Sick Leave in South Africa: The 36-Month Cycle and Medical Notes

Sick leave in South Africa is set by sections 22 to 24 of the Basic Conditions of Employment Act 75 of 1997 (the BCEA). The rules are often summarised as "30 days a year", which is wrong: the entitlement is a pool of days that lasts three years. This guide explains how the cycle is counted, the separate rule for new employees, when you need a medical certificate, when an employer may lawfully refuse to pay, and how sick leave fits with the UIF illness benefit.

All figures are current as of October 2026. Section references follow the SAFLII consolidation of the BCEA updated to 1 May 2026.

This guide is general legal information, not legal advice. For advice on your own situation, consult an attorney, or contact Legal Aid South Africa (0800 110 110) if you cannot afford one.

Who is entitled to sick leave

The leave chapter of the BCEA (Chapter 3) applies to every employee covered by the Act except someone who works less than 24 hours a month for that employer (s19(1)). Independent contractors are not employees and are not covered.

The 2026 earnings threshold of R269,600.90 a year does not affect sick leave. It switches off only certain working-time rules, such as overtime and Sunday pay, and leaves all of Chapter 3 in place. A senior manager earning well above the threshold has the same minimum sick leave as anyone else; see the Basic Conditions of Employment Act for what the threshold does remove.

The BCEA is a floor. Your contract, a sectoral determination or a collective agreement can give you more sick leave, and a bargaining council agreement may not reduce the sick leave in sections 22 to 24 (s49(1)(e)). Extra days your employer gives beyond the legal minimum are governed by your agreement rather than by the Act, unless the agreement says otherwise (s19(2)).

How the 36-month sick leave cycle works

Section 22(1) defines the sick leave cycle as "the period of 36 months’ employment with the same employer" immediately after you start work or after your previous cycle ends. Section 22(2) then sets the size of the pool: "an amount of paid sick leave equal to the number of days the employee would normally work during a period of six weeks."

So the number depends on how many days a week you normally work, not on a fixed figure:

The figures are six times your normal working days per week. If you work a rotating roster, the count is the days your roster would normally have you working in a six-week period.

Example, five-day week. Thandi starts an office job on 1 June 2025, working Monday to Friday. Her first sick leave cycle runs until 31 May 2028, and over that whole period she has 30 paid sick days. If she uses 12 days in 2026, she has 18 left for the rest of the cycle, however much time remains. On 1 June 2028 a fresh cycle of 30 days begins.

Example, six-day week. Sipho works Monday to Saturday in a retail store. His pool is 36 days for each 36-month cycle, because he normally works 36 days in six weeks.

Because the cycle starts on your own start date, two colleagues can be at very different points in their cycles. Ask your employer or payroll for your current cycle dates and balance if your payslip does not show them.

Sick leave in the first six months

The full six-week pool does not apply straight away. Section 22(3) provides that "during the first six months of employment, an employee is entitled to one day’s paid sick leave for every 26 days worked."

In practice that builds up slowly. As simple arithmetic (not a figure from the Act), a five-day worker works 26 days in a little over five weeks, so earns roughly one sick day every five weeks and about five days by the end of the six months. A six-day worker works 26 days in about a month, so earns about one day a month.

Once you pass six months, the full pool for the first cycle applies. Section 22(4) allows your employer to reduce that first-cycle pool by the sick days you took in your first six months. For example, if Thandi took 3 sick days in her fourth month, her employer may treat her first-cycle balance as 27 days rather than 30.

How sick days are paid

For each sick day your employer must pay "the wage the employee would ordinarily have received for work on that day", on your usual pay day (s22(5)).

An agreement may lower the daily sick pay, but only within strict limits (s22(6)). Each day must still be paid at no less than 75% of your ordinary wage for that day, the number of sick days must go up at least in proportion, and your total sick pay over the cycle may not fall below what the standard rule gives. For a five-day worker paid at 75%, that means at least 40 days in the cycle instead of 30.

When you need a medical certificate

Many people believe every sick day needs a doctor’s note. The Act is narrower. Under section 23(1), an employer is not required to pay sick leave if the employee "has been absent from work for more than two consecutive days or on more than two occasions during an eight-week period and, on request by the employer, does not produce a medical certificate stating that the employee was unable to work for the duration of the employee’s absence on account of sickness or injury."

Read closely, that gives three conditions, all of which must be present before pay can be withheld:

1. The absence is long enough or frequent enough. You were off for more than two days in a row (so three or more consecutive days), or this is at least the third separate occasion within an eight-week period.
2. Your employer asked for a certificate. The duty is triggered "on request by the employer".
3. You did not produce one that covers the whole absence and says you were unable to work because of sickness or injury.

A one-day or two-day absence that is not part of a pattern of more than two occasions in eight weeks does not need a certificate under the Act. Your contract or a workplace policy may ask for a certificate sooner, but under s23(1) the Act itself lets an employer refuse sick pay for a missing certificate only in the situations above.

Who may issue the certificate

Section 23(2) requires the certificate to be "issued and signed by a medical practitioner or any other person who is certified to diagnose and treat patients and who is registered with a professional council established by an Act of Parliament."

The wording is not limited to medical doctors. Other health professionals can issue a valid certificate if they are certified to diagnose and treat patients and are registered with a statutory professional council. Whether a particular practitioner meets that test depends on their registration, so if you are unsure, ask the practitioner to note their registration number on the certificate.

If you live on your employer’s premises and it is not reasonably practicable for you to get a certificate, your employer may not withhold sick pay unless it gives you reasonable help to obtain one (s23(3)). This matters most for live-in domestic and farm workers; see domestic worker rights for that sector.

When an employer may refuse to pay sick leave

Section 22 states what an employee "is entitled to", so sick leave within the pool is not a favour the employer can grant or refuse at will. Under the Act, sick pay may lawfully be withheld or does not apply in these situations:

• No medical certificate when one was required. The three conditions under section 23(1) above are all met.
• The pool is used up. Once you have used all the paid sick days in your cycle (or, in the first six months, all the days earned so far), the Act requires no further paid sick leave until the next cycle. Your contract may give more, you may agree on unpaid leave, and a long illness may open a UIF claim (see below).
• Workplace injury or occupational disease. Sections 22 and 23 do not apply to an inability to work caused by an accident or occupational disease under the Compensation for Occupational Injuries and Diseases Act, 1993, or the Occupational Diseases in Mines and Works Act, 1973, except for any period during which no compensation is payable under those Acts (s24). See COIDA for how that compensation works.
• Very short working hours. You work less than 24 hours a month for the employer, so Chapter 3 does not apply (s19(1)).

One related protection: your employer may not require or permit you to take annual leave during a period of other leave provided for in Chapter 3, which includes sick leave (s20(5)(a)). Sick days and annual leave days are separate entitlements; see annual leave in South Africa.

If you are not paid sick leave you believe you are owed, you can complain to a labour inspector at a Labour Centre. An employee earning below the threshold can also refer a claim for the unpaid amount to the CCMA; see how to refer a dispute to the CCMA. The CCMA’s call centre is 0861 16 16 16.

Sick leave and the UIF illness benefit

Paid sick leave comes from your employer. The UIF illness benefit is separate: it is paid by the Unemployment Insurance Fund to contributors who cannot work because of illness, and it draws on the benefit credits you have built up as a contributor.

Two rules link them. First, there is no illness benefit for an illness of less than seven days (Unemployment Insurance Act 63 of 2001, s20(2)(a), as amended by the 2016 Amendment Act). Second, the Fund pays the difference between any sick pay you receive and the benefit, and the two together may not exceed the remuneration you would have earned had you not been ill (s21).

In practice, the illness benefit matters most for a longer illness, especially once your paid sick leave runs out or your employer pays only part of your wage. For the benefit rates, credit days and how to apply, see UIF explained and how to claim UIF.

What does not carry over or get paid out

No carry-over. The Act gives a fresh pool for each 36-month cycle and contains no rule letting unused days roll into the next cycle. If Thandi uses only 10 of her 30 days by 31 May 2028, her new cycle starts at 30, not 50. A more generous contract term or policy can change that.

No payout on leaving. Section 40 lists what an employer must pay on termination: untaken paid time off for overtime or Sunday work, and annual leave. Sick leave is not on the list, so unused sick days have no cash value when you resign, are dismissed or are retrenched, unless your contract says otherwise. Annual leave is different and is paid out; see annual leave and notice periods.

Where to go next

For leave to care for a sick child or after a death in the family, see family responsibility leave. The South Africa labour law section links every guide in this series, and the South Africa Laws hub covers the wider site.

Frequently Asked Questions

How many sick days do I get in South Africa?

Under the BCEA you get paid sick leave equal to the number of days you would normally work in six weeks, for each 36-month cycle. That is 30 days over three years if you work five days a week, and 36 days if you work six days a week. Your contract may give more.

Does my sick leave reset every year?

No. The sick leave cycle is 36 months long and starts on the day you began working for your employer. The pool of days lasts the whole three years, and a new pool starts only when that cycle ends.

Do I get any sick leave in my first six months at a new job?

Yes, but it builds up gradually: one paid sick day for every 26 days worked (s22(3)). After six months the full first-cycle pool applies, and your employer may reduce it by the sick days you already took in the first six months.

When does my employer need a doctor’s note for sick leave?

Only if you were off for more than two consecutive days, or on more than two occasions within an eight-week period, and your employer asks for a certificate. If you do not produce one in those circumstances, your employer does not have to pay for the absence (s23(1)). A contract or policy may set stricter reporting rules.

Can a health professional other than a doctor sign my medical certificate?

The Act allows a certificate from a medical practitioner or any other person certified to diagnose and treat patients who is registered with a professional council established by an Act of Parliament (s23(2)). Whether a specific practitioner meets that test depends on their registration, so ask them to include their registration details.

What happens if I run out of paid sick leave?

The BCEA does not require further paid sick leave until your next cycle starts. You may be able to agree on unpaid leave, your contract may give extra days, and if the illness lasts seven days or more you may be able to claim the UIF illness benefit.

Will my unused sick days be paid out when I leave my job?

Not under the BCEA. Section 40 requires payment on termination for untaken annual leave and certain paid time off, but not for sick leave. Unused sick days lapse when you leave unless your contract provides otherwise.