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Posted By Jason McQueen
Just a quick question as Ive asked around the office and cant get a consensous of opinion. If you have been signed off work by your doctor do you actually have to have the time off?
We had an employee who was signed off but reported for work as he didnt want the time off. One of our managers turned him away as she was of the understanding that he needs to go back to his doctors and be signed back before he can come in.
Any views?
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Posted By Philip McAleenan
Jason,
on the basis that neither the patient nor yourselves as his/her employer are competent to make medical decisions, including decisions on fitness to work when his GP has said he isn't, your manager was correct to send him home. Consider the consequences if his condition worsened as a result of him being back at work, or an accident occured that was even indirectly related ...
Regards, Philip
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Posted By Jason McQueen
That was pretty much my opinion but I was just trying to get some information to support the argument.
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Posted By Jack
I agree with Philip.
I would suggest the employee discusses it with the GP. If all the facts about the job are considered in relation to the illness/injury it may well be that the GP will agree to a return to work. Perhaps a gradual return or perhaps with limited duties.
You could also involve an OH physician who would be better placed than a GP to advise on the work that can be undertaken.
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Posted By Delwynne
Just to reiterate the above points, if a person has been signed off then they should not work. In my experience doctors are generally a little 'quick' to issue sign off's. I'm sure if your employee returned to their doctor and explained their wish to work then provided it is not going to severely impact on their health the doctor would be happy to sign them back on.
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Posted By mike.mcdonnell
I agree with the above, I would just add if the absence was work related in any way, e.g. as a result of an accident at work, I would advise that a return to work interviewe should be conducted by the employee's line manager.
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Posted By garyh
I agree that Doctors generally sign people "on the sick" too easily - someone can claim to have had an accident at work and get a sick note..........try arguing with that!
The original question was about being able to work whilst signed "on the sick" - I believe that for insurance reasons you must be signed back "off the sick" before working. (Not if you were "self cert", of course).
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Posted By jackw.
Hi as per others the employee can not be allowed to work if a medical opinion - GP note says they are not fit.
Re they can "claim it was a work related accident" your reporting procedures should cover this. If the person says they had a work accident it must be reported and verified by the line manager after investigating. If we get a "dodgy" character saying it was work related but not reported this is clearly indicated by the line manager on the form and in the accident book. unless they can substantiate the claim - produce witnesses with a credible story etc. than stands up to investigation/scrutiny etc. then we just don't accept the statement without following all of the above
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Posted By angela westwood
occupational health physicians can overide the decisions of the GP. From personal experience The GP is sometimes not the best person to make a decison on whether someone is fit to return to work.
We would certainly take the view that the opinion of the occupational health
physician is paramount to getting a person back to work, rather than the
GPs, particularly as rehabilitation of an employee back into the workplace
works more successfully sooner rather than later. In my experience the
sooner occupational health involvement intervenes the better outcome for the
employee in returning to work. Occupational health can liase with the GP and together can form an opinion of whether a phased return is required, whether restrictions are needed etc.
Angela
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Posted By John Murgatroyd
Always supposing the patient wants any OH involvement.
His/Her gp won't inform anyone else of any medical details without written and signed consent from their patient.
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Posted By jacq
Hi
Not wishing to hi-jack the thread, but we have a slightly different slant. Employee has been off work for a considerable period of time from depression, which he alleges came from work place harassment. His GP has confirmed this diagnosis. Company OHD doctor has examined and signed him as fit to work. The employees GP and the benefit Agency doctor refuse to sign the employee as fit to work. The company has now given the employee a return to work date and intend to dismiss him if he refuses to return to work on the date specified by the company. Can he be forced to return to work if his own GP and a separate benefits agency doctor have recommended that he is unfit for work. Does the OHD doctor over-rule both these opinions?
Any opnions gratefully received
Jacq
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Posted By Chris Black
I think that the answer to Jason's original question is still missing, he is looking for a piece of legislation to cover a manager's decision.
Although I am sure they exist, I have never seen or heard of any regs governing signing off or signing fit by a doctor other than social security regs surrounding statutory sick pay, however it has always been a convention in my 30 years of working that a manager should turn away a "sick" employee if they have not had a fit slip from some doctor who is aware of the same facts as the original doctor, whether that be GP or an OHP on the company payroll.
I have never heard of any physician having the power to overule another in this setting, with doctors it is always down to opinion. I guess that this becomes a judgement call for employers and in extreme circumstances it is down to whoever is most persuasive in a tribunal or courtroom. I have had an OHP saying to me that they disagree with a GP diagnosis and declare an employee fit, telling me that the ball is in my court.
One of the many HR/H&S borderline issues that create a minefield for us from time to time. Any specialist HR people out there to advise? Should we have a link to HR Today or similar for this kind of thing?
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Posted By angela westwood
Hi all
it might be helpful to sign on with jisc mail which is the forum for occupational health advisers and occupational health physicians for their views of sickness absence. Sickness absence has come up time and time again on the jisc mail forum as well as loads of other occupational safety or health and safety issues.
I had the good fortune of working in the past for an integrated occupational health and safety department. We were also involved in sickness absence management as well as traditional health and safety issues and it is from this experience that I would always recommend occupational health involement in deciding whether someone is fit to work
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Posted By Stuart Nagle
the last time I had the misfortune to go to the doctors some years ago now, I was not in a situation where i neded or wanted time off work, and so was suprised when my Doctor said "Would you like me to sign you off for week so you can rest it, and if you come back next week and its still a little tender I can always sign you off for another week"
I did not take the offer up as she who must be obeyed would probably have worked me to death at home..... but was astounded really that I was offered time off for what I considered was a nuisance rather than a justifiable 'time of work' injury!!!
Stuart
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Posted By John Murgatroyd
My views of OH "specialists" is that they serve two masters.
the FIRST master they serve is their "employer", the company who pays them.
The SECOND is the patient.
The item below is from an OH website....
Personally, I think that using an OH advisor to force someone back to work when their personal GP (or consultant) advises against it is a risky procedure.
As I've said before, the employee may well go to see your (probably underqualified) OH advisor, but if he/she refuses to sign a release then the advisor cannot tell you squat. To do so would be a criminal offence.
Unless you're using someone who isn't a health professional, in which case you're up the creek without a paddle, legal-wise.....aand forcing a depressive back to work (when it may well have been work that made them depressed) sounds like total insanity....
****************
Leaner company profiles mean that there are now fewer employees in organisations - which makes it crucial that employees are not incapacitated or lost through preventable ill health.
Taking positive steps to improve employees' health will help recruit and retain staff, reduce staff turnover and enhance your image.
Sound advice on compliance with legislation reduces the risk of costly prosecution and loss of image.
Increasingly, employees and former employees claim compensation for work-related illness and injury, whether or not a particular hazard is covered by legislation. Noise-induced deafness, back pain, upper limb disorders and stress are good examples. These losses are preventable.
Employers' liability insurers insist that employers demonstrate that they are adequately protecting the health of their employees. The involvement of an occupational physician helps to control employers’ liability insurance premium increases.
The message is clear. Preventive occupational health measures can be every bit as beneficial to the business as the maintenance of a company's other assets.
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Posted By Jack
John, I've read your extract from the OH site and I'm not sure what point you are trying to make. As far as I can see they are trying to explain that preventing staff becoming ill as a result of their work by ensuring the company adopts appropriate standards of h&s etc will reduce sickness absence. Am I missing something.
Also why rail against OH in this case? Here we have an employee eager to return to work. An OH professional is in a far better position to assess the circumstances (the effect of work on the employees condition and the effect of the employee with the condition on his working environment) than a GP. In these circumstances why wouldn't the employee give his permission for the OH physician to receive information from the gp?
My experience of OH is that they adhere to a code of ethics.
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Posted By John Murgatroyd
There is a guy working at my place who has a bad back.
As in BAD.
He won't take time off, he also has a 1000 pound a month mortgage.
He isn't necessarily the best person to ask, or decide, about time off or not.
As to the OH code of ethics....the less said the better.
If they were any good as doctors, they'd be practicing medicine. If they're not doctors, then they ain't getting near me.
I know who my moneys on...a doctor (qualified and practicing)...a consultant (qualified and practicing)...or an OH professional (not a doctor but with an inflated idea of his/her own skills)
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Posted By Jack
Ah John, the ones I'm referring to are 'qualified and practising' occupational health doctors. ie after initial qualification they chose to work in the field of occupational medicine (after further qualifications in that discipline).
From all your previous postings it seems to me that the company for which you work has many shortcomings (the h&s staff, the managers, the OH staff and indeed all the external consultants and enforcers). It may be that the situation there is not the best on which to draw universal conclusions. In fact if you are a h&s practitioner and you are having such difficulties in making a difference perhaps best to move on.
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Posted By Adam Jackson
To respond to jacq, I'd be very cautious about an in-house or appointed OH professional over-ruling a GP and benefits agency medical practitioner. Its not intended as a slur on OH, I've worked with some excellent ones in the past, but as mentioned previously if it comes to a compensation case you have two 'independent' practitioners versus one who is paid by the employer. Personally, I'd err on the side of caution and unless you really think your chances are good in any claim go with the employee's GP.
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Posted By angela westwood
Real live case experience
employee who work with DSE went to GP complaining of upper limb pain. Employee signed off as unfit to work for 2 weeks and prescribed pain medication. sick note just said "RSI" (which frankly does not explain alot) Employee very upset wants to return to work, fastracked in to see occ health physician who diagnoses a specific upper limb disorder, plans a restricted duty rehab programme based on specific upper limb disorder , orders full ergonomic assessment undertaken and employee also fasttracked for free phsyiotherapy. Employee back at work, pain free, now very happy!
I rest my case
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Posted By Adam Jackson
Then.. employee develops complications or the injury worsens due to unforeseen circumstances. Company has put someone back to work over the advice of their GP. Company stuffed.
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Posted By Jack
Thank you Angela; it makes the point very succinctly.
Adam, I’m not sure I’d go along with your err on the side of caution approach in case it comes to a compensation case. That sort of thinking leads to bonkers conkers stories.
The OH doctors I work with are professionals; they don’t make decisions on a whim and they certainly are not influenced by what the employer wants them to say! GPs will base their decision with regard to the workplace on what the employee says to them because they have no other source of information about the workplace. The OH doctor has the advantage of having access to more information on the workplace; in most cases they have greater competence in occupational illnesses; and (provided permission is given) they will have a report from the GP. If they provide alternative advice to the gp it will be well thought out and documented. In my experience the gp will in virtually all cases go along with the OH view, treating it in the same way as they treat the views of any other medical specialist.
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Posted By Adam Jackson
If the GP goes along with it then all well and good, but where the GP and OH are at conflict the GP wins out every time.
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Posted By Jack
Adam, I was composing my last response and didn't see your latest posting.
You do seem to search out the dark cloud in every silver lining. If a gp has not got it right I would expect that view to be challenged and the OH doctor is in the right position to do it.
In a large organisation such situations regularly crop up. They are routinely challenged.
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Posted By Kieran J Duignan
Some root problems complicate the issues involved here. They include:
1. GPs vary not only in competence but also in capability to assess occupational illnesses
2. Very, very few GPs without specialist indepth training in occupational medicine have the time or inclination to challend an Associate of Fellow of the Faculty of Occupcatioal Medicine; where they might, it would be for a court to determine the matter on the basis of all available evidence. It's not a matter of perceptions of relative status.
3. Although 'stress' is a major occasion of absenteeism, reliable, valid processes of assessment are seldom used. For most GPs and OH nurses lack specialist training necessary to assess the severity of psychological disturbance or illness; and very, very few psychiatrists are members of the Faculty of Occupational Medicine. So, if the kind of dispute Adam refers to were to arise, a court could well judge that a GP or OH nurse were out of their competence in offering an assessment
4. In my own experience, doctors who are members (Associate or Fellow) of the Faculty of Occupational Medicine resist pressure from HR, etc. to assess psychological illness or disturbance and they recommend that an employer consults a chartered occupational psychologist who is a qualified counsellor and/or registered safety practitioner and is better qualified than they are to put themselves up for court cross-examination in the tiny minority of instances where this occurs.
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Posted By John Murgatroyd The NHS provide an OH service to small and medium companies (for a fee)....where you can get support from fully trained medical and psychiatric staff.....this obviously doesn't go down well with the legion of private OH service providers, but the NHS are not biased either... http://www.nhsplus.nhs.uk/
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Posted By Dave Wilson
Is it only a GP who can sign people Off?
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Posted By Rob T
One quick answer- If you want to work out who carries the most sway - contact your insurance company. They'll tell you whether the person is covered or not whilst at work regardless of what OHS or the GP say or anyone else for that matter.
If he/she is not covered they shouldn't be allowed on the premises!
This comes from a worked instance in my previous company.
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