Managers: Questions You Can Ask Occupational Health About Mr Smith

Is Mr Smith Ill?

Have you ever had an employee who is claiming all sorts of illness and ailments?  Or maybe someone who takes a day off at the drop of a hat, leaving you short-staffed and stressed? Or maybe you wonder if someone is well enough to work?  Mr Smith has had these issues – and occupational health (OH) helps every time with managing his situation.

Send Mr Smith to Occupational Health

Manager’s need to ask the right questions of occupational health to get the right help.  If the situation and questions are unclear then the report back from OH may not be what you wanted to know.  To get the right answer you need to ask the right question.

Many times I’ve had a worker arriving in my department, saying his Manager has sent him to me for an opinion.  On what? I’ve had no idea, but guessed it wasn’t about the colour of his shirt.  So I would attempt to find out by questioning the worker, but sometimes I am way off the mark.

So before sending Mr Smith for a medical opinion – why are you sending him to me and what do you want to know?

Here are the 6 most frequent reasons for referral.

1.  Can Mr Smith Attend a Disciplinary Hearing?

Often employees claim that they are unable to attend formal meetings e.g. disciplinary, capability, grievance because of ill health.  The Society of Occupational Medicine recommends that an employee is fit to attend a formal meeting if the The employee is able to:

  • Understand the issues being addressed
  • Distinguish right from wrong
  • Instruct another to represent their own interests (e.g. trade union representative)
  • Understands and follow the proceedings, if necessary with extra time and written explanation

OH follow this guidance when assessing workers and acknowledges it’s in everyone’s best interests to get issues resolved as quickly as possible.

2. How Long is Mr Smith likely to be Off Sick?

The beauty of having access to an OH service is that they know your business well.  They know work and the organisation so, with their understanding of health, able to foresee problems. Especially in areas where particular health problems will be difficult to accommodate. For example, heavy lifting jobs need a robust individual where an office worker or call centre operative may be less effective if they have mental health issues.  This will be significant when predicting a return to work date.

Return to Work Date

For physical problems (such as a broken leg) OH use their experience of the work, people and how new treatments and operations will affect their recovery time.  For mental health issues, this may be more complex but you should get a rough idea of when and how the person can be expected to return to work.

The date of return to work is never set in stone and balances many issues – any of which can change according to the individual’s motivation to return to work and complications of recovery.

The recommendations and advice will come in the form of written report which is discussed with the employee before being sent to management.

For some health conditions, the return to work is dependent on waiting for an operation, counselling or physiotherapy; in which case the employer can offer funding or private health insurance to speed this up and thus help the employee return to work earlier.

Company’s without access to OH services can ask the question of employees themselves or receive a Fit Note from the GP. Bear in mind that both of these options have their own reasons for the answers they give. Neither will fully understand the options available to return to a different or modified job to aid rehabilitation.

It is a well-known fact that returning to work early is sometimes the best possible way of avoiding other health problems associated with isolation and lack of money (mental health issues).  OH works with the person, the company and current medical guidance to give a prediction on when and how the employee is able to return.

3.  Is Mr Smith Fit for his Current Job?

Many people become ill during their working life or change jobs with different physical and mental requirements.  Employers who notice that an individual is not performing their job to the standard required have to decide whether the worker Can’t or Won’t do the job.

The Manager refers workers to OH asking for their opinion on whether the poor performance is due to a health problem.  Mr Smith answers questions about his health by occupational health and taken through relevant health checks to make sure that the result is based on scientific fact and expert opinion and not a Managers idea of why the person cannot do what they should be doing. Occupational Health will then make recommendations to the employer on the findings and suggest possible ways of dealing with the situation that is fair and lawful.

4.  What can we do to help Mr Smith Return to Work?

Employers want employees/workers at work. If they are ill, then they tend to help them return if they can. There are many ways of doing this. However, Managers are sometimes cautious of interfering with medical matters, and if things go wrong with the programme feel they might be blamed for ‘forcing’ the employee back to work too quickly. By asking the question of OH, the employer is exercising caution and getting expert advice. Once you have this you can go ahead with confidence. Hopefully, the person is able to work without risks to health or danger of relapse.

5. Does Mr Smith have an underlying Medical Condition to Account for his High Level of Absence?

The absence levels across in a company can be costly – not only for lost productivity but also to replace the missing worker, missed deadlines, poor customer service and increased pressures on those remaining.  The question from the employer is trying to decide, is whether the person has a genuine illness or is just skiving.

Occupational health will interview the worker and discuss the illness issues, occasionally high absence levels are due to an underlying illness, but often, repeating short-term absence is due to:

  • Childcare
  • Domestic issues
  • Bullying
  • Boredom with the job
  • Not understanding the rules and regulations of being absent and what this means.

For underlying health issues, the manager will be advised that things might get better or not.  And employment decisions taken. But not before the deciding whether the Equality Act (see Question 6) applies. If no underlying health problem is found then the employer is told that too. The next step being for the Manager to discuss attendance levels with the worker and the consequences of not improving attendance e.g. disciplinary action.

See also Using the Bradford Index

6. Is Mr Smith Disabled and covered by the terms of the Equality Act 2010?

The Equality Act 2010 brought together lots of discrimination laws into one.  At work, Managers need to be aware of disability and unfair treatment.  OH professionals usually comment on whether ‘in their opinion’ the terms of the Equality Act will apply.  The decision of disability and if it applies is a legal and not medical question.  OH understand this and err on the side of caution.

So you will get an answer to this question but bear in mind that it may not necessarily be supported by an Employment Tribunal who may consider different criteria.

Remember !

  1. OH Doctors and Nurses work to their own professional codes of confidentiality for maintaining public trust. Employees and workers will have rights under the General Data Protection Regulations for personal medical information not to be disclosed to the employer without the individual’s consent.
  2. OH advises management on how Mr Smith might be affected by health. But it is the Manager (not OH) who is responsible in law for any final employment decision.
  3. Always discuss the reasons for referral fully with the individual and the questions you are asking. Workers get anxious about OH appointments because they usually think OH is on management’s side.
  4. Provide an information sheet and contact numbers for the OH service in your company. That way workers can ring before their appointment if they have any questions.


It really is important to note that, without the right questions, you don’t get the right answers.  It may be obvious to you why Mr Smith needs help but he may not realise there are problems. And if he doesn’t, then it’s certain that occupational health won’t know either.

Above are the questions Managers ask about workers and give the best answers from OH. They are useful, not only for the manager but, in the long-term, for Mr Smith too.

A video on Occupational Health


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