The right to issue a medical certificate

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• The Basic Conditions of Employment Act, 1997 (Act 75 of 1997) (BCEA) stipulates that a medical certificate must be issued and signed by a medical practitioner or any person who is qualified to diagnose and treat patients, and who is registered with a professional council.
• The following people are authorised to issue a medical certificate: Medical practitioners, clinic nurse practitioners, traditional healers, community health workers, psychologists, and other health professionals who are certified to diagnose and treat patients and who are registered with a professional council established in terms of an act of Parliament.
• The BCEA does not specify what information a valid medical certificate must contain, and it will depend on each council’s rules.
• The SANC confirmed that the recommended period for sick notes issued by a professional nurse practitioner is a maximum of two days.
• The sick note must also contain the name, address, qualification and the SANC reference number of the attending practitioner.

Although there is no statutory description of a valid medical certificate, Section 23(2) of the Basic Conditions of Employment Act, 1997 (Act 75 of 1997) (BCEA) stipulates that a medical certificate must be issued and signed by a medical practitioner or any person who is qualified to diagnose and treat patients, and who is registered with a professional council.

According to Sectoral Determination 13, gazetted under the BCEA, which governs the basic conditions of employment for farm workers in the agricultural sector, the following people are authorised to issue a medical certificate: Medical practitioners, clinic nurse practitioners, traditional healers, community health workers, psychologists, and other health professionals who are certified to diagnose and treat patients and who are registered with a professional council established in terms of an act of Parliament. Two examples of these professional councils are the Health Professions Council of South Africa (HPCSA) and the South African Nursing Council (SANC).

Required information

The BCEA does not specify what information a valid medical certificate must contain, and it will depend on each council’s rules. The ethical and professional rules of the HPCSA provide more guidance to employers regarding the issuing of a valid medical certificate and requires the following information to be present on a medical practitioner’s medical certificate:

• The name, address, and qualification of the practitioner.
• The name of the patient.
• The employment number of the patient (if applicable).
• The date and time of the examination.
• Whether the certificate is being issued as a result of personal observations by such practitioner during an examination, or as a result of information which has been received from the patient and which is based on acceptable medical grounds.
• A description of the illness, disorder or malady in layman’s terminology, with the informed consent of the patient. If the patient is not prepared to give such consent, the practitioner will merely specify that, in his or her opinion and based on an examination of the patient, the patient is unfit to work.
• Whether the patient is totally indisposed for duty or whether the patient is able to perform less strenuous duties in the work situation.
• The exact period of the recommended sick leave.
• The date of issue of the certificate of illness.
• The initial and surname in block letters and the registration number of the practitioner who issued the certificate.

Notes issued by nurses

The SANC has also issued a statement confirming that a professional nurse practitioner who possesses an additional qualification in clinical nursing science, health assessment, treatment and care, and an additional qualification in occupational health nursing is deemed competent to assess, diagnose, treat, and issue sick notes to patients. Such a sick note is valid for the purposes of sick leave.

Interestingly, the SANC confirmed that the recommended period for sick notes issued by a professional nurse practitioner is a maximum of two days.

The sick note must also contain the name, address, qualification and the SANC reference number of the attending practitioner. Other requirements in terms of the notice include:

• The name of the patient.
• The date and time of the examination.
• Whether the certificate is being issued as a result of personal observations by the practitioner during an examination, or as a result of information received from the patient and which is based on acceptable medical grounds.
• The exact period of recommended sick leave.
• The date of issue of the certificate of illness.
• The initial and surname in block letters and the registration number of the practitioner who issued the certificate. – Christiaan Swart, senior legal advisor, LWO Employers Organisation

The LWO Employers Organisation assists employers to comply with labour law, and to use it to their advantage to protect their business. As a registered employers’ organisation with the Department of Employment and Labour, the LWO has the right to represent members at the Commission for Conciliation, Mediation and Arbitration (CCMA). Take note that this article is not legal advice – consult one of our legal advisors about any specific legal problem or matter. For more information, email Christiaan Swart at christiaan@lwo.co.za, info@lwo.co.za or visit www.lwo.co.za.