Sick Leave and Medical Notes in Canada: Rules by Province

Sick leave is one of the most misunderstood areas of Canadian employment law, mostly because there is no single national answer. Each province and territory sets its own rules for how many sick days an employee gets, whether those days are paid, and how much medical evidence an employer can demand. A separate set of rules applies to federally regulated workplaces like banks, airlines, and telecommunications companies.

This guide walks through what Ontario, British Columbia, and Quebec actually require, what changed in Ontario in late 2024 and mid-2025, and how job-protected sick leave differs from Employment Insurance (EI) sickness benefits. For broader context on workplace rules across the country, see Canada employment law.

Sick leave is a provincial question first

Unlike some countries with one national sick-leave standard, Canadian employment standards are split by jurisdiction. Provincial and territorial governments set the rules for most private-sector employees working within their borders. A much smaller group, roughly 6 percent of Canadian employees working for banks, airlines, railways, telecommunications providers, and a few other federally regulated industries, falls under the Canada Labour Code instead.

That split matters because the answers to common questions, how many sick days, whether they are paid, and whether a doctor's note can be required, are genuinely different depending on the province and the type of employer. A rule that is accurate for an Ontario retail worker may not apply at all to a Quebec construction worker or a federally regulated call centre employee.

Ontario: 3 unpaid, job-protected sick days

Under Ontario's Employment Standards Act (ESA), most employees are entitled to up to 3 days of unpaid, job-protected leave each calendar year for a personal illness, injury, or medical emergency. The leave becomes available once an employee has worked for the same employer for at least 2 consecutive weeks.

The days do not need to be taken consecutively. An employee can use part-days, single days, or several days in a row, and unused days do not carry over into the next calendar year. Because the leave is job-protected, an employer generally cannot discipline, threaten, or terminate an employee for taking it.

It is worth being direct about a common point of confusion: Ontario's ESA does not include a general paid sick-day entitlement. The temporary paid infectious disease emergency leave that existed during the COVID-19 pandemic period has expired. Some Ontario employers choose to offer paid sick days as a workplace benefit or through a union collective agreement, but that is a matter of the individual employment contract, not a standalone ESA requirement.

Ontario's sick-note ban, effective October 28, 2024

A significant change took effect on October 28, 2024. As of that date, Ontario employers can no longer require an employee to provide a certificate from a qualified health practitioner, defined as a physician, registered nurse, or psychologist, as evidence to support an ESA sick-leave day.

This does not mean an employer can never ask for anything. An employer may still request other evidence that is reasonable in the circumstances, such as a written attestation from the employee, or a note from a different type of health care professional. If an employer does ask for a note from another health care provider, that note can only cover a limited scope: the length or expected length of the absence, the date the employee was seen, and whether the employee was examined in person.

The change was part of a broader package of amendments to Ontario's employment standards. It reflects a policy view that requiring a formal physician's note for a short, unpaid sick day places an unnecessary burden on the health care system and on employees.

Ontario's new long-term illness leave, effective June 19, 2025

Ontario also created an entirely new leave category that took effect on June 19, 2025. Long-term illness leave allows an eligible employee to take up to 27 weeks of unpaid, job-protected leave within a 52-week period because of a serious medical condition.

To qualify, an employee generally needs at least 13 consecutive weeks of employment with the employer. The employee also needs a certificate from a qualified health practitioner (again, a physician, registered nurse, or psychologist) confirming that the employee has a serious medical condition and stating how long the employee is expected to be away from work.

Ontario's guidance does not publish a fixed list of qualifying conditions. The health practitioner is responsible for assessing whether a condition is serious, and the leave can cover conditions that are chronic or episodic, not only conditions with a fixed recovery timeline. Like the shorter ESA sick leave, the 27 weeks do not need to be taken in one continuous block; an employee can take a single week, or part of a week, at a time.

British Columbia: 5 paid days plus 3 unpaid days

British Columbia's Employment Standards Act treats paid and unpaid sick leave as two separate entitlements. Once an employee has worked for an employer for 90 consecutive days, they become eligible for up to 5 days of paid leave per calendar year for personal illness or injury.

That paid entitlement sits on top of a separate 3 days of unpaid sick leave that BC's Employment Standards Act already provided. Neither entitlement carries over from year to year if unused, and an employee, not the employer, decides whether a given day off is being taken as paid or unpaid leave. BC employers can request reasonably sufficient proof of illness, but the legislation does not set out a specific doctor's-note requirement.

Quebec: 2 paid days after three months of service

Quebec's Act respecting labour standards, administered by the CNESST (Commission des normes, de l'équité, de la santé et de la sécurité du travail), gives employees with at least 3 months of continuous service a total of 2 paid days per calendar year that can be used for a non-work-related illness or accident, among other family-related reasons covered by the same provision.

Those 2 days cannot be carried over to the next year or paid out in cash if unused. Quebec employers can request a medical certificate for longer absences, generally those lasting 3 or more consecutive days, which is a different threshold than Ontario's rule.

Other provinces and territories

Every other Canadian province and territory, Alberta, Saskatchewan, Manitoba, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, Yukon, the Northwest Territories, and Nunavut, has its own employment standards legislation covering sick leave. The number of days, whether any of them are paid, and the evidence an employer can request all vary by jurisdiction and can change over time.

If you work outside Ontario, BC, or Quebec, the most reliable starting point is your own province's or territory's employment standards office, since generic national averages can be inaccurate for a specific workplace. For a broader look at how employment rules differ across the country, see Canadian law by province.

Federally regulated employees: up to 10 paid medical leave days

A separate set of rules applies to employees of federally regulated employers, a category that includes banks, airlines and other interprovincial transportation companies, telecommunications and broadcasting companies, and some Crown corporations. These employees fall under the Canada Labour Code rather than provincial employment standards.

Since December 1, 2022, federally regulated employees earn medical leave with pay of up to 10 days per calendar year. The entitlement builds gradually: an employee earns 3 days after completing an initial 30-day qualifying period with the employer, then accrues 1 additional day at the start of each following month of continuous employment, up to the annual maximum of 10 days. The leave can be used for a physical or psychological illness or injury affecting the employee or, in some circumstances, their child.

This federal entitlement is a legislated minimum. An employer can offer more generous paid sick leave, but cannot provide less than the Canada Labour Code requires.

Employment Insurance sickness benefits: income replacement, not job protection

Job-protected sick leave under provincial or federal employment standards is not the same thing as Employment Insurance (EI) sickness benefits, and mixing the two up leads to a lot of confusion.

Job-protected leave, like Ontario's 3 ESA days or the new 27-week long-term illness leave, guarantees that an employee's position is held open while they are away, but it does not by itself provide any income. EI sickness benefits are a federal program, administered separately from any provincial leave law, that can replace part of an employee's income while they are off work for medical reasons, regardless of which province they work in.

EI sickness benefits currently provide up to 26 weeks of benefits, paid at 55 percent of average insurable weekly earnings up to a maximum set each year by Service Canada. To qualify, an applicant generally needs to have accumulated a minimum number of insurable hours of work and to provide a medical certificate confirming they are unable to work for medical reasons. An employee can, in many cases, be on job-protected leave under their province's employment standards act while also receiving EI sickness benefits for income replacement during the same period, since the two systems serve different purposes.

Can my employer ask for a doctor's note?

The honest answer is that it depends heavily on which province you are in and which specific leave you are using. In Ontario, since October 28, 2024, an employer cannot require a note from a physician, registered nurse, or psychologist for the ESA's 3 sick days, though other reasonable evidence can still be requested. Ontario's long-term illness leave is different: it explicitly requires a certificate from a qualified health practitioner because it is a longer, medically defined leave.

In British Columbia, employers can ask for reasonably sufficient proof of illness for the paid and unpaid sick-day entitlements, without a specific note requirement written into the statute. In Quebec, employers can request a medical certificate once an absence stretches to 3 or more consecutive days. None of these rules override a workplace policy or collective agreement that may set out its own, more specific process, as long as that process meets the applicable minimum standard.

What this means if you need time off for illness

If you are trying to figure out your own situation, start by identifying two things: which province's employment standards apply to your job, and whether your employer is provincially or federally regulated. From there, check whether your employer offers any paid sick days as a benefit beyond the legislated minimum, since many workplaces do.

If an illness is likely to last longer than a few days, look at whether a longer job-protected leave, such as Ontario's long-term illness leave, might apply, and separately consider whether EI sickness benefits could help replace lost income while you are away. These are genuinely separate systems, and an employee dealing with a serious medical condition may need to use more than one of them at the same time.

Disclaimer

This article provides general information about sick leave and medical-note rules for employees in Canada. It is not legal advice and does not cover every provincial or territorial employment standards act in detail. Rules can change, vary based on individual employment contracts or collective agreements, and depend on facts specific to a given workplace. For advice about a specific situation, consult your provincial or territorial employment standards office, Employment and Social Development Canada, or a licensed employment lawyer.