Long Term Sickness

Top Tips On Managing Long Term Sickness

Employee absence can take many different forms, but often the most difficult to manage is long term sickness absence, as it can raise complex legal and management challenges. Long term health conditions are also likely to trigger obligations under the disability provisions.

This page was first published on 23 September 2012. The last update was on 9 April 2018.

Top Tips On Managing Long Term Sickness

  1. Likely Length Of The Absence

    Your employee will self-certify for the first seven days of their period of absence. From the eighth day onwards, the absence should be covered by medical certificates provided by their GP or other registered medical practitioner who has responsibility for them at the time. Hospital doctors may provide medical certificates for inpatients and outpatients. For instance, when a hospital discharges a patient and advises them to refrain from work, a member of the medical team will issue the medical certificate.

    The maximum duration that a medical certificate can be issued for during the first 6 months of an employee’s health condition, is limited to 3 months. However initial medical certificates are usually for 2 – 4 weeks.

    The reason for the absence may give you an idea of how long it will take for the employee to recover. For instance, appendicitis or a broken leg. Other reasons are less easy to predict, for instance stress or depression.

    Where stress is mentioned, I always recommend undertaking an initial investigation is needed to rule out any work-related triggers for the stress.

    Where you require more information, than that provided on the Medical Certificate you will need to inform your employee that you intend to contact their doctor. You will need the employee’s consent to do this and the employee can ask to see the report before it is sent to you. Alternatively, you can refer the employee to your occupational health provider.

  2. Maintaining Contact

    Keeping in contact is a key factor in helping employees to return to work after sickness absence. Without contact, absent employees begin to feel increasingly out of touch and undervalued which can worsen their condition or leave them feeling apprehensive about returning to work. There is however, a fine line between making enough contact and badgering staff while they are supposed to be recuperating; we need to strike the right balance. You do not want to be accused of pressuring the employee to return to work or of hindering any recovery (or at worse face a claim of harassment!).

    The amount of contact will depend on the nature of the employee’s work as well as the business – for example, it might be reasonable to contact a senior employee more frequently than a junior employee. Remember, you should only contact the employee when absolutely necessary and try to deal with him/her in a sensitive manner-

    Responsibility for making contact should be left to the direct line manager as they know the individual and should be able to handle any sensitive issues. Responsibility should not be passed to others unless there are sound reasons for doing so.

    Requiring the employee to come in to work to make this contact could prove counterproductive to the employee’s health and, instead, other methods can be used such as phone calls, emails or meeting at a neutral, relaxed location such as a coffee shop closer to the employee’s home.

    The purpose of maintaining contact is to review the progress of the employee’s recovery and not, for example, asking them to return to work earlier than their scheduled return date. Before making contact, give some thought to what you will discuss, this will help avoid putting the employee under as little stress as possible. Simply calling the employee off the cuff could result in questions been asked that have already been discussed, making the employee feel they are being interrogated or put under pressure.

    Some areas that can be discussed are: how they are currently feeling; whether they are taking any measures to get better, such as medication; whether they are seeing an improvement in their health and whether any reasonable adjustments can be made to their job role that will allow them to return to work. This information is useful to know in advance because it allows time to ensure these adjustments are in place before the employee returns, thus reducing the likelihood of them going off sick again.

    Remember one size doesn’t fit all. The frequency of contact, will need to be amended due to the nature of the illness and the vulnerability of the particular employee. For instance where an absence is:

    • Unlikely to extend much beyond 14 days you may ask the employee to ring you every day.
    • Likely to extend beyond a month you may ask them to ring you once a week or just before the expiry of the medical certificate.
    • Planned treatment, you may agree, before the absence starts, the frequency of contact. That will depend on how long they are likely to be off. The employee may appreciate a hospital or home visit during their absence.
    • For traumatic injury or a sudden illness check in with relatives initially and start to make contact with your employee when they feel well enough. Again, they may appreciate a hospital or home visit when they feel well enough. For ongoing contact use discretion until the longer-term prognosis is known.

    For welfare reasons it is a good idea to maintain some contact, to be supportive and ensure the employee is updated on changes and news at work.

  3. Dealing With Potential Dishonesty

    If you have doubts or if the evidence submitted by your employee is suspicious, inform your employee that you intend to contact their doctor. You will need the employee’s consent to do this and the employee can ask to see the report before it is sent to you. If they fail to consent follow your disciplinary procedure, failure to follow a reasonable management instruction is usually regarded as gross misconduct.

  4. Assisted Return To Work

    When he employee is well enough to return to work consider what steps, if any, need to be taken to support this process. The more helpful you can be, the more likely the employee will settle back into work.

    The medical certificate or report may suggest that the employee is fit enough to work but with suggested adjustments such as hours, location, duties or responsibilities. In these circumstances, consider whether you can accommodate the suggested adjustments. If you can, then go ahead on that basis. If you can’t then the employee will remain of sick until they are able to return to their normal job. Remember, you are not under a duty to create a special job where no suggested adjustments can be agreed.

  5. Preparing For A Possible Dismissal

    After assessing the likely length of absence, the likelihood of the employee making a full recovery and exploring with the individual any means of enabling them returning to work, it may be that the continued employment of an employee is no longer feasible. In this case it may be fair for you to dismiss the employee.

    Beware claims for Unfair Dismissal! Most dismissals which take place following a period of sickness absence will be by reason of the employee’s incapacity to do the job. To establish that it was fair to dismiss an employee for incapacity, you would need to demonstrate to a tribunal that you had acted reasonably in treating the employee’s absence or attendance record as a sufficient reason for dismissal and given the likely prognosis, could not manage without or tolerate the continued absence.

    Beware claims for Disability Discrimination! If an employee is dismissed as a result of an illness that qualifies as a disability, the employee may claim disability discrimination or that there have been failures to make reasonable adjustments (and this could include adjusting the business’s standard absence management triggers and procedures). Consider carefully whether you are at risk of any such claims and how you might manage that risk e.g. by adopting appropriate processes and considering whether you have a helpful paper trail or not.

  6. Permanent Health Insurance

    Payment of PHI benefits are often conditional on the recipient remaining in employment. A dismissal could deprive the employee of benefits and give rise to expensive breach of contract claims for lost benefits up to retirement. Always check the policy rules and the employee’s contract.

  7. Special Considerations

    Complex and specific rules apply when dealing with pregnancy related illness or absence following on from maternity leave, holiday accrual and pay whilst absent, as well as permanent health insurance or ill-health early retirement.


Remember to handle the situation sensitively, follow your procedures throughout, keep a detailed and accurate paper trail and consider how any dismissal will impact upon the employee’s entitlement to any benefits.

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The Managing Long Term Sickness Absence folder contains guidance and resources to help you manage employees who are taking a period of long term sickness absence. I provide Fit For Work and Long Term Sick Flow Charts, form for your employee to consent to you requesting a medical report and template letter to send to the GP.

Top tips on managing long term sickness

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