Occupational health Not fit to work: What does it mean?

In this blog we will discuss the question Can occupational health deam you “not fit to work”?

We will also briefly discuss what occupational health Fit to work means as well as what is the occupational health fit to work assessment. 

Occupational health Not fit to work: What does it mean?

If you have been deemed Not fit to work or unfit to work in the Occupational health report after an assessment by an occupational health specialist, this means that your health condition is preventing you from working for a certain period of time. 

Your fitness to work assessment with a medical provider or a medical professional will assess your health condition to determine whether you are fit to work, fit to return to work, or whether you need more time off from work. 

If you have been deemed unfit or not fit to work, this means that your health condition does not allow you to perform well at work nor does it allow you to manage the responsibilities of your role. 

It also advises your managers and employers that you should refrain from working for the time being based on your medical condition. 

What is Fit to work Occupational health assessment?

“Fit to work” or “fitness to work” Occupational health assessment refers to a medical assessment of an employee when an employer wishes to be sure an employee can safely do a specific job or task. 

This kind of medical assessment is usually done by a medical professional that the employee has been referred to do the assessment usually for a medical condition or an injury.

The assessment is done to determine if the employee can medically do the work or the tasks that their role requires them to do- so as to determine medical fitness. 

The main purpose of health assessment fitness for work is to make sure that an individual is fit to perform the tasks of their role effectively and without risk to their own or others’ health and safety. 

The assessment is usually done at the start of their employment contract or after the employee has taken a leave of absence, to determine if after the break they are fit to return to work. 

The assessment is not done to assess if the employee should remain at the job or fired, rather it is done to check if there needs to be any adjustment or accommodations so as to 

allow the person to work efficiently and safely.

According to the Public Service Occupational Health Program, Health Canada (2015), some of the main reasons why this assessment is done include:

  • There has been a significant change in the working conditions.
  • An employee transfers to a position where the working conditions are significantly different.
  • The job at work has been modified and the returning worker is still going for physiotherapy, rehabilitation, or both.
  • There has been a change in an employee’s health
  • A medical condition may limit, reduce or prevent the person from performing a new or current job effectively 
  • A medical condition is likely to make it unsafe to do the job
  • A medical condition is likely to make it unsafe both for him/herself, co-workers or the public 
  • The medical condition may be made worse by the job

It is during this medical assessment, that the medical profession will report to the employer or the Occupational Health partner if the employee is fit or unfit to work. 

While the employer is allowed to ask information to the medical profession related to the contents of the report and issues related to the workplace, the employee cannot ask for details related to the diagnosis of the employee. 

Based on what is reported, the employee must accommodate for the employees health and safety in the workplace which means that they must do all that they can to ensure that the job, the job requirements, or the working conditions are such that the employee can continue working in a way that is safe for the employee and co-workers.

What to expect in a “fit to work” assessment?

After you have been referred to Occupational health, it is likely that you will go through a medical assessment in the case that you do not have any medical diagnosis or in the case you are looking to join work after a sick leave. 

While assessments are usually face to face with a medical professional, in some cases consultations occur over the telephone or in more recent years, via video calls. 

If the assessment can be done remotely, the Occupational health department will send across a date and time of the planned call to you as well as your manager or employer. 

This referral to the OH service is more or less via referral by the company HR or your manager with your consent. 

The telephone consultation will usually take around 30 minutes; sometimes a little longer if the issues are complex. 

Ensure that you are in a room where you can talk privately and confidentially. They will then check your identity and ask for confirmation. 

Once your have been confirmed you will be asked for your verbal consent to carry out the telephone consultation and to release an Occupational Health report to your organisation after the assessment. 

Your consent is required for the consultation to proceed, if you do not want to give consent, inform your manager immediately and beforehand. 

The consultation may be required to record the session for the following reasons:

  • improve the quality of the services we provide
  • train and provide our employees with feedback
  • resolve any complaints or concerns that may arise

The individual who is present for the assessment has the right to refuse to be recorded and must inform the professional present as soon as possible if you do not want to be recorded. 

In the case of a missed call, the assessor and the Occupational Health services will try to reach out three times and if they are unable to contact you after three tries, they will inform your manager and leave a message on your answer phone.

What is occupational health?

Occupational health is one area of the public health domain that is concerned with the physical, mental and social well-being of workers in all occupations.

This area of public health involves promoting, advocating, and maintaining the highest degree of well-being for workers in the workplace across various occupations. 

The main role of occupational health within the workforce is to support management of health issues of employees within the workplace and are concerned with how their occupation impacts the health of the employee. 

It is important to mention that occupational health, while they are occeneed about how the work or the workplace might impact on the employee, it is also focused on how the employees’ health may impact on their performance at work. 

Occupational health within the workplace provides support to employees by interpreting medical information of employees in the case that they are unwell and to present it to Managers in a way that allows for employee advocacy as well as makes rooms for accommodations to support the employee in the workplace.

The support they provide includes providing advice to both the managers and supervisors as well as the employees in areas related to:

  • How the medical condition impacts an employee’s ability to work and perform well on the job as well as the impact it has on their ability to carry out their responsibilities. 
  • Workplace adjustments and accommodations for the employees well being such as reducing work hours or workload. 
  • Time scales for the return of employees to work in the case they wish to take a medical leave of absence. 
  • Advice and referrals to Counselling and Psychological Services or any medical services. 
  • Providing employees with information related to employees fitness to return to work and  remain at their present role.

Occupational health specialists are the professionals that employees often reach out for guidance on the issues mentioned above.

What is an occupational health referral?

The occupational health referral is a process that is designed to provide advice to both employees and employers for concerns that relate to the employee’s health and their ability to do their job.

The process involves consent between employee and employer with a contractual agreement for the employee to provide such consent and to partake in a medical examination process.

In a situation where there is no contractual agreement, the employee must be made to understand that the lack of agreement may impact the employer’s ability to make a fully informed decision about the position.

Lack of consent will not stall the process, and a decision will be made based on available information which might not give the full picture of the employee’s situation. 

Thus it must be understood by the employee that this process of referral and examination is only designed to help them and is in their interest as well as information related to what the referral process will involve.

According to HRZone, referrals are made with the objective of:

  • obtaining information when an employee is on long-term sickness; usually information related to prognosis.
  • finding out if the employee’s is suffering from an underlying health condition which may be causing short-term intermittent sickness that can impact employee’s work 
  • establishing whether or not the employee is fit to attend a disciplinary or performance hearing

Some of the common reasons when a manager refers an employee to Occupational health include:

  • Situations where an employee has been absent from work on a number of occasions in recent weeks/months 
  • Situations where an employee is absent on a long-term basis that has been over a month.
  • Situations where particular patterns have been identified in an employee’s absence 
  • Situations where a potential health problem has been identified and how it impacts the employee’s ability to work.
  • Situation where an Occupational Health assessment is required for employee’s return
  • to work


In this blog we have discussed the question Can occupational health deam you “not fit to work”?

We have also briefly discussed what occupational health Fit to work means as well as what is the occupational health fit to work assessment. 


Statement of Fitness for Work: a guide for occupational health professionals. Gov.UK. Retrieved on 24th March 2022. https://www.gov.uk/government/publications/fit-note-guidance-for-occupational-health-professionals/statement-of-fitness-for-work-a-guide-for-occupational-health-professionals#:~:text=Not%20fit%20for%20 work,to%20%E2%80%9Crefrain%20from%20work%E2%80%9D.

Fit To Work. Ccohs. Retrieved On 24th March 2022. https://www.ccohs.ca/oshanswers/psychosocial/fit_to_work.html

Fitness for work assessments. University Of Cambridge. Retrieved on 24th March 2022/ https://www.oh.admin.cam.ac.uk/services/fitness-work-assessments

Six best-practice tips on how to make an occupational health referral. Fusion Occupational Health. Retrieved on 24th March 2022. https://www.fusionoh.com/blog/how-to-make-occupational-health-referral

Occupational Health Referrals. Guide. University of Glasgow. Retrieved on 24th March 2022. https://www.gla.ac.uk/media/Media_554573_smxx.pdf

Questions to ask when you are submitting an Occupational Health Referral. FusionHR. Retrieved on 24th March 2022. https://www.fusionbusiness.org.uk/occupationalhealthreferral/