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.
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 | $0-40 | 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) |
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 medical documentation |
| 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
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
Related: [Sick Note Ontario — Complete City Guide](/sick-note-ontario) | [Ontario Sick Note Cost 2026](/blog/ontario-sick-note-cost-2026)
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.