Medical leave is time off work due to your own serious illness, injury, or medical condition. In Ontario, several types of medical leave are protected under the Employment Standards Act, meaning your employer cannot fire you for taking them and must hold your job.
The main types include:
Sick leave: 3 paid days + 3 unpaid days per year for personal illness or medical emergencies.
Family medical leave: Up to 28 weeks to care for a family member with a serious medical condition.
Critical illness leave: Up to 37 weeks for a critically ill child or 17 weeks for a critically ill adult family member.
Organ donor leave: Up to 13 weeks for living organ donation.
These leaves protect your job while you deal with health issues, though most are unpaid by your employer.
Can You Fire Someone on Medical Leave?
No. Your employer cannot fire you simply because you’re on protected medical leave. This is illegal under Ontario’s Employment Standards Act.
What's Protected
While on medical leave, you’re protected from:
- Termination for taking the leave
- Losing seniority or benefits
- Being replaced permanently
- Penalty or discipline for being absent
When Termination Might Still Happen
Your employer can terminate you during medical leave only if:
The termination is unrelated to your leave: For example, your entire department is eliminated due to business closure.
They provide proper severance: If the termination isn’t for cause, you’re entitled to full severance pay and notice.
You’ve exhausted your leave entitlement: Once you exceed maximum leave periods and cannot return to work, termination may be lawful with proper severance.
If You're Fired While on Medical Leave
This is a major red flag. Contact an employment lawyer immediately because:
- The timing suggests the termination may be related to your leave (illegal)
- You may be entitled to significant damages beyond standard severance
- Your employer may face penalties for violating the ESA
Most firings during medical leave are wrongful dismissal, even if the employer claims other reasons.
Is Medical Leave Paid in Ontario?
Most medical leave in Ontario is unpaid by your employer, with limited exceptions.
What's Paid
3 sick days per year: Your employer must pay your first 3 sick days annually at your regular rate.
Employment Insurance (EI) sickness benefits: You can receive 55% of your earnings (up to maximum) for up to 15 weeks while on medical leave.
Employer top-up programs: Some employers offer paid medical leave beyond the 3-day minimum or top up EI benefits. Check your employment contract or benefits package.
What's Unpaid
Family medical leave: The 28 weeks for caring for a sick family member is unpaid by your employer (though EI compassionate care benefits may apply).
Extended sick leave: Beyond the 3 paid days, additional sick leave is unpaid.
Critical illness leave: Unpaid by employer, but EI benefits may be available.
Organ donor leave: Unpaid by employer, though EI benefits apply.
How to Apply for EI Medical Leave Benefits
Step 1: Get Your Medical Certificate
Visit your doctor and explain you need time off work for medical reasons. Your doctor must complete a medical certificate stating:
- Your medical condition prevents you from working
- Expected duration of your absence
- Any restrictions or limitations
Step 2: Notify Your Employer
Tell your employer you need medical leave as soon as possible. Provide:
- Expected start date
- Estimated duration
- Medical certificate (if required)
Your employer will issue a Record of Employment (ROE) needed for your EI application.
Step 3: Apply for EI Sickness Benefits Online
Go to the Service Canada website and apply for EI sickness benefits within 4 weeks of your last day of work.
You’ll need:
- Your Social Insurance Number
- ROE from your employer (issued electronically)
- Medical certificate
- Banking information for direct deposit
Step 4: Serve Your Waiting Period
There’s typically a 1-week waiting period before EI payments begin. You won’t receive benefits for this first week.
Step 5: Complete Bi-Weekly Reports
Every 2 weeks, complete your EI report confirming you’re still unable to work due to medical reasons. Missing reports stops your payments.
How Much You'll Receive
EI pays 55% of your average weekly insurable earnings, up to a maximum of $668 per week (2025 rate).
Benefits last up to 15 weeks for personal medical leave.
7 Things Employees Should Know About Medical Leave
1. You Don't Need Long Service to Qualify
Unlike some other leaves, there’s no minimum employment period required for medical leave in Ontario. Even if you started your job last week, you’re entitled to protected medical leave.
This surprises many people, but it’s true—your job is protected from day one of employment.
2. Your Benefits Must Continue
While on medical leave, your employer must continue your benefits if you continue paying your share of premiums. This includes:
- Health and dental insurance
- Life insurance
- Disability insurance
- Pension contributions
Your employer cannot cancel your benefits simply because you’re on medical leave.
3. Medical Certificates Can Be Required
Your employer can ask for a medical certificate proving you need time off. This certificate should state that you have a medical condition preventing work, but your employer cannot demand details about your specific diagnosis.
The certificate should confirm:
- You’re unable to work
- Expected duration of absence
- Any limitations or restrictions
4. Mental Health Conditions Qualify
Medical leave isn’t just for physical illness or injury. Mental health conditions like depression, anxiety, PTSD, or burnout qualify for protected medical leave.
You have the same rights to job-protected leave for mental health as for physical health conditions. Your employer cannot treat mental health leaves differently than physical health leaves.
5. You Can't Be Forced to Return Early
Your employer cannot force you back to work before your doctor says you’re ready. If your medical certificate says you need 6 weeks off, your employer must respect that.
Pressuring you to return early may constitute:
- Violation of the ESA
- Constructive dismissal if the pressure is severe
- Disability discrimination under human rights law
If you feel pressured to return before you’re medically cleared, document everything and consult an employment lawyer.
6. Accommodation May Be Required When You Return
When you’re ready to return to work, your employer may need to accommodate any ongoing medical restrictions. This could include:
- Modified duties
- Reduced hours initially
- Ergonomic equipment
- Flexible scheduling
- Work-from-home options
Under human rights law, employers must accommodate disabilities up to the point of undue hardship. Don’t assume you can’t return because you have ongoing limitations—accommodation discussions should happen.
7. Extended Leave Beyond ESA Minimums
The ESA provides minimum protections, but you may need more time than statutory leave periods allow. If your medical condition requires longer absence:
Request additional leave: Your employer may grant unpaid leave beyond ESA minimums.
Apply for long-term disability: If you have LTD coverage through work, apply when short-term benefits end.
Seek accommodation: Frame longer absence as disability accommodation under human rights law.
Get legal advice: If your employer refuses reasonable accommodation or threatens termination, consult an employment lawyer immediately.
What Happens If You Can't Return to Work
If your medical condition prevents you from ever returning to your job, the situation becomes complex:
Your Employer's Options
Offer accommodated work: If possible, your employer should offer modified duties or a different position you can perform.
Terminate with severance: If accommodation isn’t possible, your employer can terminate your employment but must provide full severance pay and reasonable notice.
Wait until leave expires: Some employers wait until your maximum leave period ends before making termination decisions.
Your Rights
You’re entitled to:
- Full severance pay based on your age, service, position, and ability to find new work
- Continued benefits during reasonable notice period
- Long-term disability benefits if you have coverage
- Potentially significant damages if termination was improper
Never agree to resign or sign releases during medical leave without consulting an employment lawyer first. Your rights and entitlements may be much greater than what your employer offers.
Key Takeaways
Medical leave in Ontario is job-protected under the ESA, meaning your employer cannot fire you for taking necessary medical time off.
Most medical leave is unpaid by employers, but you can access EI sickness benefits (55% of earnings for up to 15 weeks).
Apply for EI within 4 weeks of stopping work, and complete bi-weekly reports to continue receiving benefits.
You don’t need long service to qualify—medical leave protection starts on day one of employment.
Mental health conditions qualify equally with physical conditions—both are protected medical leaves.
Your employer must continue benefits during leave and cannot force you back before you’re medically cleared.
If fired during medical leave, consult an employment lawyer immediately—this is often wrongful dismissal with significant damages available.
When you can’t return to work, you’re entitled to full severance plus accommodation discussions before termination is considered.
