The Fit Note: everything an employer needs to know

Fit Note tissues


The Statement of Fitness for Work, otherwise known as the fit note or Med 3 form is a medical certificate that is issued by a doctor or relevant medical practitioner to state whether or not an employee is fit to work. Fit notes were introduced in 2010  to replace the old sick note system and were updated in 2022 with two significant changes: it replaces the signature in ink with the name and profession of the issuer, which means it can be received through digital channels, and it can be issued by other medical professionals, not just doctors.  We have provided information and frequently asked questions to support you with the fit note.

1. Understand the fit note

As an employer, you should be aware of the following information about fit notes:

  • Fit notes are valid for up to three months.
  • Fit notes can state that an employee is either fit for work, unfit for work, or fit for work with restrictions.
  • If an employee has a fit note that states they are unfit for work, they are entitled to statutory sick pay (SSP), if they fulfil the following criteria:
  • have been off sick for at least 4 ‘qualifying days’ in a row – these are days when they are usually required to work
  • earn on average at least £123 a week, before tax, in 2023/24.
  • have told their employer they are sick within any deadline the employer has set or within 7 days.

2. Who can issue a fit note?

A fit note can be issued by any of the following healthcare professionals:

  • Doctor
  • Nurse
  • Occupational therapist
  • Pharmacist
  • Physiotherapist nurses

3. Does an employer have to accept the fit note as proof of absence?

Yes, as an employer, you must accept a fit note as proof of absence. However, you can request further medical evidence if you have concerns about the fit note.

4. Who does the fit note belong to?

The fit note belongs to the employee. However, you are entitled to request a copy of the fit note.

5. Who should have a copy of the fit note?

Both the employee and you should have a copy of the fit note. The employee should keep their copy for their own records, and you should keep a copy to verify the employee’s absence and to process any SSP payments.

6. When should the employee send it?

The employee should send their fit note to you as soon as possible after they receive it. This will help to ensure that the employee’s absence is processed correctly and that any SSP payments are made on time.

7. How should the employee send it?

The employee can send their fit note to you by post, email, or fax. If the employee sends their fit note by email, they should make sure that it is in a secure format, such as a PDF.

8. Can a fit note be issued retrospectively?

Yes, a fit note can be issued retrospectively.

You should be understanding if there is a delay getting a fit note and the employee should contact you to explain:

  • why there is a delay, e.g., difficulty booking a doctor’s appointment.
  • when you, as their employer, will get the fit note.

9. Can I pay SSP without a fit note?

You can request a copy of an employee’s fit note, but you cannot refuse to pay SSP if an employee does not provide one.

10. Do I have to do what it says on a fit note with regards to a phased return?

Some absences which last longer than 6 weeks may require a phased return to work to support the employee in getting back into the workplace or supporting any condition or disability that may need to be accommodated going forward. As an employer you should consider any recommendations for a phased return to work included in the fit note, such as reduced hours, a different role, or adapted equipment to support physical conditions, however, you are not legally obliged to follow these recommendations if they cannot be accommodated within your workplace.

This phased return to work plan should be reviewed regularly and updated as needed. It should outline the following:

  • The employee’s gradual return to work schedule.
  • Any restrictions that the employee has.
  • Any support that the employee needs.

You should refer to your policy or agree with your employee what will be paid during the phased return to work.

11. How can a doctor decide an employee is suffering from work related stress?

A doctor will decide whether an employee is suffering from work-related stress based on the employee’s symptoms and medical history. The doctor may also ask the employee about their work environment and the stressors that they are facing.

12. What to do if the fit note says the absence is work related stress?

If a fit note states that the employee’s absence is due to work-related stress, you should take steps to address the underlying causes of stress. This may involve providing the employee with support and counselling or making changes to the employee’s work environment. It can be helpful to carry out at a stress risk assessment to work out if and how you can deal with the work-related stressors.

Additional tips for employers

  • Be understanding and supportive of employees who are returning to work after a sickness absence.
  • Communicate regularly with employees who are off sick because this will help you to understand their progress and to make a smooth return to work plan. You should agree a pattern of communication with your employee, such as by phone, email, or video call, depending on what you have agreed and supports your employee.
  • Keep a record of all sickness absences and the reasons for them.
  • Review your sickness absence policies and procedures regularly.


Understanding the fit note is important as part of your duty to support your employee and can help to ensure that your employees are supported during their absence and assure employees can return to work smoothly and safely.


Albany HR

As an outsourced HR consultant based in Edinburgh, and operating across the UK, Albany HR can support with:

Please get in touch for a chat about how we can support you, 0131 364 4186.

Photo by Kelly Sikkema on Unsplash