When an employee is unable to work due to illness, the employer may request a medical certificate. This obligation usually stems from the work rules. A medical certificate confirms the incapacity for work and its likely duration. In addition, the medical certificate also clarifies whether an employee is allowed to leave their place of residence. Employers are increasingly confronted with certificates and documents that do not qualify as medical certificates… What do all these variations mean and what legal consequences and/or obligations do they entail for an employee and employer? Time for an overview…

1. The traditional medical certificate

This is the certificate referred to above. If an employee is unfit for work, he will generally have to submit a medical certificate. Compliance with this obligation is important if an employee does not want to lose his right to guaranteed pay.

A medical certificate is signed by a medical doctor who is recognized by the professional association for medical practitioners (“Orde der artsen – Ordre des médecins”).

2. A medical certificate issued by a doctor abroad

For several years now, employees who fall ill during their legal holidays have the right to take the ‘lost’ holiday days at another time during the holiday year.

An employee who wishes to make use of this option must submit a medical certificate. In this respect, there is no legal provision prohibiting an employee from consulting a doctor working abroad.

It can therefore not be excluded that an employee submits a medical certificate to their employer that is written in a foreign language that the employer does not understand. In that case, the employer may request a translation.

A certificate drawn up by a foreign doctor who does not use the (optional) specific template provided for this purpose still qualifies as a medical certificate if it contains all the information that a traditional ‘Belgian’ medical certificate must contain (see above).

3. Proof of attendance at a medical consultation

This is not a medical certificate as it does not certify incapacity for work. It is merely a confirmation that an employee attended a medical consultation (e.g. during normal working hours).

An employee cannot invoke such a certificate to claim guaranteed pay (we are setting aside the right of pregnant employees who retain the right to guaranteed pay to undergo pregnancy examinations when these cannot take place outside working hours).

4. The “dixit” certificate

A “dixit” certificate is not a medical certificate. As the name suggests, in a dixit certificate the doctor merely confirms what has been communicated by the employee. The doctor has not examined this and does not make a diagnosis.

An employer can easily recognise a dixit certificate as it will state: “according to statements made by person X…”.

5. An “a posteriori” medical certificate

This type of document is a medical certificate. An “a posteriori” medical certificate means that the doctor confirms the start of the incapacity for work at an earlier date than the date on which the doctor actually examined the employee.

Doctors will only issue an “a posteriori” medical certificate in exceptional cases. After all, doctors have a professional obligation to issue medical certificates truthfully and conscientiously.

Only if medical findings confirm the statements made by an employee-patient regarding the start of a period of incapacity for work may a doctor issue an “a posteriori” medical certificate.

Important: if an employee has not timely submitted a medical certificate to the employer and is therefore not entitled to guaranteed pay for the days preceding the submission of the medical certificate, an “a posteriori” medical certificate will not be able to rectify this situation. Even if an “a posteriori” medical certificate is provided, the employee remains in breach of their obligations towards the employer. Indeed, a doctor will date an “a posteriori” certificate on the date on which he/she actually issues it (it is not permitted for a doctor, neither ethically or legally, to backdate a medical certificate).

6. The apt for work certificate with conditions

This is a certificate issued by a doctor in which the latter makes recommendations about the conditions under which an employee can resume work. Examples include the suggestion to allow an employee to work from home, to perform less heavy work or to provide him with adapted ICT equipment. It is important to note that a doctor makes these suggestions outside the framework of a formal and legally regulated reintegration track.

The professional association for medical practitioners (“Orde der artsen – Ordre des médecins”) accepts that a doctor may issue this type of certificate on the condition that the doctor ‘adopts a cautious approach’. According to the association, this means that the doctor: (i) checks with the incapacitated employee whether the proposed adjustments are feasible and realistic in practice; (ii) involves the occupational doctor/prevention advisor in the process, subject to the consent of the incapacitated employee; (iii) limits the proposed adjustments in time; and (iv) regularly reassesses the health condition of the incapacitated employee.

An employer is not obliged to comply with the doctor’s suggestions. Please note however that if an employer decides to dismiss an employee who is unfit for work and the employee subsequently contests the dismissal on the grounds of an alleged discrimination or a manifestly unreasonable dismissal, it cannot be ruled out that a labour court will still examine whether the employer actually investigated the doctor’s suggestions before proceeding with the dismissal.

In summary, not every document issued by a doctor qualifies as a medical certificate. Both employees and employers would therefore be well advised to distinguish between the different types of certificates and to correctly assess their legal implications.

The ALTIUS Employment Team advises employers when dealing with employees who are unfit for work due to a work incapacity and offers them practical advice (e.g. on re-integration tracks, the termination of the employment contract, …).