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An employer's guide on fit notes

What is a fit note?

On 6 April 2010, the "statement of fitness for work", or "fit note", was introduced with the aim of encouraging dialogue between doctor and employee, and employee and employer, on possible ways to enable the employee to return to work.

How has the form changed?

The “fit note” introduces a number of changes from the Med 3 form. They are as follows:

  • A doctor now has two options: to either sign the employee as "not fit for work", or "may be fit for work taking account of the following advice". A doctor is no longer required to sign the employee as “fit for work” at the end of a period of absence as this section of the form has been removed.
  • To assist the doctor and the employer to identify ways to enable an employee to return to work, the form contains a number of tick boxes for the doctor to complete as appropriate. These cover the following: a phased return to work; altered hours; amended duties; and/or workplace adaptations.
  • If the doctor wishes to tell the employer how the employee's condition will affect the work they do and to put forward ideas which may enable them to return to work, then there is sufficient space on the form to do this. These notes are only advisory. In some circumstances, the doctor may use this as an opportunity to suggest that the employee is seen by the employer’s occupational health advisers.
  • A note issued in the first six months of a medical condition is limited to a maximum of three months duration.

 How do we use fit notes?

  • Sick pay. If the employee is certified "not fit for work", the fit note will be evidence of incapacity for SSP purposes. This will also be the case if the employee is certified as "may be fit for work" but the employer is unable to accommodate any of the suggestions made. This is would similarly apply for company sick pay entitlement in most cases. However, for company sick pay, if the employee refuses to return to work despite the employer being willing to implement the doctor’s recommendations, the employer may want to consider whether the sick pay schemes allows them to withhold payment. If it doesn’t then, as such schemes may be contractual, consent will be needed to amend them.
  • Disability discrimination and long-term absence. The fit note does not change the employer’s duties towards as disabled employee, but is a useful prompt for employers to consider and enter into discussion with the employee about what adjustments should be made. Similar discussions should take place with employees on long term absence as an employer should look at what steps it can take to assist the employees.
  • Does it affect employers’ liability insurance? Some employers may be concerned that their employers’ liability insurance will be invalidated if they allow employees signed off as "may be fit" to return to work once the doctor’s recommendations have been implemented. Attached is a link to the DWP guidance for employers on fit notes. The DWP guidance on fit notes states that insurance should not be affected, but as a precaution, employers should contact their insurer if in doubt. The guidance goes on to say "you will need to continue to manage the employee appropriately and carry out a risk assessment, based on the evidence from the doctor, your knowledge of the work and workplace and further support where necessary".

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