By Michelle Naidoo / Partner 

and Diyara Ishwarlall / Candidate Attorney/ Mooney Ford Attorneys 

In Part 1 of this series, we addressed a common misconception circulating on social media: that employers may never require a medical certificate for a single day’s absence. As discussed, the legal position is far more nuanced.

In Part 2, we consider another frequently misunderstood issue:

Must an employer automatically accept a medical certificate simply because an employee submits one?

The short answer is no. While a medical certificate is important proof of incapacity, it is not immune from scrutiny.

What Does the BCEA Require?

Section 23 of the Basic Conditions of Employment Act 75 of 1997 (“BCEA”) regulates proof of incapacity.

In terms of section 23(1), an employer is generally not obliged to pay an employee for sick leave where the employee has been absent for more than two consecutive days, or on more than two occasions within an eight-week period, and fails to produce a medical certificate when requested.

Section 23(2) further provides that a medical certificate must be issued and signed by:

• a medical practitioner; or
• another person qualified to diagnose and treat patients,

provided such person is registered with a professional council established by an Act of Parliament.

Importantly, while the BCEA identifies who may issue a medical certificate, it does not comprehensively regulate what the certificate must contain. That is where professional and ethical rules become relevant.

What Makes a Medical Certificate Valid?

A common assumption is that any note issued by a doctor automatically constitutes a valid sick note. That is not necessarily correct.

The Health Professions Council of South Africa (HPCSA) provides ethical guidelines regarding the contents of medical certificates. A properly issued certificate should generally contain:

• the practitioner’s name, address, qualifications, and registration number;
• the employee’s name (and employee number, where applicable);
• the date and time of examination;
• whether the certificate is based on the practitioner’s personal examination or on information received on acceptable medical grounds;
• the recommended period of sick leave;
• whether the employee is totally unfit for duty or capable of less strenuous work; and
• the date of issue and practitioner’s signature.

Accordingly, a certificate that simply states “Booked off for two days”, without sufficient identifying details or clinical basis, may legitimately raise concerns.

Must the Diagnosis Be Disclosed?

Employers often want to know the precise nature of the employee’s illness—whether it is flu, stress, anxiety, injury, or something else.

However, medical practitioners remain bound by patient confidentiality.

Under HPCSA ethical rules, a diagnosis may only be disclosed with the employee’s informed consent. If consent is not given, the practitioner is not required to disclose the illness and may simply certify that, in their professional opinion and following examination, the employee is unfit for work.

This is an important distinction. An employer is generally entitled to know whether an employee is fit for work, but not necessarily why.

Medical privacy remains a protected right.

How Vague Is Too Vague?

Not all vague certificates are invalid.

A certificate stating: “Patient examined and medically unfit for work from 1–3 July 2026”, may still be entirely valid, even without disclosing a diagnosis.

By contrast, certificates containing wording such as: “Seen at rooms”, “Patient consulted”, “Patient reports feeling unwell”, may be problematic because such wording may merely confirm that the employee attended a consultation, it does not necessarily certify incapacity.

There is a crucial legal distinction between attendance at a consultation and medical incapacity preventing work.

When May an Employer Challenge a Medical Certificate?

Employers are not required to accept every certificate at face value.

A medical certificate may be challenged where there are reasonable grounds to question its authenticity or reliability. Examples include:

• missing practitioner details or registration number;
• suspicious alterations or inconsistencies;
• repeated certificates from questionable sources;
• certificates apparently issued without proper examination; or
• evidence contradicting the alleged incapacity.

For example, if an employee claims to be bedridden but is seen engaging in strenuous public activity during the same period, this may justify further enquiry.

Our courts have recognised that medical certificates are not beyond challenge. In labour disputes, they may constitute hearsay evidence, meaning their evidential weight can be tested. Where a certificate is challenged, the employee may need to prove both:

1. that they were genuinely ill; and
2. the extent of their incapacity.

This becomes particularly relevant where dishonesty, abuse, or misrepresentation is suspected.

Can an Employer Require a Second Opinion?

The answer depends on the circumstances.

An employer cannot arbitrarily demand unrestricted medical disclosure or subject employees to unnecessary examinations.

However, in cases involving long-term incapacity, reasonable accommodation, or suspicious absence patterns, an employer may reasonably request a further medical assessment or independent opinion.

This commonly arises where clarity is needed regarding:

• the duration of incapacity;
• whether alternative duties are feasible;
• whether reasonable accommodation is required; or
• whether the employee is fit to return to work.

Any such process should be handled carefully, lawfully, and with due regard to confidentiality and dignity.

Key Takeaway

A medical certificate is not a mere administrative formality, nor is it an unquestionable shield against scrutiny.

For employees, submitting a doctor’s note does not automatically end the enquiry where legitimate concerns arise.

For employers, the absence of a disclosed diagnosis does not, by itself, render a certificate invalid.

The legal position lies between two extremes:

• Employers may not demand unlimited medical disclosure, but
• Employees cannot assume that every sick note must be accepted without question.

The law seeks to balance two competing but equally important interests: employee privacy and workplace accountability.

 

Photo by Vitaly Gariev on Unsplash