Can I Let an Employee Back to Work the Day Before Doctors Notes Says
Your doctor will give you a fit note if your health affects what you can do at work.
This guide explains what different sections of your fit note mean, and how you can use it to talk with your doctor and employer about returning to work.
How the fit note works
Doing the right kind of work is good for your health, including if you have a health condition.
You do not always need to be fully recovered to go back to work, and in fact it can often help your recovery. Your fit note can help you go back to work when you are able to.
Your doctor will not automatically assess that you are not fit for work if you have a health condition. Instead, they will discuss with you how your health affects what you can do at work.
They will think about your fitness for work in general rather than just your current job.
You should ask your doctor to give you practical advice in the fit note about what you can do at work, rather than simply record your health condition.
You should then discuss this advice with your employer, to see if they can make any changes to help you return to work.
How work affects your health
If your doctor doesn't ask you about how your health affects what you can do at work, you should raise the issue yourself.
Research shows that work can be good for your physical and mental health, lowers the risk of experiencing financial difficulties, and improves your overall quality of life.
You do not always need to be 100% 'fit' to be able to do some work, indeed, work can help your recovery from health problems or support your all round wellbeing if you have a long term health condition.
Your doctor is there to help you with your health. Doctors understand that work can be good for your health, and will talk to you about what you can do and whether you could return to work without making your health worse.
Getting a fit note
Temporary change to fit notes
For Statutory Sick Pay (SSP), where employees go off sick on or after 10 December 2021, employers can only ask employees for proof of sickness (such as a fit note) after 28 days of sickness (including non-working days). Proof of sickness cannot be requested earlier than 28 days.
Fit notes do not have to be provided for DWP benefit claims until 27 January. This will not affect claims to benefit.
These changes are to give GP's more time to work on the Coronavirus (Covid-19) booster programme.
If you are concerned about your health condition, you should continue to see your GP.
Your doctor will only give you a fit note if your health affects your fitness for work. The fit note is your property and you should keep it. Your employer can take a copy if they want one for their records.
If you are fit for work, you do not need a fit note. You also do not need one if you are off sick for 7 calendar days or less, because you can self-certify your leave for this time – see guidance on employee's statement of sickness to claim Statutory Sick Pay.
Your doctor cannot give you a fit note for non medical problems (such as problems at home or relationship trouble at work). They may, however, be able to suggest other sources of help – some are listed in further support.
Rules of the fit note
You should get a fit note from the doctor who is treating you. This will usually be your GP, but if you are getting treatment in hospital you should ask for one from your hospital doctor (if you do not already have one). Fit notes are usually printed but can be handwritten, but must be signed by a doctor and the address of the practice must be included on it. Duplicate fit notes can only be issued if the original has been lost.
The fit note is classed as advice from your doctor. Your employer can decide whether or not to accept it, and your doctor cannot get involved in any disputes between you and your employer. You may wish to seek help from a trade union or ACAS (Advisory, Conciliation and Arbitration Service) in such situations.
How your doctor will assess your fitness for work
Your doctor will assess your fitness for work by considering how your health affects what you can do at work (for example your stamina and concentration).
They will decide whether you are not fit for work of any kind, or whether you may be fit for work taking account of their advice.
Your doctor will not automatically assess that you are not fit for work if you have a health condition, and they will consider your fitness for work in general instead of just thinking about your current job.
This gives you and your employer the maximum flexibility to think about ways to help you go back to work (which might include moving you to a different job for a while or changing your duties).
You can use your fit note to support a claim to benefits. More information can be found on how to make a claim on the fit note itself, or on the benefits pages.
If your fit note says that you are not fit for work
Show the fit note to your employer to arrange your sick pay. They can take a copy but you should keep the original.
It's usually a good idea to keep in touch with your employer while you are away, so that you are ready when it's time to go back. You can get advice about sick pay from your trade union or see information about sick pay.
If your fit note says that you may be fit for work
Your doctor will give you advice in the rest of your fit note about how your health affects what you can do at work. Make sure you discuss this with them and understand their advice.
You should discuss your fit note with your employer to see if they can help you return to work; this won't necessarily mean doing your old job, or working full time. We know that employers want to help their employees return to work, and can often make changes to the workplace or job duties.
Your local safety representative or trade union may be able to help you in your discussions, and the checklist below may help you prepare for them:
- look at the tick boxes and comment box for advice on what you can do at work, and how your employer could support you
- check how long your fit note lasts and whether you are expected to be fit for work when it expires – explaining the sections of the fit note explains how you can do this
- think of possible changes to help you return to work
It may be helpful to put any changes you agree down in writing, so that everyone is clear on what has been agreed. See an example of someone using their fit note to help them go back to work.
If your employer cannot make any changes, they do not have to. In these circumstances, you should treat your fit note as if it said that you are not fit for work and use it as explained above. You should not go back to your doctor for a new fit note.
The tick boxes
The tick boxes enable your doctor to indicate the kind of general adaptations that might help you return to work. This is not binding on you, and you should feel free to discuss other options. Adaptations include:
- a phased return to work: a gradual increase in work duties or hours
- altered hours: changing your work times or total hours
- amended duties: changing your work duties
- workplace adaptations: changing aspects of your workplace
Your doctor should use the comments box to give you more detailed advice about the impact of your condition on what you can do at work. This will be advice about what you can do at work in general, and will not be tied to your current job. This gives you and your employer maximum flexibility to discuss ways to help you return to work.
It is helpful for your doctor to give practical information about what you can do at work, eg 'should not drive, take regular breaks if using a display screen' instead of simply 'dry eyes'. If your doctor thinks that your job may be affecting your health, they will also indicate this in the comments box.
The information in this box is often very helpful for employers, so you should ask your doctor to provide advice here if they can. Ask your doctor to include details about how your condition affects what you can do at work, rather than simply a diagnosis or description of your symptoms.
Possible changes
Check further support for other resources which could help, and guidance for particular conditions. You should discuss anything that you think would help. Some examples are listed below:
- changing to a different job or location
- reduced or flexible hours, or a phased return to work
- changing work premises or equipment
- changing your duties / giving some of your tasks to somebody else
- providing additional training or supervision
- providing a reader or interpreter
- working from home
- arranging a mentor or work buddy
- working in a team instead of by yourself (or vice versa)
- arranging for an occupational health assessment.
Going back to work
You should go back to work as soon as you feel able to and with your employer's agreement – this may be before your fit note runs out. You do not need to go back to see your doctor before going back to work. Your doctor cannot give you a fit note stating that you are 'fit for work'.
For a small number of jobs there are separate processes to ensure it is safe for you to return. If this applies to you, your employer will tell you. You do not need a fit note to cover this period while you wait for your employer's assessment and your doctor will not be able to issue further fit notes to cover it.
Explaining the sections of the fit note
1. The date your doctor assessed you, either in person or over the telephone, or when they considered a report from another healthcare professional.
2. The condition(s) affecting your fitness for work. It's usually best for your doctor to be as accurate as possible, but they can enter a less precise diagnosis if being too detailed might harm your position with your employer.
3. Your doctor's assessment that you are either:
- not fit for work – you are not fit for work of any kind
- may be fit for work taking account of the following advice – you may be fit for work, taking account of your doctor's advice in the fit note. This does not necessarily mean doing your current job
4. Your doctor's advice about the impact of your health condition. See the comments box for more information.
5. The period that your doctor's advice covers. This will either be from the date of the assessment (Box 1), or between a particular start and end date. These dates are inclusive (so a fit note dated from 2 April to 10 April will no longer apply from 11 April onwards). This section may cover a previous period if your doctor thinks that your condition has affected your fitness for work before your assessment. This can be for any time up to an indefinite period.
6. Whether your doctor needs to see you at the end of your fit note. If they expect you will be fit for work at the end of the fit note, they will indicate that they do not need to see you again.
7. Your doctor needs to sign the fit note.
8. The date the fit note is issued. This may not always be the same as the date of the assessment.
Important: You can go back to work at any time you feel able to (including before the end of the fit note) without going back to see your doctor, even if your doctor has indicated that they need to assess you again.
Illustrative examples of how the fit note works
Using the fit note to go back to work
Case study 1: Working from home
A proof reader for a publishing company has a fit note from his GP saying that he has a common cold and cystic fibrosis but that he may be fit for work taking account of the following advice. The workplace adaptations box is ticked. His fit note has a duration of 10 days and his doctor has indicated that they do not need to see him again once it expires.
The advice in the comments box reads: Your employee cannot travel into the office because he is at local high risk of developing a chest infection whilst he has a cold. The increased risk is due to his pre-existing chest condition – cystic fibrosis. He is able work from home during this period.
The employee and his employer discuss his fit note agree that he should work from home for the next 10 days. His boss emails him some work to do, and he does not go on to sick leave. After 10 days, he has recovered from his cold and comes back to work as normal without going back to see his GP.
Case study 2: A delivery driver who can't drive
A delivery driver for a major logistics firm has just had laser eye surgery. He has been told that he should not drive for 2 weeks.
His GP explains that the fit note is about his general fitness for work, and discusses what other tasks he can do. The GP indicates on his fit note that he may be fit for work. The comments box reads 'Dry eyes, may experience temporary blurring of vision. Should not drive for 2 weeks. Can still perform other reasonable physical tasks. Mental function unaffected. If he uses a VDU (Visual Display Unit) he should take regular short breaks as per standard guidance.' The GP ticks 'amended duties'.
His GP indicates that they will not need to assess him again at the end of the fit note because they expect him to be back to normal by then. The driver and his employer discuss the advice in the fit note.
Although he should not drive, the driver's knowledge of the company and its operations means they decide he can work in a back office role for the 2 weeks. The employee therefore keeps his full pay, and keeps in the routine of working. After 2 weeks, his eyesight is back to normal and he returns to his previous duties without going back to see his GP.
Further support
Managing health conditions at work
Access to Work provides practical and financial support to people with a physical or mental health condition or disability to help them start work or keep a job. This can include paying towards aids or equipment; support workers; communication support at interviews; support services; or travel to and in work.
Recovery from Surgery – Royal College of Surgeons of England provides practical tips and advice about getting back to work after common surgical procedures.
Recovering well from gynaecological procedures – Royal College of Obstetricians and Gynaecologists provides advice on recovery, including return to work, following gynaecological surgery.
Work and Mental Health – Royal College of Psychiatrists provides advice about returning to work after a period of mental ill health.
Work and cancer - Macmillan provides information about work and cancer for patients, carers, employers and healthcare professionals.
Upper limb disorders: Occupational aspects of management - Royal College of Physicians Evidence based guidance for employees.
Fit notes can only be issued for medical problems. Your doctor may be able to refer you to support for other personal or social problems. For example:
Problems at work
For help on dealing with bullying, harassment or discrimination and preventing or managing disputes and conflict at work contact ACAS or telephone 0300 1231100.
Your local trade union or safety representative may also be able to help with issues at work.
Support for carers
NHS Social care and support guide
Debt issues
Citizens Advice – Help with debt
National Debtline
Career advice
National Careers Service
Help with relationships
Relate
Occupational health services
Occupational health support can be very helpful in complex cases and when work may be affecting your health. Occupational health services are often provided by large employers and sometimes by the NHS or local authorities. Trade or regional business associations may have details of occupational health providers or other sources of help. For details of providers in your area, contact:
Commercial Occupational Health Provider Assocation
NHS Health at Work
Supporting Organisational Health and Well being Professionals
Safe Effective Quality Occupational Health Service: list of approved occupational health providers.
More information on the fit note
For more information on the fit note see fit note guidance.
Important information
This is only a guide and does not cover every circumstance. We have done our best to make sure that the information is correct as of September 2021. It is possible that some of the information is oversimplified, or may become inaccurate over time, for example because of changes in the law.
Can I Let an Employee Back to Work the Day Before Doctors Notes Says
Source: https://www.gov.uk/government/publications/the-fit-note-a-guide-for-patients-and-employees/the-fit-note-guidance-for-patients-and-employees
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