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Workplace Occupational Health Referrals

There are occasions when every business may need to initiate an occupational health referral and it is important for managers to recognise these occasions when they present themselves.

An employer might wish to consider a medical report in respect of an employee or a prospective employee, but here we are specifically focusing on occupational health referrals for current employees. 

Occupational Health is a service that provides advice to employees and employers in relation to the employee’s job role and work environment.

The question often crops up as to how a referral to occupational health is different from an employee going to see their doctor. Although there can be a degree of overlap, as both concern the health and well-being of the individual, the report received from occupational health will provide more detailed advice on the interactions between work and health.

A referral to occupational health should be considered when concerns arise relating to an employee’s health and their ability to do their job. Some examples include:

  • an employee who has incurred a substantial number of short-term intermittent absences linked to an underlying medical condition;
  • an employee who is on long-term sickness absence to seek advice on how to assist a return to work and to gauge when they are likely to return to work;
  • an employee who is returning to work after a period of long-term sickness absence for advice on a phased return to work plan;
  • to help determine whether an employee is suffering from a physical or mental impairment which might constitute a disability under discrimination law;
  • to help determine whether there are any reasonable adjustments that might assist an employee to do their job or avoid workplace disadvantages.

There is no blanket rule as to when an occupational health referral would be appropriate. The manager needs to make this assessment based on the specific circumstances and seek advice if they are unsure.

It should be kept in mind that many health or wellbeing issues that arise with an employee can be addressed through talking with them. It could be that the employee is already seeking medical advice or treatment and is happy to keep their manager informed or is engaging with them on workplace adjustments, in which case occupational health referral would be of less benefit.

To get the most out of an occupational health referral, we recommend that a manager dedicates time to completing the referral in full, rather than treating it as a tick box exercise. In doing so the manager should:

  • Include all relevant information – including details about the employee’s job role (e.g. job description), absence record and health condition/s to help the occupational health practitioner make an informed assessment.
  • Ask specific questions to get precise answers, for example ‘when can they return to work’ or ‘are there any side effects to their medication that might affect their ability to safely carry out their role’, to ensure the report contains the information they are actually after.
  • Steer away from overly intrusive questions or requests for irrelevant information to avoid the risk of breaching the employee’s right to privacy or being discriminatory.
  • Provide the details of any adjustments that are already in place or that have been considered, so the occupational health practitioner does not recommend something that is already in place or that is unsuitable.

It is not uncommon for employees to be resistant to an occupational health referral, or even to flat out refuse. Often this can be avoided if the correct approach to the issue is made by the manager in the first place and this is all about communication.

If there has not been clear communication about the purpose of an occupational health referral, an employee can quickly jump to the conclusion that it is not genuinely in their interest or that it will be to their detriment.

For this reason, it is good practice for the manager to explain that the process is designed to provide advice and support to the employee, which will be shared with the manager who can then be informed on how they can make work life easier for them.

It is also advisable to discuss the content of the referral with the employee and show the final version to them beforehand. This will help with the employee’s cooperation in the process, so they feel secure in that it is something that is happening with them, rather than to them.

Even with a manager’s best efforts and intentions, there are of course still occasions when an employee might refuse to attend an appointment or decide not to consent to the report being shared.

Where an employer has done all it reasonably can to obtain medical information, but has been prevented in doing so by the employee, the employer can act on the limited information it has available and, depending on the circumstances, a decision to dismiss may be within the range of reasonable responses.

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The information contained in this blog post is provided for guidance and is a snapshot of the law at the time it is written. It is provided for your information only and should not be used as a substitute for obtaining legal advice that it specific to your particular circumstances.

The guidance should not be relied upon in any decision making process. It is strongly recommended that you seek advice before taking action.


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