Fit Notes and Self-Certification: What You Need, and When

Proof of sickness causes more friction between employers and staff than the money does. Managers ask for notes they are not entitled to, employees book GP appointments they do not need, and both sides misread what a fit note actually says.

The rules are short and worth knowing properly. This is general information about how sickness certification works in the UK, not medical or legal advice.

The First Seven Days: Self-Certification

If you are off work for seven days or less, you do not need a fit note or any other proof from a healthcare professional. You tell your employer you are ill and that is the proof.

Two details people get wrong.

First, those seven days are calendar days, not working days. They include weekends, bank holidays and days you were not scheduled to work. Go off sick on a Wednesday and the self-certification period runs to the following Tuesday, whatever your rota says.

Second, the count is on the eighth day. If you are back at work on day eight, you never needed a note. If you are still off on day eight, you need one covering from that point.

Form SC2

Employers can ask you to confirm your sickness in writing, and the standard way of doing that is form SC2, a written statement of sickness available from GOV.UK. Plenty of employers use their own absence form instead, which is fine.

What an employer cannot do is treat SC2 as optional evidence and demand a doctor's note for the same period. For the first seven days, your own statement is the evidence the system provides for.

After Seven Days: The Fit Note

Beyond seven calendar days you need a fit note, still widely called a sick note. It is free if you have been ill for more than seven days. A note for a shorter absence is a private matter between you and the practice, and may be charged for.

Fit notes are no longer a doctor-only document. They can be issued by:

• A GP or hospital doctor
• A registered nurse
• An occupational therapist
• A pharmacist
• A physiotherapist

That change matters practically. If your absence is musculoskeletal and you are already seeing a physiotherapist, they can issue the note. If you are under a specialist nurse for a long-term condition, so can they. You do not have to compete for a GP appointment purely to get a piece of paper, and you can ask whichever professional is already treating you.

The Two Options on a Fit Note

Every fit note says one of two things.

"Not fit for work." The straightforward one. In the issuer's opinion you should not be working at all for the period stated.

"May be fit for work." The one that causes trouble. This says you could work if certain things changed, and the note will indicate which: a phased return, altered hours, amended duties, or workplace adaptations.

This second option is not an instruction to your employer, and it is not a declaration that you are fit. It is advice, opening a conversation about what would let you come back sooner.

What the Four Adjustments Mean

A phased return is building back up to your normal hours over a few weeks, perhaps two days a week rising to five.

Altered hours means a different pattern rather than fewer overall: later starts to avoid rush hour, shorter days with more of them, or dropping night shifts.

Amended duties means keeping the job but changing the content, taking out the heavy lifting, the driving or the customer-facing part while you recover.

Workplace adaptations means changing the environment: a different chair, ground-floor working, a parking space nearer the door.

None of these is an entitlement in itself, though if your condition is a disability under the Equality Act 2010 your employer has a separate duty to make reasonable adjustments, which is a stronger obligation. Our article on long-term sickness covers that duty.

Pay During a Phased Return

This is the question nobody thinks about until the payslip arrives. If you return part-time on a phased return, you are normally paid for the hours you work, and there is no automatic right to full pay for the hours you do not.

SSP is not payable for a day you have worked, even for an hour, because it is only payable for a full day of incapacity. So a phased return often means a genuine drop in income during the transition. Some employers pay full salary through a phased return as a matter of policy, and it is worth asking directly rather than discovering the answer at the end of the month.

Backdating, and Notes That Run Out

A fit note can be backdated to cover a period that has already passed, so if you could not get an appointment in time, ask for the dates you were actually off.

Notes are issued for a fixed period, and if you are still unwell when one expires you need another. The gap between one running out and the next being issued is exactly where SSP payments get interrupted, so ask for the follow-up a few days before the current note ends.

A fit note issued for more than a short period may state that no further assessment is needed, in which case you would not normally have to come back for another one covering that time.

If You Disagree With What the Note Says

You cannot appeal a fit note, and a second opinion is a clinical matter rather than an administrative one. What you can do is go back and explain what your job actually involves.

Fit notes are frequently written on an incomplete picture of the work. A GP who thinks you sit at a desk may write "may be fit for work" without knowing you spend the day on a ladder. Telling them the real duties often changes the note.

The same applies in the other direction. If you want to get back to work and the note says you should not, say so and discuss what would make it possible.

What Employers Can Legitimately Do

Plenty, and none of it depends on a fit note.

• Set a reasonable deadline for reporting sickness, and require you to follow it
• Ask you to complete their absence form or an SC2
• Hold a return-to-work meeting after any absence
• Keep records of absence and apply an absence policy with trigger points
• Refer you to occupational health, though they cannot make you attend
• Keep in reasonable contact while you are off

What they cannot do is withhold SSP because they doubt you are ill. If they think you are not entitled, they have to say why, and there is a proper route for challenging that, which our article on employers refusing SSP sets out.

Keep Your Own Record

Note the dates you were off, the date and time you told your employer, who you told, and keep a copy of every fit note before handing it over. Photograph it on your phone.

Almost every SSP dispute turns on dates: when the absence started, whether two absences linked, whether notification was within the deadline. The person with the record usually wins the argument, and it takes seconds to keep one.