Occupational health not fit for work?

In this guide, we will discuss the topic “occupational health not fit for work”, who can provide occupational health services, what is an occupational health referral, and some additional considerations.

Occupational health not fit for work

If you have been to an occupational health assessment and they have agreed with your doctor you are still not fit for work.

However employers are not responsible for all aspects of their employee’s state of health but they have a duty to ensure their employee is medically fit to perform a certain job, and ensure the work conditions do not affect the employee’s health.

In order to do this, your employer may ask to get an updated medical report from your GP about your health status.

However, your employer can’t request any medical records without your consent, “While medical details are private and confidential to every person and no manager has the right to know an employee’s medical details, doctors and nurses are bound by the principles of patient confidentiality (personneltoday.com).”

Moreover, we can consider the role of the OH focuses mainly on the physical and mental wellbeing of the employees in their workplace.

According to fitforwork.com, the aim of OH is to prevent work-related illness and injury by:

  • encouraging safe working practices;
  • ergonomics (studying how you work and how you could work better);
  • monitoring the health of the workforce;
  • supporting the management of sickness absence.

This ultimately means that the OH is not a punishment or your employer wanting to have reasons to dismiss you.

It is in their best interest to ensure your safety and wellbeing in your workplace.

People also want to if Occupational health can sign them off work?

Who can provide OH services?

Where companies don’t actually have an OH department, employers opt for getting an external OH service for support.

Here is a list of the specialists that can provide OH support:

  • specialist nurses in occupational health;
  • doctors specialising in occupational health;
  • occupational therapists;
  • occupational hygienists;
  • physiotherapists;
  • counsellors.

Occupational Health referral

There are some steps that are needed before you are referred to OH according to Dr. John Cooper from personneltoday.com:

Step 1

Your manager needs to be clear about the reason for the referral and also the questions to ask the OH practitioner.

Some questions that could be asked to know the OH practitioner could be:

  • Is this employee medically fit to work in this role?
  • When, if absent, are they likely to be able to return to work?
  • Is a phased return recommended?
  • Is a review appointment recommended?
  • Would the employee’s condition be covered by the disability provisions of the Equality Act (2010)?
  • Are any adjustments needed to help the employee in their work?
  • Are there any restrictions on what the employee can do in their role?
  • Is the employee receiving the appropriate medical care and support?
  • Should the employee be considered for ill-health retirement?
  • Is the employee’s illness caused or exacerbated by their work?
  • If the employee is taking medication, is it likely to impair their ability to do their job safely and effectively?

Step 2

After making the referral, the manager would need to explain the employee the purpose and procedure for the referral and obtain their consent.

Here is an example of what a manager could say to an employee:

“I have recently become increasingly concerned about your performance at work. And I want to refer you to occupational health so they can explore whether or not you might have some illness that could be the cause of this and, if so, what can be done about it.”

Step 3

This step requires the manager to write the referral itself and there is usually a template for it.

There are important details that should be included such as the employee’s job role, how long have they been working for the company, their absence record, date of birth, and other related questions regarding the workplace.

“The specific reason for the referral should then be clearly stated, along with the questions to be answered by the OH practitioner”, indicates Dr. Cooper. In addition, referrals should be limited to 4 to 6 questions max, as there is unlikely to be sufficient time for the OH to make any more questions.

Employees are entitled to get a copy of the form and ideally should also sign it providing their consent before arranging an appointment.

Step 4

This step would be the appointment or consultation itself, where the OH practitioner takes details of the medical history as well as any potential hazards or stressors that could be identified or involved.

It is important to mention that employees are primarily patients of their GP and not the OH.

However, some OH services do offer counseling and physiotherapy services for faster assessment and recovery.

Step 5

Here the OH writes a report where it is necessary to get informed consent from the employee. 

The General Medical Council guidance recommends the employee has the right to see the report first before it can be sent to their manager.

As Dr. Cooper indicates, “the employee may ask for a fact to be corrected, which should be done.  But if they disagree with an opinion in the report (perhaps, for example, in relation to when they could return to work) then the OH practitioner is not obliged to change the opinion. However, they may point out in the report that their opinion differs from that of the employee.”

Step 6 and 7

The report gets sent to the employee’s manager with a copy to the employee and their HR department.

Some OH services may also send a report to the employee’s GP.

After reading the report, the manager can review the situation after seeing the recommendations from the OH where the manager can (ideally) resolve the situation completely.

What happens if I refuse to attend OH?

Employees have the right to refuse to attend an OH health assessment or any other health meeting.

Usually, employees refuse to attend due to personal beliefs, fear of sharing their medical details, or due to religious reasons. 

As recommended by StayWell Occupational Health “Employers should always do their best to gently encourage their employees to attend any recommended health meeting, but to remember that a staff member does have the right to refuse. That said, if an employee refuses they should be made aware that management will then have to make any and all decisions about their future employment without any medical information.”

 Unfair dismissal

Many employees that have been on sick leave either short or long, due to ill health fear being dismissed.

However, if you get fired and you think it is an unfair dismissal, you can challenge your employer’s decision on the ground of ‘unfair dismissal’ and as long as you were employed for at least 2 years.

In addition, if you are legally disabled you could also make a claim of discrimination under the Equality Act

The downside of the situation would be the costs since taking your employer to a tribunal isn’t cheap at all.

According to Rachel Lacey from MoneyWise, “A claim for unfair dismissal carries a £250 issue fee and a whopping £950 hearing fee.

Although these charges do need to be paid by the employee, Pritam says you might find some lawyers will pay the fees upfront,

or they might be paid by any legal cover you have as part of your home insurance. Alternatively, if your income does not meet certain thresholds they may be waived.”

Why is this blog about occupational health not fit for work important?

Most employees fear to get a referral for occupational health because they feel their employers could dismiss them after getting the report from the OH practitioner.

However, as we have discussed, the aim of OH is to support employees and make sure health and safety is a priority for employers.

In addition, it is important to consider the steps of an OH referral, your rights, and the aim of an OH report.

Also, remember that your employer can’t ask for your medical records unless you give written consent, and if you don’t feel comfortable you can refuse to go to the OH assessment. 

Please feel free to leave any comments or thoughts about the content of this article!

Frequently Asked Questions (FAQs) about occupational health not fit for work

What do I do if I’m not fit for work?

If you are not fit to work and you have a fit note, you should stay off work until your fit note ends.

If your GP has considered you need time off to recover and has issued a fit note saying you are not fit to work then, consider the recommendations from your doctor.

Can my employer force me to go to occupational health?

Your employer can’t force you to go to occupational health or ask for your medical records without your consent but on the long run, it can be detrimental if you refuse to cooperate with your employer since occupational health will attempt to support you when you return back to work suggesting any necessary adjustments so you feel better at your workplace

What is occupational health assessment?

An occupational health assessment is a medical examination performed by an occupational health professional.

It is intended to advise employers on an employee’s health and they can make recommendations on adjustments that can be considered to ensure the employee’s health and safety.

Is occupational health assessment compulsory?

An employee can refuse to attend an occupational health assessment.

In some cases, employees have a genuine fear of attending an appointment with occupational health such as being fired or getting in trouble with their employer as a result of the assessment.

Can I return to work without a fit note?

You can return to work without a fit note if you have been sick for less than 7 days since you are allowed to self-certify.

However, if you have been off more than 7 days then you need a fit note which will indicate to your employer you needed time off. 


Cooper, J. (2017) Good practice when making occupational health referrals. Retrieved from personneltoday.com.

Fitforwork.org: “The role of occupational health”

Fitforwork.org: “Occupational health support”

Staywelloh.co.uk: “What is an Occupational Health Assessment?”

Lacey, R. (2013, Nov.) Are you too ill to work? What are your rights?. Retrieved from Moneywise.co.uk.

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