How to Get a Medical Certificate (診断書) for Mental Health in Japan
Ask your psychiatrist directly during a consultation: that is how you get a medical certificate (診断書, shindansho), and simple certificates are often ready the same day or within a week. Leave from work, accommodations at school, insurance claims, and subsidy applications all run through a doctor's certificate, and for mental health that is usually the psychiatrist treating you.
When do you need one?
Work leave, benefit claims, and subsidy applications are the usual reasons, along with school and insurance paperwork. The common situations:
- Taking leave from work: a certificate recommending rest for a stated period is the document you submit when you request leave (休職, kyushoku) under your company's rules (details in our leave guide)
- Claiming sickness allowance (傷病手当金, shobyo teatekin): the claim form has a section your doctor completes for each period you claim, and the Japan Health Insurance Association (協会けんぽ, Kyokai Kenpo), the insurer for many company employees, recommends claiming one month at a time
- Applying for support programs: Jiritsu Shien Iryo and the disability certificate each use their own designated certificate format
- School accommodations, insurance claims, and similar paperwork
How do you ask for one?
Say it plainly during a consultation; "I think I need a shindansho for work" is a normal request in a psychiatry clinic. Simple certificates are often issued the same day or within a week; forms with designated formats, such as the sickness allowance form, take longer. Certificates are self-pay documents outside health insurance; the exception is the doctor's section of the sickness allowance form, which is billed through insurance. If you need a certificate in a specific format, bring the form or the requirements with you.
For use outside Japan, ask for a physician's letter in English that summarizes your diagnosis and treatment.
What does it say, and who sees it?
A diagnosis, a recommendation to rest, and the period; your employer sees only the certificate you hand them. The diagnosis is sometimes stated in general terms, discussed with you. The certificate does not describe your history or what was said in sessions, and the medical record behind it stays at the clinic. What an employer can and cannot learn is in our guide to talking to your employer about mental health.
If you are uneasy about a specific diagnosis reaching HR, say so. There is often room in how a condition is described, within what the doctor can certify, and that conversation is a normal part of writing the document.
Can a doctor refuse?
Only with legitimate grounds. Article 19 of the Medical Practitioners' Act obliges a doctor who has examined you to issue a certificate on request unless there are legitimate grounds to refuse. The usual ground is that the doctor cannot certify something they have not clinically established: a first-time visitor asking for a certificate covering the past month, for example. So if you are struggling, get seen early. A doctor who has followed you can document the course of your condition; a doctor meeting you for the first time can only certify what is found that day.
Frequently asked questions
This article is general information, not medical advice for your individual situation. If you're unwell, please see a doctor.
Medically reviewed by our psychiatrist (M.D.). Updated October 16, 2026.