Termination Due to Disease (Philippines): Who Secures the Medical Certificate and What Are the Requirements?

This is a practical, comprehensive guide based on the Philippine Labor Code and long-standing DOLE practice and jurisprudence. It’s general information—not legal advice.

Quick answer

Who secures the medical certificate? The employer. Because the employer bears the burden of proving an authorized cause for dismissal, the employer must obtain—before termination—a certification from a competent public health authority (i.e., a government physician/health officer or doctor in a public hospital/health facility).
What must the certificate say? It must expressly state that the employee suffers from a disease and that continued employment is either prohibited by law or prejudicial to the employee’s health or to co-employees, and that the disease cannot be cured within six (6) months even with proper medical treatment.

Legal basis (what the law requires)

Authorized cause: Termination due to disease is an authorized cause under the Labor Code (Article 299, formerly Article 284).
Substantive requirements (all must be present):
1. The employee has a disease;
2. Continued employment is prohibited by law or prejudicial to the employee’s or co-workers’ health; and
3. The disease cannot be cured within 6 months even with proper treatment—as certified by a competent public health authority.
Procedural requirements:
- 30-day prior written notice to the employee and to the DOLE (authorized-cause due process).
- Separation pay: at least one (1) month pay or one-half (1/2) month pay for every year of service, whichever is higher. A fraction of six months or more counts as one whole year.
- Reporting to DOLE: File the Establishment Termination Report (often via the DOLE field office) at least 30 days before effectivity.

“Competent public health authority”: who qualifies?

Government physicians (e.g., city/municipal health officers; doctors of DOH/DOH-retained hospitals; government medical centers/clinics).
Not enough: a company doctor’s note or a private clinic’s medical certificate, standing alone, is typically insufficient to justify dismissal. Employers commonly refer the employee for examination by a public physician, or request a confirmatory opinion from a government facility.

Practical rule: If the decision to terminate will rely on medical grounds, secure the public health certification first. Terminating without it usually results in illegal dismissal.

Who pays for the medical exam?

Because it is the employer’s burden to prove the authorized cause, employers should shoulder the cost of referral and certification and make reasonable arrangements for the employee’s medical evaluation at a public facility.

The six-month rule (cure vs. termination)

If curable within 6 months: Termination is not allowed. The employer should consider temporary off-work arrangements, medical leave, or job modification/reassignment consistent with safety and operational needs.
If not curable within 6 months: Termination may be effected, provided all substantive and procedural requirements are satisfied.

Interaction with other laws and policies

Occupational Safety and Health (OSH): Employers must maintain a safe workplace. If continued work poses a material health/safety risk, the employer should remove the risk (PPE, engineering controls, reassignment) before resorting to termination.
Anti-discrimination laws: Termination cannot be based on status alone (e.g., disability, HIV status, pregnancy). Decisions must rest on work-related medical unfitness as certified by a public health authority and the six-month incurability standard.
Persons with Disability (PWD) protections: Provide reasonable accommodation where feasible (e.g., transfer to a safer role), unless it imposes undue hardship.

Due process: how to do it right (employer’s checklist)

Identify the concern Document performance/attendance/safety issues linked to suspected illness, without disclosing medical details beyond what’s necessary.
Referral for medical evaluation
- Obtain employee’s written consent for medical examination and information sharing consistent with privacy rules.
- Arrange evaluation by a competent public health authority.
- Provide the doctor with a job description and workplace exposure/hazard information.
Obtain the certification (prior to termination) The certificate should clearly state:
- Diagnosis (or functional assessment if diagnosis must be limited for privacy);
- That continued employment is prohibited by law or prejudicial to health/safety; and
- That the condition cannot be cured within 6 months even with proper treatment.
Consider alternatives
- If curable within 6 months or manageable with accommodations, do not terminate; consider temporary leave or reassignment.
- If not curable within 6 months and risks persist, proceed to Step 5.
Serve notices (30 days before effectivity)
- To the employee: Written notice specifying authorized cause (disease) and attaching (or summarizing) the public health certification and the effectivity date (≥30 days out).
- To DOLE: File the Establishment Termination Report indicating the authorized cause (disease) and effectivity date.
Compute and prepare separation pay
- At least 1 month pay or 1/2 month pay per year of service, whichever is higher (≥6 months counts as a year).
- Pay on or before the effectivity date; release final pay and standard clearances.
Confidentiality Protect medical data; disclose only to those who need to know to implement the decision.

Employee rights and remedies

Ask for the basis: You may request a copy of the public health certification or at least the specific findings that satisfy the statutory test.
Challenge defects:
- No public health certificate, or certificate is conclusory/insufficient → dismissal is typically illegal.
- Curable within 6 months per medical evidence → termination is invalid.
- No 30-day notice to you and/or no DOLE notice → dismissal may remain valid (if the cause is proven) but you may claim nominal damages for lack of procedural due process.
Reliefs if illegal: Reinstatement with full backwages (or separation pay in lieu if reinstatement isn’t viable), plus damages/attorney’s fees as warranted.
If only procedure was defective (cause is valid): Nominal damages (jurisprudence has awarded ₱50,000 for authorized-cause terminations), plus the statutory separation pay.

Separation pay: how to compute (with example)

Rule: Pay the higher of:

One (1) month of the employee’s last monthly salary OR
One-half (1/2) month salary × years of service (count ≥6 months as a full year)

Example

Last monthly salary: ₱30,000
Years of service: 5 years and 7 months → 6 years (round up)
Option A (1 month): ₱30,000
Option B (0.5 × 6 × ₱30,000): 0.5 × 6 = 3; 3 × ₱30,000 = ₱90,000 Pay ₱90,000 (the higher amount), plus any other lawful final pay components.

Common pitfalls (and how to avoid them)

Relying on a private/company doctor only → Get the public health certification.
Vague certificate (e.g., “not fit to work” without the six-month incurability finding) → Ask the public physician to address the statutory elements explicitly.
Skipping DOLE notice → File the termination report at least 30 days pre-effectivity.
Terminating when condition is curable within 6 months → Consider leave, accommodations, or reassignment.
Disclosing medical details broadly → Limit access; document handling and storage.

Templates you can adapt (plain-language)

A. Referral for Public Health Evaluation (Employer → Employee)

Subject: Referral for Medical Evaluation by Public Health Authority We are referring you for evaluation by a competent public health authority in relation to your ability to safely perform your job. This is to comply with Article 299 (formerly 284) of the Labor Code. Please proceed to: [Public Hospital/Clinic, Doctor’s Name if known] on [Date/Time]. The doctor will receive a description of your job and workplace conditions. Kindly bring a valid ID and prior medical records (if any). The evaluation is at no cost to you.

B. 30-Day Notice of Termination Due to Disease (Employer → Employee)

Subject: Notice of Termination (Authorized Cause—Disease) This is to notify you that your employment will end effective [Date ≥ 30 days from notice] pursuant to Article 299 (formerly 284) of the Labor Code. Based on the certification issued by a competent public health authority dated [Date], your condition [i] makes continued employment prohibited by law/prejudicial to health and [ii] cannot be cured within six (6) months even with proper treatment. On your last day, we will release your separation pay of [Amount], whichever is higher between one month pay or one-half month pay per year of service. Please coordinate with HR for clearance and final pay.

C. DOLE Establishment Termination Report (key items to include)

Authorized cause: Disease (Art. 299/old 284)
Employee details, position, effectivity date
Public health certification date/issuing office
Separation pay formula and amount

Frequently asked questions

1) Can the employer terminate immediately for a highly contagious disease? No. The public health certification and 30-day notices are still required. In practice, the employee can be excused from reporting to work (for safety) during the notice period; wages during that period are generally due only if work is rendered or if company policy/CBAs provide otherwise.

2) Can the employee refuse a public medical exam? You may withhold consent to a particular doctor, but outright refusal to cooperate with a reasonable evaluation (needed to comply with law) can expose you to discipline for insubordination. A practical compromise is to agree on a government facility/physician.

3) Must the employer try to transfer the employee to another job? The statute doesn’t expressly require it, but employers are encouraged—consistent with OSH duties and anti-discrimination norms—to consider accommodations or reassignment where feasible, especially when the condition is temporary or manageable.

4) What if the public health certificate later proves wrong? If termination was made in good faith based on a proper certification and due process, the dismissal is generally upheld. If the certificate was absent or deficient, dismissal is typically illegal.

5) Are benefits like SSS sickness or PhilHealth relevant? Yes—separate from termination rules. An employee undergoing treatment may claim SSS sickness benefits and PhilHealth coverage where applicable. These do not substitute for, or excuse, the legal requirements for termination due to disease.

Takeaways

Employer: Secure the public health certification first, serve 30-day notices (employee & DOLE), and pay the correct separation pay. Consider accommodations if the condition is curable within 6 months.
Employee: You can ask for the medical basis, challenge procedural or substantive defects, and seek appropriate reliefs if the law wasn’t followed.

If you want, I can turn the templates into editable Word/PDF forms and a one-page checklist you can use internally.