If you are too unwell to work, you will often need a fit note to claim sick pay or a sickness benefit, or to explain a longer absence to your employer. Knowing how fit notes work, and when you need one, helps you get the support you are entitled to. This guide explains fit notes, who can issue them, and how they fit with sick pay and benefits.
What a fit note is
A fit note, sometimes still called a sick note, is a statement from a healthcare professional about how your health affects your ability to work. It is official evidence that you are not well enough to work, or could work with some support, and it is used by employers when paying Statutory Sick Pay and by the DWP when you claim a sickness benefit. It records the professional's advice about your fitness for work.
The first seven days
For the first seven days of sickness, you do not usually need a fit note. Instead, you can self-certify, which means telling your employer you are unwell and, if they ask, completing a simple self-certification form. You only need a fit note from a healthcare professional if you are off sick for more than seven days in a row, including non-working days, so for short illnesses a fit note is not required.
Who can issue a fit note
Fit notes can be issued by a range of healthcare professionals, not just GPs. As well as doctors, nurses, occupational therapists, pharmacists and physiotherapists can issue fit notes, which makes it easier to get one without always needing a GP appointment. The professional issuing it must have assessed your fitness for work, and they base their advice on your condition and how it affects what you are able to do.
Not fit for work, or may be fit for work
A fit note says either that you are not fit for work, or that you may be fit for work taking account of certain advice. If it says you may be fit for work, the professional can suggest changes that would help you work, such as a phased return, altered hours, amended duties or workplace adaptations. Your employer then discusses this with you. If they cannot make the suggested changes, the fit note is treated as saying you are not fit for work.
Fit notes and Statutory Sick Pay
Your employer can ask for a fit note as evidence for Statutory Sick Pay once you have been off for more than seven days. For the first week, your self-certification is enough. Providing a fit note when required makes sure your sick pay continues, so it is important to get one if your absence goes beyond a week, and to give it to your employer promptly to avoid any gap in your pay.
Fit notes and benefits
If you claim a sickness benefit such as New Style ESA, or you have a health condition affecting your Universal Credit, you usually need to provide fit notes to show you are not fit for work, at least until a Work Capability Assessment has been carried out. Keep providing fit notes for as long as you are asked to, without gaps, so your claim is not affected. Once a decision on your capability for work is made, you may no longer need to provide them.
If you disagree with a fit note
A fit note reflects the professional's clinical judgement, but if you feel it does not reflect your situation, you can discuss it with them or seek another opinion. If you are returning to work after illness, a conversation with your employer and, where available, occupational health, can help make sure any return is safe and suitable. The aim of a fit note is to support your health and a sustainable return to work, not simply to sign you off.
Hospital and longer absences
If you are in hospital or have a long-term condition, you will still usually need to provide fit notes to cover your absence from work or to support a benefit claim, until any assessment of your capability for work is completed. The professional treating you can issue a fit note covering the expected period. Keeping your fit notes up to date and covering the whole of your absence makes sure your sick pay or benefit is not interrupted.
Returning to work gradually
The may be fit for work option on a fit note is designed to support a gradual, safe return to work, for example through reduced hours or lighter duties for a period. A phased return can help you get back to work without risking your health. If your fit note suggests adjustments, talk to your employer about how they could work in practice, as a well-planned return is better for both you and your employer than returning before you are ready.
Keep copies of your fit notes
It is sensible to keep a copy of every fit note you are given, along with a note of the dates each one covers, especially if you are claiming benefits or have a long absence. This helps you make sure there are no gaps in your evidence, and gives you a record if any question arises about your sick pay or claim. A simple file of your fit notes can save confusion later.
Mental health and fit notes
Fit notes are just as relevant for mental health conditions as for physical ones, and a healthcare professional can sign you off for stress, anxiety, depression or other mental health difficulties in the same way. If your mental health is affecting your ability to work, do not feel you have to struggle on; speak to your GP or another professional, who can advise you and issue a fit note if appropriate, and point you towards support.
In short
A fit note is evidence from a healthcare professional about your fitness for work, needed once you are off sick for more than seven days, as you can self-certify before then. It can say you are not fit for work, or may be fit with adjustments. It is used for Statutory Sick Pay and sickness benefits, and can now be issued by a range of professionals, not just GPs.
Fit notes are advice, not a barrier
It is worth remembering that the purpose of a fit note is to support your health and, where possible, your return to work, not to act as a hurdle. A good conversation with your GP or other healthcare professional, and with your employer, can help make sure any time off and any return to work are right for you. Treat the fit note as part of looking after your health, rather than just a piece of paper for your employer.
Self-employment and fit notes
If you are self-employed, you do not get Statutory Sick Pay, but you may still need a fit note to support a claim for a sickness benefit such as New Style ESA or to show limited capability for work on Universal Credit. The same rules apply about who can issue one. So even without an employer, it is worth getting a fit note if illness stops you working, to support whatever benefits you claim.
Where to get help
Your GP surgery, Citizens Advice and your employer can help with fit note questions. See our guides to Statutory Sick Pay and New Style ESA.