Stress Leave in Ontario: How It Works and How Therapy Fits

Stress leave in Ontario is time off work for stress-related health reasons, usually backed by a note from your doctor or nurse practitioner. There's no single stress leave law. Instead, you may be covered by job-protected sick days or an unpaid leave of up to 27 weeks. Workplace disability benefits and up to 26 weeks of EI sickness benefits can help with income. Therapy can support your recovery and help you plan your return.

Last reviewed October 2026

Maybe you're reading this at your desk late at night, or in your car before a shift you're dreading. Taking time off for stress can feel like a big, confusing step. Here's how it works in Ontario, step by step, and where therapy fits in.

When should you consider stress leave?

It may be time to talk to your doctor about time off when stress is affecting your health, your safety, or your ability to do your job. Another sign is when weekends no longer help you recover. Common signs include:

• You're exhausted most days, even after a full night's sleep.
• You're making mistakes at work that you wouldn't normally make.
• Headaches, an upset stomach, or a tight chest come and go with your workweek (American Psychological Association).
• Dread about work spills into your evenings and weekends.
• You're leaning on alcohol, food, or your phone just to get through the day.

If several of these sound familiar, take them seriously. At Trillium, our therapists often work with stress and are Registered Social Workers (RSWs) and Registered Psychotherapists (RPs) who support people before, during, and after time off work. You can meet them on our stress therapy page.

So how do you actually go on leave?

How do you go on stress leave in Ontario?

Most people follow the same basic steps. You don't have to do them all in one day.

1. See your doctor or nurse practitioner. Describe what's been happening at work and at home, including your sleep, mood, and any physical symptoms. They decide together whether you're medically unable to work and for how long.
2. Tell your employer. Let them know before your leave starts, or as soon as you can after. Tell them in person or by phone, but a short email also gives you a record.
3. Share what's needed, not your whole story. Your employer can ask about your limits and when you expect to return. They generally don't have the right to know your diagnosis or treatment (Ontario Human Rights Commission).
4. Check your benefits. Look up sick pay, short-term disability, and therapy coverage in your benefits booklet, or ask HR.
5. Apply for income support if you need it. If you don't have paid sick leave, apply for EI sickness benefits soon after your last day of work.
6. Keep copies of everything. Save notes, forms, emails, and dates in one folder.

Who can sign a stress leave note in Ontario?

A note for stress leave usually comes from your doctor or nurse practitioner. For EI sickness benefits, you need a medical certificate signed by your treating medical practitioner. You may be asked to send it with your application. If not, keep it for six years (Government of Canada).

For Ontario's longer unpaid leave, the certificate must come from a physician, registered nurse, or psychologist. In Ontario, that includes psychiatrists and nurse practitioners (Government of Ontario).

Therapists can't sign these notes. In Ontario, Registered Social Workers and Registered Psychotherapists can't diagnose. What a therapist can do is support you through the whole process. With your consent, they can also share how you're doing with your doctor.

Short absences work differently. Since October 28, 2024, employers can't require a medical note for sick days under Ontario's Employment Standards Act. They can still ask for other evidence that's reasonable in the circumstances. They can also ask for medical documentation for workplace accommodation or a return-to-work plan (Government of Ontario).

How long can you be on stress leave in Ontario?

There's no single limit, because stress leave is a mix of separate rules. Some protect your job. Others replace part of your pay. Many people use more than one at the same time.

The long-term illness leave is newer. It came into effect on June 19, 2025, and covers up to 27 unpaid, job-protected weeks for a serious medical condition (Government of Ontario). If you need more time or changes to your job, your employer also has a duty to accommodate you. That duty goes up to the point of undue hardship (Ontario Human Rights Commission).

In the end, your doctor or nurse practitioner decides how long you're medically unable to work. Many people return in stages, with fewer hours or lighter duties at first.

Is stress leave paid in Ontario?

Job-protected leave under Ontario's Employment Standards Act is unpaid. Your income usually comes from one or more of these:

Workplace sick pay and disability insurance

Many employers offer paid sick days, short-term disability, or long-term disability through a group plan. Waiting periods, forms, and payment amounts vary by plan, so check your benefits booklet or ask HR. The same plan may also cover therapy with an RSW or RP.

EI sickness benefits

If you can't work for medical reasons, EI sickness benefits can pay 55% of your earnings, up to $729 a week, for up to 26 weeks (Government of Canada). Apply as soon as you stop working. Applying more than 4 weeks after your last day may mean losing benefits (Government of Canada).

WSIB for work-related mental stress

If a substantial work-related stressor, such as workplace harassment, was the main cause of your stress, you may be able to file a WSIB claim for chronic mental stress. WSIB needs a diagnosis from a physician, nurse practitioner, psychologist, or psychiatrist. It generally doesn't cover stress caused by your employer's decisions about your work, such as workload changes, discipline, or termination (WSIB).

Can your employer fire you for taking stress leave?

Ontario's Employment Standards Act says employers can't threaten, fire, or penalize you in any way for taking or planning to take sick leave (Government of Ontario). Human rights law also protects people with mental health disabilities at work.

Here's what your employer can usually ask for, and what they generally can't:

• They can ask: that you have a medical condition, what your limits are, what accommodation you need, and when you expect to return.
• They generally can't ask: your diagnosis, symptoms, cause, or treatment, unless it's clearly needed to accommodate you (Ontario Human Rights Commission).

If you think your rights aren't being respected, an employment lawyer or the Ontario Ministry of Labour can explain your options. A therapist can help you prepare for those conversations, but can't give legal advice.

What can you do on your own while you decide?

You don't have to sort everything out at once. A few small steps can take some pressure off:

• Write down what's been hardest. Specific examples help your doctor, your therapist, and any accommodation talk with your employer.
• Notice your patterns. Track your sleep, mood, and energy on workdays and days off for a week or two.
• Protect your basics. Regular sleep, healthy meals, exercise, and time with people who help you cope can steady you (National Institute of Mental Health).

It may be time to talk to a professional if you're struggling to cope, if your symptoms won't go away, or if stress is getting in the way of everyday life (National Institute of Mental Health). If you're having thoughts of harming yourself, use the crisis resources at the end of this page.

How do you return to work after stress leave?

Going back usually works best as a plan, not just a date. Your doctor or nurse practitioner can help you decide when you're ready. Some people start with shorter days or lighter duties, if their doctor and employer agree.

If you were on Ontario's long-term illness leave, you have the same rights as someone coming back from pregnancy or parental leave (Government of Ontario). In most cases, that means your old job back at the same pay or more. If your old job no longer exists, you may be entitled to a comparable one (Government of Ontario).

Your employer also has a duty to accommodate a mental health disability, short of undue hardship. That can include modified job duties, a flexible schedule, different supervision arrangements, or changes to breaks (Ontario Human Rights Commission).

A few things can make the first weeks easier:

• Meet before your first day. Agree on your hours, your duties, and who you'll check in with.
• Get your limits in writing. A short note from your doctor about what you can and can't do yet helps the accommodation talk.
• Keep your first two weeks light. Protect your sleep and keep evenings free where you can.
• Keep your support going. Staying in therapy for the first few months back helps you catch old patterns early.

How can therapy help during and after stress leave?

Therapy gives your time off a direction. Instead of resting and hoping the stress passes, you look at what led you here. Then you build a plan for going back.

That plan matters. A study of people with burnout found that therapy focused on the work situation helped people get back to work sooner than standard CBT. It included looking at the job's pressures and building a return-to-work plan (Demerouti et al., 2021).

Depending on where you are, therapy might focus on:

• Early in your leave: rest, sleep, and calming a stress response that's been running for months.
• In the middle: understanding the patterns that kept you going past empty, such as perfectionism or trouble saying no.
• Before you go back: a gradual return plan, what to ask for in accommodations, and the boundaries you want to keep.
• After you're back: spotting early warning signs so you can adjust sooner next time.

If your leave is mostly about exhaustion and feeling detached from your job, our burnout therapy page explains how recovery from burnout works.

What does getting support for stress leave look like at Trillium?

Our therapists are Registered Social Workers (RSWs) and Registered Psychotherapists (RPs) who work with people navigating time off work, burnout, and the return afterward. When you contact us, our intake team will listen to what you're looking for and help match you with a therapist who feels like a good fit.

You can meet in person in Waterloo or connect online from anywhere in Ontario. You'll find details about fees, insurance, our current team, and what to expect in your first sessions on our stress therapy page.

This guide covers Ontario's Employment Standards Act, which applies to most people working in Ontario. If you work for a federally regulated employer, like a bank, airline, or telecom company, the Canada Labour Code applies instead. It gives up to 10 days of paid medical leave a year and up to 27 weeks of unpaid medical leave (Government of Canada). Your union contract or workplace plan may give you more. Rules can change, so check the official pages linked here, and talk to HR or an employment lawyer about your own situation.

Frequently asked questions

Can a therapist put me on stress leave in Ontario?

No. Registered Social Workers and Registered Psychotherapists can't diagnose, so the medical note or certificate comes from your doctor or nurse practitioner. A therapist can support you through the leave and help you plan your return. With your consent, they can also share updates with your doctor.

Is stress leave paid in Ontario?

It depends on your situation. Job-protected leave under Ontario's Employment Standards Act is unpaid. EI sickness benefits can pay 55% of your earnings, up to $729 a week, for up to 26 weeks. Many employers also offer paid sick days or short-term disability through a group plan, so check your benefits booklet or ask HR.

How long can you be on stress leave in Ontario?

There's no single limit. Most employees get up to 3 job-protected sick days a year. After 13 straight weeks with an employer, you may also qualify for up to 27 weeks of unpaid, job-protected long-term illness leave with a certificate. EI sickness benefits last up to 26 weeks, and workplace disability plans set their own timelines.

Do I have to tell my employer my diagnosis?

Generally, no. Your employer can ask that you have a medical condition, what your limits are, and when you expect to return. Under Ontario human rights policy, they generally don't have the right to know your diagnosis, symptoms, or treatment unless it's clearly needed to accommodate you. For Ontario's long-term illness leave, the certificate only has to say your condition is serious and how long you'll be off. It doesn't have to name the condition (Government of Ontario).

Should I start therapy before going on stress leave?

If you can, it often helps to start early. A therapist can help you think through whether time off is right for you, prepare for the talk with your doctor, and make your leave more restful. You don't need to be on leave, or have a note, to book a consultation.

Will my benefits cover therapy while I'm on stress leave?

Many extended health plans cover therapy with a Registered Social Worker or Registered Psychotherapist, but it isn't covered directly by OHIP. Ask your plan administrator whether your coverage continues during your leave, and how much is left for the year.

If stress has reached the point where you're thinking about time off, you don't have to sort it out alone. A therapist can help you recover, understand what got you here, and plan a return you can keep up.

Learn more about stress therapy at Trillium Counselling →