Long-term illness leave in Ontario gives eligible employees up to 27 weeks of unpaid, job-protected leave in a 52-week period when a serious medical condition prevents them from working.
You qualify after working for your employer for at least 13 consecutive weeks. A qualified health practitioner must provide a certificate confirming that you have a serious medical condition and stating how long you will be unable to work.
Your employer can’t refuse qualifying leave because your absence is inconvenient. Just as importantly, reaching the end of the 27 weeks does not automatically mean your employer can fire you. Disability-accommodation rights can continue beyond the ESA leave.
On This Page:
- 1. How Long Is Long-Term Illness Leave?
- 2. Who Qualifies?
- 3. Medical Certificate & Notice
- 4. Is the Leave Paid?
- 5. Job Protection & Returning to Work
- 6. FAQs
How Long Is Long-Term Illness Leave in Ontario?
Eligible employees can take up to 27 weeks of Long-Term Illness Leave within a 52-week period.
The leave became part of Ontario’s Employment Standards Act on June 19, 2025.
Do you have to take all 27 weeks at once?
No. The leave can be taken in separate weeks or parts of weeks if your medical needs require it.
However, taking even part of a week can count as one full week against your 27-week entitlement.
Your employer can’t force you to remain off for the rest of the week if you only need one or two days.
What if your medical certificate says you only need 10 weeks?
Your leave is limited to the period supported by the medical certificate.
The ESA provides a maximum of 27 weeks. It does not automatically give every employee 27 weeks regardless of their medical evidence.
Can you take another leave later?
Yes. If you don’t use all 27 weeks, another medical certificate can support additional leave within the same 52-week period, as long as your total does not exceed 27 weeks.
If your serious medical condition continues after that 52-week period ends, you can also qualify for a new Long-Term Illness Leave if the legal requirements are met.
Who Qualifies for Long-Term Illness Leave?
You qualify after at least 13 consecutive weeks of employment if a serious medical condition prevents you from performing your job.
The entitlement applies to ESA-covered employees whether you are:
- Full-time
- Part-time
- Permanent
- Working under a fixed-term contract
What counts as a serious medical condition?
There is no government list of medical conditions that automatically qualify. A qualified health practitioner decides whether your condition is serious.
A serious medical condition can be chronic or episodic. That means the leave is not limited to sudden or catastrophic illnesses.
Can a mental health condition qualify?
Yes. A serious mental health condition can qualify when it prevents you from working and the required medical certificate supports the leave.
For mental-health-related absences, see our Stress Leave Ontario guide.
How is this different from regular sick days?
Ontario sick leave provides up to three unpaid days per calendar year for illness, injury or a medical emergency after two consecutive weeks of employment.
Long-Term Illness Leave is for more serious conditions and provides much more time away, but it requires 13 weeks of employment and a medical certificate.
Do You Need a Medical Certificate?
Yes. Unlike Ontario’s three statutory sick days, Long-Term Illness Leave requires a certificate from a qualified health practitioner.
The certificate must:
- Name you
- State that you have a serious medical condition
- State the period when you will not be working because of the condition
Does your employer need to know your diagnosis?
No. The ESA certificate does not have to identify or describe your medical condition.
It must clearly state that the condition is serious. Simply naming a condition without stating that it is serious is not enough for this particular ESA leave.
Who can complete the certificate?
A qualified health practitioner can include a physician, registered nurse or psychologist who is legally qualified to practise where you receive care or treatment.
In Ontario, this includes nurse practitioners and psychiatrists.
Do you need the certificate before starting leave?
No. You can start the leave first if your medical situation requires it.
However, a qualifying certificate must eventually be issued. Your employer can request a copy, and you must provide it as soon as possible.
How do you notify your employer?
You must tell your employer in writing that you are taking Long-Term Illness Leave.
If you have to stop working before giving notice, provide written notice as soon as possible afterward.
If you take the leave in separate periods, you must notify your employer each time a new period begins.
Is Long-Term Illness Leave Paid in Ontario?
No. Ontario’s ESA does not require your employer to pay your wages during Long-Term Illness Leave.
Income can instead come from:
- EI sickness benefits
- Employer-paid sick leave
- Short-term disability benefits
- Long-term disability benefits
Can you get EI sickness benefits?
Yes, if you meet the federal EI eligibility requirements.
EI sickness benefits can provide up to 26 weeks of financial assistance when you can’t work for medical reasons.
In 2026, EI sickness benefits generally pay 55% of insurable earnings up to a maximum of $729 per week.
Is Long-Term Illness Leave the same as long-term disability?
No. Long-Term Illness Leave is an employment-law right to protected time away from work. Long-term disability is an insurance benefit that replaces part of your income if you meet the policy’s disability test.
Is Your Job Protected During Long-Term Illness Leave?
Yes. Your employer can’t threaten, fire or penalize you because you take, plan to take or qualify for Long-Term Illness Leave.
Employees on protected leave also generally continue to receive credit for length of employment, service and seniority and can continue participating in qualifying benefit plans.
When the leave ends, your employer must generally return you to your previous job or a comparable position if the previous job no longer exists.
What happens after 27 weeks?
Reaching 27 weeks is not an automatic termination date.
If you still have a serious medical condition, another Long-Term Illness Leave can become available after the applicable 52-week period if you meet the requirements again.
A disability can also create separate accommodation rights under Ontario’s Human Rights Code. Those rights can require additional medical leave, modified duties or another reasonable return-to-work arrangement unless accommodating you would cause undue hardship.
Can your employer fire you while you’re medically unable to work?
Your employer can’t fire you because you took protected medical leave or because of a disability that can still be accommodated.
A termination can occur for a genuine reason unrelated to your leave, but being away for 27 weeks does not by itself make termination lawful.
For the broader provincial leave framework, see our Leave of Absence Ontario guide.
Long-Term Illness Leave Ontario FAQs
How long is Long-Term Illness Leave in Ontario?
Eligible employees can take up to 27 weeks of unpaid, job-protected leave in a 52-week period.
How long do you need to work before qualifying?
You must have worked for your employer for at least 13 consecutive weeks.
Is Long-Term Illness Leave paid?
No. The ESA leave is unpaid. EI sickness benefits or disability insurance can provide income if you separately qualify.
Do I need a doctor’s note?
You need a certificate from a qualified health practitioner confirming a serious medical condition and the period you will be unable to work.
Does my employer need to know my diagnosis?
No. The ESA certificate does not have to identify your diagnosis.
Can I take the 27 weeks separately?
Yes. The leave does not have to be consecutive, although taking part of a week can count as one full week of entitlement.
Can I be fired after 27 weeks?
The end of the ESA leave does not automatically end your employment. Further statutory leave or disability-accommodation rights can apply.
Samfiru Tumarkin LLP advises non-unionized Ontario employees dealing with denied medical leave, accommodation problems, workplace reprisals and termination during or after a medical absence—and gets the compensation they’re entitled to.