Absence from work is for many reasons – the main one used is an illness. People get sick and get better.

Some, however, have reasons for pretending they’re ill, especially where work is concerned.

They might embellish the truth a little, exaggerate symptoms and catastrophise incidents to get things like compensation, time off work, sympathy, staying off work and political and economic considerations.

Before I go any further, I am not saying that everyone exaggerates or wants sympathy – some hate showing any weakness and go out of their way to minimise the health issue.

In the workplace, your team depend on you to do a job. If you are sick then you can’t do it, but what about those who take the odd day off here and there?

Can’t or won’t get out of bed in the morning or have constant domestic situations which mean they call in sick?

These workers get known as unreliable and a Manager’s nightmare.

The solution is to send them to occupational health.

Ask OH for their opinion, and employees won’t be able to bamboozle them – like they might be able to baffle the Manager – using long medical words and what the doctor said to them.

James’ Interview with Occupational Health

James was such a person. He usually took a day off sick every month. He wasn’t sick, but if he felt tired or had an urgent appointment he would ring in sick with a stomach upset, headache. You get the drift.

The company had a sick pay scheme which entitled James to full pay for up to three months if he was absent due to illness.

James and his colleagues had worked out that they all could get some free days from this allowance, as long as they didn’t take it too far.

The manager was used to a high rate of absence in the department and although it was a real headache for him trying to cover the shift and work,  couldn’t figure out what to do about it.

He certainly didn’t know enough about the illnesses James kept mentioning, so felt helpless to put a stop to it.

And this was true for other departments across the firm too. Consequently, the absence rate was above the national average and, what was worse, customer service was suffering due to missed deadlines. Some members of the team were openly hostile to both the Manager (who didn’t challenge anyone about pretend sickness)  and someone who took a day off, even if it was genuine.  The workplace was like a battlefield.

In desperation, the company hired an occupational health service who advised on the best way to deal with recurrent sickness absent. In consultation with the unions, and led by HR, James was eventually asked to go to Occupational Health about his periodic odd days off sick. Ted and all the other managers had enough.

James was the first to pull the sickie stunt under the new regime.

James agreed to talk to the OH nurse and an appointment set up.

The Absence Interview

The manager provided a list of James’ illness over the past year.

The list went something like this:

Monday 2nd January – 1 day, headache and cold
Wednesday, Feb – 2 days diarrhoea and vomiting
Friday, March 15- 17th – Flu

The OH nurse’s task was to find out if the days off were connected at all. She started by showing James his list of illness and then, one by one, talked about each episode.

The nurse was trying to find if James has a real health problem that made all these illnesses fit together? Because it is not usual to have so many minor illnesses. Maybe there was something wrong with James immune system, perhaps he had a mental health issue, had he been to the Doctor to check why he kept getting ill?

James looked at the list of illnesses was a bit embarrassed by the number of days he’d had off.  Suddenly it didn’t matter that everyone in his team was doing the same.  Here he was having to discuss imaginary illnesses with a person who was trying to help him.


The OH nurse, Jenny started by with the headaches he’d  had in January:

  • Where do they start?
  • Do they make you sick?
  • What medication do you take?
  • Have you been to the Doctor about them?

She then took Jame’s blood pressure and checked his eyesight to rule these as a cause for headaches; both were normal.

James was happy about that but continued to squirm as the next absence came up.

Diarrhoea and Vomiting

Then Jenny moved on to diarrhoea and vomiting:

  • Was it something he ate?
  • Were others affected?
  • Had he been abroad before the illness?
  • Had he been to the Doctor?
  • Was it after eating certain foods?
  • What were the stools like?
  • How many time had he been sick?
  • Had he taken medication?


  • Was he sure it was Flu, that usually lasted about 5 days?
  • Had he had the Flu vaccination?
  • Perhaps it was a cold instead?

“Maybe,” said James

For each illness, the nurse looked for an undiagnosed condition or anything that might suggest an untreated illness, which could recur. If she found anything that could be causing the absences, she could easily get him an appointment with his GP; he might need blood tests or treatment.

Occupational health will always look for a real health problem before jumping to any conclusions about James and his short term repeated absence.

I’ve referred many who had high blood pressure to their GP for treatment, and I believe I have saved lives that way.

But returning to James…..

James is getting quite uncomfortable about the questioning. For many of the days in the list, he can’t even remember why he took a day off. As for details about the illness, he starts valiantly making up the symptoms but begins to falter when questioned closely about the details.

Jenny too has found inconsistencies in his accounts and starts to get the idea that James has been skiving.

Nevertheless, she carries on with the review of his absences, or, as James tells a colleague later, ‘the Inquisition’.

James eventually just gives up trying and nods and grunts to the questions.

Jenny concludes her examination and tells James that she can find no reason to think that he has an underlying health condition or medical reason why he has had so many absences. And she will be telling his manager Ted this. Unless there is anything he is not telling her, can he think of anything?

Work or Other Factors?

Now, is James’ opportunity to discuss any work factors that may have forced him to stay away from work; things like:

  • Being bullied
  • Stressed
  • Unable to cope with job requirements
  • Domestic issues (relationship problems, no transport, money for fares, etc.)
  • Other, e.g. alcohol or drugs, childcare

James fed up with maintaining the pretence and feeling aggrieved, tells Jenny, “No there is nothing”.

What Happens Next?

James sits while Jenny writes her notes and then:

“Is this confidential?” he asks

Jenny explained early in the appointment that their discussions were confidential, and gave him a leaflet explaining occupational health’s role.

“Certainly James”

“Well, the truth is that we all take the odd day off. Everyone does it. Managers know and play the game. It’s been going on for years. Why are they picking on me?”

Why Short Term Absence Matters

Jenny explains that occupational health was brought in because the company was losing money, customers, and overworked team members, because of the high sickness absence rate across his team and other teams in the company. Taking days of sick willy-nilly was not a sustainable practice anymore. And yes everyone knew it went on. It seemed it was part of the culture.

But it could not continue.

He was one of the first to be investigated, but others would follow. The firm had to change the practice as they were struggling to survive.

James laughed at this but Jenny could see he was worried.

No Underlying Health Condition to Account for the Short Term Absence

Jenny told James that she would be telling his manager that there was no underlying health problem to account for the level of absence.

James thought about this and decided that wasn’t too bad an outcome.  He stood to leave.

“What happens now, Nurse?” He asked, moving towards the door.

“You will probably have a meeting with your Manager to discuss the findings from this referral and, as there is no illness linking the absences, then your Manager will be setting targets for you to attend work.

If you carry on with this level of absence, your Manager could stop your company sick pay, or put you into the disciplinary process.  If this pattern of short-term absence continues, ultimately, he could sack you.”

James, shocked, could think of nothing to say.

“Er, thanks,” he said moving towards the door.

To Read Also on This Site:

Managing Absence a Manager’s Guide

Setting Targets for Absence Yes or No

The Bradford Index for Managing Absence

Questions You Can Ask Occupational Health


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