Doctors Medical Certificates, also known as a Med 3 or Fit for Work certificates are issued after a period of 7 consecutive days of absence due to sickness
Medical certificates are required for Statutory Sick Pay purposes for employees who are either incapable of work or who may be fit for work with support from their employer. They are required for any period of absence lasting longer than seven calendar days. The duty to provide a Medical Certificate, rests with the doctor who, at the time, has clinical responsibility for the patient. So, if a Hospital Consultant tells an employee that they should not return to work it is their responsibility to supply the employee with a Medical Certificate. Medical Certificates are also known as a Med 3 or Fit for Work certificates.
This page was first published on 23 November 2018. The last update was on 24 June 2022.
UPDATE 14 March 2022
Digital Medical Certificates Introduced
From 6 April 2022, the Government introduced legislation to implement digital Medical Certificates. This means that Medical Certificates no longer require a wet-ink signature from the Doctor.
Questions and Answers about Medical Certificates
Can a GP issue a duplicate medical certificate to a patient who has two part time jobs?
No. A GP can only issue a duplicate Medical Certificates if the original certificate has been lost. They should clearly mark it “Duplicate”.
Where an employee has more than one employer and they submit the original certificate to you, take a copy of the certificate and make a note of why you don’t have the original. Then return the original to the employee so they can then present the certificate to their second employer.
Can healthcare professionals other than doctors give medical certificate to patients?
No. The Social Security (Medical Evidence) Regulations state that only a registered medical practitioner can issue statements of a person’s incapacity for work. A fundamental principle of sickness certification in the United Kingdom is that GPs provide advice on fitness for work as an integral part of the clinical management of a patient’s condition.
Whilst, the opinion of another healthcare professional, for example a nurse, psychologist or dentist, would clearly be of interest, they would need to provide it in a format other than a Medical Certificates. The statement should clearly identify the name, address and speciality of the practitioner.
UPDATE 24 JUNE 2022
New Legislation Permits Medical Certificates To Be Signed By A Wider Group Of Healthcare Professionals
When an employee is off work for more than seven days their absence needs to be certified by way of a Medical Certificate. Currently only doctors are able to certify and issue Medical Certificates. New legislation, coming into force on 1 July 2022, will allow a wider group of registered health professionals to be able to certify and issue Medical Certificates. This will include occupational therapists, physiotherapists, nurses and pharmacists. The legislative change is intended to reduce pressures on doctors.
When can a Medical Certificate be backdated?
A Medical Certificate can only be issued for a backdated period when it is based on a previous assessment.
An assessment is defined as the date the patient either had a face-to-face consultation, a telephone consultation or considered a report from another doctor or registered healthcare professional. The GP can issue a Medical Certificates on or after this date, but not before.
If there has not been a previous assessment, for example, if the employee has not been appropriately issued with a Medical Certificates on discharge from hospital or at a previous consultation with another GP, the GP may write in the comment box of the certificate or in a separate letter provide advice that the patient was not fit for work for an earlier period. This is acceptable for Sick Pay purposes.
If a hospital discharges a patient and advises them to refrain from work, should the hospital or the GP issue a medical certificate?
The duty to provide a medical certificate rests with the doctor who has clinical responsibility for the patient at the time. Hospitals are required to provide all statements for Social Security and Statutory Sick Pay purposes and statements for both inpatients and outpatients who are incapable of work.
Therefore, if a hospital doctor with clinical responsibility for the patient advises them to refrain from work it is appropriate for a member of that medical team to issue a medical certificate for this forward period.
Can employers refuse to accept the advice a GP provides on a Med 3?
Although employers have a liability to pay SSP to qualifying employees, it is up to the employer to decide in the first instance whether they accept that their employee is incapable of work. A doctor’s statement is usually strong evidence of incapacity and should normally be accepted as conclusive, unless there is evidence to the contrary, but the decision ultimately rests with the employer.
If you have good reason to believe that the employee’s incapacity is not genuine, you can refuse to pay SSP despite having a medical certificate. If the employee disagrees with the decision, they can ask the HMRC Disputes team in Newcastle for a formal decision on the matter. Alternatively, you can, with the employee’s consent, seek a report direct from the employee’s doctor or from Atos Healthcare’s Medical Services. HMRC have a contract with Atos Healthcare Medical Services to provide advice about employees’ incapacity for work in connection with SSP. They can also give medical advice when lengths of sick absence seem unreasonable or when an employee has several periods of short term absences. Further information can be found on the HMRC website.