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This page gives advice on the rehabilitation of employees at work after a period of illness or an injury. You will also find details of legal duties and obligations around rehabilitation, and links to further information.
At some time, most employers will have an employee, or prospective employee, with a health problem. This could become evident at recruitment, during a change of job, or when returning to work after illness or injury.
Anyone can suffer difficulties at work because of their health, even if only temporarily. Employers must therefore ensure they do not put their employees' health and safety at risk, or endanger the health and safety of others.
It is important to distinguish between ill health and disability. This topic does not deal with the vocational needs of disabled employees.
For information on disability and the workplace, please see our page on
disability within the Equality Act and also our section on
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There are a few jobs where the law lays down strict standards for physical fitness to protect the employee and others, e.g. divers, members of the police, and fire and rescue services.
There are other jobs where a good state of health is required, e.g. food handlers (who may be carriers of infectious disease), or lorry or bus drivers (for whom a sudden loss of consciousness could have disastrous results).
It is important not to discriminate unnecessarily against people who have health problems. There is a risk that a potentially excellent employee is lost, or that such actions may be challenged by an employment tribunal.
There is a wide range of jobs that require no medical standards or levels of fitness, as they have no serious hazards related to medical conditions or fitness.
Common sense often suggests certain health requirements may be necessary, e.g. good colour vision, or where an employee may be highly allergic to a product used in the work process.
Working at heights may be restricted where an employee is liable to become dizzy or suddenly lose consciousness.
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The health requirements of most jobs are fairly straightforward, but a properly worked out policy identifying and dealing with health problems can save time and money when dealing with individual cases.
A review of the jobs in your workplace may reveal the need for further action, or may reassure you that nothing further needs doing.
The Health and Safety at Work etc Act 1974 Employers have a legal duty under Sections 2 and 3 of this Act to protect the health, safety and welfare of their employees and others who may be affected by the work they do. They therefore need to know if someone’s state of health may affect their health or safety at work.
Employees need to know whether they may be at risk or put others at risk. They have duties under Section 7 to take reasonable care of themselves and others by their actions or omissions whilst at work and to co-operate with their employer.
Job applicants should know the full demands of the job for which they are applying and what training is required.
The Management of Health and Safety at Work Regulations Regulation 3 of these Regulations require that
Risk Assessments consider the risks to the individual. This would include the vulnerable employee, and so employers need to consider who might be harmed and how.
To read more about the above legislation online, follow the links under
Health is only one of several factors involved in the recruitment process, but it important to have health questions related to the job thought out in advance.
Employers may fear that taking on people with health problems could lead to recurrent sickness absence. Do not reject potential employees on this basis; rather give them a chance to prove themselves within a tight probationary period.
It is important to get advice on the applicants’ likely ability, as many health problems do not cause sickness absence. The Disability Advisors attached to Job Centres can help with this, as can the Employment Medical Advisory Service of the Health and Safety Executive.
If you are considering pre-employment screening or a health assessment for job applicants then an Occupational Health professional should be contacted for advice.
Employers must also be careful not to discriminate against people with disabilities or long-term health conditions and that they comply with all the requirements of the Equality Act.
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Employees often change jobs whilst working for the same employer. A good health at work policy should reflect the needs of job change, as well as recruitment.
Job moves can trigger stress in an employee for a number of reasons. Some employees simply need more time to deal with and adjust to the changes, while others may need help to cope.
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Most sickness absence is short term, but research shows the longer someone is off work, the harder it may be for them to return.
The employee’s general practitioner (GP) may know a little about the employee's work conditions, but frequently will know nothing at all. This often gives rise to unnecessary medical certificates or requests for ‘light work’.
The GP might not understand there is scope for modifying work activity, and delay a return to work where someone could be carrying out other activities, or working shorter hours for a period of time.
An early return to work helps both employer and employee because, in a small business, one employee can be a significant proportion of the workforce. Therefore, getting to grips with practical tasks can aid return to normal capabilities and boost confidence.
It is important to consider whether the employee’s ability to carry out the job safely and effectively has been affected by their illness or injury.
Will continuing with that job further compromise the employee’s health?
The employer may have to modify the job, the workplace, the pattern of the work temporarily or permanently, or it may be necessary to find an alternative post until rehabilitation back into their substantive post has progressed.
Arrangements may need to take account of continuing treatment including the effects of medication. In some cases, specialist occupational advice may be required as well as advice on the technical aspects of job modification.
Employers should consider:
Fit for Work Scotland is a free, confidential advice and support service to help manage long term sickness absence. Employers worried about their employees and GPs concerned about their patients can, with consent, refer them to the service (online referral is quick and easy). Provided by NHS Scotland the service offers expert support, assessment and back-to-work advice.
Fit for Work Scotland or call the Adviceline to discuss your options 0800 019 2211.
Sometimes, an employee’s ill health may prove too serious to allow them to return to work in any capacity, and ill health retirement, or a termination of employment may be the only option.
These options should not be considered lightly, and it is important the employer follows the recognised procedures. Not doing so may result in the employee appealing for a ruling of unfair dismissal to an Industrial Tribunal.
Employers must show in all cases that they have acted reasonably.
Essential principles have emerged from past cases that employers should follow:
The Employment Medical Advisory Service (external site) This division of the Health and Safety Executive has a small staff of doctors and Occupational Health Inspectors based in their offices in Aberdeen (Tel:01224 252510) and Edinburgh (Tel:0131 247 2000), or see your local telephone directory.
Jobcentre Plus (external site) The Jobcentre Plus network, part of the Department of Work and Pensions, can give advice on rehabilitation matters. Many offices also operate the
Pathways to Work and the Condition Management Programme.
The Advisory, Conciliation and Arbitration Service (ACAS) (external site) This independent statutory organisation has a national network of offices that provide information and advice on employment practice and industrial relations.
Patient and Voluntary Organisations Organisations, such as the
British Epilepsy Association (external site) and
Diabetes UK (external site), can advise employers on the general needs of people with specific conditions.
The Health and Safety at Work Act 1974.
The Management of Health and Safety at Work Regulations 1999 .
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