Myrna Sachs, Head: Health Management Solutions at Alexforbes
Sick leave is an essential workplace protection for employees who are genuinely unwell. For employers, the challenge is to manage it in a way that protects trust, supports wellbeing and keeps operations running smoothly. Recent reports have highlighted concern about questionable or improperly issued sick notes and the effect these can have on absenteeism, productivity and business costs. Absenteeism places a significant burden on employers across South Africa, underlining the need for employers to take a more structured, fair and proactive approach.
The concern is not new, but the environment has changed. As questionable or improperly issued medical certificates become more difficult to verify, employers need systems that help them respond consistently and fairly. Some certificates may appear legitimate but may have been issued or obtained without the appropriate process being followed. In other cases, certificates may be issued without proper medical examinations or produced without the required checks or legitimacy. A clear, evidence-led process helps organisations protect both their operations and the integrity of genuine sick leave.
This creates an important balancing act for employers. Organisations have a legal and ethical responsibility to support employees who are genuinely ill, while also maintaining operational continuity and managing absence-related costs responsibly. The most effective response is not suspicion, but structure: a fair, strategic and data-driven approach to absence management that promotes accountability and wellbeing.
The opportunity in better absence management
When absenteeism is discussed, the immediate focus is often on salary costs. However, our work with clients shows that the true impact extends far beyond paid sick leave, which is why a structured approach can create meaningful value for both employers and employees.
Repeated unplanned absences can result in overtime costs, temporary staffing expenses, reduced productivity, operational inefficiencies and increased pressure on colleagues who must absorb additional workloads. Over time, these disruptions can affect service delivery, employee morale and customer experience. This highlights the importance of helping organisations build more resilient and consistent absence management practices.
Employers also face practical limits when verifying medical certificates. Medical confidentiality and privacy laws rightly protect employees’ health information, but organisations can still put fair processes in place to confirm the administrative validity of certificates without intruding on confidential medical details.
Moving beyond reactive management
Many organisations only address absenteeism once it has become a significant problem. By that stage, absence patterns may already be embedded and harder to reverse. The positive alternative is to act earlier, using data, clear governance and occupational health expertise to identify risks before they become entrenched.
A more effective approach is to proactively identify risk factors, establish robust governance processes and support employees before attendance concerns escalate.
Absenteeism should be managed as a workforce risk and a workforce wellbeing opportunity, not only as a disciplinary matter. By combining occupational health expertise, analytics and governance frameworks, organisations can reduce absenteeism while maintaining fair, supportive and legally sound workplace practices.
Employers can strengthen the integrity of sick leave processes by adopting a more proactive, structured and data-led approach to absence management.
Understanding the patterns behind absenteeism
One of the most useful tools available to employers is data. HMS assists organisations in analysing absence trends and identifying patterns that may indicate emerging risks, including recurring absences around weekends and public holidays, repeated one-day absences, unusual sick leave trends within specific teams or departments, or attendance patterns that differ significantly from established norms. By identifying these indicators early, organisations can respond consistently, support employees where needed and prevent more serious issues from developing.
Strengthening medical certificate verification
Many employers are unsure about how far they can go when reviewing or validating a medical certificate.
HMS assists organisations in developing practical verification frameworks that align with the Basic Conditions of Employment Act while respecting confidentiality and privacy requirements. Rather than seeking confidential medical information, verification processes can focus on confirming whether the healthcare practitioner is appropriately registered, whether the practitioner issued the certificate and whether a consultation took place. This helps create an appropriate balance between employee rights, organisational accountability and trust in the sick leave process.
Occupational health expertise for complex cases
Not every absence concern can be resolved through policy and monitoring alone.
Where employees experience repeated absences, prolonged periods of sick leave or situations where work capacity is unclear, occupational health input becomes essential. HMS provides independent occupational health guidance, including fitness-for-work assessments, interpretation of functional capacity evaluations, return-to-work planning and workplace accommodation recommendations. These interventions help employers make informed decisions while ensuring employees receive appropriate support.
Building strong governance and compliance
Absenteeism management is most effective when supported by clear and consistent governance.
HMS works with organisations to establish comprehensive sick leave and incapacity management frameworks that define reporting requirements, documentation standards, employee and manager responsibilities, attendance counselling processes and review and escalation protocols. A structured framework not only supports the integrity of the sick leave process but also improves consistency, fairness and legal defensibility.
Addressing the root causes of absenteeism
Importantly, absenteeism is not always driven by abuse.
Stress, burnout, mental health challenges, workplace culture and employee engagement all play a role in attendance patterns. Organisations that focus only on compliance often overlook these underlying drivers.
For this reason, HMS advocates a balanced approach that combines attendance management with employee wellness programmes, mental health support, disability management, early intervention strategies and leadership development. By addressing the underlying causes of absence, organisations can create healthier and more productive workplaces while reducing unnecessary absenteeism.
The future of sick leave management
The growing sophistication of questionable or improperly issued medical certificates highlights an opportunity for more modern, secure and employee-sensitive verification methods.
Secure digital solutions such as electronic medical certificates, practitioner registration validation, QR code verification and tamper-proof records could make it easier to confirm authenticity while protecting the confidentiality of employees’ health information.
Combined with data analytics and proactive workforce health management, these technologies will enable organisations to move away from reactive responses and towards smarter, evidence-based absence management practices.
A workforce risk that requires strategic leadership
Effective sick leave management is more than an HR concern. It is a business issue that affects productivity, workforce planning, service delivery and organisational performance. The concerns raised by labour relations experts reinforce the need for employers to move beyond reactive management and adopt a more strategic approach to absenteeism.
The answer is not to challenge every medical certificate or assume that every absence requires further review. It is to establish robust governance, monitor absence trends, use occupational health expertise where appropriate and create a workplace culture that promotes both accountability and wellbeing. Organisations that achieve this balance will be better equipped to manage absenteeism, support employees appropriately and build healthier, more resilient and more productive workforces.
ENDS
