Sick Notes In South African Workplaces: Clear Rules, Fair Processes

South African law treats sick leave and medical certificates as part of a balanced system. The Basic Conditions of Employment Act, 1997 (BCEA) gives employees paid time to recover, but it also equips employers with clear thresholds for when a medical certificate is required, what makes it valid, and how to verify it—without breaching medical privacy. Done properly, this reduces conflict, protects productivity, and keeps disciplinary action on a firm legal footing.

The legal framing (BCEA essentials)

Two provisions do the heavy lifting:

• Section 22 (sick-leave entitlement): After the first six months, employees receive a three-year sick-leave "cycle" equal to the number of days they ordinarily work in six weeks (typically 30 days for a 5-day week; 36 for a 6-day week).
• Section 23 (medical certificates): A certificate is required when an employee is absent for more than two consecutive days, or on more than two occasions in any eight-week period. It must be issued and signed by a person certified to diagnose and treat patients and registered with a professional council established by an Act of Parliament.

This framework is designed to protect legitimate incapacity while enabling employers to manage abuse through reasonable rules and fair verification.

What makes a certificate "valid"?

At minimum, a compliant certificate should carry the practitioner's name, practice/registration number, contact details, the date of consultation, and the period booked off. Crucially, the BCEA does not require disclosure of the diagnosis; "medical condition" is sufficient wording because diagnosis is confidential personal information. Employers may adopt policies that stipulate format and submission timelines, but those policies cannot demand disclosure of diagnosis.

Traditional healers

Certificates from traditional healers are recognised only if the healer is properly registered with the Traditional Health Practitioners Council (a statutory council). If registration requirements are not met, employers may lawfully reject the note for paid sick leave purposes, consistent with s23(2). Recent commentary and regulatory updates underscore this point.

Virtual vs In-person consultations

The BCEA is silent on how the consultation occurs. Properly issued certificates following virtual/telephonic consultations are generally acceptable unless company policy reasonably requires in-person examinations for specified circumstances. Make the stance explicit in policy and apply it consistently.

Verification: What you may check – what you must not

Employers are not required to accept certificates at face value. You may (and should) verify factual elements:

• That the practitioner exists and is registered (HPCSA/AHPCSA/THPC),
• The date of consultation, and
• The period of incapacity.

You must not probe into diagnosis, medication, or clinical notes. Verification is about validity and dates, not medical detail. Keep a short audit trail of your checks.

So, when can a certificate be challenged?Red flags include illegibility, alterations (e.g., scratched-out dates), mismatched names/practice numbers, or wording that suggests no clinical assessment ("patient informs..."). In such cases, verify with the practice and relevant register; if concerns persist, follow internal procedures and invite an explanation. Where evidence shows intent to deceive (forgery/alteration), disciplinary action may be justified.

Misuse and consequences: Recent guidance from the courts

Two strands of case law are particularly useful for employers:

• Dishonesty while on sick leave: In a 2021 matter, the Labour Appeal Court confirmed that attending a rugby match while booked off sick can justify dismissal for dishonesty, provided a fair process is followed. Employers may rely on objective evidence (e.g., social media) showing conduct inconsistent with incapacity.
• Fraudulent/irregular certificates: Courts and tribunals have upheld dismissal where employees submitted certificates they knew were not genuine or were obtained without proper consultation. As always, the sanction must rest on solid proof and a procedurally fair enquiry.

Managing this well: How Fairbridges partners with your team

A short, well-communicated policy prevents most disputes and gives you a defensible position when you need to act. We'll work with your HR, legal and line management teams to get there quickly and cleanly.

What we do with you (end-to-end):

1) Clarify the rules and write them down. We align your policy to the BCEA's thresholds (more than two consecutive days; more than two occasions in eight weeks) and set out, in plain language:

• What a valid certificate must contain,
• Who may issue it (registered councils, including traditional healers where properly registered), and
• Your stance on telemedicine (virtual vs in-person) with narrowly tailored exceptions.
  You get a concise policy plus a staff-facing notice you can publish immediately.

2) Make submission practical and consistent. Together we decide what "as soon as reasonably practicable" means in your environment, and when "on return to work" applies. We then standardise how certificates are received (original, scanned, or secure upload) and build a short line-manager checklist so the process is applied evenly.

3) Introduce a light-touch verification step. We design a POPIA-aligned verification playbook so managers check validity and dates, not diagnoses. It includes:

• A one-page script for calling the practice,
• Links to the relevant practitioner-register lookups, and
• A 3-line note template capturing who was called, what was confirmed, and when.
  No medical detail is recorded; privacy stays intact.

4) Define the disciplinary path (and the brakes). We map your internal steps for suspected abuse – e.g., forged/altered notes or conduct inconsistent with incapacity (the "rugby-match problem") – with charge wording, evidence lists, and hearing notice templates. We also add the "brakes": When to pause and seek further information, and how to ensure procedural fairness.

5) Upskill the people who make it work. We run a 60-minute briefing for HR and line managers (live or virtual) covering:

• What's valid, what's not, and why;
• How to verify without breaching privacy; and
• When to escalate to formal process.

Attendees leave with the policy, the playbook, and the templates.

6) Keep you current. If you'd like, we provide an annual refresh pack reflecting statutory updates and notable judgments touching dishonesty on sick leave, telemedicine acceptance, and traditional-healer certificates – so your documents stay current without a rewrite.

Ready to implement?

We can start with a rapid audit (policy + three recent sick-leave files), then turn around a tailored policy, manager toolkit and briefing within a tight timeline. If you'd like a version co-branded for your intranet, we'll format and supply that too.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.