Occupational health role in absence management image
Occupational health role in absence management

Occupational Health Role in Absence

Many workers worry if they’re asked to go to occupational health after they’ve been off sick. They’re not sure why they should go because their GP is looking after them very nicely thank you. Or the day off was just a one of – not likely to happen again.  A random thing.  Gone, forgotten.  But is it?

Maybe, you think, my Manager is checking up on me to make sure I was/am genuinely ill, or they don’t trust me or my GP.

The Two Types of Sickness Absence

Neither of the above statements is true; well not entirely. Occupational health’s role in absence management depends on the kind of absence – whether short-term (the odd day off here and there) or long-term absence when you have been away from work for more than four weeks.

These two types of absences are dealt with quite differently by the Manager and each brings their own issues.

Differences Between Short and Long Term Absence

Apart from the number of days and the duration of absence of the two types of absence, there are other issues which make Manager’s keen to get more medical information.

Short-term absences (STA) is more disruptive to an organisation than long-term absence (LTA); even though the number of days off sick for long-term absence can go on for a year or more sometimes.

This article looks at why and how occupational health becomes involved in both types of absence and what their goal is in both.

Short-Term Absence Issues

  • STA is unplanned
  • Workers can call in sick any day
  • Workers are self-diagnosing a health problem
  • Just think if everyone called in sick one day – what would you have to do to keep your department going?
  • Others tend to copy this type of behaviour
  • Workers who have regular days off sick get little sympathy from the rest of the team
  • Most companies offer sick pay and the fraudulent employee is getting money for nothing

Long-Term Absence Issues

  • Managers can often get a temporary replacement for the worker
  • Managers get Fit Notes from a GP which means you have seen a Doctor
  • There will be a reason for absence on the Fit Note which gives the Manager some idea of what the problem is and how long the illness is likely to last; this allows Managers to get extra cover
  • There are no last-minute surprises with an employee phoning in every day.  It is a real panic sometimes to cover that day’s workload at short notice
  • Others in the team feel a sympathy for those who have a long-term illness
  • Sick pay eventually runs out and there is no real cost to keeping a sick employee on the books

So is your appointment with occupational health for a short-term recurring absence issue or are you off long-term sick?

Why Am I Going to Occupational Health?

Before going to occupational health, your Manager should discuss the reasons for the visit and explain the advice needed.  Sometimes you can avoid the need to attend by answering the question directly yourself, or perhaps correcting a misunderstanding.  It may be the first time your Manager has mentioned the problem due to embarrassment or communication difficulties.  Maybe your Manager doesn’t understand how your health problem could affect your work? After all, everyone is different.

Enlisting the help of occupational health gets this sorted out quickly.

1.  Occupational Health and Short-Term Sickness Absence

The most common reason for a STA referral to occupational health is due to you hitting a target set by your Company as being in the ‘not acceptable now’ box.  Have you had more than three absences in three months? Or perhaps you use an absence monitoring system like the Bradford Index and triggered an investigation point? Do you often take off a Monday or a Friday?  Or perhaps have an extra day off after your holiday?  Was your last absence after a national event like your football team winning an important match?

These absences get noticed and counted.

The medical team in occupational health will help both you and your Manager, by trying to figure out if there is a health condition affecting your attendance at work. And, if so, giving you advice on how to deal with the health issue.

The occupational health interview will go something like this:

  • First, you have an opportunity to discuss all your recent absences due to illness.  For example, you have been off sick on 1st May, 3rd May, 15th May, 1st June, 17th June et cetera.
  • You’ll be asked about each absence in turn:
    What were you off with on May 1st? Then May 3rd?

    It’s important that you remember accurately exactly what happened on those dates.  It’s most unusual not to remember the details of a real sickness episode.  So tell the interviewer your symptoms on the day and how they affected you.  Did you see the Doctor? Has this happened before? Was it something you ate?  How often does it happen?  And so on…

    If you get the same illness, again and again, the occupational health nurse or doctor will make suggestions about how you can avoid having any days off in the future. For example, if you keep getting headaches, they will check your blood pressure and eyesight and talk about drinking plenty of water etc. Or what about going to your doctor for stronger headache tablets or perhaps being referred to a migraine specialist. You might get information leaflets and website addresses for you to find out more about how to avoid headaches in the future.

  • If all your absences are for different reasons, such as headaches, diarrhoea, a cold, bad back, etc., then there is no link between the absences.  The absences are random. Which is not good news for you; there is little in the way of treatment or advice available to help improve your attendance.
  • With no link to each absence, the next area to explore is your drive to come to work. Why is your attendance so poor? Why don’t you want to come to work? Lots of people come to work with a cold or a headache? You turn over and go to sleep.  You haven’t even been to the Doctor to find out if you have a health problem.  Or, maybe you have a problem at work?

Work Problems as a Reason for Absence

Answering questions about work problems are difficult.  Many people keep quiet about being bullied or harassed.  Or their stress and an overwhelming workload.  Even worse, is admitting to having home problems like your marriage breaking up or problems with a child or ageing parent.  But, do not be shy.  Tell the occupational health adviser why you don’t come to work.  Seriously, we have heard it all before.  They may be able to suggest some options for you.

Sometimes the workplace helps by altering working hours and, of course, dealing with any bullying issues. If there are work-related elements which are keeping you away from work, then you need to tell the adviser so Management can help you.

Bear in mind; your Manager is under no obligation to deal with domestic issues, but if a Manager has asked the question of how to help improve attendance then s/he should try to help you – otherwise why ask? Well, that’s my philosophy.

Doesn’t always work.

Summary – What Does Occupational Health Say to My Manager

Occupational health sends a report of your interview back to your Manager with one of two comments:

1.  There is an underlying cause for the level of absence and advice has been given to the employee (attendance should improve now),  or

2.  There isn’t an underlying cause, and no medical information or intervention can help (attendance level likely to stay the same)

Many OH services offer you the option to have a copy of the report too. Always take that option.  You need to know the contents of the report and, occasionally there are factual mistakes which might need correcting.

Purpose of the Appointment

The occupational health interview is there to investigates all the following medical issues in confidence:

  • An underlying disease requiring treatment
  • A domestic issue preventing you coming to work
  • Workplace issues affecting your attendance

The appointment with occupational health has, in effect, ruled out any health problems caused or made worse by work or covered by legislation; such as The Equality Act 2010.  The whole process is part of your Company rules too; so needed, to keep consistency and fairness across the workforce.

The sting in the tail is that if casual days absence continues after your Manager has sorted out the issues in the occupational health report; the only option is formal disciplinary rules and ultimately, if there is no improvement, you could be dismissed.

2.  Occupational Health and Long-Term Sickness Absence

Occupational health plays an entirely different role when someone is off long-term sick, that is, four weeks or longer, with a health problem. Here, they play the role of an enabler; removing barriers to returning to work and helping the sick employee return safely.

The Process of Referral to Occupational Health

  • Your Manager needs more information about your health and when you are likely to come back to work.  Fit notes usually cover four weeks absence at a time, so a referral helps your Manager make plans to cover for your absence and return to work.
  • Many discussions about long-term sickness absence happen over the phone in the first instance; starting with your Manager asking you to talk with occupational health.  If you are in agreement, occupational health calls and talks about your health situation. The early call gives you a chance to get to know your case worker and opens up the communication; so that when you are ready to return to work, occupational health has an idea of your job and your capabilities.  They  work with your Manager to remove barriers to your come back and may suggest:
    • Rehabilitation programmes
    • Regular visits to work before returning
    • Change of job temporarily as you build up your strength
    • Reduced hours
    • Working from home
  • As the time nears for you to return, the frequency of contact increases.  Finally ready, you have a Fit Note from your GP, and now occupational health works with you and your Manager to make it easy for you as possible. Safety and HR will check risk assessments and deal with pay issues.

Reports from your GP and specialist

Occasionally your company requires information about your ability to come back to your job.  Maybe clarification about an aspect of your work. In such cases, occupational health may ask a report from your Specialist Doctor or GP. For this, you will need to give permission, called “consent”; a legal form you sign for your doctor to release information to the workplace.

If you have any doubts about allowing this, discuss it with both occupational health and your treating doctor.

To see a standard GP letter that occupational health sends out, go to the link on my website (registration required).


The difference between the two types of absence, short and long-term, are quite distinct.  The occupational health role in absence is far different too.

For STS, the interview with occupational health covers reasons for absence and how to improve attendance.  For LTS, it’s about planning the workforce needs and enabling the return to work, quickly and safely.

Both long and short-term absence interviews make sure anyone truly sick has access to professionals who give workers the best possible chance of coming to, and staying in their job, as long as they are fit and able.

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What is Occupational Health? Video