Medical certificate: Content and wording

A medical certificate is a document that provides information about a person's state of health in connection with their occupation and must be completed truthfully by the attending physician in compliance with medical confidentiality. In most cases, a medical certificate is required if a person is unable to work due to illness or an accident. A medical certificate usually comes in the form of a pre-printed blue slip of paper, which is filled in by the doctor. In some cases, a detailed medical certificate can also be written, usually in the form of a letter.

Falsifying this document is a criminal offence. This is laid down in the Swiss Medical Association Code of Conduct (FMH). Article 34 FMH specifically states that no certificates of favour may be issued. The Swiss Criminal Code (SCC) also explicitly mentions medical testimonials. If a doctor wilfully issues a false certificate, a custodial sentence of up to three years or a fine may be imposed. This also applies if the person has been promised a reward for doing so (Article 318, paragraph 1 SCC).

A medical certificate is usually used when an employee wishes to claim certain benefits, such as continued payment of salary in the event of incapacity to work. It may then be necessary to disclose the reasons for the incapacity as evidence. In other words, a medical certificate allows a person to prove that they are actually ill.

A medical certificate only has to be submitted if the employer requests it, for example because they have doubts about its credibility or if it is stipulated in the employment contract. There are no legal requirements that a medical certificate must be submitted as evidence.

A medical certificate is always required if you need to prove your state of health. It is most frequently used when a person is unfit for work but still wishes to receive continued payment of salary in accordance with Article 324a of the Swiss Code of Obligations (CO). Among other things, a medical certificate is required in the following situations in everyday working life:

• Incapacity for work due to illness
• Inability to work due to an accident
• Unacceptability of work due to bullying incidents
• Leave to care for sick relatives, for a maximum of three days

Young people under the age of 18 when they enter into an employment relationship. According to the Labour Act (ArG), this ensures the protection of minors. The aim is to prove that the person is fit for work and in good health for the job (Article 29, paragraph 4 ArG).

In general, you as the applicant have the burden of proof. This is laid down in the Swiss Civil Code (CC). Article 8 CC states:

"Unless the law provides otherwise, the person who derives rights from an alleged fact must prove its existence."

A medical certificate is often just a small piece of paper with little information. In any case, the certificate should contain specific details. In case of doubt, these must be medically verifiable. A medical certificate should contain the following points:

• Personal details of the sick person
• Date of onset of the incapacity for work
• To what extent is the person unable to work? Can he/she not work at all or should only the number of hours be reduced?
• When is the person expected to be able to return to work? This can sometimes be difficult to estimate, so in these cases the date of the follow-up examination is sufficient.
• Stamp and signature of the attending physician

Good to know: In exceptional cases, a start date in the past is also permissible. In case of doubt, however, it must be possible to provide sufficient proof of this. It is therefore worth making an appointment with your doctor immediately and arranging for a medical certificate to be issued at the start of your absence from work.

Medical confidentiality

All doctors are subject to a duty of confidentiality and may not pass on private patient information (Article 11 FMH). Doctors must also observe confidentiality when issuing a medical certificate. This means that the certificate must not contain a diagnosis. In principle, an employer has no right to know the nature or severity of the illness. This information may only be included in the medical certificate if the patient expressly consents to this.

Medical certificates are individual and should always be adapted to the specific situation of the person in question. The specific activity of the employee should also be taken into account. An active and standing job requires a different level of exertion than a predominantly sedentary job. A medical certificate should refer to this, as well as to the extent of the incapacity for work. Below you will find some typical situations and formulations that occur in medical certificates:

Partial fitness for work

A medical certificate must always state the extent to which a person is unfit for work. If it is not a complete absence, for example due to flu or an accident, the person may be partially fit for work. This is generally stated as a percentage, for example as follows:

• The person is able to carry out all their usual activities, but is only able to work 50% of the time. Working hours should be reduced accordingly.
• The person can only work part-time.

It is also possible that only certain tasks should not be carried out. This is the case, for example, if the person performs physically strenuous work as part of their normal job. In this case, it can be stated in the medical certificate that the person should only perform these activities partially or not at all, but that sedentary work or office activities can be performed without any problems.

Incapacity for work in relation to the workplace

In this case, the incapacity to work is usually due to psychological reasons and relates more to the working environment than to the job itself. This is often due to negative structures or incidents in the workplace, such as bullying or sexual assault. The person concerned would actually be able to do their job - but not in the working environment in which they find themselves.

Some employers are rather sceptical about such situations. The problem here often lies in the medical verifiability of the incapacity to work. Doctors often use phrases such as "according to the patient" in this context. In this case, it is up to the employer to believe the information and check the situation in the company itself.

Neither the Labour Code nor the Code of Obligations contain provisions on the mandatory submission of medical certificates. Employees are therefore not obliged to submit a medical certificate without being asked to do so. However, every company is free to stipulate certain regulations in its contracts. By signing the employment contract, the employee agrees to these regulations. This can be regulated either in the individual or collective labour agreements. Ultimately, every employer is free to decide whether to require a medical certificate in the event of incapacity for work. It is also up to the company to decide from what point in time it requires a medical certificate. For short absences of a few days, many employers refrain from requesting a medical certificate. In many companies, it is customary to submit a medical certificate from the third day of absence.

If the employer questions the accuracy of the medical certificate

It is quite possible that an employer or the insurance company responsible for continued payment of wages will question a doctor's certificate. This can be the case in particular if the circumstances are questionable, for example if an employee is frequently ill on days before or after the weekend. The employer then has the option of requesting a diagnosis from a medical officer. The employee then undergoes a consultation with a doctor chosen by the employer. In this case, the employer bears the costs of the examination and the issuing of the certificate.

This medical certificate also does not mention the nature of the illness, but it can confirm that the person is actually unfit for work. From a legal point of view, a second medical examination cannot be enforced under duress. Employees can therefore also refuse - but will then also have to bear any consequences. This may result in the employer refusing to continue to pay wages. This is legitimate in that the burden of proof lies with the applicant. If you need a lawyer for labour law, you are welcome to contact us.