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Sick Leave Application Form (Ghana)

Sick Leave Application Form (Ghana)

Sick Leave Application Form

SICK LEAVE APPLICATION FORM — [Employer Name]

Date of Application: [Application Date]

Submitted to: [Supervisor Name], Human Resources / Line Manager, [Employer Name], [Employer Address]

1. Employee Details

1.1

Employee Name: [Employee Name]

1.2

Employee ID: [Employee ID]

1.3

Job Title: [Job Title]

1.4

Department / Unit: [Department]

2. Sick Leave Request

2.1

I, [Employee Name], hereby apply for sick leave under Section 58 of the Labour Act 2003 (Act 651) of the Republic of Ghana.

2.2

Period of absence: [Leave Start Date] to [Leave End Date], being [Number of Days] working day(s).

2.3

Nature of illness or injury (if disclosed): [Nature of Illness]. I understand that any medical information I provide will be processed by my employer in accordance with the Data Protection Act 2012 (Act 843) and used only for the purpose of processing this leave application.

2.4

Medical Certificate: [Medical Certificate].

2.5

Expected return-to-work date: [Expected Return Date].

2.6

I confirm that the sick leave applied for is within my contractual sick leave entitlement under my employment contract and the Labour Act 2003 (Act 651), or, where it exceeds my entitlement, I understand that additional leave may be unpaid or subject to my employer's discretion.

3. Manager / HR Approval

FOR COMPLETION BY LINE MANAGER / HUMAN RESOURCES:

Application: Approved / Declined (circle as applicable)

Comments / Conditions: _______________________________________________

Approving Manager Name: _________________________ Date: ______________

Signature: _________________________

Employee Signature

I confirm that the information provided in this Sick Leave Application Form is true and accurate.

Employee

________________

Signature

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Sick Leave Application Form (Ghana)?

A Sick Leave Application Form in Ghana records the particulars needed to apply for the registration, permit or approval it concerns.

The Sick Leave Application Form (Ghana) is governed primarily by the Labour Act 2003 (Act 651), which is the principal statute regulating employment relationships in Ghana. Section 58 of the Labour Act 2003 (Act 651) provides that a worker is entitled to sick leave on full pay where the worker is certified by a registered medical practitioner as being incapable of work due to illness or injury. The duration of paid sick leave to which a worker is entitled under Act 651 is prescribed in the worker's contract of employment or in any applicable collective bargaining agreement registered with the National Labour Commission (NLC).

The National Labour Commission (NLC), established under the Labour Act 2003 (Act 651), is the principal body responsible for the settlement of labour disputes in Ghana. The NLC registers collective bargaining agreements and receives complaints from workers and employers about the breach of labour obligations, including the unlawful denial of sick leave entitlements. The Fair Wages and Salaries Commission (FWSC), established under the Fair Wages and Salaries Commission Act 2007 (Act 737), sets minimum wages and conditions of service for certain categories of workers in Ghana.

The Workmen's Compensation Act 1987 (PNDCL 187) governs compensation for workers who suffer injury or illness arising from or in the course of employment. Where the illness or injury giving rise to a sick leave application is work-related, the worker may be entitled to compensation under PNDCL 187 in addition to sick leave pay under the Labour Act 2003 (Act 651). The Social Security and National Insurance Trust (SSNIT), established under the National Pensions Act 2008 (Act 766), administers Ghana's national pension scheme and certain work-related disability benefits.

The Data Protection Act 2012 (Act 843) and the Data Protection Commission (DPC) regulate the processing of personal data in Ghana, including medical information contained in sick leave applications and medical certificates. Employers who collect and store employee medical data must comply with Act 843, including the requirement to process personal data only for a specified and legitimate purpose and to implement appropriate security measures to protect the data.

The Electronic Transactions Act 2008 (Act 772) recognises electronic signatures and records. A Sick Leave Application Form submitted and approved electronically through a compliant human resources management system is legally valid under Section 8 of Act 772. Disputes about sick leave entitlements in Ghana may be referred to the National Labour Commission (NLC) under the Labour Act 2003 (Act 651) or litigated before the High Court (Labour Division) in Accra.

The legal framework governing the Sick Leave Application Form (Ghana) in Ghana draws on several key statutes and regulatory bodies. Under the Labour Act 2003 (Act 651), the National Labour Commission (NLC) adjudicates workplace disputes in Ghana. Section 12 of the Labour Act 2003 requires written terms of employment. The National Pensions Act 2008 (Act 766) mandates employer contributions to the Social Security and National Insurance Trust (SSNIT). The Ghana Revenue Authority (GRA) administers PAYE under the Income Tax Act 2015 (Act 896). The Labour Division of the High Court hears employment appeals. Parties executing a Sick Leave Application Form (Ghana) in Ghana should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Labour Act 2003 (Act 651) s.58 sets the foundational requirements.

When Do You Need a Sick Leave Application Form (Ghana)?

A Sick Leave Application Form in Ghana is needed whenever an employee is unable to attend work due to illness or injury and wishes to formally apply for sick leave under their employment contract and the Labour Act 2003 (Act 651).

A Sick Leave Application Form is required when an employee of a company incorporated under the Companies Act 2019 (Act 992) or a public sector institution falls ill and needs to notify their employer of the expected period of absence. Formal notification through a written form creates a record that protects both the employee and the employer.

A Sick Leave Application Form is needed when an employee has been absent from work for more than one day due to illness and the employer's internal policy requires a formal application supported by a medical certificate from a registered medical practitioner. Hospitals and clinics registered with the Ghana Health Service (GHS) and the Ghana Medical and Dental Council issue medical certificates that are recognised for this purpose.

A Sick Leave Application Form is required when an employee wishes to apply for extended sick leave beyond the paid sick leave entitlement under their employment contract or the applicable collective bargaining agreement. Extended leave may be unpaid or may require approval from the employer's human resources department and the National Labour Commission (NLC).

A Sick Leave Application Form is needed when a worker seeks to access disability benefits or compensation under the Workmen's Compensation Act 1987 (PNDCL 187) for a work-related illness or injury. The form documents the period of incapacity and supports the worker's claim for compensation through the Department of Factories Inspectorate of the Ministry of Employment and Labour Relations.

A Sick Leave Application Form is required in public sector employment in Ghana — including the Ghana Education Service (GES), the Ghana Health Service (GHS), and other government agencies — where specific leave regulations apply to civil servants under the Civil Service Act 1993 (PNDCL 327) and the applicable conditions of service.

Employers in Ghana should maintain sick leave application forms as part of their human resources records to demonstrate compliance with the Labour Act 2003 (Act 651) in the event of a labour dispute referred to the National Labour Commission (NLC).

What to Include in Your Sick Leave Application Form (Ghana)

A valid Sick Leave Application Form in Ghana under the Labour Act 2003 (Act 651) and applicable employment law must contain the following essential elements.

Employee Details: The employee's full name, employee identification number, department or unit, job title, and direct supervisor's name. These details identify the employee within the employer's human resources records and route the application to the correct approving manager.

Employer Details: The name of the employing company or organisation, its registered address, and the name and title of the human resources manager or approving officer to whom the application is addressed. Where the employer is a public sector institution, the relevant ministry or agency should be identified.

Dates of Absence: The first date of absence, the expected last date of absence, and the total number of working days of sick leave requested. Accurate dates are essential for payroll processing and for determining whether the leave falls within the paid sick leave entitlement under Section 58 of the Labour Act 2003 (Act 651) or requires additional approval.

Nature of Illness (Optional): A brief description of the illness or injury — for example, malaria, injury, or post-operative recovery — or a statement that details will be provided in the accompanying medical certificate. Where an employee chooses not to disclose the nature of their illness, the employer must respect the employee's privacy under the Data Protection Act 2012 (Act 843).

Medical Certificate: Where required by the employer's policy or the employment contract, a certificate from a registered medical practitioner affiliated with a hospital or clinic registered with the Ghana Health Service (GHS) or the Ghana Medical and Dental Council, confirming the employee's incapacity for work and the expected duration of the incapacity. Medical certificates are required for sick leave of more than two consecutive working days in most Ghanaian employment contracts.

Entitlement Declaration: A statement by the employee confirming that the leave applied for is within their contractual sick leave entitlement or, where it exceeds the entitlement, an acknowledgment that additional leave will be unpaid or subject to the employer's discretion.

Return-to-Work Date: The date on which the employee expects to return to work, enabling the employer to plan for the employee's absence and arrange cover if necessary.

Employee Signature and Date: The employee's signature and the date of submission of the application. For electronic submissions through a human resources management system, an electronic signature compliant with the Electronic Transactions Act 2008 (Act 772) is sufficient.

Manager Approval: Space for the direct supervisor or human resources manager to approve or decline the application, with their signature, date, and any conditions attached to the approval — such as a requirement to submit a medical certificate on return to work.

HR Records: The employer must retain sick leave applications as part of the employee's personnel file in compliance with the Data Protection Act 2012 (Act 843), the Labour Act 2003 (Act 651), and applicable records retention policies. Forms-legal.com provides this Sick Leave Application Form template as a starting point for employers and employees in Ghana.

Additional compliance elements for a Sick Leave Application Form (Ghana) used in Ghana include: Under the Labour Act 2003 (Act 651), the National Labour Commission (NLC) adjudicates workplace disputes in Ghana. Section 12 of the Labour Act 2003 requires written terms of employment. The National Pensions Act 2008 (Act 766) mandates employer contributions to the Social Security and National Insurance Trust (SSNIT). The Ghana Revenue Authority (GRA) administers PAYE under the Income Tax Act 2015 (Act 896). The Labour Division of the High Court hears employment appeals. Forms-legal.com provides this template as a starting point for Ghana-compliant documentation.

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Sick Leave Application Form (Ghana) (Ghana) [Legal document template]. Forms Legal. https://forms-legal.com/ghana/employment/forms/sick-leave-application-ghana

MLA

"Sick Leave Application Form (Ghana) (Ghana)." Forms Legal, 2026, https://forms-legal.com/ghana/employment/forms/sick-leave-application-ghana.

BibTeX
@misc{formslegal-sick-leave-application-ghana,
  author       = {{Forms Legal}},
  title        = {Sick Leave Application Form (Ghana) (Ghana)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/ghana/employment/forms/sick-leave-application-ghana}},
  note         = {Free legal document template}
}

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Frequently Asked Questions

Statute-referenced template — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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