Sick Notes for International Workers in Ontario (Work Permits & LMIA)

Sick Notes for International Workers in Ontario

If you're working in Ontario on a work permit (LMIA, IEC, PGWP, or other), you have the same employment rights as Canadian workers — including sick leave.

Your Rights Are the Same

Under Ontario's ESA:

• 3 unpaid sick days per year (from day one)


• No medical note required for ESA sick days


• Job protection during legitimate illness


• No discrimination based on immigration status

Common Concerns for International Workers

"Will taking sick leave affect my work permit?"
No. Using your legal sick leave entitlements does not affect your immigration status.

"Can my employer threaten my LMIA if I call in sick?"
No. This is illegal. Employers cannot use immigration status as leverage against workers exercising their rights. Report this to the Ministry of Labour.

"Do I need an Ontario doctor for my sick note?"
Yes. Your note should be from a physician licensed in Ontario (CPSO-registered). MedLetter physicians are all CPSO-registered.

Barriers International Workers Face

• No family doctor (OHIP coverage may have a waiting period)


• Language barriers at walk-in clinics


• Fear of employer retaliation


• Unfamiliarity with Ontario's healthcare system

How MedLetter Helps

MedLetter provides sick notes from CPSO-registered physicians with no clinic visit required. Our simple online form is accessible regardless of language barriers.

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.