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Overview

Long-term illness leave came into effect on June 19, 2025. This leave provides eligible employees with an unpaid, job-protected leave of up to 27 weeks in a 52-week period due to a serious medical condition.

Eligibility

Long-term illness leave may be taken if the employee will not be performing the duties of their position due to a serious medical condition.

A qualified health practitioner must issue a certificate that does both of the following things:

  • states that the employee has a serious medical condition
  • sets out the period during which the employee will not be working due to the serious medical condition

All employees who have been employed by their employer for at least 13 consecutive weeks and who are covered by the Employment Standards Act, 2000 (ESA) may be entitled to long-term illness leave, whether they are full-time, part-time, permanent or term contract.

Definition of a qualified health practitioner

For long-term illness leave purposes, a qualified health practitioner is a person who is qualified to practise as a physician, registered nurse, or psychologist under the laws of the jurisdiction in which care or treatment is being provided. In Ontario, this includes psychiatrists and nurse practitioners.

Different types of health practitioners may be able to issue certificates in different jurisdictions, depending on the laws of that jurisdiction.

The medical certificate

The employee does not have to have the medical certificate before they can start the leave, but a certificate must eventually be obtained. If a certificate is never issued, the employee will not be entitled to the leave. This means that the employee would not be entitled to any of the protections afforded to employees on long-term illness leave.

Certificate requirements

The certificate from the qualified health practitioner must:

  • name the employee
  • state that they have a serious medical condition  
    • There is no requirement that the certificate specify the medical condition, but it must state that the medical condition is “serious,” which can include conditions that are chronic or episodic.
    • If the certificate names or describes the condition without stating that it is “serious”, this will not be sufficient.
    • The ministry does not provide a list of medical conditions it considers serious. Only the qualified health practitioner can make an assessment about whether an employee’s medical condition is serious.
  • sets out the period during which the employee will not be working due to the serious medical condition

An employer is entitled to ask an employee for a copy of the certificate of the qualified health practitioner to provide proof that they are eligible for a long-term illness leave. The employee is required to provide the copy as soon as possible after the employer requests it.

The employee may wish to provide the health practitioner with the “Medical certificate to support entitlement to long-term illness leave” form. The health practitioner is not required to use this form. Any certificate stating that the employee has a serious medical condition and indicating the period during which the employee is not working due to the serious medical condition can be used.

The employee is responsible for obtaining and paying the costs (if any) of obtaining the certificate. The Ministry of Labour, Immigration, Training and Skills Development cannot assist the employee in obtaining the certificate.

Interaction with other leaves

There are different types of leaves under the ESA, including:

  • long-term illness leave
  • sick leave
  • infectious disease emergency leave
  • bereavement leave
  • domestic or sexual violence leave
  • child death leave
  • crime-related child disappearance leave

The purposes of the leaves, their length and eligibility criteria are different. See the other chapters of this Guide for more information on each leave.

An employee may be entitled to more than one leave for the same event. Each leave is separate and the right to each leave is independent of any right an employee may have to the other leave(s).

Length and timing of long-term illness leave

A long-term illness leave can last up to 27 weeks in a 52-week period. A “week” is defined as running from Sunday to Saturday.

If a medical certificate issued by a qualified health practitioner sets out a period that is less than 27 weeks, then the employee is entitled to take a leave only for the period set out in the certificate.

If the certificate sets out a period of 52 weeks or longer, the employee may take up to 27 weeks of leave but the leave must end no later than the last day of the 52-week period that begins on the earlier of:

  • the first day of the week in which the certificate was issued
  • the first day of the week in which the employee stopped working because of the serious medical condition

The employee may, however, be entitled to an additional leave after the expiry of the 52-week period — for more information, see “Additional leaves” below.

Example

  • On June 30, 2025, a certificate is issued stating that the employee will not be working due to a serious medical condition from June 30, 2025 to October 2, 2026. The employee had not started their leave before the certificate was issued.
  • Because the period is more than 52 weeks, the last day the employee must end long-term illness leave under this certificate is June 27, 2026, which is the end of the 52-week period that began on June 29, 2025 (the first day of the week when the certificate was issued).
  • Therefore, the employee can take a maximum of 27 weeks of long-term illness leave between June 30, 2025 and June 27, 2026.

The 27 weeks of long-term illness leave do not have to be taken consecutively. An employee may take a single week, or part of a week, of leave at a time.

However, if an employee takes part of a week off work as long-term illness leave, they may be considered to have used up one full week of their entitlement. If the employee is on leave for two or more periods within the same week (for example, on leave on Monday and Thursday of the same week), only one full week of the entitlement may be considered to have been used up.

The employer cannot require the employee to take an entire week of leave if the employee only wants to take leave for a single day(s), cannot prevent the employee from working prior to taking a single day(s) of leave during a week, and cannot prevent the employee from returning to work after a single day(s) of leave during the week.

Example

  • On June 30, 2025, a certificate is issued stating that the employee will not be working due to a serious medical condition from June 30, 2025 to July 2, 2025.
  • Although the maximum entitlement to long-term illness leave is 27 weeks, because the certificate only sets out a period of 3 days, the employee is only entitled to a leave of 3 days during this period.
  • The employer may count this as the employee taking one full week of long-term illness leave.

Further leave

If an employee takes long-term illness leave but does not use up the maximum 27-week entitlement before the expiry of the 52-week period, the employee may qualify for another long-term illness leave if they still have a serious medical condition.

The employee will be entitled to another leave if:

  • a qualified health practitioner issues a new certificate setting out a different period during which the employee will not be working because of a serious medical condition
  • the total leave taken in the 52-week period is not more than 27 weeks
  • the employee ends their leave no later than the last day of the 52-week period

Example

  • On August 3, 2025, a certificate is issued stating that the employee will not be working due to a serious medical condition from August 3, 2025 to August 23, 2025.
  • The employee takes long-term illness leave from August 3, 2025 to August 23, 2025, which is 3 weeks.
  • The 52-week period in which this employee is entitled to a maximum of 27 weeks of long-term illness leave is August 3, 2025 to August 1, 2026.
  • Because the employee has only used 3 weeks of leave, they may qualify for another leave of up to 24 weeks until August 1, 2026.
  • A new certificate is issued on November 9, 2025 stating that the employee will not be working due to a serious medical condition starting November 9, 2025 for 6 weeks (until December 20, 2025).
  • The employee may take up to 6 weeks of long-term illness leave under the new certificate because the total leave taken (9 weeks) will be no more than 27 weeks and the employee’s leave will end no later than August 1, 2026.

Additional leaves

If an employee continues to have a serious medical condition after the 52-week period expires, the employee may qualify for an additional long-term illness leave if the requirements for eligibility are met.

The same rules as those described above will apply to any additional long-term illness leave taken by an employee.

Notice requirements

An employee must inform the employer in writing that they will be taking a long-term illness leave of absence.

If an employee has to begin a long-term illness leave before notifying the employer, they must inform the employer in writing as soon as possible after starting the leave.

If the employee does not take the maximum 27 weeks all at once, the employee is required to provide notice to the employer each time the employee begins a new part of the leave.

Rights during and at the end of a long-term illness leave

Employers do not have to pay wages when an employee is on long-term illness leave.

Employees who take long-term illness leave are entitled to the same rights as employees who take pregnancy or parental leave. For example, an employer cannot threaten, fire or penalize in any other way an employee for taking, planning on taking, being eligible or being in a position to become eligible to take a long-term illness leave. See "Rights during pregnancy and parental leaves."