Fill in the [brackets]
Subject: Medical certificate request for Work and Income
Dear Dr [Name] / Practice team, I would like to book an appointment to discuss a medical certificate for Work and Income. I lost my job on [date] and my [condition / injury] affects my ability to [work / look for work / do [type] work]. I am applying for [Jobseeker Support - Health Condition or Disability / a deferral of work obligations]. Work and Income needs a medical certificate that states: - My diagnosis or condition. - How long it is expected to last. - What I can and cannot do, including any reduced hours or hours of work. - The date it started. I will bring the form from Work and Income [if I have it]. Please let me know the cost and how long the form takes. If I cannot afford the fee, I would like to talk to you about options. Thank you, [Your name] [DOB, NHI if known, phone]
Tips
- Ask Work and Income whether they will cover the cost of the certificate or the doctor's visit, and about the Disability Allowance for ongoing health costs. Check the current rules with them.
- Use the Work and Income form if they gave you one; otherwise ask your doctor to write the required details.
- For mental-health reasons, you do not need to share more than is necessary. A certificate can state your capacity without full details.
- If you can work some hours, the certificate can say so. This is fine.
- Healthline (0800 611 116) is free if you cannot get an appointment quickly.
General information, not legal advice. Keep a copy of everything you send. Spotted something out of date? Email help@unemployed.nz.