Can a Manager Overrule a GP Fit Note?
Are you confused about the legal status of the fit note? Or do you have a letter from a Specialist suggesting something weird for one of your workers? This is one of the most asked questions I hear. Can a Manager overrule or ignore suggestions from the worker’s doctor?
Employees are often suspicious when OH asks for GP or specialist reports, thinking they are not believed —or worse, not telling the truth about their health.
Why Do You Want a Letter from the GP?
Occupational Health (OH) services can ask for a GP or specialist report for a variety of reasons, such as:
- Asking a doctor for confirmation of the medical condition
- Investigating the progress of illness
- Confirming facts about a medical situation
- Informing the GP about a work situation on an employee’s health and asking advice
- Discussing ill-health retirement reasons
- Investigations before starting work, especially in jobs such as working with children or vulnerable adults
- As part of company rules (e.g., dismissal due to ill health)
Doctors and specialists will not release any information unless their patient has given permission for the information to be shared. This is called giving consent, which is a legal requirement; remember that the employee cannot be forced to give consent.
It is clear from advice and for purely practical reasons, that fit notes and/or specialist reports with their recommendations are not legally binding on the employer. Often a manager must overrule as the recommendations may be impossible.
Guidance from the Department of Health agrees and gives advice to employers:
The assessment about whether your employee is not fit for work or may be fit for work (and any other advice in the fit note) is classed as advice, and it is for employers to decide whether to accept it. Occasionally, you may believe that your employee is not fit for work when they have been assessed as fit for work by their doctor, or you may think that your employee could do some work when they have been assessed as ‘not fit for work’ by their doctor….. In situations like this, you as the employer are within your rights to gather other evidence about your employee’s fitness for work from other doctors or healthcare professionals. You can choose to give this other evidence precedence over the advice in the fit note.
Why Not Send GP or Specialist Reports to HR/Management?
Why can’t Managers and HR write to GP’s is another question.
It’s because they do not have medical training, so are unlikely to have a lot of experience with people working or stopping work due to health conditions. Many form opinions from personal experience, media, prejudice and myths. Some will Google health conditions. Here, you find extraordinary tales of horror and treatment failures. Health is a personal thing and everybody is different. Just because someone had the wrong leg amputated – it is unlikely to happen to you too. People exaggerate and catastrophize their health especially when writing for a blog.
This approach has no place when deciding a person’s livelihood and how best to help sick or ill workers. Health issues should be dealt with on an individual basis, using tried and tested methods. Don’t randomly Google health problems – go to responsible sites such as the NHS Choices website. Please do not visit unethical or personal view websites when looking for health advice.
Occupational health professionals know the workplace. They know what is achievable and find ways through this delicate maze for the benefit of the worker and the workplace. They really are best placed to overrule a fit note, if necessary.
Doctors and specialists know they are writing to health professionals and so can write without the worry of prejudice by the reader. This is why the report is not sent directly to HR or management. There is also the matter of confidentiality. Other health professionals keep to their professional code of conduct to keep health details secret from others.
Note that managers and HR can ask for reports from medical professionals (with consent from the person). However, the report coming back is for a lay person. The contents then, take on a whole different tone. The GP is much stronger with the advice and really specific on what the patient requires, even though it may not be available. Writing to another health professional, the GP is less prescriptive and able to give options or leaves it to the medical person in the company to make the best decision.
So yes, a Manager overrules many recommendations. At the end of the day, it is their business and s/he has responsibility for the worker under the law.