Updated August 2026, Current Ontario ESA and CPSO telemedicine standards.
Need a sick note in Ontario? MedLetter provides official physician-signed documentation for $49 with same-day delivery. No walk-in clinic visit needed — submit your request in 2 minutes and receive your note by email. Valid for employers, universities, and insurance across Ontario.
The Cost Question
Who pays for your sick note depends on your employer's policies and Ontario employment law.
Ontario Employment Standards Position
The Ontario government has stated that requiring sick notes places an unnecessary burden on both employees and the healthcare system.
What OHIP Covers
OHIP covers the medical appointment but NOT paperwork like sick notes. Many clinics charge $20-50 for note completion.
Employer Reimbursement Policies
Check your:
- Employment contract
- Employee handbook
- Collective agreement
- Company expense policy
MedLetter's Transparent Pricing
$49 flat fee for sick notes from CPSO-registered physicians. We provide a receipt for reimbursement. Many customers successfully claim through their employer or health spending account.
The Urgency Factor: When You Need a Note Immediately
Many Ontario workers find themselves in situations where they urgently need medical documentation. Perhaps your boss is demanding a note by tomorrow morning, or you called in sick without realizing your company policy requires a note for even a single day of absence. Finding a walk-in clinic that is open during evenings or weekends can be incredibly stressful, especially when you are already feeling unwell. Clinics in cities like Toronto, Mississauga, and Brampton often have long wait times, and many close early on weekends. If you are a shift worker at TTC, OPG, or Amazon warehouses, your schedule might not align with traditional clinic hours at all. In these high-pressure scenarios, an online sick note provides a fast, reliable solution without the need to leave your bed. Whether you are dealing with a sudden flu on a Sunday evening or a migraine that prevents you from driving to a clinic in Hamilton or London, having access to a quick, CPSO-compliant virtual service can alleviate significant anxiety and protect your employment status.
How Major Ontario Employers Handle Sick Notes
Different employers across the province have varying policies regarding sick notes and who bears the cost. While the Ontario Public Service and large financial institutions like TD Bank and RBC often have comprehensive benefits that cover the cost of medical documentation, other employers may not be as accommodating. Tech companies like Shopify tend to have more flexible, trust-based absence policies, whereas hourly or shift-based roles might strictly enforce documentation requirements. Regardless of where you work, it is crucial to understand your specific workplace policies. For instance, employees at large logistics hubs or manufacturing plants may face strict attendance point systems where failing to provide a sick note results in immediate penalties. In these environments, knowing exactly how to quickly obtain valid New sick-note requests are temporarily paused while we review our service. We are not accepting new orders at this time. is essential for job security.
Legal Framework: ESA Section 50 and the Working for Workers Act
Understanding your rights under the Employment Standards Act (ESA) is essential for every Ontario worker. Under ESA Section 50, eligible employees have the right to take up to three days of unpaid sick leave each calendar year. However, the ESA allows employers to require "evidence reasonable in the circumstances" to verify the absence. The recent Working for Workers Act has sparked ongoing discussions about modernizing these requirements to better protect workers and reduce the strain on the healthcare system. Furthermore, any medical documentation provided must adhere to the strict privacy and professional standards set by the College of Physicians and Surgeons of Ontario (CPSO), including their comprehensive telemedicine guidelines. If an employer's demands for medical information become excessive or discriminatory, employees may have grounds to file a complaint with the Ontario Human Rights Tribunal. For workplace injuries, the Workplace Safety and Insurance Board (WSIB) has its own specific documentation and reporting requirements.
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
Breakdown of Sick Note Costs in Ontario
| Provider | Cost to Employee | Wait Time | OHIP Coverage |
|----------|-----------------|-----------|---------------|
| Family doctor | $0-20 (admin fee) | Days-weeks for appointment | Visit covered, note fee varies |
| Walk-in clinic | $20-50 (note fee)-40 | 1.5-3 hours (GTA) | Visit covered, note may cost extra |
| Virtual clinic (Maple, Tia Health) | $0-69 | Minutes-hours | Some OHIP-covered, some private |
| MedLetter | $49 | Within 6 hours | Not OHIP (flat fee, all-inclusive) |
| ER visit (not recommended) | $0 | 4-12 hours | OHIP covered, inappropriate use |
| Specialist | $0 | Weeks-months | OHIP covered (referral needed) |
Comparing Sick Note Options Across Ontario Cities
Access to healthcare and the cost of obtaining a sick note can vary significantly depending on where you live in Ontario.
| City | Average Walk-in Wait Time | Typical Clinic Note Fee | Accessibility Challenges |
|------|---------------------------|-------------------------|--------------------------|
| Toronto | 2-4 hours | $25 - $50 | High clinic density but severe overcrowding |
| Ottawa | 3-5 hours | $20 - $45 | Limited weekend clinic hours |
| Mississauga | 2-3 hours | $25 - $50 | Long travel distances between clinics |
| Brampton | 3-6 hours | $30 - $50 | Extremely high patient volume |
| Hamilton | 2-4 hours | $20 - $40 | Fewer downtown walk-in options |
| London | 2-5 hours | $20 - $45 | High demand from student populations |
| Kitchener | 2-4 hours | $20 - $40 | Limited after-hours availability |
| Windsor | 3-5 hours | $20 - $45 | Shortage of primary care physicians |
The OHIP Sick Note Controversy
A key issue in Ontario: while OHIP covers the physician visit, many doctors charge an uninsured service fee for the actual sick note document:
- This fee ranges from $20-50 at most Ontario clinics
- The Ontario Medical Association (OMA) considers sick notes an "uninsured service"
- OHIP does not cover the administrative work of completing employer forms
- Some physicians refuse to charge, while others consider it standard practice
Can Your Ontario Employer Make You Pay?
Under Ontario employment law:
- The ESA does not address who pays for sick notes
- Employers cannot deduct the cost from your wages without written authorization (ESA Section 13)
- Some employment contracts include sick note reimbursement
- Many Ontario unions have negotiated employer-paid documentation
- The Ontario Human Rights Commission has suggested employers should bear the cost when they require documentation
The True Cost of a "Free" Walk-in Clinic Visit in Ontario
For a GTA worker earning Ontario's median wage ($28/hour):
- Wait time cost: 2.5 hours × $28 = $70 in lost wages
- Travel cost: TTC fare ($3.35) or driving ($10-25 parking + gas)
- Note fee: $0-40 at the clinic
- Total real cost: $73-135 for a "free" visit
Compare this to $49 for an online sick note with no travel, no wait, and no additional lost wages.
What Ontario Unions Have Negotiated
| Union | Sick Note Policy |
|-------|-----------------|
| OPSEU | Employer pays for all required New sick-note requests are temporarily paused while we review our service. We are not accepting new orders at this time. |
| CUPE (Ontario) | Reimbursement up to $50 per note |
| Unifor | Employer-paid documentation after 3+ days |
| OSSTF | Full reimbursement for required medical certificates |
| ONA (Nurses) | Employer pays, no note required for first 3 days |
Tax Implications in Ontario
- Sick note fees are eligible as medical expenses on your Ontario tax return
- Must exceed the lesser of 3% of net income or $2,635 (2026)
- Can be claimed on Line 33099 (for yourself) or 33199 (for dependents)
- Keep all receipts, CRA may request documentation during audit
- If your employer reimburses you, you cannot also claim the tax deduction
The Impact of Telemedicine on Ontario Healthcare
The rise of telemedicine has fundamentally changed how Ontarians access basic healthcare services, including medical documentation. The CPSO telemedicine guidelines ensure that virtual care meets the same high standard as in-person visits. This shift is particularly beneficial for residents in areas with physician shortages, such as Windsor or rural Ontario. By utilizing services like MedLetter, patients can obtain necessary documentation without unnecessarily burdening emergency rooms or walk-in clinics, which are often overwhelmed with more severe cases. This not only saves the patient time and money but also supports the broader provincial healthcare system by freeing up valuable in-person resources.
Employer Best Practices (Ontario Chamber of Commerce Recommendations)
The Ontario Chamber of Commerce recommends employers:
- Eliminate sick note requirements for absences of 3 days or fewer
- Reimburse sick note costs when documentation is required
- Accept virtual/online sick notes to reduce employee burden
- Implement self-declaration forms for short absences
- Consider the productivity cost of sending sick employees to clinics
Frequently Asked Questions
How much does a sick note cost in Ontario?
Costs vary: walk-in clinics charge $20-50, telehealth apps charge $30-75, and MedLetter charges a flat $49 with same-day delivery included.
Are sick notes covered by OHIP?
No. Sick notes are considered uninsured services in Ontario. OHIP does not cover the cost of completing employer-requested medical forms.
Why do doctors charge for sick notes?
The Ontario Medical Association considers sick notes an uninsured service because they serve an administrative rather than medical purpose.
What is the cheapest way to get a sick note in Ontario?
Online services offer the best value when you factor in time saved. MedLetter charges $49 flat with no travel time, no waiting, and same-day delivery.
Can my employer fire me for not providing a sick note in Ontario?
If your employer's policy clearly requires a sick note and you fail to provide one, it could lead to disciplinary action. However, under ESA Section 50, you are entitled to sick leave, and employers must be reasonable in their requests for evidence.
Do online sick notes meet CPSO standards?
Yes, as long as the service uses CPSO-registered physicians who follow the College's telemedicine guidelines. MedLetter ensures all assessments and documentation comply with these strict provincial standards.
What should I do if my boss demands a note on a Sunday?
Finding an open clinic on a Sunday can be difficult in many Ontario cities. Using a telemedicine service like MedLetter allows you to request an Ontario sick note online at any time, ensuring you have the required documentation ready for your next shift.
Related: Sick Note Ontario, Complete City Guide | Ontario Sick Note Cost 2026