X

COVID-19 Government indemnity scheme and vaccines information

< BACK TO LATEST NEWS

Clarity on providing medical certificates during COVID-19

28 May 2020 | Kate Gillman, BA LLB, Head of Medico-legal Advisory Service, NSW and Sonya Black, LLB (Hons), B.Com, Special Counsel – Employment Law, Avant Law, QLD, Avant

As restrictions ease and people return to school and work, there is an increasing demand for letters and medical certificates from both patients and employers. The provision of medical certificates is now a common member query, with many unsure of their obligations. So here is our advice on how to manage common scenarios and letter templates to use.

Whenever you are asked to provide a medical certificate it is important to bear in mind the Medical Board’s Code of conduct and that information in any certificates or reports is current, accurate and not misleading.

Confirmed or suspect case of COVID-19

Patients who test positive for COVID-19 must self-isolate until they meet the appropriate release from isolation criteria in the CDNA guidelines. Patients can be given a medical certificate to cover their self-isolation period and release (template 1).

Where patients are suspected of having COVID-19, they should be advised to self-isolate until their test results are known. This should be documented in their medical record. If the test results are negative, consider the advice in the CDNA guidelines about whether the patient should continue to self-isolate or can be released, and provide a medical certificate for the appropriate period of time (template 2).

Pregnant women

Consider the patient’s personal circumstances and the AHPPC’s current advice, which effectively says there is limited evidence of the risk of COVID-19 to pregnant women, as well as current information from RANZCOG.

If you believe your patient is unfit to return to work due to issues unrelated to COVID-19, you can certify she is not fit for work as usual. Likewise, if you believe it is not appropriate in the current climate for the patient to attend work, you can issue a certificate for a set period and reconsider your view as the COVID-19 situation evolves (template 3).

Most pregnant women, however, are able to return to work if their employers have the appropriate risk management strategies in place. As these patients may fear doing so, discuss the current risks of COVID-19 and refer them to the RANZCOG factsheets for further information.

Vulnerable workers

A ‘vulnerable’ worker may ask you to provide a certificate stating they are unable to return to work, or, as part of their risk assessment process, an employer may ask you to provide a ‘clearance certificate’ certifying that a vulnerable patient is fit to return to work.

Most vulnerable patients are fit for work. They are simply at a potentially higher risk of contracting COVID-19 or becoming very unwell if they contract the virus. If your clinical opinion is that your patient is not fit for work (generally this will be for a reason unrelated to COVID-19), you can issue a certificate or provide information about fitness as you usually would.

Given the evolving clinical advice about COVID-19, it is not possible to certify a patient is at no risk or low risk of contracting COVID-19 if they return to work. The Department of Health’s advice is “… anyone could develop serious or severe illness from COVID-19.” However, people with “… chronic health conditions or weakened immune systems are at greater risk” and may need to be given a certificate to support their request to work from home (template 4) or return to work (template 5).

The AHPPC provided guidance about vulnerable persons on 30 March 2020, which also reflects the general work health and safety law about eliminating and minimising risk to workers. Fortunately, Australia’s environment has changed since the AHPPC guidance was issued, notably:

  • there has been a reduction in the number of COVID-19 positive patients;
  • community transmission is significantly less than anticipated;
  • advice has been provided to employers about risk management in the workplace (for example, Safe Work Australia advice); and
  • many employers have implemented measures in their workplace to minimise risks to health and safety.

As it may take years to find a vaccine or treatment for COVID-19, and life needs to return to normal at some point, it won’t be possible to continue to certify all potentially vulnerable patients as unable to attend workplaces. In each case, consider the patient’s medical and working conditions as a combination of factors which may put the patient at greater risk of complications from COVID-19, such as the need to use public transport to attend work. Patients undergoing treatment like chemotherapy or those highly anxious about returning to work, may need further investigations to assess their risks before any certification can be provided.

Some people are concerned that community transmission will significantly increase in the coming weeks following the easing of restrictions, and with students returning to school and many employees returning to work. Therefore, it may be appropriate for particular vulnerable employees to ‘wait and see’ whether there is an increase in community transmission before they return to work.

If there are any specific restrictions that you recommend for a vulnerable person, you should state those restrictions in your letter (for example, must leave the workplace immediately if there is a suspected case of COVID-19).

Workers who live with a vulnerable person

Many workers are also concerned about the possibility of transmitting COVID-19 to a vulnerable person who lives with them. As discussed above, consider the vulnerable person’s particular circumstances to determine what certification can be provided.

More information

Read our factsheet about issuing medical certificates.

COVID–19 template letters or medical certificates

1

Positive COVID-19 patient

On [insert date], [insert name] tested positive for COVID-19.

[insert name] is required to isolate until [he/she] can be released from isolation in accordance with the current CDNA guidelines.

OR – when ready to return to work

On [insert date], [insert name] tested positive for COVID-19.

[insert name] was required to self-isolate but has now met the CDNA guideline requirements for release from isolation. [insert name] is able to return to work from [insert date].

2

Probable or suspect COVID-19 patient

On [insert date], [insert name] presented with symptoms of COVID-19. I advised [insert name] that [he/she] should be tested for COVID-19 and directed [insert name] to a testing centre.

[insert name] is required to self-isolate until [he/she] can be released from isolation in accordance with the current CDNA guidelines.

3

Pregnant patient – reasons for working from home

[insert name] has a medical condition that places [him/her] at a significantly increased risk of contracting COVID-19 or of becoming seriously ill from the virus.

Based on the current clinical advice and the current risk of community transmission of COVID-19, I recommend that [insert name] be allowed to work from home (if appropriate) until [insert date].

I will review [insert name] on or before [insert date]. If community transmission has reduced, I will consider [his/her] return to work.

4

Vulnerable patient – work from home

[insert name] has a medical condition that places [him/her] at a significantly increased risk of contracting COVID-19 or of becoming seriously ill from the virus.

Based on the current clinical advice and the current risk of community transmission of COVID-19, I recommend that [insert name] be allowed to work from home (if appropriate) until [insert date].

I will review [insert name] on or before [insert date]. If community transmission has reduced, I will consider [his/her] return to work.

5

Vulnerable patient – safe to return to workplace

Based on the current clinical advice, the current risk of community transmission of COVID-19 and assuming that [insert name]’s workplace has adopted the risk management strategies recommended by Safe Work Australia, [insert name] is able to return to the workplace.

I will reassess this advice if the clinical advice changes or it there is an increase in community transmission of COVID-19.

Share your view

We welcome your feedback on this article.

< BACK TO LATEST NEWS