Occupational Health Advice – A Case Study

My occupational health advice giving career started over 20 years ago.  I remember going for my first job interview not even knowing what occupational health advice was myself! But got the job with the promise of supervision and intense training programme.

A man in a wheelchair stuck at the bottom of the stairs
Ted’s Story

The difference between occupational health advice from a specialist is that they understand the organisation, the people, what is legally acceptable and what is available.  Consider Ted’s (not his real name) story taken from my early casebook of work situations…

Case Study: TED

Ted was an architect and had been diagnosed with the degenerating condition of  Motor Neurone Disease (MND), it was unclear how the disease would progress in the future but the prognosis is not good.  In a relatively short time, Ted was a wheelchair user and having difficulties communicating with his team and with clients.  He had been with the company since starting work (30 years) and loved his job.  Ted’s GP had written a sick note (now called a Fit Note) to say that Ted was unable to work and signed off sick from work indefinitely.  The GP suggested Ted apply for ill health retirement on grounds of permanent ill health. 

On receiving the sick note, Ted’s manager visited Ted and the family at home.  The family and Ted said that he wanted to stay at work as long as he could but the GP thought it unrealistic and that Ted was in denial about having MND. 

Ted’s Job

Ted’s job involved working in a large office complex,  much of his work involved using the telephone, advising and talking to the team, members of the public and dealing with everyday issues.  He was a respected and experienced worker.  When Ted got tired (usually after about 4 hours at work) he could not use the phone at all due to speech difficulties.  Things were not going to improve and probably deteriorate very quickly; so the GP suggested that Ted stay at home and make the most of his time left.

Ted was devastated by both the illness and his enforced absence from work; although he was physically disabled his mind remained as clear as ever.  He told his wife he wanted to ‘work until the day he died’ and not being able to work made everything so much worse and also said that he felt trapped inside his body.

We Rally Round

Rallying around, Ted’s manager and work team pulled out all the stops and in collaboration with occupational health, safety and human resources undertook an extensive health and safety risk assessment (which particularly focused on health issues) and action plan that addressed the obstacles preventing Ted from working including: 

  • Working only part time hours
  • Flexible working for fluctuations in health
  • Assistants to answer the phone
  • Voice to text software and vice versa
  • Specialist adaptations to the office environment
  • A buddy system for fire evacuations and emergencies
  • Training for the office team to explain Ted’s condition and what to do in an emergency
  • Taking away parts of his role that were too difficult for him to do
  • Regular reviews of the workload and the health risk assessment
  • Case management reviews with Ted and others as required

Ted died quietly in his sleep one year after starting back to work with the control methods in place.  He had worked up to one week before his death. 


Ted’s story sums up the benefits of occupational health medical advice over that of the GP and is perhaps one of the most moving cases that I have been involved with.  I understood the GP’s stance, perhaps he did not want to give Ted hope where there wasn’t any – after all this was long before the time of the Equality Act (2010) and reasonable adjustments. The list of adaptations is daunting and there were issues around Ted being ill at work; legally too there were a lot of factors to consider.

The co-workers were a huge consideration in the plan without their courage and determination things could have been very difficult.

Ted had been with the company for years and had extensive knowledge and networks of contacts for solving problems. He also knew the past history of the buildings which could never be replaced.  By keeping Ted at work both benefited.  The GP could not have known about the culture or the determination of the business. We wanted to make sure that Ted’s end of life was as comfortable as his co-workers and family could make it.

Given the many aspects of keeping the Ted at work and an employer’s duty to provide a secure and healthy workplace, it was essential that a systematic approach was used. We needed to evaluate the potential for individual harm and protect against any dangerous practices or exposures. Using specialist knowledge, experience and expertise.

Further Reading

An adapted extract from my book – How to Look After the Elf in Health and Safety available from the Kindle Store – buy now for more insights into how OH can help employees.

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