The information provided in this article is for general informational purposes only. It does not, and is not intended to, constitute legal advice.<\/p>\n
Medical certificates, also commonly called sick leave certificates, may seem just like another simple administrative task for doctors. However, there are many legal, ethical and professional issues you need to consider when issuing one to a patient.\u00a0<\/p>\n
A medical certificate is most commonly issued to an employee to show absence from work due to illness or medical condition, or because of carer obligations. Under\u00a0the Fair Work Act<\/a>, the certificate can be requested by an employer as evidence to support the issuance of sick leave payment to an employee.\u00a0<\/p>\n Doctors can face challenges with their dual role as an advocate for the patient and assessor for an employer. Medical certificate rules are outlined in the Australian Medical Association\u2019s (AMA)\u2019s\u00a0Guidelines for Medical Practitioners on Certificates Certifying Illness\u00a0<\/a>.<\/p>\n According to the Medical Board of Australia, for notifications received between\u00a01 July 2023 and 16 June 2026,\u00a0when regulatory action was taken, the concerns raised typically related to:<\/p>\n Inadequate clinical assessment and issuing certificates without appropriate consultation (including telehealth contexts);Accuracy and integrity issues.Doctor\u2019s responsibilities when issuing a medical certificate<\/p>\n Nerissa Ferrie, Senior Manager, Medico Legal Advisory at MDA National Insurance says, \u201cDoctors should act in accordance with the\u00a0Medical Board of Australia\u2019s Code of Conduct<\/a> and respect the trust with which the public views the medical profession. Doctors should only put their signature to documents they believe to be true and accurate, and the clinical notes should support the certification.\u201d<\/p>\n A medical certificate must be based on a medical examination and assessment of patient history, information provided by the patient, and on facts known to the doctor.\u00a0<\/p>\n Doctors also need to remain impartial. As AMA\u2019s guidelines specify, doctors who deliberately issue a false, misleading or inaccurate certificate could face disciplinary action under the Health Practitioner Regulation National Law. Doctors may also expose themselves to civil or criminal legal action.\u00a0<\/p>\n The patient trusts that the GP will maintain confidentiality, and only disclose personal information related to the medical certificate to a third party with the patient\u2019s express consent or where required by law. A certificate should also not be forwarded to a third party without the patient\u2019s consent.<\/p>\n What information should appear on a medical certificate?<\/p>\n AMA\u2019s guidelines outline medical certificate requirements:<\/p>\n Name and address of medical practitioner issuing the certificate;Patient name;Date of medical examination;Date of issue of certificate: Under no circumstances can this be breached and the certificate can not be backdated;\u00a0Date(s) the patient is or was unfit for attendance. Dr Rudge says, \u201cThe period you certify can reach into the past \u2014 but only as far as you can clinically justify and have documented;\u201dSpecific details of the condition that is being certified; andAddress the certificate to the party requiring the certificate.<\/p>\n The certificate should also be legible so that a non-medical member can read and understand it.\u00a0<\/p>\n Document clinical findings in patient record<\/p>\n As Ferrie says, \u201cThe clinical notes are the best source of truth, so anything that relates to a doctor writing a certificate should be evidenced in, and supported by, the patient\u2019s clinical notes.\u201d Keep a copy of the certificate in the patient\u2019s medical record.<\/p>\n The University of Sydney\u2019s\u00a0Dr Christopher Rudge<\/a> is Lecturer and Deputy Director of Sydney Health Law (Law School). He refers to a case that underlines the importance of accurate, clear and thorough documentation. \u201cDoctors have been sanctioned over a certificate that was entirely honest and accurate.\u00a0<\/p>\n \u201cIn Fitzpatrick [2023] VCAT 517 the Board alleged no dishonesty and no false certificates, yet a well-regarded rural GP was found guilty of professional misconduct, reprimanded, and placed under two years of record-keeping audits, for taking \u2018unacceptable shortcuts.\u2019 These included issuing certificates that included no documented assessment or clinical justification, undated certificates, dates reaching months into the past, one filled in by the patient themselves, certificates for a relative without a recorded consultation, and one running six months into the future without planned follow-up or review.\u201d<\/p>\n Challenging medical certificate scenarios GPs may face<\/p>\n There are a variety of situations whereby a doctor may need to balance the requests between employees and employers.<\/p>\n Employee requests a medical certificate for dates different to visit\u00a0<\/p>\n Patient says they have been unwell before visit\u00a0<\/p>\n A doctor may issue a certificate with dates prior to the examination visit, only if after careful patient examination and in their careful and professional clinical judgement can conclude that the patient was unwell for the symptoms they present or say they had.\u00a0<\/p>\n Patient informs of condition that has resolved before visit<\/p>\n According to\u00a0Avant<\/a>, certificates that purport to confirm an illness or period of incapacity that has resolved before the consultation are a common cause of complaints to regulatory bodies.<\/p>\n It is not legitimate to provide a certificate for that period as there is no condition for which the doctor can examine and provide findings on.\u00a0<\/p>\n Patient with ongoing illness\u00a0<\/p>\n For illnesses that started prior to the doctor visit and is ongoing, the date should show the period for which the patient was unfit for work, with\u00a0Avant<\/a> advising wording such as, \u201cBased on the history provided and my examination…\u201d.<\/p>\n Employer or third party seeks further information or verification\u00a0<\/p>\n When a doctor is approached by an employer:<\/p>\n Verify the party’s identity.\u00a0Ask for a copy of the certificate, view it and confirm if the certificate is genuine and was completed by the doctor.\u00a0No other information should be provided to the third party without patient consent.\u00a0<\/p>\n A medical certificate cannot be clinically justified<\/p>\n Explain to the patient the reasons and document this in their medical record. If appropriate, the doctor may offer alternative options, as\u00a0Avant<\/a> suggests, such as issuing a certificate for a shorter period than requested or offering to review the patient again if their condition persists.\u00a0<\/p>\n Vagueness to get around this can constitute misconduct, as Dr Rudge explains, \u201cIn the recent case of Foong[2026] NSWCATOD 29 the GP wrote \u201cconfidential medical condition\u201d not to protect privacy but, on the practitioner\u2019s own admission, because the real basis fell outside the exemption criteria for COVID-19 mandates and would have been rejected for the specific purpose the certificate was issued for if the truth was disclosed.\u201d<\/p>\n Telehealth medical certificate services<\/p>\n Doctors providing\u00a0online medical certificate services<\/a> must be honest, ethical and trustworthy, only signing documents they believe to be accurate. As the\u00a0Medical Board of Australia Telehealth consultations with patients guidelines<\/a> state, issuing a medical certificate requires medical judgement and is providing healthcare.\u00a0<\/p>\n The Medical Board of Australia<\/a> strongly recommends against providing medical certificates where there has been no examination or real-time discussion with the patient. In most of these cases, their indemnity insurance will not cover doctors.\u00a0<\/p>\n Conclusion\u00a0<\/p>\n Issuing a medical certificate is an administrative task as much as it is providing a medical service. To abide by the Medical Board\u2019s Code of Conduct, doctors should only issue one if after careful clinical examination, judge that the medical certificate is true and clinically justifiable. However, it also requires honest, accurate, clear and complete documentation.\u00a0<\/p>\n As Dr Rudge says, \u201cYou can do everything honestly and still be sanctioned. The risk in issuing a certificate isn\u2019t whether the patient was sick \u2014 it\u2019s whether you can show the assessment and the record behind it.\u201d<\/p>\n Summary of Key Points\u00a0A medical certificate is a legal document and doctors need to base their decision to issue one only after they have conducted a clinical examination, together with information from the patient, and in their professional, clinical judgement deem the patient was unfit for work due to a medical condition.\u00a0Doctors should only put their signature to documents they believe to be true and accurate, and the clinical notes should support the certification.Doctors may need to balance the competing requests between employers and third parties with those of employees. It\u2019s important to maintain confidentiality and not release information to third parties without patient consent.\u00a0Clear, accurate, complete, truthful documentation can help protect doctors against the risk of notifications, complaints, legal action or professional conduct proceedings.FAQs\u00a0<\/p>\n What if patient alters medical certificate?<\/p>\n Discuss this with the patient, although this may affect their ongoing\u00a0relationship with the patient<\/a>.<\/p>\n Under what circumstances can a doctor decline to issue a medical certificate?<\/p>\n Ferrie says a GP can refuse to provide a certificate if they don\u2019t genuinely believe the reason for the certificate is truthful, or if it\u2019s outside their scope of practice.\u00a0<\/p>\n Can a doctor write a medical certificate for family and friends?<\/p>\n As per the\u00a0Code of Conduct\u00a0<\/a>, doctors should not be in a treating relationship with anyone close to them, including friends, family, or anyone they work with.\u00a0<\/p>\n How should a doctor handle conflicts between patient confidentiality and employer requests?<\/p>\n Do not release any information to the employer without the patient\u2019s consent, and the doctor can explain this to the employer.<\/p>\n The third party should recognise the right of individuals to keep details of their medical condition confidential. For example, employers should not expect to see a diagnosis on the employee\u2019s certificate unless in certain circumstances where it\u2019s legally required.<\/p>\n Still, some patients may request doctors withhold other types of information on a certificate. The\u00a0Medical Council of NSW<\/a> recommends that the doctor explain to the patient that the information provided may not be sufficient for the employer to accept the certificate for sick leave.\u00a0<\/p>\n What are a doctor\u2019s obligations if an employer or patient disputes a certificate they have issued?<\/p>\n First check the identity of the third party, ask for a copy of the certificate they have received, and then confirm if the certificate is genuine and completed by themselves.<\/p>\n