fitness for work medical assessments

Sick Absence and Rehabilitation

We can help employers manage this vitally important issue proactively in a robust but fair way.

Having assessed the individual’s history, our clinicians will advise you on the possible causes of the absence. We consider both medical and non-medical issues for absence and help your employee deal appropriately with their health situation advising the need for appropriate or additional treatment.

If there appears to be a work related cause we can help the employer identify this and deal with the situation appropriately.

We will liaise with the general practitioner or medical specialist, physiotherapist or counsellor as appropriate, ensuring early referral to these practitioners and preventing unnecessary delays in diagnosis, treatment and ultimately return to work.

For those with general medical problems, as well as ensuring adherence to prescribed treatment, we will advise about the prognosis and design a return to work programme assisting overall rehabilitation. This can include an earlier return to work. Will also advise on ‘adjustments or accommodations’ with sensible timescales to enable those with medical problems to return to work. Remember it often only requires some basic ‘adjustments’ to the job to help most people back to work sooner rather than later. Read more at the link “Is Work Good for your Health and Well Being”.

We will do this by giving management and the individual clear impartial advice based on medical evidence.

Remaining in employment has established health benefits for most people. There are obvious benefits for your company also. Therefore, a return to work can be used as part of someone’s overall rehabilitation back to better, or even, full health. This should be seen as a ‘win/win’ situation. If, however, a return to work is not a foreseeable outcome, we will also advise you why this is and whether retirement on health grounds may be an appropriate outcome for someone who is permanently unfit for work.


Disability Assessment

‘Disability’ is the reduction or loss of an ability to perform an activity.

It is a practical description of functional effects many medical conditions can cause. However, simply having ‘a condition’ or ‘a diagnosis’, does not necessarily mean someone is disabled.

For those who have a disability, and hence have problems performing certain activities, this can mean problems with standing or sitting for too long, or problems walking or ‘getting about’, difficulty with lifting weights or manipulating things with their hands e.g. a keyboard or tools. It could also be a problem with concentrating on a task or difficulty communicating e.g. speech or hearing or vision.

We as occupational health clinicians have an excellent working knowledge of the relevant disability discrimination legislation – Disability Discrimination Act 2005 (NI), Equality Act (GB) and Employment Equality Act (IRE). With this in mind, we will give you advice about possible adjustments or accommodations that might be needed to accommodate your disabled employee in the workplace.

We can also give you guidance on whether an individual’s disability is likely to fall within the ‘legal’ definition of disability, giving you some idea whether you are likely to be meeting your legal responsibilities or not. (Ultimately, of course, in the UK it is only a relevant legal body which decides this for sure).

We can do this not by disclosing confidential medical details in our report, but by describing what functional difficulties your employee is experiencing and how the job or workplace might be adjusted to overcome these difficulties. Hence, maintaining a valuable member of your workforce in work, when possible.

We work closely with relevant agencies such as RNIB and RNID, as well as the local disablement employment advisors, vocational rehabilitation centres and other relevant bodies as needed in your area.


Pre-employment

Pre-employment assessments can take a number of forms including paper based screening or face-to-face assessments either with an occupational health nursing advisor or occupational health physician.

This depends on your requirements and the nature of the job. We will ensure that your pre-employment health questionnaire is appropriate to the job and not potentially discriminatory. The purposes of pre-employment health screening should be to ensure new entrants into the workforce will be physically and mentally capable of undertaking the role safely without adversely affecting their health or significantly impacting on the health and safety of others in the work environment.

We will advise you with regards the potential effects of known disabilities and indicate possible adjustments.

As well as this, a pre-employment assessment can help establish a baseline for future health surveillance programmes where there are known and significant occupational hazards like noise, vibration or respiratory contaminants. This can help the conscientious employer successfully defend against future litigation.


Pension Assessments

Does an applicant meet the medical criteria for pension benefit?

We already have considerable experience in assessment of these situations. Helping to create and deliver a medical assessment process which is both fair yet robust is our approach in conjunction with pension trustees.

For example, we seek to ensure the diagnosis and prognosis have been properly established, and determine the practical or ‘functional’ implications in the work setting of the condition and, whether these are likely to be permanent. Also whether all appropriate therapy has been considered and reasonable adjustments implemented, are questions we often expect to address.

Pension related benefits will vary in different schemes but include:

  • Sick Pay at Pension Rate
  • Injury caused by work or ‘injury on duty’
  • Medical or dental treatment allowance
  • Early Payment of Preserved Award
  • Ill Health Retirement – own and/or All work

Health Surveillance Assessments

Health Surveillance Programmes (HSPs) are very different from ‘health screening’ programmes.

HSPs may form part of the employer’s duties under relevant legislation in the UK and Eire such as:

  • Management of Health and Safety at Work (1999) Regulations
  • Control of Substances Hazardous to Health (2004) Regulations
  • The Control of Noise at Work Regulations (2005)
  • The Control of Asbestos Regulations (2012)
  • The Safety, Health and Welfare at Work Act 2005 (Eire) including Control of Vibration at Work Regulations 2007

Under the above regulations, having identified which of your employees require to be under health surveillance, we can help you implement the appropriate plan subject to the risk involved. As such, this ultimately depends on the level of risk and does not always from the outset require the input of a doctor. For example, with appropriate training a ‘responsible person’ can be trained to screen for skin disorders in some work environments. Thereafter, referral to a nurse may form the next course of action before any consideration is given to referring for medical input.

Health Surveillance is only one aspect of the hierarchy of control measures you as an employer may wish to consider. It will provide you with objective evidence regarding the effectiveness of the control measures in place or otherwise, by assessing the health of your employees periodically. This helps ensure that work is not damaging their health, first and foremost, and with this not leaving you exposed to the potential legal consequences.

We can help you design health surveillance programmes appropriate to the hazard involved, for example noise, dust, vibration, irritants and allergens and stress. We can also provide appropriate vaccination programmes for example Hepatitis B vaccination which is yet another form of health surveillance.


Periodic (task specific) health assessments

To ensure an individual remains safely fit to undertake their job we provide medicals tailored to the task, and proportionate to the risks involved. For example, assessing the potential for illness or sudden incapacity and, with this, the risks to the health and safety of the employee, colleagues and others. This can include tasks such as forklift truck driving, working at heights and confined spaces, driving (Class 1 and Class 2 license holders), night shift workers, pregnant workers and food handlers.

These assessments are undertaken according to defined protocols and we advise management and the employee regarding fitness for the task with or without adjustments, as required.