Sick Note to Fit Note John Monigatti Occupational Physician Goodfellow Symposium 25 March 2012

Roles The health practitioner’s role is to determine the person’s capacity for work. The employer’s role is to decide whether the risk of employing someone with that level of capacity is acceptable.

Health Practitioner to decide Is there a need to confine to home? Will working worsen the condition or delay recovery? What work is the person capable of doing? Will doing this work compromise the safety of that person or others?

Employer to decide Is the probability of substantial damage high? Is the risk significantly greater than the other risks being assumed already? Can reasonable accommodations be made to reduce the risk? Can the loss of efficiency (the economic risk) be tolerated?

1) # metacarpal 2) lumbar sprain Is there a need to confine to home? Will working worsen the condition or delay recovery? What work is the person capable of doing? Will doing this work compromise the safety of that person or others?

Towards the Sick Note Confusion as to role Lack of training, knowledge & confidence Extra time & workload Assuming level of activity from the job title What the patient wants Perception of the employer “It’s easier to wait till 100% fit”

Towards the Fit Note Work is good for you… Partial work capacity can often be accommodated Most workers learn the most physically economical method of doing the job Impaired workers can often cope with support of fitter colleagues “No need to wait till 100% fit”

Ask yourself.. If the person came to you asking for a clearance to resume work, would you have a medical reason for advising that he/she could not or should not do so?