Extend your

Illness Benefit or Medical
Certificate

How it Works

  • PLEASE NOTE - This form is only applicable if you need to extend illness benefit/medical certificate. You must see a GP to receive an initial illness benefit certificate.
  • If you need to extend your cert, you can submit this form and we will contact you if you need to be reviewed by a GP.
  • You may get Illness Benefit from the Department of Employment Affairs and Social Protection (DEASP) if you cannot work because you are unwell.  You must get a medical certificate called a ‘Certificate of Incapacity for Work’ from your GP. Your GP completes the certificate and can submit it electronically through a secure online system. This cert is only required if your illness exceeds your 5-day Statutory Sick Leave entitlements.
  • To open your claim, you can apply online here.
  • Your employer may require you to provide a separate medical certificate ('sick note/work cert' from your GP) when you are on sick leave.
  • For questions regarding the above, please contact us by phone directly on 061-362 903.

Cancel Appointment

Required
Required
Required
Required
Required
DD/MM/YYYY
Required
DD/MM/YYYY
Required
Optional
Required
Required

Sent!

Your request has has been sent.

A member of our team will be in touch soon.

Thank you.

Something went wrong while submitting the form. Please try again or refresh the page and try again.
We are affiliated with