days you provide above the ESA minimum

The Working for Workers Act Impact

The Working for Workers Act specifically:

• Prohibits requiring a medical certificate for ESA sick days


• Limits the type of evidence employers can demand


• Protects employees from retaliation for using sick leave

Should You Accept MedLetter Notes?

Yes. MedLetter notes are issued by CPSO-registered physicians following a clinical assessment. They are legally equivalent to notes from any other licensed physician in Ontario.

Best Practices for 2026

1. Accept online/virtual sick notes — CPSO recognizes virtual care as legitimate
2. Be consistent — Apply your policy equally to all employees
3. Document your policy — Put it in writing and ensure all employees have access
4. Consider reimbursement — Reimburse sick note costs as a goodwill gesture

Learn more about MedLetter for employers — [Contact us](/contact)

Ontario Employment Standards: Your Rights

Under Ontario's Employment Standards Act, 2000 (ESA), employees are entitled to 3 unpaid sick days per year (some employers offer paid days). Important provisions:

• Employers cannot require a doctor's note for ESA-protected sick days as of January 2024 (Working for Workers Act amendments)


• The Ontario Human Rights Code requires employers to accommodate medical conditions to the point of undue hardship


• Federally regulated employees in Ontario get 10 paid sick days under the Canada Labour Code


• Many Ontario employers still request notes as a matter of company policy (distinct from legal requirement)

Statistics: Healthcare Access in Ontario

According to Ontario Health and Statistics Canada (2025-2026):

• 2.3 million Ontarians lack a regular family doctor or nurse practitioner


• Average emergency room wait time in Ontario: over 4 hours for non-urgent cases


• Walk-in clinic wait times in the GTA: 1.5-3 hours on average


• Ontario has the lowest physician-to-population ratio of any large province

Practical Steps for Ontario Employees

1. Know the ESA - Your employer cannot penalize you for taking your 3 statutory sick days
2. Check your employment contract - Many Ontario employers offer 5-10 paid sick days beyond the ESA minimum
3. Unionized workers - OPSEU, CUPE, and Unifor contracts typically provide 12-18 paid sick days annually
4. Document everything - Keep a record of when you called in and who you spoke to
5. Accommodation requests - If you have a chronic condition, consider requesting formal workplace accommodation under the OHRC

When a Sick Note May Not Be Required

While Ontario law has specific rules, most employers still require documentation. Here's when you need to protect yourself:

• Your 3 annual ESA sick days (Working for Workers Act, 2024)


• Family responsibility leave (up to 3 days)


• Bereavement leave (up to 2 days)


• Domestic or sexual violence leave

What Employers Need to Know

Canadian employment law balances employer interests with employee privacy:

• Employers can request confirmation of illness but not specific diagnoses


• The note should state: dates of absence, that the employee was/is unfit for duties, and expected return date


• Employers cannot contact the physician directly without employee consent


• Requiring a note for every single-day absence may constitute harassment in some jurisdictions

Cost Considerations for Employers

• Walk-in clinic notes cost employees $20-50 and require 2-4 hours away from work


• Virtual sick notes reduce time away from work to minutes


• Some employers reimburse sick note costs as a best practice


• The cost of replacing a sick employee for a day far exceeds the cost of documentation

Frequently Asked Questions

Can I get a sick note online in Ontario?
Yes. CPSO-licensed physicians can assess patients through virtual consultations and issue legally valid sick notes accepted by all Ontario employers.

How much does an online sick note cost in Ontario?
MedLetter charges a flat $49 for a sick note with same-day delivery. This includes the physician assessment and official documentation.

Will my Ontario employer accept an online sick note?
Yes. The College of Physicians and Surgeons of Ontario recognizes virtual care. Online sick notes are legally equivalent to in-person notes.

How long does it take to get a sick note from MedLetter?
Most sick notes are delivered within 2-6 hours of submission. Same-day delivery is standard.