On July 1, 2023, the Medical Certificates for Employee Absence Act (Schedule B) came into effect to limit the circumstances in which employers can require employees to provide medical notes from a qualified health-care professional, including a physician.

Employers with a sick note policy for missed time put an added burden on the health-care system. When employees seek sick notes, they reduce access for those patients who really need to see their physician and increase the hours physicians must spend on paperwork. Both have a direct impact on patient care.

This legislative change was made primarily to limit the unnecessary use of and administrative burden on the health-care system.

Nova Scotia Health is working with EMR vendors to include a template letter in EMRs that physicians can print to provide to employees/employers.

 When is a medical note allowed?

Provincially regulated employers are only allowed to request a medical note from employees who:

• are absent for more than five consecutive working days, or
• who have already had two non-consecutive absences of five days or less due to illness or injury in the previous 12 months.

 To whom does the Act apply?

The new Act applies to provincially regulated employees and employers. These include:

• employers whose business is regulated by the provincial government (this applies to approximately 90% of employers in Nova Scotia)
• employees of provincially regulated employers regardless of the employee’s status, e.g., probationary, permanent, full time, part time, casual, seasonal

To whom does the Act not apply?

The new Act does not apply to federally regulated employers or employees. These include (but are not limited to) financial institutions, airlines, federal Crown Corporations and federal civil servants, and radio telecommunications companies.

What can happen if an employer requests a medical note in violation of the Act?

Complaints regarding a potential contravention of the Act can be filed with the Labour Standards Division. If it is determined that an employer violated the Act, this can result in an order directing the employer to comply with the Act and to pay a financial remedy to the employee. Employers can also be subject to penalties for violating the Act.

Employers and employees can contact the Labour Standards Division at 1-888-315-0110 or labourstandards@novascotia.ca with questions about the Act. 

Letter to employers

For situations that fall outside of the legislation, physicians can use this template letter to inform employers about the impact of requiring medical notes from employees who miss work due to illness, and to request a change in the requesting company’s policy. Download medical notes template

Doctors Nova Scotia advocacy

In 2007, Doctors Nova Scotia asked large employers to stop the practice of requiring sick notes from their employees and developed a template letter for physicians. The letter informed employers about the health-system impact of medical note policies and it requested a change in the company’s policy.

A commitment from the provincial government to reduce paperwork on physicians was secured in the 2019 contract negotiations. Medical sick notes were again identified as an issue by physicians through work to reduce physicians’ unnecessary administrative burden. Learn more