What are the rules for sick leave in South Africa?

You wake up with a fever and phone in sick. Will you be paid? Does your manager need a doctor's note for one day? You were off for a week last year, so have you "used up" this year's sick leave? The answers come from sections 22 to 24 of the Basic Conditions of Employment Act 75 of 1997, the BCEA, and they are more generous in some ways, and stricter in others, than most workplace folklore suggests. This guide explains the three-year cycle, the rules for new employees, what you are paid, exactly when a medical certificate can be demanded, what it must say, and what happens when your paid sick leave runs out.

This guide is part of our Leave in South Africa: every type of leave and your rights, which links every guide on the topic.

Whether you can be dismissed for being ill is a separate question, covered in our guide on whether you can be dismissed for being off sick. This guide deals with the leave itself.

The three-year cycle

Section 22(1) defines a sick leave cycle as 36 months of employment with the same employer, starting on your first day of work and then running from the end of each previous cycle. It is not tied to the calendar year, the tax year or your annual leave cycle.

In each cycle, section 22(2) gives you paid sick leave equal to the number of days you would normally work in six weeks:

• five days a week: 30 days per cycle;
• six days a week: 36 days per cycle;
• three days a week: 18 days per cycle.

Those days are for the whole three years, not per year. People often describe the entitlement as "ten days a year", but that is wrong in a way that matters. If you are seriously ill in year one and need 25 days, you are entitled to be paid for all 25, because the cycle allowance is available whenever you need it. You would then have five days left for the rest of the cycle. At the end of the cycle, unused days fall away and a fresh allowance begins. Our sick leave calculator works out your cycle dates and balance.

The chapter applies to anyone who works 24 hours or more a month for the employer (section 19(1)), whatever they earn.

Your first six months

During the first six months of employment, section 22(3) replaces the full allowance with a slower one: one day of paid sick leave for every 26 days worked. On a five-day week, that is roughly one day a month. A new employee who falls ill in week three may have no paid sick leave at all yet.

Once you pass six months, the full cycle allowance applies. But section 22(4) lets the employer subtract the sick days you took during the first six months from your first cycle's allowance. The first six months are part of the first 36-month cycle, not an extra period on top of it.

What you are paid

For each day of sick leave, section 22(5) requires the employer to pay the wage you would ordinarily have received for that day, on your usual pay day. Sick leave applies to days you would have worked; a day you are ill on your rest day does not use up an allowance.

There is one variation. Section 22(6) allows an agreement, such as a collective agreement or your contract, to reduce your daily sick pay to no less than 75 percent of your ordinary wage, but only if the number of sick days is increased at least in proportion and your total sick pay over the cycle is at least what the standard rule would give. A scheme that simply pays less, without more days, is not allowed.

The BCEA is a floor. Many employers give more sick leave, and some bargaining councils run sick pay funds. Leave granted beyond the statutory minimum is governed by the contract or agreement rather than the Act (section 19(2)), so read the policy to see whether extra days carry over and what proof they require.

When a medical certificate is required

Section 23(1) lets the employer refuse to pay sick leave if two things happen together. First, you were absent for more than two consecutive days, or on more than two occasions during an eight-week period. Second, the employer asked for a medical certificate and you did not produce one.

In practice:

• A one-day or two-day absence on its own does not trigger the rule. The employer cannot withhold pay for those days merely because you have no certificate.
• An absence of three or more consecutive days does trigger it.
• So does a third separate absence within any eight weeks, even if each absence is a single day. This is the rule that catches the pattern of odd Mondays and Fridays.

Many workplaces have a policy requiring a certificate for every absence. Asking for one is not unlawful, and failing to follow a reasonable reporting procedure can lead to discipline. But the BCEA only allows the employer to refuse to pay sick leave when one of the two statutory triggers applies.

Section 23(3) adds a protection for employees who live on the employer's premises, such as many domestic and farm workers. If it is not reasonably practicable for them to get a certificate, the employer may not withhold pay unless it provides reasonable help to get one, such as transport to a clinic.

What the certificate must say and who may sign it

Section 23(1) requires a certificate stating that you were unable to work for the duration of your absence because of sickness or injury. A note that only says you attended a clinic or a consultation on a particular day does not meet that test.

Section 23(2) requires it to be issued and signed by a medical practitioner, or by another person who is certified to diagnose and treat patients and is registered with a professional council established by an Act of Parliament. Doctors registered with the Health Professions Council of South Africa clearly qualify. Clinic nurses, traditional healers and other practitioners raise harder questions, which our guide on whether a clinic sick note is valid deals with in detail.

The certificate does not have to disclose your diagnosis. The Health Professions Council's ethical rules allow a practitioner to describe the illness only with your consent, and "medical condition" is enough for your employer.

Injuries and illness caused by work

Section 24 says the sick leave rules do not apply to an inability to work caused by an occupational injury or disease covered by the Compensation for Occupational Injuries and Diseases Act, except for any period during which no compensation is payable under that Act. If you are hurt at work, the absence should be reported as an injury on duty, not taken out of your sick leave. Our guide on claiming from the Compensation Fund explains the process.

When sick leave runs out

Once your cycle allowance is used up, the BCEA does not require the employer to pay you for further sick days. Your options are:

• Annual leave, if your employer agrees to let you use it.
• Unpaid leave, which is the default.
• The UIF illness benefit, if you are unable to work for at least seven days and your pay has stopped or been reduced. Our guide on how to claim the UIF illness benefit explains how it fits with sick pay.

Running out of sick leave is not, on its own, a fair reason for dismissal. Where absence becomes long-term or frequent, the employer has to follow an incapacity process, which our guide on incapacity versus misconduct explains.

Unused sick leave is never paid out when you leave the job. That makes it different from annual leave, which is paid out under section 40, as our guide on how much annual leave you get explains.

Worked example

This example is illustrative. Sipho starts work as a warehouse assistant on 1 February 2026, working a five-day week. His first sick leave cycle runs from 1 February 2026 to 31 January 2029.

At the end of April 2026, he has worked about 60 days, so he has earned two days of paid sick leave at one day for every 26 days worked. He is then off with bronchitis for three consecutive days. Because the absence is more than two consecutive days, his employer asks for a medical certificate, and he brings one from his GP. He is paid for two days. The third day is unpaid, because he has not yet earned it.

From 1 August 2026 he is past six months and has the full 30 days, less the three days taken in his first six months, leaving 27 days for the rest of the cycle. On 1 February 2029 he starts a new cycle with 30 days, whatever remains unused.

Change the facts: later in 2026, Sipho is off on a Monday in September and a Friday in October, with no certificate. Both days are paid. In November, still within eight weeks of the first absence, he is off another Monday. That is a third occasion in eight weeks, so if his employer asks for a certificate and he cannot produce one, it may treat that day as unpaid.

What to do

1. Find your start date and work out your current 36-month cycle and balance. Ask HR for your leave record in writing if you disagree with it.
2. Follow your employer's reporting procedure: tell your manager as early as possible on the first day.
3. Get a certificate whenever an absence will run past two days, or when you have already been off twice in the last eight weeks. Check that it covers every day you were away and states that you were unable to work.
4. If you are hurt at work, insist that it is recorded as an injury on duty.
5. If sick pay is wrongly withheld, write to your employer with the dates, certificates and your calculation. If that fails, go to a labour inspector at the Department of Employment and Labour, or the CCMA if you earn below the earnings threshold.