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Phased return to work after sickness absence

Written by: Fit for Work team | Posted in: Blog

phased return to work

Returning to work after a long illness can be a daunting prospect, sometimes compounded by a loss of confidence and potentially hampered by a slow recovery after medical treatment.

But there is an increasing awareness that a swift and well-supported return to the workplace (and back to a normal routine) can aid a person’s full recovery and ensure their mental wellbeing.

The fit note, which replaced the sick note in 2010, focuses on what people can do rather that what they can’t. The idea behind the fit note is that individuals do not always need to be fully recovered to go back to work, and in fact it can often help recovery to return to work.  The fit note allows the doctor to make recommendations about adjustments that could be made to your work to allow employees to return sooner than would otherwise be the case. One of these recommendations could be for a phased return to work.

The benefits are twofold:

  • the employer gains the skills and experience of their member of staff;
  • the employee can benefit financially and emotionally from being back at work.

With our ageing population, some experts believe that more people will be faced with returning to work after an illness and that employers need to act to avoid losing some of their most experienced and valuable staff prematurely.

The figures for long-term sickness make for difficult reading. Sickness absence is estimated to cost the UK economy around £15 billion per year. According to Dame Carol Black’s 2008 report (‘Working for a healthier tomorrow’), long-term sickness – defined as an absence that lasts longer than four weeks – accounted for up to 75% of the total sickness absence costs in 2008, and 40 percent of the total working time lost, despite only making up 5 per cent of total absence.

Common causes of long-term work absence absence are back ache, stress, anxiety and depression, coronary heart-disease and cancer. In many cases, with care and consideration, employees can return to the workplace and continue to make an important contribution to an organisation or business despite their health issues.

Meaning of the term ‘phased return to work’

The term ‘phased return to work’ embraces the idea of returning to work gradually, in stages, before an employee can complete all of their normal tasks and/or is able to work all their allotted hours and days. It includes any level of work, from a couple of hours, to a few days a week, but relies on an agreement between the employer and employee. Each employee’s situation is different, so solutions need to be flexible and well planned, including regular reviews of the arrangement and an agreed date to return to their normal hours/duties.

An ideal phased return to work should include:

  • A gradual build up towards the employee’s usual hours and duties that begins with hours of work that are manageable for the employee at the current stage of their recovery.
  • A timeframe that may be as little as one week, and not usually more than 4-6 weeks, unless the employee has a condition with long-term fatigue issues.
  • Consideration of work timings that may support a return to work where there is some flexibility, for example hours that allow an employee to avoid a commute in rush hour traffic.
  • Duties during the phased return that are beneficial to the organisation but that allow the employee to be confident in their return (an example of this may be removing the requirement for business travel initially, or direct customer facing work depending upon the health issues).
  • Review timeframes so that the line manager and employee can adjust, where necessary, or ensure all is on track.

Benefits of a phased return

Both employers and employees will benefit from a planned and agreed phased return to work.

Employers benefit in the following ways:

  • An earlier return reduces costs to the employer by reducing the need for someone else to cover the work.
  • Nurturing employees and making them feel valued increases staff retention and reduces recruitment costs.
  • An organisation’s treatment of its employees while off sick and returning to work can shape the way they and others regard the company. Good treatment will create a positive culture and boost morale.
  • Returning to work in a phased way reduces the likelihood of employees not returning at all, thereby saving the need to recruit and train a new staff member.
  • With an ageing population, employers need to look at ways to encourage and enable staff to return to work after illness and avoid losing them to early retirement.

Employees also benefit from a phased return to work:

  • In general, being in work is good for health and wellbeing and brings financial security. Failure to return to work can lead to them dropping out of work or taking early retirement and exclude people from working life in the long term.
  • Returning to work brings routine and a sense of normality after illness. It increases self-respect, and boosts mental health and social inclusion.
  • A good return to work process could increase a person’s speed of recovery and prevent potential relapses or complications resulting from continuing to be off work.

Key points when considering a phased return

Problems may occur with a phased return to work if it is not arranged collaboratively and with the full agreement of everyone involved.

Key points for employers:

  • A phased return to work is not a quick fix and will involve extra admin and meetings, which can put greater pressure on the line manager. Phased return plans need to be carefully considered and agreed and need to take into account all relevant legislation (e.g. health and safety requirements).
  • A person’s recovery may be slower than expected, which may cause setbacks.
  • Some jobs lend themselves more easily to phased return to work.
  • Developing a sensible return to work plan can be difficult without an understanding and awareness of occupational health issues and knowledge of broaching potentially difficult topics about a person’s mental or physical health. (The Fit for Work advisors can help.)

Key points for employees:

  • If the phased return to work process isn’t properly managed, employees may feel pressurised into agreeing a plan that they don’t believe to be realistic.
  • An unexpectedly slow recovery may impede the return to work process.

Advice to employers

Employers are being increasingly encouraged to be open-minded about the potential benefits of an employee returning to work early, on reduced hours or changed duties. But they need to be aware that the way a member of staff is treated while they are off work through illness will have a profound effect on how they view the company, their colleagues and, ultimately, how successfully they return to work.

Research has found that the actions and attitudes of the line manager can be crucial to a person’s successful return. Line managers can take a number of steps to improve the return to work process, including:

  • keeping in contact with absent employees whilst they are off work in order to keep them updated on the events at work;
  • meeting with absence employees before they return to work draw up a plan for their gradual return. This plan should stipulate what their duties will be and how their hours will increase over time;
  • being flexible with regards to duties and hours and adapting quickly if recovery turns out to be slower than expected;
  • remaining positive, flexible and understanding.

There are quite specific rules that relate to the payment/eligibility of statutory sick pay (SSP) during a phased return.

For guidance about work-related health issues, employers can call the Fit for Work advice line on 0800 032 6235 (English) or 0800 032 6233 (Welsh), or visit the Fit for Work website. Those in Scotland can call 0800 019 2211 (or visit

Advice to employees

Employees should understand their rights with regards to retaining their employment throughout an extended period of illness and should remain flexible and give themselves time to recover at a pace that suits them. To maintain good relations with employers, it’s important to communicate openly with managers about health issues, treatment, recovery and ambitions for returning to work.

For support and information about making a phased return to work, contact the Fit For Work advice line on 0800 032 6235 (English), 0800 032 6233 (Welsh) or 0800 019 2211 (Scotland). Useful resources about work-related health issues can also be found on the Fit for Work website (or

Editor’s note: This article was originally published in March 2015 and was updated in December 2016 for accuracy.


  1. Wayne Trevena


    I worked in I.T. for around 7yrs which ended in May 2007 due to a lost battle with Ulcerative Colitis. I had an operation which removed my large colon so I now have a ileostomy (wear a bag).

    I have not worked since May 2007 for an employer, at present I work for myself as an I.T. consultant and am struggling to get this to a place where I can rely solely on a salary from my own business. I battle daily with my circumstances and am sad at where I am. I have a wife who is the breadwinner, and two adorable children. Were it not for them, I don’t know where I would be. They are my only motivation at present. My purpose to get up in the morning.

    I’ve contemplated going back to work and am typing this now because having seen a couple of potential job opportunities, the thought of attending an interview with an agency let alone a potential employer fills me with fear. I’m sad just thinking about how I seem to lack the courage.

    I feel as though I have so much to offer but am scared at the thought of it all.

    Please can you offer any advice?

    Thank you in advance.

    • Fit for Work team

      It sounds like you’ve been through some difficult times and need to work on rebuilding your confidence in order to be able to contemplate re-entering the job market without fear.

      Having searched around for information I have found a couple of potential resources for you.

      This might offer you some help around confidence building and interview coaching and may be worth looking into. Job centre Plus might also be able to advise you on local resources.

      Cognitive Behavioural Therapy (CBT) might help with some techniques for restoring your confidence and there is a good free online resource called Mood GYM: MoodGYM Training Program where you can register and work through some exercises. You can also begin to look at how to relax when you get anxious about taking steps towards getting back to work using the CBT techniques.

      There are some useful ‘You Tube’ resources about confidence building and interview skills which you should be able to find using your search engine.

      There are a number of books and articles about writing a good CV and interview guides that can be found online or at your local library and you might want to explore this option.

      I wish you luck with your next steps.

  2. Beata

    I’m planning a phase return to work after 3,5 months in hospital as an inpatient. I will still be a day patient there and would like to ask if I would be eligible for SSP if I worked initially 1 day per week – Wednesday, and after some time 2 days – Wednesday and Thursday?
    Could you, please, clarify how should the ‘consecutive absence days’ be arranged? (Because in case of working on Wednesdays the off work days would be: Mon, Tue, Thu& Fri – do they count as ‘consecutive, or would I have to work on Mon and have the rest of the week off in order to be paid SSP?)

    • Fit for Work team

      Thanks for your question. I’m sorry to hear that you have been in hospital and that you will still be an inpatient on your gradual return to work.

      Yes, if you return as you suggest, SSP should be payable for the consecutive days that you do not work.

      I have included a link to the Fit for Work fact sheet about SSP:

      Additionally, If you need further information, you may wish to contact our Advice Line (0800 032 6335) and you can also chat online to one of our specialist advisors or email a question to them.

  3. john smith

    Hi, I have been off work since having a possible seizure at the end of November last year, I have undergone a number of tests to ascertain whether it might be epilepsy which have come back negative.Whilst this has been going on I have been deemed unfit to drive and operate machinery which I am told will be for a period of at least six months.The doctors say I may be allowed back to work if my employer can find me alternative work which does not involve active machinery and I am keen to return as I feel generally fit and well.My problem would be actually getting to work as it is a 17 mile journey and there is no appropriate public transport.I was advised that there may be a scheme which my employer could use to get me taxi’d to and from work,is this true?

    • Fit for Work team

      Thanks for your question.

      Yes, you are correct that there is a scheme. This is called called ‘Access to Work’ and it is a specialist disability service delivered by the Department for Work and Pensions. A person with a disability or long term health condition that has a substantial adverse effect on their ability to carry out their job can apply for support under the scheme.

      This support, if you are eligible, could include grants to meet additional costs for travel while you are unable to drive to work because of a disability or health condition.

      For information about this and how to apply, please go to

      You may also wish to contact our Advice Line (0800 032 6335) to speak to one of our specialist advisors if you need further information about returning to work. Additionally you can chat online to one of our specialist advisors or email a question to them. You can find the links on

  4. Sophie H


    My Mum is recovering from Bowel cancer and chemotherapy. She is currently 7 weeks into a phased return but now her employer has said that she can only have 8 weeks phased return so after that she’ll have to go part time permanently. I’m sure cancer is covered by the Equalities Act. She is not strong enough to return to full time and cannot afford to go part time. Is there a maximum period for a phased return or is it at the employer’s discretion? Is there any advice you can give me?

    Thank you.

    • Fit for Work team

      Phased return duration would normally be at the employer’s discretion. Depending on your mum’s employer’s policies, they may allow her to use annual leave to make up the reduced hours, or have a temporary change of contract for a short period.

      Macmillan have some good information about returning to work after cancer which might be useful for your mum to use when she speaks to her employer

      The Equality Act means that an employer should consider reasonable adjustments but an employer would only pay for hours worked following any agreed phased return.

      You may wish to contact our Advice Line (0800 032 6335) additionally you can chat online to one of our specialist advisors or email a question to them.

  5. Daniel gray

    Hi, I had an accident at work in which a van fell on me and I broke my spine. Iv returned to work on light duties.. Was fine being in the office for two weeks but now iv had a full week in the workshop in the cold and I’m really suffering. Colleagues are being awkward because they want me in the workshop fulltime and I can’t cope with it. I was on full pay on the sick for 3 months and if I get put back on the sick I’m worried I won’t get full pay. Where would I stand on this??

    • Fit for Work team

      I’m sorry to hear about your accident. Payment of sick pay would depend on your employer’s policy on this. You may wish to speak to your employer about whether there is any additional support or alternative work they could consider for you whilst you build up your tolerance to work following your absence which might prevent you having to take further time off work. If you need further information or advice, you may wish to contact our Advice Line (0800 032 6335) additionally you can chat online to one of our specialist advisors or email a question to them.

  6. Elsie May Anderson

    I have been absent from work since August due to fractured hip and femer and had an operation to put pin in my leg. My doctor has given me a sick line saying I can return to work but my employer does not agree and is asking my doctor for a medical report, can my employer refuse to let me go back to work even though the doctors are saying I am fit for work?

    • Fit for Work team

      Your fit note from you GP is advisory and depends on whether your employer is able to accommodate any adjustments to enable you to return to work safely. You do not indicate what type of work you do, however, your employer might consider a referral for you either to Fit for Work for advice on returning to work or to an Occupational Health Provider.

      If your employer has concerns about your safety in the workplace, they may consider completing a risk assessment with you to identify what aspects of your work that you can do and what restrictions are required.

      If you need further information, you may wish to contact our Advice Line (0800 032 6335) additionally you can chat online to one of our specialist advisors or email a question to them.

  7. Tracey

    Hi, I recently returned to work on a phased rtw plan after 3 years on sick leave.

    My company is paying me at the same salary rate I was on when I left, which is now 10k less than the minimum salary of the position and I had been in the position 3 years already before I went on sick leave so was above the minimum threshold originally.

    After a long absence is the employer required to adjust the salary at all?

    Any help would be greatly appreciated as I cannot find any information on this elsewhere.

    Kind regards,


    • Fit for Work team

      I think that you might benefit from contacting Acas, who are the specialists in issues regarding employment law, particularly if you feel you are being unfairly penalised on your return to work. You can contact them and ‘ask a question’
      Or telephone: 0300 123 1100 Monday 8am – 8pm, Tuesday 8am – 6pm, Wednesday to Thursday 8 am – 8pm, and Friday 8am – 6pm.

  8. Katrina

    My nightmare of health issues started July 2015 when I ruptured a tendon in my leg, caused by a small fall. (They still are not sure what caused it), it’s almost unheard of to rupture this specific tendon. It seemed everything was getting better, but then I got bronchitis and a sever sinus infection 11, 2015. I was out of work for almost a week, following my return I started to get swelling in my left wrist, fingers, and ribs. I went into the ER due to severe stomach pain, was referred to a surgeon who removed my appendix. They had to go back in 1 month later to remove my gallbladder due to pain. Both reports show acute inflammation of the appendix and gallbladder, plus I had endometriosis that they removed and had to take out all of my tubes on both sides. With all of this I have had horrible symptoms, but am a high achiever and pushed through work outside of the surgery leaves, but the inflammation is not on both sides (hands, fingers, feet, toes, ribs, and my knees.) I have seen every specialist, but was not referred to a Rheumatologist till August 2016. They did ultrasounds of my feet/toes, wrist/fingers which showed active synovial inflammation, erosion, and effusion (mainly in my wrists/fingers). At my follow-up he put me on plaquinel 8-2016 with a follow-up 3 months later in November, and to see an eye doc before staring medication. Eye doc confirmed active inflammation (put me on medicated drops) and now I have to wear glasses all the time (which I have never had to wear glasses my whole life). My symptoms were getting horrible, I couldn’t even take off my sunglasses in doors. Went back to doc Sept and they initiated Methotrexate. They have increased the doss twice, putting me now on the max injectable dose, with a follow up in January. They state that if no additional improvement then they will add a biologic. I can barely use my hands, let alone type for more than 15 min without them getting stuck in place and the burning pain starts. I have been out of work since September 1st this year, with my leave return ending December 31st. I don’t know what to do, or what my options are right now. Its like a battle that I am always fighting alone, my doctors don’t understand the importance of getting back to work and keeping my job. I don’t want this to be forever, but when I ask my doc he says that its hard to say when or if I will ever be able to get back to that place to work again. He said the only way to know is what I’m doing now, that we have different treatment options, but that he has to wait 3 months between initiating or increasing dosage, to see if it actually is working. Right now they only can tell me that I have an auto immune disease, but since only my compliment levels are the only blood markers showing, and my symptoms currently make it difficult to make a decision as to what disease it is. They did confirm that the eye issue is sjogren’s, but that it’s secondary to the other immune disease that I have. I just with someone had options that are avail that I can look into for my place of employment, other than sit at home and wait.

    • Fit for Work team

      I’m sorry to hear about your health issues and hope that the treatments will begin taking effect soon. You are correct in stating that work of some kind is important for recovery and in order to help you to identify potential return to work options, if this is possible, you may wish to speak to your GP or your employer about referring you to Fit for Work for an assessment. Alternatively, you could speak to your employer about making a referral to their company Occupational Health Service, if they have one or to an external Occupational Health Provider to assess what might be feasible and what adjustments might be available to help you to return to work during this time.

  9. dorothy wainwright

    I was off long term sick with a mild stroke but my gp said I can return to work on lights duties does my employer have to give me a phase to work return before I return to work to discuss things

    • Fit for Work team

      I’m pleased to hear that your recovery is progressing well and you are ready to plan a return to work. Employers are encouraged to accommodate a phased return to work/amended duties where these would be helpful in supporting an employee back to work after illness. This isn’t however a legal requirement and it is up to the employer to decide whether they can accommodate alternative duties or amended hours. If an employer cannot accommodate alternative duties or a phased return to work, you would usually need to remain off sick until well enough to return to your full duties and usual hours of work.

  10. Lisa

    Hi fit for work
    Basically I’m on phased return after an emergency spinal surgery in March.i work as a teaching assistant nd was off form March till July nd been on mornings since even tho I was full time previously . I’m fine working in the mornings as the medication I take in evenings help me through the mornings aswell but cannot take next dose till evenings therefore find it very very difficult to work in afternoons. I have tried it nd had to go home at 2! My employer now wants to refer me to occupational health but my gp still provides fit notes to say I shud stay on mornings only…am getting stressed now as I’m scared of losing my job yet I really enjoy it..also my gp initially didn’t want me to go back so soon but I was adamant I shud to feel better…can you please advise me on my rights nd wat the employer can/cannot do! I’ve got to add employer has been good to let me carry on phased return since July wid full pay nd day have made reasonable adjustments at work for me.
    Many thanks

    • Fit for Work team

      It’s lovely to hear that you have managed to return to your job successfully and also that your employer has been so supportive. It would be standard practice for most employers to refer staff in to occupational health services (where these are available)after a long-term absence or where long-term adjustments are necessary. Referring you to OH is usually a very helpful step for both you and your employer as it should highlight the best practice to keep you safe and well at work, and provides information and advice for your employer on your health issues and how they may impact upon your fitness long term.

  11. Alf

    hi, I was off sick for nearl 6 months after losing loved one. I returned back on phase return over 4 weeks but I was placed in another job ‘temporarily ‘ rather than my existing substantive post, I have worked with company for more than 30 years in the same job and department. I have been back in fulltime work for over 5 months now and still no sign of my original job being returned to me. I have raised it a few times but only meetings off the record seem to be initiated and no real date is given only to say that your position is being considered and because of departmental restructuring they cant confirm a return date. this is nonsense as many others have returned from sickness absence and have been returned back into their original posts, why I am being singled out ? I have witnessed my original seat in the office being sat in by 2 different people doing different jobs in last 2 months but I am not allowed to return to my ‘original ‘ seat, again , I am being singled out. My management are still dithering and still no firm committal date for my return to my substantive post. The ‘temporary job’ that I was slotted into is now stressing me out because of time constraints and targets. If I dont return soon to my original post I may end up going off sick with strees, which I want to avoid . How and what must I do to convince my management to give me back my substantive post without any further delay.

    • Fit for Work team

      I’m sorry to hear that you are struggling with the alternative role that you assumed would be temporary. Ideally, you should request to meet with your employer to raise your concerns and request information about what is happening with your employment. If you still feel that you are being unfairly treated, there is a free, confidential and impartial service that will be able to provide you employment law advice. It is called Acas ( If you have union representation, they may also be able to assist you.

  12. Rob

    This is all well and good if your employer sticks to your return to work plan. More often than not they do not. Before you know it, you are back at work being given sometimes non achievable goals and workload prematurely and find yourself going sick again which increases your absence and harms your absence record.

    • Fit for Work team

      I’m sorry to hear that it sounds like your experience has not been positive. It is really helpful for employers to meet regularly with employees when they first return to work on any amended duties/phased return, as this allows an opportunity to ensure that all is on track and make any adjustments needed to the plan along the way.

  13. lisa

    I was off work for 7 weeks due to a knee ligament injury,
    on returning t work I had a short back to work where they didn’t even access my chair and I came back with crutches as id torn my ligament, this was in july I came back to work in September but since coming back my rle just changed I was a plant cost manager training staff on plant and invoices, since coming back I am like the office junior and the person I trained I answer to him and my line manager tells me to do his filing, I have spoken to my head office and basically they have just said like it or lump it.
    I have been with the company over 10 years and feel I am being discriminated here, what shall I do.

    also my new line manager is a person I trained to be and office manager 3 years ago, I was put on this job covering for maternity so wasn’t really doing my job, but now she is my new line manager??

    • Fit for Work team

      I’m sorry to hear that you feel that you have been unfairly treated at work. I’m not sure if you have met with your management team yet to outline your concerns, as this is usually the best first step to take. If however you are still unhappy and feel that you are not being treated fairly, there is a free, confidential and impartial service (ACAS) that provides advice . You can see more on their website or can phone them on 0300 123 1100.

  14. kadar

    I have been on my annual leave for the last 3 weeks and today i have to report back to my office, but i am little bit sick so can i stay my home or i go to my work.

  15. Mark Myers

    I am currently claiming for ESA and jobcentreplus are not accepting my new return to work plan, because I had sent one in already, from last month. I believed I didnt need a fitnote from the doctors but yet they say I do. They said they will not pay me until I get one, please advise.

    • Fit for Work team

      I’m sorry to hear that you have had difficulty. You do not need a fit note from your doctors when the period of absence is certificated in your return to work plan. Please ask your job centre to contact Fit for Work for more information if they will not accept the plan as evidence of incapacity on 0800 032 6235 as we can advise them directly for you. If it is easier for you, you can contact our administration team on 0203 425 5000 and we will take details of the job centre you are using and follow this up for you.

  16. John


    I have a quick question regarding my current situation.

    I have been given a return to work note by my GP that stipulates certain criteria for the first week – I can work remotely but can only drive for up to 20 minutes. Following week 1 it is then outlined it is down to myself to judge distances to travel.

    My role is uk based so normally I would do quite a bit of travel. However, I am unable to fulfill this criteria of my role but still able to attend 1 of our sites and help in other areas in the business whilst working remotely – also this allows me to catch up with what I have missed whilst being off sick.

    I think this is a fair phased return option for my employer to to take but they have refused and state I must stay off sick.

    This financially impacts me significantly as I will be on SSP so I lose earnings despite wanting to return to work.

    Is this correct or do my employer have to allow me back to work under these recommendations?

    Any advise is appreciated as I cannot afford the loss of earnings.

    Kind regards

    • Fit for Work team

      I’m sorry to hear that your employer has been unable to accommodate the advice from your GP. Recommendations about adjustments to support your return to work are advisory only, and it is entirely at your employer’s discretion to decide what they can and cannot implement. Unfortunately, this does mean that your employer can stipulate that you remain absent from work until fit to return to your full duties. If you feel that you could compromise a little with the advice from the GP (it is a recommendation only) and carry out some more of your work duties and return to work a little earlier, it may be worth discussing this with your employer.

  17. josefina arcay

    Hi i have a question,
    the case of an employee who did not work for 8 months, does she have to re-apply all over again ? or do i just have her update her records by submitting professional license and other requirements rather than than starting all over again like a new hire?

    • Fit for Work team

      I’m sorry but I’m not really sure from the information that you have provided that we are best placed to help you with your query. ACAS ( is a service that can provide specific impartial employment advice which may answer your query.
      The Fit for Work team

  18. Tom

    Dear Fit for Work Team.
    Year ago i hurt my back at work so im on sickness leave at the moment, my GP send me to neurosurgeon for consultation, it take 11 months to get appointment, mean time i went to company doctor who told me to take a pain killers and go back to work. 6 months later when i get finally fit for work from my GP and want to return to work same company doctor not allowing me and forcing that im depressed. What i should do now? It was very difficult year for me and every day is fight for surviving but im not feel depressed, im not in great mood but that normal.


    • Fit for Work team

      It’s good to hear that you now feel that you are ready to return to work. Your company doctor has clearly formed some concerns about your mood level from discussion with you. Your employer is likely to take any concerns raised by your company doctor seriously as they would usually be considered the experts in understanding the relationship between your health and your job. If you contact the occupational health unit directly, they should be able to provide you further information in relation to their advice. If you have been in regular contact with your GP and your GP feels that you are fit and well, the occupational health company may request a medical report with your consent to confirm this.

  19. Abbey

    Hi. I had total abdominal hysterectomy nearly 12 weeks ago with vertical cut to my abdomen. My 12 weeks sick note will expire in 3 days time. Currently I still don’t feel well enough to go back to work as I can still feel pain in my belly and discomfort especially when turning. my tummy still feels swollen. I have seen my consultant and GP’s and they tell the same thing that it is a major and big surgery and so it will take awhile to fully recovered. I went back to my GP and has given me further 8 weeks sick note.
    I was seen in Occupational Health at work and was surprised that further 8 weeks has been given, that 8 weeks is a long time to come back. She want’s me to come back sooner if not now in a phased return. She even emphasized that normally estimated sick off for hysterectomy is between 6-12 weeks which i already had. I do understand that but what can i do if my recovery is slow. Although I keep on telling her that i still feel discomfort and pain hence a GP has given me further sick note especially that i work in a busy department. She is imposing that I should really need to come back to work. No compassion or gentleness in the way she spoke to me. Very upsetting experience. I know that I need to go back to work as soon as possible as it affect my work place. But maybe a little of compassion and understanding from your work force will be a great help, but instead it made me feel worse.
    Does the occ health has the right to force me to come back to work even with sick note?

    • Fit for Work team

      I’m sorry to hear that you are still struggling after your surgery. Your employer is entitled to take advice in relation to your fitness to work from their occupational health team who would usually be considered the experts in understanding your health and fitness to work and the environment you work in. Returning to work can be difficult after major surgery, but if the return is planned well, it can be a positive factor in the progress of your recovery. You do not need to be 100% fit to return and if there are adjustments in place to support you, you may well find that you find that the return helps you to feel better as long term absence can begin to impact on your mood and confidence. I’m sorry to hear that you feel there wasn’t much compassion shown in dealing with your concerns.

  20. Jomel

    I am absent in my work for 4 days. Still i have a right to go back to my office even though i only notified them 1st day of my absence?

    • Fit for Work team

      You should ideally always ensure that you keep your employer informed of your absence and when you intend to return to work. You would be able to self-certificate for a 4 day absence and do not require a fit note from a doctor. There should not be a problem in you returning to work after a 4 day absence, though your employer may have concerns if you have not maintained contact during this time.

  21. John

    I’ve been off work for a while. My GP signed me to return to work on the 29th after one final round of treatment. During this period my Manager decided to move for an ill health dismissal on the grounds that it would be not known when I would be well enough to return to work. This was despite receiving a fit for work note from my GP specifying the 29th of September as a return date and my own confirmation that I would be well enough to start a phased return at this point. The cause of the illness is unknown, but vitamin boosting treatment along with dietary controls has caused the symptoms to disappear permanently.

    Now I have just found out that I am to have an ill health dismissal meeting on the 7th of October, just over a week after I have returned to work.

    I would appreciate any advice with regards to my position and also understanding what exactly is going on here, because from my position, having an ill health dismissal meeting with someone who has been signed as fit to return to work seems incorrect. It’s just causing me stress and worry that I would return to work and then get dismissed despite finally being well enough.

    Many thanks,


    • Fit for Work team

      I’m sorry to hear this but pleased that you have recovered well. There are quite complicated rules in relation to dismissal on the grounds of medical capability and you can find more information at Your employer can look at attendance over a long period if there has been more than one absence but usually would have met with you and discussed their concern. Acas are a free impartial service that provide employment law advice to employers and employees and are likely to be able to provide you with more specific advice. Their website is

  22. Dawn

    I am on a phased return to work with both my employers one employer is being very helpful and staturgies are in place, the other not very haloful at all, and putting a great deal of stress on me can to continue a phase to work with one and put a sick note into the other

  23. Kevin

    When a member of staff returns to work and is recomended for a phased return – is there a timeframe where an employer is expected to pay full salary without time being acounted for as sickness absence and or maybe annual leave?

    • Fit for Work team

      The decision about whether salary should be paid to an employee when they are on a phased return rests with the organisation and any policies already in place. The employee should, of course, be paid as usual for any hours worked. The non-worked hours may qualify for statutory sick pay, but there are very specific requirements to ensure that the absence qualifies for this – more detailed information is at or the HMRC website. The employee may use excess annual leave during the phased return for the non-working days or hours, or opt not to be paid. Some companies do opt to pay staff full salary during a phased return for an agreed number of weeks (not usually more than 4-6 weeks maximum) but there is no requirement to do this.

  24. Carley

    Hi I have been on phased return since February following some very serious back operations, I now feel well enough to go back to my normal hours but my employer is making this difficult where do i stand?

    • Fit for Work team

      I’m assuming you had a recommendation from your GP for a period of reduced hours after your surgeries? If this advice has now expired, and you now feel well enough to be fully fit for your normal hours and duties, there should be no reason why you cannot do this. However, your employer may have concerns about your health and you should discuss these together if this is the case – your employer could carry out a risk assessment. You can also return to work before your fit note expires, but if this is the case, we would definitely recommend a risk assessment be carried out to ensure that your return is safe. If either you or your employer would like to discuss this, we would be happy yo advise you more specifically though our advice line.

  25. Louise

    Hi, I have a staff member that keeps getting phased returns to work from his GP – he’s been at four days a week for 6 months now. We’d like to make this a permanent arrangement and reduce his working hours to 80%, but understandably he’s not keen if he keeps getting fit notes from his GP and therefore getting sick pay. Can we change a person’s contract if they’re not able to work at 100% for the foreseeable? We keep asking for an indication of when he thinks he can return at 100% but never get an answer.

    • Fit for Work team

      As an employer, you are able to decide what is ‘reasonable’ for your business to accommodate. The employee may be protected by the disability component of the Equalities Act if the relevant condition is long term and impacting upon his activities of daily living. Regardless of the protection if this applies, you should be able to meet with the employee and discuss how you can accommodate the longer term needs, consider adjustments where relevant and also manage the regular absence if this is impacting upon your business. You may wish to seek further advice from ACAS on this ( in relation to any employment law matters.

  26. adam


    My wife has been off work now for six months due to breast cancer, she returned to work on Monday.

    She has asked that she is given more flexible working as the driving to and from work is very tiring, some days she wakes up and just cannot face the drive to work. Most days she is sitting in the office doing work she could be doing at home on the laptop they have supplied her with.

    Her employer has said that they will give her a months phased return and then they expect everything to be back to normal or she will have to go sick again.

    Do the company not have to make reasonable adjustments even if they are to be permanent?



    • Fit for Work team

      It’s good to hear that your wife is getting better and has been able to return to work. The company can decide if they are able to accommodate an adjustment to work, whether this is temporary or a permanent change. It would be a shame for your wife to return to sickness absence after one month if she is able to manage the majority of her duties and needs only minimal support. If there is access to Occupational health support? ?This may help to plan an effective and sustainable return to work. If not, it would still be good to meet with the employer to discuss the help that may support her in work. Your wife would be protected by the disability legislation (the Equalities Act 2010) – but it is still up to the employer to determine if an adjustment is reasonable for them to accommodate. You could call our advice line on 0800 032 6235 if you or the employer would like any more information.

  27. Jason

    over Christmas i suffered sever bullying from my employers which resulted in me having severe anxiety/panic attacks as well as being diagnosed with depression. i was on sick leave for 4 month and have had therapy to assist me in trying to return to normal. my employers reached out to me and even sent me a letter offering support to help me return to work. we had several meetings to discuss this and i have since been back at a reduced rate for 7 weeks. my employers came to me this week and said that as of next week i am back to my normal hours (18 currently going to be 40) and working the night/weekend shift every week. as a result of the medication i am on i no longer am able to get myself around and rely on public transport and explained several times at the meetings i would not be able to work the shifts i once did. my employers have ignored all the things agreed at the start of this ( slowly upping hours and working day shift and 1 on 1 off weekends) and telling me they dont care i cant do those shifts because they need me to do them. i have since got a doctor note telling them i cannot do what they are asking but they brushed it aside and said that once it expires i will be doing what they want me to work. as a result of this i now feel worse than when i first went off. i feel scared and afraid while at work (especially around management staff). i am waiting to hear back from my therapist but is there anything i can do here? they aren’t following through with what was originally agreed and are impacting my mental health once again.

    • Fit for Work team

      I’m sorry to hear you are struggling – though it is good that you have managed to return to work and it does appear your employers are trying to offer some support. Unfortunately, the recommendations on a GP fit note are only recommendations and can be implemented at the discretion of the employer. If not done already, it may be helpful for your employer to carry out a stress risk assessment with you which helps to identify areas of concern, and support that can help you remain in work and progress back to good health. More information on stress risk assessments can be found at:

      An occupational health assessment may also be helpful to support you in work, and if your employer or you would like to understand more about this or about a stress risk assessment, you can call our advice line on 0800 032 3265.

      I hope your recovery continues and please don’t hesitate to contact us on the advice line if we can be of further assistance.

  28. Gaynor Morris

    Hi I am recovering from total knee operation and have 4 week left before I go back to work however I am concerned that I will not be able to do my job as 90% of my day i am standing a phase return has been suggested how does this work as I work 4 days a week am I expected to work a full day or so I work so many hours per day could you please advise

    • Fit for Work team

      Hi Gaynor,
      Thank you for your enquiry. We hope your recovery continues well. A phased return is usually agreed between the employee and employer and can be set for any number of hours or days but is usually for not more than 4 weeks. A phased return would allow you to limit the length of time you need to stand and gradually introduce you to your duties. There may be other temporary adjustments that are also helpful. Your employer can refer you to Fit for Work for a free confidential assessment to help to support you back to work if you are both in agreement. There is more information on our website (
      The Fit for Work team

  29. Liz

    Hi i have been off sick for 14 months and i have just been deemed fit for work. HR have advised that a date for my return needs to be set but i am afraid that this can take some time as my employers will not be prepared and possibly a new role will need be created?. My question is from when i submit a fit note am i entitled to go back on the payroll from the date of the note or do i have to wait for my employers to confirm a date in the future and suffer a financial loss?

    • Fit for Work team

      Hi Liz,
      Thank you for your enquiry. This can be complicated. If you are ‘fit for work’ (i.e. There is now no current fit note in place) then your employer would assume you are fit for your full role. If you are not fit for your current role and require adjustments, you would usually have a fit note that says ‘fit with adjustments’ from your GP which should include some information about what would help you to be at work. If the adjustments cannot be accommodated with immediate effect and there is a lead in time whilst this is organised, your fit note ‘fit with adjustments’ essentially transfers to ‘unfit’ and you remain off work until you are either fully fit or the adjustments are possible.
      It may be helpful to be referred to Fit for Work to help to plan your return to work if your employer would like to do this. You can see more information on our website
      The Fit for Work team

  30. Penny Sexton

    Hi there,
    Are you able to advise me? I have been off work for the last 6 weeks due to a mental health crisis and am due back next week.
    My work doesn’t have a Occ Health department but I have been advised by the hospital to come back as phased return. How do I go about telling my boss this? Or should it come from my doctor? Who advises me how to go about instigating the phased return? I feel it should be someone official, rather than me. But I am lacking in information.
    Also, although I have been discharged from hospital it has been advised I will continue treatment for the next 6-18 months which might involve 2 days a month. I am not sure how to discuss this with work as nothing is confirmed yet? I guess they can’t cover my pay for those times I am off for treatment?
    Finally (sorry about all the questions), are you able to advise me- I have been told I can’t drive for 3 months, and I can’t get to work via public transport, is there anyone who might be able to help me with this?
    Many thanks, Penny

    • Fit for Work team

      Hi Penny,
      Thank you for your enquiry. We are pleased to hear you are recovering well and ready to consider a return to work. As you have been off work now for more than 4 weeks, either your GP or employer could refer you to Fit for Work for an assessment and we could look at what options would support your return to work. There is more information on our website for your GP or employer about how to refer ( , but it sounds like an assessment by one of our health professionals could really help to ensure that the right support is in place. Time off for further medical support and whether this is paid or not is really down to the policies your employer has in place.
      The Fit for Work team

  31. Dave Beston

    I had a hip replacement operation 15 weeks ago which has been successful. Prior to that though I was diagnosed with a blood clot in my leg and I attend the Warfarin clinic every few week. My employer pays full pay for 26 week. I have had 13 week off so far I am undecided whether to return to work now or have the full 26 week off as my leg still swells up. Obviously i will have to return to my GP to get further sick note.

    • Fit for Work team

      Hi Dave,
      We’re sorry to hear about the difficulties you have had with the blood clot, but very pleased your surgery went well. It should be possible to plan a safe return to work for you now. More information would be needed around the swelling of the leg as you may need some adjustments to help you. It’s very unlikely to be helpful for you to remain off sick more long term as returning to work can usually help you towards full recovery more quickly.
      The Fit for Work team

  32. Elaine

    Hi I have been off work for a year due to me having an operation on my elbow that hasn’t really gotten better. I agreed to working mornings as my pain worsens throughout the day with the Area Manager and 2 shifts a week for a while. However the Branch Manager has put me down to work a late shift when I agreed to do mornings. What should I do as I’ve gotten back in touch with the Area Manager and he hasn’t responded.


    • Fit for Work team

      Hi Elaine.
      Thank you for your enquiry. This looks like a simple communication issue which can hopefully be resolved with discussion with either the Branch Manager or Area Manager. If, however, it is not possible to resolve this by discussion, your fit note can revert to cover an absence if the phased return is not possible. We hope you can resolve this with discussion though, as after such a long absence, a phased return to work is very likely to support you to return more successfully.
      The Fit for Work team

  33. rita jones

    my wife as work at ladbrokes for 40 years has been bullied for 12months by her superviser and area manger she finished work they sent letter she will get 3months pay and holiday pay what they said she will get as yet she as not been payed a penney what can i do i have sent letters to there h r in february which they have never got back to me

    • Fit for Work team

      Thank you for your enquiry and we are sorry to hear your wife is having such a difficult time. We feel that your question would be better answered by ACAS as they can deal more appropriately with employment law questions such as this (our expertise is more related to health and work). You can contact ACAS in a number of ways, they have a website where you can ask a question (just as you have here) or you can call them to speak to one of their advisors on 0300 123 1100. Alternatively, the Citizens advice bureaux provides excellent advice and support
      The Fit for Work team

  34. Elaine Williams

    Hi, please can someone help me, I have worked for a company for 8 years and work 4 on and 4 off 12 hr night shifts, 1 year ago I was diagnosed with ME and Fibromyalgia and Osteoporosis and have been in chronic pain and tiredness so was off sick for 6 weeks, my doctors put me on medication and I have returned to work on reduced hours with a fit note from the Doctors until I am fit enough to resume to my normal hours so I only work 6 hrs a night shift instead of 12 hrs. I am contracted to have 30 nights holiday a year for 12 hrs a night but my company are only paying me 6 hrs now while I am on reduced hours. Are they allowed to do this as I thought I would be entitled to my contracted holiday hours?

    • Fit for Work team

      Hi Elaine,
      Thank you for enquiry. Holidays are usually accrued in relation to the hours you work, but as your altered hours are temporary and not contractual I suggest that you discuss this further with your Human Resources manager as our area of expertise is not really related to pay. You may find that ACAS can provide you with future information as they deal primarily with employment law. They can be contacted on 0300 123 1100 or on
      The Fit for Work team

  35. Sean

    Hi. My wife is currently off work with depression and anxiety, her original sicknote was due to end on April 2nd. 3 weeks prior to this she agreed a phased return to work when she eventually returned with reduced hours for a month or two to help her get back into the routine of working. (Working one less day a week) This was done on the advice or her companies occupational health department

    Her condition has not improved, it has got worse and a further sick note was issued for her on the 26th of March meaning her return to work would not be happening until the start of June instead of April. Her employer was given this note well in advance of April 2nd and she is in constant contact with her boss

    Her employer has advised her yesterday that her pay would be reduced by £340 a month for the next 2 months as even though she hasn’t actually returned to work yet the company have changed her shift and reduced her hours. This was meant to be for a phased return to work when actually has ‘returned to work’.

    Her boss is saying that they submitted a ‘flexi time request’ for 2 months instead of a phased return to work and they will not change pay back to full time ssp. I feel they are taking advantage of her and she is in no state to fight it with them. Is there anything I can do to help her?

    • Fit for Work team

      Hi Sean,
      We are sorry to hear that your wife has been too unwell to return to work as planned and that there has been some impact on pay. Unfortunately, we cannot provide legal/financial advice at Fit for Work as we are health professionals, but it is likely that ACAS will be able to provide more specific support in relation to the fairness of contractual changes during absence. Their website is and they provide free impartial employment law advice to employees and employers.
      The Fit for Work team

  36. Richard Cossier

    Hi, I have needed to take sick leave due to stress , following an at-work panic attack . I have had counselling , paid for by my employer . The counsellor tells me take as much time as I need before a phased return . Our occupational nurse supports this action .However my GP suggests no more that 2 weeks absence only.

    Can my employer decide who’s advise to following bearing in mind the Fit to Work documentation is a medical document ?



    • Fit for Work team

      Hi Richard,
      Thank you for your query. Sorry to hear you have not been well recently. It is important that you feel well enough to return to work, however, returning to work can be part of the recovery process and can be helpful, remember you do not need to be a 100% fit before returning to work. If your anxiety is linked to your work it is also important to address this and to do so you can discuss a Stress Risk Assessment with your manager, the following link will provide you with some guidance around this issue Remaining absent can increase your anxiety if you do not deal with the causes. You should work with your counsellor to build some coping strategies, to manage any future anxiety, you might also find some self help techniques helpful with this and many can be found on the NHS choices website. Evidence does show that the longer you are absent, the harder it is to return to work.
      It is for your employer to decide whose advice to follow. But if you really believe that you are not currently in a fit state to attend work, then I would suggest you discuss this further with your GP, explaining to them how you feel and why you do not feel ready to return to work. Your GP will generally be happy to review your situation as the need arises.
      We hope you continue to recover and have a successful return to work when the time is right.
      The Fit for Work team

  37. Tan Abbott

    My Partner has just agreed a phased return to work after being off for the last 5 months with PTSD. His employers have been fantastic, however nobody seams to be able to answer the question about his pay. He is salaried, and normally would work 8am till 5.30pm. His Phased hours are 10am till 2pm. Are you able to advise what % of his salary he will be paid please ?

    Many Thanks,

    • Fit for Work team

      Hi Tan,
      Thank you for your query. Generally it is up to the business to make a decision about what hours they will pay during a phased return to work, some business may opt to pay full salary and others will only pay for the hours their employee works. With regard to the payment of SSP, because your partner will be working every day, he would not be entitled to receive SSP, the following link will provide more information about payment of SSP. Please do not hesitate to contact us if we can be of further assistance.
      The Fit for Work team

  38. Danielle

    Hi, I have been off work since the end of November 2015 with my relapsing/remitting ms, I work 4 days a week and I am due to go back on a phased return to work, I want to drop a day as I think that it would be too much for me due to my increased fatigue, if I work 16 hours am I entitled to help from the government due to my illness? I want to be sure that I could get some help before I drop the day and discuss with my employer.

    • Fit for Work team

      Hi Danielle,
      Thank you for your query. It is not clear whether you are already in receipt of any benefits, but it may be that there is financial support available to help you if you choose to continue to work but reduce your hours. We do not provide any specific benefits advice, but you can find out more at:
      This is a free government funded website that is confidential and looks at your earnings and other details and helps you to decide if you should apply.
      Good luck on returning to work.
      The Fit for Work team

  39. Andrew Dodds


    I am in a bizarre position – after a phased return through March I started working full time from the start of April, which I am perfectly capable of and have been doing. However, they are demanding a note from the doctor saying that I am fit for work, even though I am currently working full time and contributing fully. The doctors are refusing to issue one to me because this note doesn’t really exist. What am I meant to do?


    • Fit for Work team

      Hi Andrew,
      It is good to hear you are progressing well and have returned to your normal hours of work successfully after your phased return to work. Your GP is quite correct in stating that GPs no longer issue fit notes to confirm fitness for work. You could provide your employer with the Fit Note guidance which can be found at the following link, – page 3 provides confirmation of this.
      If your employer continues to want you to provide medical evidence they may need to write to your GP for confirmation of your fitness, there will however, be a charge for this service, and your full consent will be required. If your employer is concerned about your safety and insurance cover, then discussion with yourself followed by a thorough Risk Assessment should be adequate to reassure them.
      The Fit for Work team

  40. L Badenoch

    Hi all,
    I have been signed off work for the last 7 weeks with an ankle ligament tear, my recent sick certificate expires next Monday and I have told my manager I will be returning to work however I have been told by my physio that even though it is upto me whether I go back to work or not I can not be putting any extra pressure on my foot whether that be manual lifting or being on my feet for long periods of time which is 90% of my job, having told all this to my manager he has told me that I am not fit for my job role and I need to be signed off for a further period of time untill I am fit but only a couple of weeks ago my manager contacted me to ask if I can come in to work to only sit in our office so he can take holiday, but now he can’t make these reasonable adjustments for me to return.
    Is he in the wrong or should I be signed off untill I am 100% fit.

    Kind Regards Lee

    • Fit for Work team

      Hi Lee,
      Thank you for your enquiry. It is for your employer to decide whether or not they can make a reasonable adjustment, and as you indicate that 90% of your role would be difficult at present, it may be that they are unable to make large changes. You might consider speaking to your manager to see if any other adjustments might be possible, and if so, agree between you what you can/cant do. If your employer is unable to make the required adjustments then they are within their rights to refuse.
      You may wish to consider if a referral to Fit for Work is possible to assess what you can or cant do, and to make recommendations about your fitness. If this is something which interests you either your employer or your GP is able to refer you to ourselves.
      The Fit for Work team

  41. Janey Kennedy


    I have been off work since October last year and am finally making progress regards returning to work. My GP has prescribed me medication that makes me drowsy but hopes that this will decrease over time as I get used to it. He has written on my fit note that I may be fit to work but that my employer should be aware of the sedative effects of the medication. I have been in regular contact with my manager and at the beginning of February we discussed a referral to our Occ Health for an assessment however she only made the referral last week and now says that I cannot return to work until Occ Health have assessed me. I am also about to go on to half pay. Do I have to wait for the appointment at the end of March before I return to work or can I insist that I am fit to work and return next week as I had hoped?

    I would appreciate your advice please.

    Many thanks


    • Fit for Work team

      Hi Janey,
      Your employer or GP could refer you for a Fit for Work assessment as you meet the eligibility criteria and this would progress much more quickly. Your employer may still wish to wait for an opinion from your own occupational health department, but please do ask if she would like to consider a referral, or contact our advice line for further information as we would be happy to help.
      The Fit for Work team

  42. Agge

    Hi , that is me (Agge) again.
    What if I have a fit not and my employer still doasn’t want to put me on rota? The manager said to me that they don’t have hours because of the refurbishment. I don’t know what to do now. SSP is not enough. Someone told me that if I’m fit to work and my employer doasn’t won’t to take me back because “refurbishment issue ” still have to pay my contact salary. Is that true?

    • Fit for Work team

      Hi Agge,
      Your employer is normally entitled to tell you not to come into work, but in many cases they will still have to pay if you are fit to carry out your role. Your employer can lay you off without pay or on reduced pay if this has been written in your contract. For further information on your rights you would be advised to call ACAS (0300 123 1100). This service offers free and impartial advice to employers and employees on workplace issues.
      If you are still unable to perform all your job tasks and your employer cannot find you alternative work then you would need to remain on either the company sick pay or SSP. You could ask either your employer/manager or GP to refer you to Fit For Work. A case manager can listen to your concerns and work with you to support a return to work. Provided you consent your case manager can speak to your employer/manager about adjustments that may help you return to work at a time that’s right for you. You can find out more about the service and how we can support you here
      The Fit for Work Team

  43. Alex C

    Hello !

    I am in the following situation. I have strong lower back pain , and I am unable to go to work , mainly because it involves lifting,pulling, pushing . I have visited my GP he classified me as unfit for work , but without any time interval. He said that I do not need more then 7 days rest therefore I do not need a medical leave , as my employer does not require any medical proof if the time off is less then 7 days . When I have talked to my employer , he urged me to read my contract that states that I am not entitled to any kind of pay when I am, for no matter the period of time, on sick leave , including with medical leave from my GP that may state that I am unfit to work for whatever time he considers sufficient , while I am on my probation period . So basically as the probation period ends on the 26th of March if I cannot work until then I will get paid one single penny .

    As this happened on Friday 19th of February , when I went to work to show my manager the letter from the GP he said that the paper is useless , he ripped it , and then he told me that if I want to stay home I can use my holiday days . Which I have agreed.

    Can you please give me some advice on how to adress this situation ? It feels rather illegal to not pay any medical leave ….


    Alex C.

    • Fit for Work team

      Hi Alex,
      Thank you for your enquiry. With regard to company sick pay it is up to your company’s policy if this is payable, and it is not unusual for company sick pay not to be paid during a probationary period. However, providing you are eligible, Statutory Sick Pay is legally payable. The following link has some information for you which details when you are eligible for Statutory Sick Pay Having read this, talk to your employer if you think their decision not to pay you SSP is wrong or you’re not getting the right amount of SSP. You can ask them for a reason. If this doesn’t solve the problem, contact the HM Revenue and Customs (HMRC) employees’ enquiry line on 0300 200 3500.
      With regards to your GP note, it is advisory only. However, your employer has a duty of care under the Health and Safety at Work Act 1974 to protect your health at work. If your employer decides to ignore medical advice and you suffer a further injury as a result of their actions towards you they may possibly have to justify their decisions at a later date in a court of law if it came to it. It is worth noting you also have a responsibility for your own health under the Act and so you would be advised to risk assess your tasks so you don’t injure yourself further.
      The Fit for Work team

  44. Agge

    Hi I have been on sick note 3 month after hip arthroscopy. I decide i would like to return to work. After when I spoke with my manager and HR they ask me to bring medical certificate, and werbaly they gave me” return plan” . the plan is just only for a few hours weekly, and I understand that they want me to coming back slowly, because they worry about my condition.
    Because my contract is on full time( 40) I was wondering how they will pay me. When I ask my manager she was a little bit unhappy. She said that they need to check it, and then they will let me know. Since that conversation they didn’t give me any answer, I was contact them, sending emails, and nothing. The fit nott witch i get from GP(maybe fit for work) will be expired soon. It seems like they don’t want me to back because better for company will by if I”m still on a SSP.
    And I really want to back.
    Is the way how they dealing with my case correct?


    • Fit for Work team

      Hi Agge,
      Thank you for your enquiry. We are pleased to hear you are recovering and keen to return to work. With regard to your employer asking you to bring a medical certificate this is not required, your current fit note states that you may be fit for work, so this is confirmation that you can return to work, GP’s no longer issue a note which states you are fit for work, and you may return to work at any time during a fit note providing both you and your employer feel you are fit to do so, undertaking a risk assessment if necessary.
      How they pay you while you are working reduced hours will be a decision for your employer and depends on their policies. They are only obliged to pay you for the hours you work, I would suggest you continue to discuss this with your employer to understand what their policies are. You may be eligible for company sick pay or SSP – please see the attached link for further information about SSP payment.
      With regard to how they deal with your case, it does sound as though they are keen to support your return to work in a way which eases you back to work slowly so that your health does not deteriorate, but if you feel able to undertake your full hours and duties you should discuss this with them.
      The Fit for Work team

  45. Sophie

    Hi, I work for a large company but am not a member of the trade union.

    12 months ago I was in a car crash and suffered whiplash (severe neck and back pain) a condition that got progressively worse, and whilst I attempted to work I had to go on sick leave after a few days and still unable to return. During my absence, both my direct boss and senior management has changed, meaning I have no rapport, relationship or work history with either. Therefore it has been challenging to have very personal conversations about my condition.

    During this time, I have had regular contact with occupational health whom have also recived reports from my GP and an independent osteopath. 12 months on I am still having twice weekly physio sessions, counselling for depression and a myriad of painkillers. Both my GP and physio agree I am not fit for work and my work occ health reccomend another review in three months time.

    However, I have been contacted by my new boss, pressurising me to return sooner rather than later, starting with a phased return of one day a week (my contract is for 21 hrs), suggesting it is detrimental to the team and my future role if I do not return soon.

    Is this allowed? My concern is not just being able to competently do my job, but also being able to cope with the travel to work. Due to my condition, I am unable to drive for the period of time required to get to work, and travel by car and public transport would exhaust me before I got to the office.

    • Fit for Work team

      Hi Sophie,
      Thank you for your enquiry. We are sorry to hear you are having a difficult time following your whiplash injury. In terms of the contact with your boss, The Health and Safety Executive (HSE) advises employers that keeping in regular contact is a key factor in helping employees to return to work after sickness absence. It is recommended that employers create a climate of trust by adopting a sensitive flexible fair and consistent approach when contacting employees who are off work due to long term sickness. The HSE also recommends that managers don’t say things like “colleagues are under pressure” or that “work is piling up”. It may be worth having a conversation with your new employer and explain how you’re feeling pressured to come back to work before you’re ready and that you do hope to make a good recovery. If your mobility is the main barrier you might discuss this with your manager, you may wish to ask if would there be any chance of you being provided with transport as this is preventing a return to work. Ultimately it is for your employer to decide if this is reasonable or not.
      If are unable to return to work your employer may decide to follow their sickness absence policy if they are unhappy with your level of sickness absence. The current government guidance as out lined in the Fit Note is that employees don’t have to be 100% fit to return to work if their employer can make adjustments that would support them returning to work sooner.
      If you feel you are being treated unfairly then you would be advised to contact Acas. They can provide information, advice, conciliation and other services for employers and employees to help prevent or resolve workplace problems.. It may also be that you decide to follow your company’s grievance procedure. You can call Acas on 0300 123 1100 or you can read information about work place issues on the Acas web site With regard your condition, you might also find a short book called ‘The Whiplash Book’ useful.
      The Fit for Work team

  46. Siobhan Caulfield


    A colleague of mine has returned to work on a phased basis as recommended by her doctor, however her manager has told her that she must use her annual leave for the time she is unable to attend work despite her doctor recommending a phased return, surely this is incorrect as on the days she is not at work she is unfit to be at work and should therefore be completing self certs.

    • Fit for Work team

      Hi Siobhan,
      Thank you for your enquiry. We are pleased to hear your colleague is improving to a point where she is able to begin to return to work. Management of the phased return to work does remain the decision of the employer, your colleague is able to submit a self cert for the days she is not working, however, if her GP has covered her phased return to work with a fit note, then a self cert will not be required. Your company’s absence policy should cover the eventuality of a phased return to work, and how this will be paid with regard to company sick pay, including whether using annual leave is expected. Our guidance sheet on Statutory Sick Pay will give you some information about whether SSP would be payable during a phased return to work. It may be that financially, using annual leave is the better option for your colleague.
      The Fit for Work team

  47. Miranda mak

    I have return to work after work cover for bullying incidence, after one year working in other position, an employer no work offer to me since December 2014 until today. I have email to employer and asked about what is my employment situation, but they only sent me a letter on 28-1-2016 and required I need to see Psychiatrist 0n 11-2-2016, also they require me that to sign the medical release form.

    I have questions:

    (1) In the no work period from 18-12-2014 to 10-2-2016, did I been dismissed or been terminated by an employer ?

    (2) The employer wrote on the letter that your absence from work has been treated as personal leave, and you have been taken to be on period of unpaid personal leave. Is this fair to me that they unable to offer me a returning work and now they stated as personal leave ?

    (3) My employer required and provided the psychiatrist to see on 28-2-2016, I have promised that I will give a copy of medical report to my employer. But, do I have to sign the medical release form?
    Why I need to provide this medical authority to my employer? I feel that it is breach my personal privacy in this situation.

    I am looking forward to hear your advice, and I am appreciated your help!

    Best Regards,
    M Mak

    • Fit for Work team

      Hi Miranda,
      Thank you for your enquiry. with regard to your specific questions:
      1. You would need to discuss this in detail with your employer, but from the limited information you provide it does not sound as though you have been dismissed, we would also expect that if you had been dismissed you would have been notified by your employer.
      2. With regard to taking personal leave for this period of absence, you would be advised to contact ACAS for further information about the legal position with regard to this. Some of this will be determined by your contract of employment. ACAS can be contacted through their advice line on 0300 123 1100 or you can visit their website where you can ask a question or take part in an online chat.
      3. You do not have to sign a medical release for to allow your employer to obtain a report from your treating consultant. You may wish to read our guidance sheet at the following link, this will give you further advice on your rights around a access to medical reports. Also please bear in mind that if you refuse to consent to a report being provided, your employer may have to make decisions about your employment based on the information they already have available to them.
      Feel free to contact our advice line at any time if you need further explanation: 0800 032 623.
      The Fit for Work team

  48. Kate Fielder

    My father has just returned to work, he works shifts and has been off for just under 4 months with ongoing heart issues. His GP gave him a note that said she would advise he did a phased return to work of about 4 hours per day, instead of 12 hours. His manager has said he can do 6 hours per day (half his shift) and the other additional 6 hours per day missing will be classed as annual leave taken- is this correct? He isn’t bothered about the loss of annual leave, but I’m concerned that they maybe aren’t considering his Dr’s advice of returning to work gradually to regain full fitness.

    • Fit for Work team

      Hi Kate,
      Thank you for your query. It would really be your father’s decision as to whether he accepts the amended shift pattern as the fit note is advisory only. The GP is clearly keen to facilitate a gradual reintroduction to work, and it may be possible for your father to work 4 x 6 hr shifts (plus one rest day), or 3 x 6 hr shifts (with 2 rest days) and be paid statutory sick pay for the non work/working days. This would be likely to have a similar benefit in allowing him to adjust back into work. The advice from a doctor is advisory only and it is up to the employer to decide what is reasonable and practical for them to implement. I hope your father’s return to work is successful.
      The Fit for Work team

  49. Kay Smith

    I am a teacher and have been on sick leave since 7th January with a prolapsed disc in my neck. I am awaiting an appointment with a specialist to decide the next course of treatment. I am on strong painkillers which really help with the pain but make me incredibly tired and forgetful. If I am too active, pain returns despite the painkillers.
    I really feel I could return to work on a half day basis – but not to teach as working with thirty 7 year olds and being in a classroom is too physically demanding and would significantly increase pain. Also I would be too tired on the medication to work all day and could certainly not work for the 3 hours of evening marking and planning at home. The GP says it’s up to me to decide what level of pain/tiredness I can take. But there is no teaching job I can do in school on a mornings only basis.

    As I am effectively not fit to do my job, how do I stand? The GP is ready to continue a not fit for work note.

    • Fit for Work team

      Hi Kay,
      Thank you for your query. There are a number of actions you could undertake. You could remain absent from work, and work on some self-help techniques to improve your health. However, being off work can have a negative effect on your mood and you may find you would benefit from returning to work in some form. Perhaps your employer may be able to provide you with some alternative work or a combination of adjusted work, reduced hours etc. If your employer has an occupational health service you might ask if you can be referred to them in order that they can assess what you may be able to do if you do return to work. You could also speak to your GP or employer about obtaining a referral to Fit for Work. We are able to make recommendations and provide you with advice and guidance on managing your condition and helping to improve your condition to a point where you may be able to return to work.
      The Fit for Work team

  50. Vickie


    I have been off sick for six weeks and th doctors has said I can go back on 18 hours a week until 1st March my question is does my employer have to allow me to have my old contract back after this period ie the same hours or do they have to do a new one

    • Fit for Work team

      Hi Vickie,
      Thank you for your enquiry. The recommendation of returning to work for 18 hours per week made by your GP is a recommendation only and there is no obligation on your employer to implement this if they are not able to do so. However, most employers regard this as a temporary measure and once your condition has improved they would generally re-instate your normal work and hours. We would advise that you contact your Human Resources department or your manager who will be able to advise you on the company’s workplace policy and perhaps offer you some reassurance and clarity.
      The Fit for Work team

  51. Mel

    Good morning – I have a friend seeking advice. He is due to return to a full time teaching position in March, following 12 months treatments of Leukemia. His Head Teacher has asked that he presents a proposal for a phased return to work. Over what time and with what reduction of hours would be acceptable? How does this effect pay? Is there any guidance on what a proposal could look like?

    • Fit for Work team

      Hi Mel,
      There are several options you could suggest to your friend with regards to phased returns and pay. Firstly your friend could ask if the school has access to occupational health and if he could be referred to them. Following an assessment, they would be able to make recommendations to the head teacher on adjustments that would support his return to the work place.
      Secondly, he could ask his GP or employer for a referral to the Fit For Work service. The referral can be done online and this service is quick, free and confidential provided he consents. To be eligible he just has to have been off work for 4 weeks or more. A case manager would work with him to produce a return to work plan which can include recommendations such as a phased return. The case manager can also speak to his employer with his consent and discuss adjustments that are likely to support him as he returns to his post.
      Another option would be to his GP or Specialist as they should have in-depth knowledge of his physical condition, past and present treatments and what his physical capabilities are likely to be. There is also space on the Fit Note that his doctor can use to advise the employer with. He could also discuss his options with his union representative as they will also be able to offer advice and support.
      In terms of what a phased returns looks like, the simple answer is that they vary. Large companies allow permitted hours e.g. 2 hours per week. This gives an employee who has been absent for some time an opportunity to be gradually reintroduced to the work environment. An employer may allow employees to return to work on up to 50% of their usual hours, building up to their contractual hours over a number of weeks or months. There are no hard and fast rules and the return is often guided by company policies and discussions between the employee and employer and whether the employer can accommodate the request. If your friend feels he would struggle to maintain full time hours he could ask if his employer could consider a temporary reduction in his contractual hours. As he has a diagnosis of cancer he automatically comes under the Equality Act 2010. His employer is under a legal obligation to consider making reasonable adjustments for him. The Equality Act 2010 legally protects people from discrimination in the workplace and in wider society.
      In answer to questions around a proposed phased return and pay, again there are no clear guidelines. The employer may set out guidance for sickness and phased returns in the employee’s contract or company policies and procedures. It is also worth consulting his union on what the employer has offered to employees in the past. Some employers offer very generous terms and pay an employee’s full salary even if the employee is working very few hours, as they feel it encourages the employee to return to work sooner. Many employers pay for the hours worked and the employee claims SSP for days they don’t work provided they meet the qualifying criteria. Others employers allow employees to make up their salary using holidays. Your friend has likely accrued holidays while he has been absent and he may wish to discuss using these to make up his pay. Again, it’s down to what the employer considers reasonable.
      The Fit for Work team

  52. Anne

    Thank you very much for your response.

    Does my employer have to (legally) enforce any recommendations made to them by the fit for work team or occupational health team or my GP?

    I think my employer will ignore them, since she hasn’t bothered to refer me to the company’s occupational health team, even after my GP suggested I discuss it with my employer.. My doctor has said that I am not fit for work at the moment and said that I will be phased back to work. I’m very worried that if the advice is ignored I will be forced to resign.

    Thanks again.


    • Fit for Work team

      Hi Anne,
      We’re sorry to hear that you feel your employer is not likely to support any recommendations for adjustments at work. It is always the employer’s decision as to whether they can support recommendations – and they can always contact our advice line to discuss these and find out more. We very much hope you can agree a way forward with your employer.
      The Fit for Work team

  53. Georgia

    After being off work for around 3 weeks with a sick note from the doctors I have recently tried to return to manager agreed I could do slowly after. Since then I was going in to work for a few hours a day and making it longer hours each day and slowly returning back to normal duties. It’s only been going on a week and now the work place have told me not to come in and to stay off til I have completely recovered. I want to go to work but they are not allowing me and have told me they are going to employ someone else. They have not sacked me in one sense as they said I can return in a couple of months of I’m completely better. Can they do this? Thanks in advance.

    • Fit for Work team

      Hi Georgia,
      The employer is able to decide if they can accommodate a phased return to work or any adjustments where an employee is not fully fit. If an employer feels they cannot accommodate such adjustments, they are able to employ temporary staff/allocate the duties to another employee and ask an employee to return when they are ‘fully fit’ – though we do usually encourage to consider carefully if they can accommodate adjusted duties as this can help an employee to become fully fit more quickly. We are sorry to hear that your employer doesn’t wish for you to continue in an adjusted role – you could ask them for more information on why this is and if there is a compromise available? If not, we wish you a speedy recovery and successful return to work.
      The Fit for Work team

    • Fit for Work team

      Hi Anne,
      Thank you for your email – yes we have received it but it won’t appear until we post a reply. We will be responding to your query asap.
      The Fit for Work team.

  54. Robert Bradley

    Hi there,

    A friend has been on sick leave for 5 months (following maternity leave) with severe anxiety issues. The company she works for has a sickness policy of 6 months full pay before reducing to half pay for a further period. Her GP recommended a phased return to work on her fit note, which was agreed by management. However upon her return to work she was informed that she would only be paid for the days that she works. She has been on full pay for the last 5 months and has not yet reached the 6 month trigger for half pay. I may be wrong but I thought that the days that she was not in should be treated as sick absence in line with the company’s policy i.e. still be paid at the rate she in entitled to according to the policy?

    Any advice is greatly appreciated,thanks

    • Fit for Work team

      Hi Robert,
      Our advice would be to ensure the fit note from the GP extends through the period of the phased return, which would mean the employee is able to be classed as “sick” on non working days. Any pay during this period would depend on the company policy.
      If statutory sick pay is to be paid for non working days during the phasing period, there needs to be 4 consecutive non working days, eg, employee works Tues, Wed, Thurs and is “sick” Fri – Mon for statutory sick pay purposes.
      The Fit for Work team.

  55. Samantha

    Hi. I tried to post a message on here a little while ago and was wondering if you had actually received it?

    • Fit for Work team

      Hi Samantha,
      Yes we have received your email and will be replying to you shortly.
      Many thanks
      The Fit for Work team.

  56. Samantha


    Thank you for your blog, I have found it very interesting. I have a bit of an odd situation. I have just returned to work after a 3 month absence due to having a car accident. I am on a phased return to work as I have a nerve and disc problem with my neck which has left me currently unable to walk for long periods of time, and at the moment I am having concentration and speech difficulties (although the speech problem is stuttering/stammering and should ease off now, as I spoke to my Doctor yesterday and it could/should hopefully be due to one of the medications I am on.)
    While I was off, I was supposed to have a disciplinary hearing for capability (one which I do not agree with due to bullying and lack of sufficient training – although that is a different conversation). My question is that I believe that my Deputy Manager wants to book me in for my hearing now that I have returned although I feel that this is unfair as I have only just returned and am not fully fit so don’t think I’d be able to argue my case correctly if that makes sense. I understand that I have to have the meeting, I just think that the timing is not correct and feel that it should wait until I am fully fit.
    Any help or advice you could give me would be very welcome.

    • Fit for Work team

      Hi Samantha,
      Our initial advice would be to speak to your manager in an open manner to express your anxieties and belief that you are not fit to attend disciplinary meetings at this time. It would be helpful to advise of the likely recovery time and subsequent time frame to schedule the meeting. Often, it is helpful to resolve work place issues as soon as possible and you may find that attending the meeting will also help to reduce other symptoms of reduced concentration.
      If you feel it necessary, you may wish to request an Occupational Health review to assess your fitness to work and to attend disciplinary meetings, although having a direct conversation with your manager would be the preferred initial action.
      The Fit for Work team

  57. Lola dunlea

    I have recently been signed fit for work after having an accident at work and injuring my back. I have been off for about 13 months. I have been advised to use my annual leave entitlement before I come back which I have done and I am due to return to work 18/01/16. I work as a support worker in a hospital the doctor has put on my sick note that I have to avoid manual handling until March. I have been told that because I am using annual leave before I come back to work that I am not entitled to phased return. I am just wondering how true this is. Thank you for all your help.

    • Fit for Work team

      Hi Lola,
      If a phased return has been recommended for you by an Occupational Health professional or your GP/consultant, it is for your employer to consider, but they do not have to comply if they feel it is not reasonable to the business, it would depend upon the company policy.
      Commencing annual leave indicates that you are fit for work, rather than “sick”. Depending on your company’s policies, you might be able to take annual leave and then resume to a phased period, although this would usually be recommended by a health professional.
      Our advice would be for you to speak to your line manager about your concerns and whether a phased approach is appropriate. You would also benefit from risk assessment in relation to manual handling/patient care as well as consideration of refresher training in these areas. More information can be found at
      The Fit for Work team

  58. Laura

    Hi I’ve been signed off work for some time now. Coming up two years. I did have a job before I started feeling ill, but lost that job due to severe clinical depression, which was starting to really affect my work and others around me. I am on medication for this have had couselling, each day is a struggle for me but nowhere near as bad as before. I have three young children that I take everyday. I feel ready to go back to work but need help and advice in getting a job as with me having children. Companies don’t tend to like the fact that I won’t be able to be as flexible as those without children, and also the fact I have been out of work for so long worries me that I will struggle to get a job. I Feel ready to go out and find work, as although I am there for my children . I feel this will help me further, and so I can provide for my children and have something for me. I don’t know where to start and I need advice on these issues. I hope someone can help me. I really would appreciate any help

    • Fit for Work team

      Hi Laura,
      Fit for Work is a service aimed towards employees who remain in employment but are off work due to illness.
      Jobcentre Plus should be able to direct you to appropriate services aimed at helping people to identify appropriate roles depending on their skills and experiences. You can find information on for further support and
      You can also find information regarding childcare, training and job trialling schemes.
      The Fit for Work team

  59. Lisa

    i was on sick leave from Dec 17th to Jan 4th. On Jan 5th, I was in hospital to get my clearance letter so could not attend duty but my clearance letter mentions Jan 5th. Does the 5th goes still as STD or can it be counted as a vacation leave.

    • Fit for Work team

      Hi Lisa,
      If your fit note states that you were fit for work on 5th January, then your “sick” period ended on 4th January. If you did not attend work on 5th Jan, your employer would need to refer to their own policies to advise you whether you are able to take an annual leave day or not.
      If your fit note expired on 5th Jan, then your “sick” period ended on 5th Jan, meaning you are fit to return to work on 6th Jan.
      The Fit for Work team

  60. Anne


    I am currently off work with stress and have been for three months should my team leader have referred me to the occupational health team at my place of work by now? The main part of the stress is work related. When I told my team leader that I would like to speak to a member of the occupational team to discuss a phase to work plan, she was reluctant and said that she would speak to me in a couple of weeks and that once I return I would be working at the main branch of the company (where the team leader is based) for training and supervision purposes for about two months rather than at the sub branch that I am normally at. The main branch of the company is in another city, which is about 30 miles away and involves a train and bus journey to get there. Can they insist upon this?

    Any advice would be gratefully received.

    • Fit for Work team

      Hi Anne,
      Any referral to Occupational Health would be according to your employer’s policies and procedures. It would be helpful for you to have a discussion with your line manager and express your anxieties. It might also be helpful for both you and your manager to consider a stress risk assessment, either before you return to work or shortly after you have returned. This will help to identify any actual or potential issues within the work place or duties and you and your manager can then take steps as necessary to address them. Information about this can be found at and search stress risk assessment.
      In relation to the move of office, again, it would be helpful for you to speak with your manager and let them know that this is a concern for you. A period of training and supervision may also be helpful for you to return to work as symptoms of stress at work can often be linked to training needs and addressing these can help in some cases to reduce anxiety. Whether or not the company can insist on you moving to another branch would depend on their policies and your contract of employment.
      You may wish to request a referral to Fit for Work (If you live in England or Wales), where a Case Manager will undertake a telephone assessment with you, identify obstacles to returning to work and help to formulate a Return to Work Plan which you can choose who you share with, usually, your manager and GP. The Return to Work Plan will contain recommendations for work place adjustments, as well as techniques to help you recover/reduce the symptoms of stress. Your GP or employer can make this referral through our web site
      The Fit for Work team

  61. Mark

    Thank you for the blog.

    I am currently off with Stress and a flare-up of Colitis (which has now calmed down).My absence follows a complaint I made about an unfair selection process for promotion. The complaint is now progressing via ACAS. Whilst I hoped it would have been sorted before my return, it is clear that it will take longer. I don’t want to be off longer than is necessary. I am signed off until 20/01/16. I would like to return to work, but think a phased return would be best, rather than a “hit the ground running” approach.

    How do I negotiate the phasing? Should my GP dictate it or does the employer decide? Do I need a Fitness To Work certificate for the phased period?

    Any advice is appreciated. Thank you.

    • Fit for Work team

      Hi Mark,
      Thank you for your enquiry. We would agree that it is best to return to work as soon as you are able, and there are a number of options you could take with regard to negotiating a phased return to work. You could simply speak to your manager and agree this, or, you could ask your GP if he is able to include this in the fit note, and then negotiate the details with your employer prior to your return to work.
      A further alternative could be that either your GP or employer could refer you to Fit for Work, and following your assessment a case manager could make this recommendation if they felt it was justified and required. Any recommendations made either by the GP or Fit for Work would be recommendations only, and ultimately it is for the employer to make the decision if they can accommodate this adjustment. You would require a fit for work certificate for this period.
      We hope this helps with your enquiry
      The Fit for Work team.

  62. Charlene

    In November last year I was signed off work as broke my ankle.
    I was off for 5 weeks and then given a phased to work sickline, during this time I made an error which 10 months later has just came apparent.
    My company are looking to discipline me, is this something they can do on while i was still on a phased back to work sicknote?

    • Fit for Work team

      Hi Charlene,
      Whilst on a phased return, the hours worked would usually be treated in the same way as any others when full time – and as such, errors made that require disciplinary action would not usually be exempt. The only exception to this could be where adjustments are also agreed during a phased return period such as increased supervision or support. We hope that answers your question,
      The Fit for Work team.

  63. sarah summerfield

    Hi I had 11.5 days off work due to sickness but not all in my given time…. I am not being told that I have to have a meeting with HR to discuss my future with the company.

    I just don’t understand why they are doing this to me when other member of the team have had months off 🙁 I have always said to my manager I can get a sick note of doctor to cover my absences and have seen the doctor every time I have been poorly….

    I think its disgusting the way I have been treated this isn’t the first meeting I have had and I was off 4 days 1 day was in may 2015 and the other was in june 15 for 3.5 days I was sent home from work… stayed off for rest of week to get better I was then given a meeting saying I wasn’t ill at all.

    The company has been making me feel like rubbish I work hard when im here but they make rumors up about me I have been told 3 x by members of staff that I am in a domestic relationships I come to work feeling so down !

    • Fit for Work team

      Hi Sarah,
      We are sorry to hear this has caused such distress. It really is quite common policy for employers to take steps to manage attendance at work at an early stage, and this should usually apply across the board to all staff. Though it may seem unfair that some colleagues have had much longer absences than others, most companies treat long-term absences quite differently to short-term absences, and it is common for companies to set ‘trigger’ points where they would want to discuss this. The trigger may vary, but it could be two or three absences within a 12 month period.
      The meetings are usually held in order to discuss the absences, enquire about whether there are any ongoing issues likely to result in more absence, if there are any issues at work, and most commonly, whether the company can do anything to help you. Sometimes, targets are set for future attendance over an agreed period of time.
      You can find further information that may help on this page of the ACAS site – – where employers are advised on how they can manage attendance within the workplace. If we can help further please do not hesitate to contact our freephone advice line by calling 0800 032 3265.
      The Fit For Work team.

  64. Pauline Green

    Just wondered if you could advise? I am recovering following a hysterectomy. I went to see my consultant and she said I needed to take another 4 weeks off work. However my gp said he disagreed and has signed me fit for work. He did not examine me or ask me anything about my recovery. Who do I listen to? What do I do ?

    • Fit for Work team

      Hi Pauline,
      Without knowing what your job is or how long you have already been absent it’s a little harder to comment, but surgeons and GPs should usually follow the guidance below in relation to return to work after a hysterectomy (unless there have been significant problems / complications after the operation). As such, in an administrative, active or light manual role, you would be able to consider going back to work 2-4 weeks after the surgery, if you are feeling well. Regardless of the advice from the surgeon or your GP, it is actually your decision when you return to work in that you can choose to return before a fit note expires if you feel fit and well. Your employer in this case should usually meet with you though, to ensure a basic risk assessment is carried out so that your return is safe:
      Hysterectomy (abdominal) – Sedentary admin/Sedentary light manual/Active light manual: 2-4 weeks
      Hysterectomy (abdominal) – Heavy manual/Physically demanding: 6-8 weeks
      Hysterectomy (laparoscopic) – Sedentary admin/Sedentary light manual/Active light manual: 2-4 weeks
      Hysterectomy (laparoscopic) – Heavy manual/Physically demanding: 4-6 weeks
      Hysterectomy (vaginal) – Sedentary admin/Sedentary light manual/Active light manual: 2-4 weeks
      Hysterectomy (vaginal) – Heavy manual/Physically demanding: 4-6 weeks
      The Fit for Work team.

  65. Adele


    I work fulltime and I am now on a phased return to work recently after 5 weeks off following a miscarriage, I have gone from 5 days per week to 3 days per week and I should receive 12 weeks OSP. My employer has only been paying me for the days that I work and not paying me any OSP or SSP for the days I am not working even though I have a note from my doctor advising I only work part time. Should I be being paid OSP for 2 days per week and salary for the 3 days I do work? Also should I still be accruing annual leave as a full time employee? They have pro rata’d this also.

    Many thanks


  66. CJBinns

    I’ve just returned to work following 5weeks I’d sick leave. I’m on a phased return to work organised by the occupational health nurse. I’ve now been told for the hours I don’t work during my phased return I have to make up the hours with my annual leave. Otherwise I will not be paid the full time hours. This will add up to three weeks of annual leave used over the 5 weeks of phased return. Is this right?

    • Fit for Work team

      Hi Carolynne,
      Company policy dictates what is and is not paid in relation to company sick pay, and statutory sick pay is not payable for part days. Many companies use annual leave entitlement to support a phased return to work, and as annual leave accrues during periods of absence this will usually mean that after long-term absence there is sometimes more available to take. We hope your return is successful.
      The Fit for Work team.

  67. Marianne

    Hi there,
    I am currently off work pending an operation and have tried twice to return to work on a phased return but my manager has not adhered to the fit note and has actually increased my duties and hours, as well as preventing me from applying for an internal promotion. He has also told staff not to contact me at home either about work or anything else. I have an excellent track record and good attendance prior to needing this operation. There is no concern about my practice. I am concerned that I am being bullied out. What can I do? Can my manager do this?

    • Fit for Work team

      Hi Marianne,
      If there is support available within your organisation, such as Human Resources or a more senior manager, you may wish to consider contacting these. You can also be helped with workplace issues such as these via ACAS – their advice is impartial and free of charge and the website is: It is really important that you are able to air your concerns and ensure they are addressed, and ACAS can also support these discussions with your employer where this would be helpful.
      The Fit for Work team.

  68. F Moffat

    Hi, my husband was off for 6 months with depression after his boss refused a request from him to work 3 days. He has been back to work 3 weeks and has had a TIA, so will be off at least another month. He is 63, a carpenter and is on building sites. Speaking to his boss he said he would be as well off as he couldn’t work on the site. It is a family business. What I am asking is I know he will have to go on to ESA in the coming weeks would it be prudent for my husband to insist on a phased return to work as previous requests have been met with downright hostility.

    • Fit for Work team

      Dear Fiona,
      Your husband may benefit from asking about returning to work on a phased return, as this will increase his confidence levels and will enable him to build up his strength, capacity and tolerance to work gradually rather than waiting until he is fully fit before returning. Your husband may also require a risk assessment before returning to work and returning to his normal duties. Additionally, your husband may benefit from being referred into Fit for Work (either by his GP or his employer) and having an assessment carried out by an occupational health specialist who will be able to give advice on workplace adjustments via a personalised Return to Work Plan:
      The Fit for Work Team.

  69. Np


    We have an employee who has been off work since May 2015. He returned on a phased return to work basis in October for three days a week. We paid him for the days he worked (3 days a week)

    He now has a doctors note for one week but since he is only working three days a week, should I pay him SSP for the three days as SSP applies to 4 days or more sick days off work.


    Thank you

    • Fit for Work team

      Hi Np,
      Yes you would only pay your employee the three days that he works. You can get £88.45 a week Statutory Sick Pay (SSP) for up to 28 weeks and you can only get SSP for the days you would normally have worked. SSP is not paid for the first three days you’re off, unless you’ve been paid SSP within the last 8 weeks and are eligible for it again.
      The Fit for Work Team.

  70. Chris

    I had spinal cord surgery 4 weeks ago. I have been cleared to return to work by my doctor.I am a teacher assistant at a day treatment center for non-violent teenagers. The program is a hands free program that is run by the state, but I am a public school employee. I am being told though I have a medical release I my employer will most likely not let me return to work because I still have to wear a hard neck brace. Can an employer deny you work when you have been medically released.

    • Fit for Work team

      Hi Chris,
      Your manager may benefit from conducting a risk assessment on your return to work, and may also discuss with you some reasonable work place adjustments for a period of time. Your employer may be following the standard policies and procedures for your workplace with regards to health and safety, and it is up to them whether or not you are able to come back to work, or whether you have to wait till your fully fit. You can approach your employer or your GP to be referred into Fit for Work, where you will be given a free occupational health assessment and a unique Return to Work Plan created just for you with suggested reasonable adjustments. Please note that your employer will be under no obligation to necessarily comply with these suggestions.
      The Fit for Work Team.

  71. Carl

    I have been off work sick since June 2009 (mental illness), and there is a job that has come up which really interests me. How do I go about this? How do I explain the gap in my CV? Can you offer some advice please?

    • Fit for Work team

      Hi Carl,
      We would recommend that you are honest when filling in your CV with regards to the gap in your CV for June 2009. Currently 1 in 6 of people are dealing with mental health problem such as anxiety, depression or stress and it is becoming more of an accepted issue. Most workplaces have some kind of occupational health system to support employees in the work place. If your mental health is managed using medication or any other treatment, don’t be afraid to inform your new manager, as they will be able to support you with this too. For more information about the Equality Act click on the following link:
      The Fit for Work Team.

  72. andy

    Can you be disciplined for a former issue which occurred prior whilst on a phased return to work? A manager had put in a spurious grievance about being threatened by an employee and the independent director now seems to favour his manager’s story, although there were no witnesses. after returning from long term sick the employer now wants to set an agenda for discipline whilst the phase return is still in place.

    • Fit for Work team

      Hi Andy,
      Thank you for your enquiry. We believe this is really a matter of employment law and that ACAS would be better placed to assist you with your enquiry. You can contact ACAS on 0800 123 1100 or if you go to their website you can ask a question on line. If you are in a union you could ask your union representative for further advice and guidance.
      The Fit for Work Team.

    • Fit for Work team

      Hi Andy,
      In addition to the above answer it should be noted that essentially, there are no time limits for where an employer wishes to carry out an investigation of a disciplinary issue – and these can unfortunately sometimes be delayed by extensive sickness absence. If a hearing is required, this can take place during a phased return to work as long as the employee is well enough to attend, and there are usually only rare grounds where we would advise not to press ahead, as delays also cause anxiety.
      The Fit for Work Team.

  73. John Swift


    I tried to return to work on a phased return some weeks ago. It went terribly badly, assurances were broken, goals changed without discussion. It ended with a very innapropriate meeting which I have raised a grievance regarding.

    I was signed off sick again and have now returned to work. They are now refusing a phased return, and insisting I am managed by the manager responsible for the last mess.

    Where do I stand? Confused and lost.



    • Fit for Work team

      Hi John,
      Thank you for your enquiry. Sorry to hear your return to work did not go to plan, however, it is up to the employer to make the decision on implementing adjustments at work, including a phased return.
      With regard to the issues with your manager, perhaps if he/she understood your position better they would be more sympathetic and open to helping you to return to work. Can you discuss this further with your HR department, who can perhaps liaise with your manager so that some mutual understanding can be achieved. If you feel unable to resolve your issues in the workplace, you may wish to consider contacting ACAS who can offer mediation services when this is appropriate.
      The Fit for Work team.

  74. charles pearce

    I have been off sick for the best part of the year. After carpal tunnel relief I went back to work in December last year after 12 weeks. I then developed Reynaurds, and have been off sick since April of this year. Four doctors, 2 specialists and a occupational health report say I can now go back to work on amended hours and amended duties. My manger says NO as there is nothing like that where I work. If I can’t do my contracted job and hours, then he will sack me.

    • Fit for Work team

      Hi Charles,
      Thank you for your enquiry. It is entirely up to your employer to decide if they can accommodate adjusted duties and a phased return to work. The advice given by Occupational Health is advisory only, and if your employer feels they are unable to assist with this then this would be for them to decide – although all decisions should be considered.
      If your employer is unable to accommodate the adjustments, then you should work on continuing with your recovery by gradually increasing your activity over the period of recommended adjustment, so that by the end of that time you will be better equipped to return to your substantive role.
      You could also request a referral back to Occupational Health prior to your return to work, in order to confirm that you are able to undertake your role at that time.
      The Fit for Work Team.

  75. HD77


    I’ve had two operations in two months and have been signed unfit to work by the doctors since my first operation 6 weeks ago. I’m in a relatively senior position and during that time none of my work has been reallocated to anyone else.

    i’ve had enourmous pressure from work to work from home during my time off (using my left arm despite being right handed and having an operation on my right shoulder) and then a laproscopy last Monday when they expected me to start working again 2 days later, whilst still having right arm in sling!

    I’ve been working on average half days throughout my absence and even attended work on Friday due to pressure as it’s the company’s year end.

    Where do I stand with these hours worked. Am I entitled to ssp even though I’ve worked? Can my employer not pay me for these hours as I was officially on unpaid sick leave? My manager has even publically told people I’m working from home including our external accountants for example, yet mentioned on Friday that as I’ve exceedef my sick leave I won’t get paid.

    Feeling frustrated to have struggled to work in pain approx 3 weeks worth of hours work for nothing, and prob slowing down my recovery.

    At the moment I’ve not handed in my sick notes. I feel once I do then I’m entitled to no pay for the work I’ve done. By telling everyone that I’m working from home is that not him giving me permission to work from home and flex my working conditions instead of me taking sick leave?

    Feeling very sore, fed up and stressed 🙁

    • Fit for Work team

      Hi Heather,
      Thank you for your enquiry. We would advise that you speak to your HR department regarding pay for the hours you have been working – technically if you are working from home, you would still be considered as working and should therefore be paid at least for the hours worked. In terms of SSP if you work even part of a day you will not be entitled to SSP. Again your HR department will be able to provide you with their policy with regards to company sick pay. We would advise that you have a discussion with your immediate manager regarding whether you are actually on sick leave or undertaking adjusted duties when you are working at home.
      Since you feel that attempting to undertake these duties is affecting your recovery, then perhaps you also need to discuss this with your employer and advise them of how you feel. An informed decision can then be made about whether you should currently be undertaking this work. With regard to your Fit Note, you are able to work during the course of a fit note so handing this in should not be an issue for you. However, it seems that you require some guidance about what you are able to do currently.
      You could consider asking your employer or GP to refer you in to Fit for Work for an assessment and we can make personalised recommendations on returning to work. We hope you find this helpful.
      The Fit for Work Team.

  76. laura


    My partners was signed off for 4 weeks after a burglary at work.
    His work have said they want to integrate him back into work but his pay will be cut, can he return to work without this happening.
    Is it his choice or the choice of the employer? Also is it true that his pay will be reduced during this time, he is a 37 hour contract and wants to go back asap on full pay.
    Thank you
    Laura 🙂

    • Fit for Work team

      Hi Laura,
      Thank you for your enquiry. It’s good to hear your partner is recovering and reaching a point where he is able to return to work. It sounds as though his employer is happy to support him and allow him to return to work in an integrated manner. With regard to pay during this period, this is dependant to some degree on the policies of his employer. If he receives company sick pay at present, then in this instance it will be for the company itself to decide how they will pay the employee in these circumstances.
      If your partner is receiving Statutory Sick Pay (SSP), this is only payable for full days not worked. So for example, if he worked 3 days per week, he would receive his normal contractual pay for those 3 days, but would be entitled to receive SSP for the days he did not work. However, if he worked 5 half days then SSP would not be payable.
      If he feels well enough he can of course return to work on normal hours, and the option of returning gradually is usually provided to offer support to people returning to work after illness. If he does return to full time working, he should of course receive his normal pay. We hope this helps with your enquiry.
      The Fit for Work Team.

  77. Alison

    On 19 May 2015 I began work however had to stop as I was unwell. I had been involved in a road traffic accident a few days earlier and on the 16 Sept had emergency surgery on my eye possibly caused by the accident. I have yet to return to work. I am entitled to six months full pay, six months half pay. If I return to work on phased hours ie 4 hours a day, are these days counted towards my six months entitlement

    • Fit for Work team

      Hi Alison,
      Thank you for your enquiry. As you are entitled to six months full pay and six months half pay, this would be company sick pay rather that Statutory Sick Pay, therefore it will be a company decision on what would count towards your entitlement. With regard to Statutory Sick Pay, this is payable for 28 weeks and would only be payable for full days not worked. So, if you were to return on 4 hours per day, you would not be eligible for Statutory Sick Pay for the hours not worked. We would suggest that you discuss this with your manager or Human Resources staff who will be able to inform you of the company policy on paying company sick pay.
      The Fit for Work Team.

  78. Dan

    Hello, I had a spinal cord injury many years ago (recovered 90% of the functions), now I have an office job but I am off sick since February 2015 due to neuropathic pain caused by stress at work (confirmed by tests and specialists). I have followed all possible therapies, but have made very small progress since. I have income protection insurance, which should have started to pay in August, but they are still to confirm the claim. Last week I was requested to visit Occupational Health, which advised a phased return to work: from home for 2 months, then start work in office from 4h/day increasing to full time over another 3 months. My employer kindly accepts that plan. I am willing to return to work as I have no income. Could you please clarify:
    1. What if my GP considers I am not yet ready for return to work, as this may worsen my symptoms?
    2. What if I start to work now as advised by OH, but the symptoms worsen and I have to be on sick leave again? Would that invalidate my claim with the insurer?
    3. What if my return to work will take longer than estimated by OH? (their estimates are clearly out of thin air).
    Many thanks, Dan

    • Fit for Work team

      Hi Dan,
      Thank you for your enquiry. In response to your questions we would advise the following:
      a) If your GP considers you not yet ready for work, then it will be up to your employer whether to take the advice of your GP or of the Occupational Health Specialist you saw. If you feel, as you do, that your condition has been aggravated by stress at work, we would suggest that you discuss a Stress Risk Assessment with your manager prior to your return to work. The following link will provide some guidance with this which you can use as the basis for your discussion with your manager –
      b) Unfortunately each insurer will have differing policies regarding attempted return to work and we would suggest you contact them directly to discuss this possibility, they will then be able to provide you with accurate advice.
      c) You do not indicate in your query whether Occupational Health have made any plans to continue to review you during your phased return to work, but if not, then we would suggest you have regular review meetings with your manager to discuss how things are going. This will help address any issues promptly which will avert further difficulties. Your Occupational Health provider has recommended a very long phased return to work, and with the right support in place, this should be achievable. Each employer will have different policies with regard to this eventuality so it would be worth speaking to your manager about this as well. It is possible that a formal reduction in hours may be indicated, should you not be able to achieve your return to work in the suggested time frames.
      The Fit for Work Team.

  79. JB

    I am due to return to work following abdomial surgery after 7 weeks on a phased return. My employer has rostered me for 5 shifts working 5hrs per shift increasing this to 6 hrs the following week. With the possibility of working full shifts by the 3rd week is this right

    • Fit for Work team

      Hi Janet, thank you for your enquiry.
      Each phased return should be based on the capability of the individual undertaking it, and it would also depend on the type of work you will be doing. However, undertaking the return you have indicated takes you to 10 weeks after your surgery, so providing your work is not extremely heavy manual work, the pattern you outline should be achievable. We would suggest you arrange to have regular meetings with your manager to discuss how things are going, and that way you can address any issues quickly and highlight any concerns you may have.
      The Fit for Work Team.

  80. Sophie

    I have been signed off sick from work for just over 6 months now. In a recent meeting with my employer we discussed the possiblity of starting a phased return to work mid October, which I feel I will be ready for. My employer suggested that I remain signed off sick from work for the first 2 weeks of this phased return (and has asked me to go back to the doctor to obtain a new sick note to cover this period). Is it legal for me to be signed off sick from work whilst starting a phased return or should a phased return, be extactly that?

    If it is illegal please could you point me in the right direction for some official wording on this so I can take it with me to my next meeting please.

    • Fit for Work team

      Hi Sophie,

      Thank you for your enquiry regarding the payment of SSP during a phased return to work.
      It is perfectly legal for you to be signed off sick whilst returning to work on a phased return to work. You should ask your GP to provide you with a Fit Note, which states that you will be Fit for Work with adjustments, and those adjustments would be a phased Return to Work.
      In this way, your GP is confirming you would be fit to return to work, but also covering you for the payment of SSP if you are still receiving it. This means that for the days you do work your employer would pay you normally, and for any full days not worked you would be entitled to SSP. SSP is not payable for any days where you have worked part of the day.
      Hopefully this helps clarify matters for you.
      The Fit for Work Team.

  81. FY

    Dear Fit for Work Team,
    I would like to know whether the Fit for Work case manager will refer/provide me to have rehabilitation services such as physiotherapy during the period when i am not fit for work. Do fit for work provide any medical treatment to help me return to work in a shorter time? thanks.

    • Fit for Work team

      Hi Fy,
      Thank you for your enquiry regarding the provision of treatment by Fit for Work. Fit for Work do not make any referrals for treatment. However, if it is appropriate we may make a recommendation for treatment that your employer may wish to fund in order to assist your return to work. If your employer does agree to refer you for private treatment, then they would be entitled to up to £500 tax exemption on the cost of that treatment.
      The Fit for Work Team.

  82. louise

    I have just returned to work after 6 months on sick leave. My doctor recommended a phased return to work. I usually work a four day week so my employer suggested I do two days for two weeks then three days the next week then back to my full four the week after. I am satisfied with this but wondered if am required to take annual leave for the other two days per week that I am off or should this be unpaid? Thanking you in advance for your help.

    • Fit for Work team

      Hi Louise
      Thank you for your enquiry. We are pleased to hear you are feeling better and ready to begin your return to work. As you have been absent for 6 months, it is likely that your entitlement to SSP has expired, so we would suggest you speak to your employer – if you still have some entitlement to SSP you will be able to be paid for the days you do work, and SSP may be payable for the days you do not work during your phased return to work. If you are currently in receipt of ESA (Employment Support Allowance) you should speak to your local job centre adviser who will explain how the return to work will affect your entitlement to continued ESA.
      You might also wish to speak with your employer to see if they have any policies in place regarding this, as some companies are able to pay in full during this phased period, but this is entirely a company decision.
      If all entitlements are exhausted then you may wish to consider whether to use up untaken annual leave which you will have accumulated during your sick leave, or whether you would prefer to take this time off unpaid.
      The Fit for Work Team.

  83. Majid Wahid


    I have been off work due to an operation to my spinal cord which was in October 2013. I have been off sick ever since & not worked. However I wa given a fit note at the end of November 2014 by my GP saying I can return to work to amended duties or a phased return. I contacted my employer whom denied me the opportunity to come back to my previous role as I had walking stickstick saying I wasn’t for for work. I would be to slow. So he tried to pay me off with a p45. However I’m a union member so I checked with my union & had a grievance meeting. There was not outcome but I went to another meeting for a work capability hearing. They said they would organise a health assessment. Now that was in March 2015. I have still had no answer. They did try to call me back to work by a shortcut but I’m really lost. My union rep says I should keep asking them when my assessment can be put in place ? But I’m really lost at this time.

    Regards Majid

    • Fit for Work team

      Hi Majid
      Thank you for your enquiry. In these instances it is most likely that your employer is trying to obtain information as to whether you are fit to undertake your substantive role, and if there were any reasonable adjustments which they could accommodate. I would suggest you contact your Human Resources department and ask if they have arranged your referral for an independent assessment, and if not, if this could this be arranged. It is unclear what you mean by your business trying to call you back to work via a short cut, but perhaps this is also something you could discuss with your employer.
      If you have concerns about being prevented from returning to work, you may wish to contact ACAS for further advice on the legal aspects of this. They do have a helpline – 0800 123 1100 – or you could look at their website where you can also ask questions on line.
      We hope this information is helpful, but please do not hesitate to contact us again if we can be of further assistance.
      The Fit for Work Team.

  84. Shelby Dorsett

    My daughter has had some instances off sick over the last year due to hospital appointments for an ongoing illness that has still not been diagnosed. She now has a disciplinary hearing which could result in dismissal. Also her new manager has backdated sick pay and has deducted this over a number of months from her wages. I have read that she should have had a letter and given written consent for this to happen is his true? Also is she really at risk of losing her job?? Thanks Shelby

    • Fit for Work team

      Hi Shelby,
      Thank you for your enquiry.We believe that the questions you have raised would be better answered by ACAS as they seem to be related to employment law and payment. ACAS have a website where you can ask questions on line or your can call their helpline 0800 123 1100. Your daughter should also check the company policies around hospital appointments – some companies will consider this sick leave but others often permit time off to attend hospital, but this may be unpaid.
      The Fit for Work Team.

  85. verity

    I have been off with anxiety and depression for nearly 4 months and awaiting therapy Gp has signed me off until 3rd September 2015 with no need for further review however I am concerned re my capability currently how can I return on a phased return throgh GP or manager>

    • Fit for Work team

      Hi Verity,
      Thank you for your enquiry, you have a number of options. You can either discuss a phased return to work with your employer who may be very happy to accommodate this, you can ask your GP to write on your Fit Note that you are fit for work with adjustments (a phased return to work), or you can speak to either your manager or your GP and ask them if they can refer you to Fit for Work for an assessment. Our website gives more information on making a referral for both your GP and your employer. Once we receive the referral we can undertake an assessment of your needs with regard to returning to work and make the necessary recommendations for your employer to enable you to get back to work in the way which is right for you.
      Hopefully this answers your queries but please do not hesitate to contact us again if we can be of further assistance.
      The Fit for Work Team.

  86. Bobby Chancellor

    I have been off work since January this year, due to having Cancer. I have been undergoing chemotherapy since then till now, I have spoken to my employer about a staged comeback to work and they have said that a staged return is set between 4-6 weeks! After I return part time? is this true??
    Any help would be greatly appreciated.


    • Fit for Work team

      Dear Bobby,

      It is great that you are recovering well and beginning to plan your return to work. It is really at the discretion of companies to decide how long they can support a phased return to work, and most of the medical evidence suggests that four to six weeks would meet the needs of most employees returning to work from a range of illnesses. The assumption is really that if an employee is not well enough to increase their hours over a 4-6 week period – they may not yet be well enough to consider a return. There are however always exceptions, and a return to work on shorter hours after chemotherapy can be really helpful physically and mentally if carefully planned.
      If your company does not have access to occupational health services, you could ask your GP to refer you to Fit for Work and we could help you plan the return to meet your needs.
      The Fit for Work Team.

  87. Ohmesh

    My partner suffered a stress reaction in mid May following harsh treatment by her managers. Her sick note has expired saying that her doctor no longer needed to see her, the employer insisted she see an occupational health specialist which took some weeks to arrange, the report from the specialist arrived two weeks later (in mid June) which stating that my partner had suffered a ‘normal stress reaction’ given the treatment she received and that she could return to full time work and ‘a meeting should take place as soon as possible for issues to be discussed’. This meeting did not not place until the end of July and at the meeting no return to work date was proposed, another meeting was arranged for the first week in August but for some reason the employer said the meeting had not been confirmed and rescheduled the meeting as a ‘grievance investigation meeting’ with a date yet to be confirmed. The company asked my partner to get a sick note to cover her up to the date of the grievance meeting otherwise they would not pay her SSP.
    Can an employer continue to prevent an employee from returning to work and not pay them even though they are considered fit to return to work by their occupational therapist and their doctor?
    Surely my partner should be receiving full pay from the day her sick note ran out or when the occupational therapist said she was fit to return to work?
    Can a company force an employee to sign themselves off sick when they have been told they are fit to work?
    The company are clearly using the fact that my partner has raised a grievance against her manager as an excuse to exclude her from work without pay (Two months so far and counting).

    • Fit for Work team

      Dear Ohmesh,
      Thank you for your enquiry. We are sorry to hear of your partners issues at the present time and would suggest that your partner speak with Human Resources to establish why she is being prevented from returning to work. If your partner is fit for work, then her GP should not issue a Fit Note. We would suggest you speak to ACAS regarding whether or not the employer should be receiving SSP or whether she should actually be on full pay. The telephone number for ACAS is 0300 123 1100 or you can ‘Ask a Question’ via their website
      The Fit for Work Team.

  88. Jacqueline B

    I have been signed off work for 17 months due to bi-lateral golfers elbow and I had an operation on each which failed. I have been advised by my health care provider that I have a chronic illness, which has also been backed up by my consultant surgeon, my doctor, the company’s doctor, and my physiotherapist. My works insurers have recently had me assessed by an independent physiotherapist, who has advised that I am capable of a phased return to work, and that they are no longer prepared to support my claim, therefore I no longer have any income with the only alternative but to go back to the same job which is what is on offer. I am incapable of doing this job as it is the reason for my illness, caused by repetitive strain of the job requirements.

    • Fit for Work team

      Hi Jacqueline,
      We are sorry to hear of your on-going health problems. Did you have a specific questions which you wanted us to answer? If you feel that the independent physiotherapist has offered advice which you do not feel is appropriate, can you establish if there is an appeals process which you can follow? If so – take any and all documentation from the surgeon/GP and company doctor to support this. Alternatively, consider if there is any way you can return to your role, with some adjustment if necessary, and ask if the company doctor can make any recommendations of what adjustments you may need.
      The Fit for Work Team.

  89. Petronel Paun

    Hello. I was on medical leave for six months after a bypass operation and on Monday 3 august I was supposed to return to work but my employer said I need to be deemed ‘fit for work’. I asked my GP but they said these are no longer issued. I’m not sure what to do. Thanks.

    • Fit for Work team

      Hi Petronel,
      Thank you for your enquiry. I think there is some confusion here about whether you require a Fit Note which states you are fit to return to work or whether you need a Fit for Work assessment. Try to clarify with your employer which one they require. If they are requesting a Fit Note which states you are fit to return to work, then your GP is correct – these do not tend to be issued/required now and once a fit note has expired you are free to return to work, indeed if you feel well enough and your employer is satisfied that you are and do not pose a risk to your self or others then you may return to work at any time during a Fit Note. However, if your employer requires a Fit for Work assessment, then you can ask your GP to refer you to Fit for Work, details of the referral process can be found on our web-site
      The Fit for Work Team.

  90. Carmen

    I’ve been in light duties due to back pain since January. Since February my employer offered me another position which I’m not qualified or trained for. Now I want to come back to work and I have been deemed “Fit for work” by my GP. My question is: who decides that I can come back to work, my GP or Occupational Health?

    • Fit for Work team

      Hi Carmen,
      Thank you for your enquiry. It is great to hear your recovery is going well and you now feel well enough to return to work. Either your GP or your Occupational Health provider can determine if you return to your role. I suspect your employer will be trying to ensure that you are fit for your role, particularly if a degree of manual handling is required. Essentially it is up to your employer to decide, but when the role has specific risks it would not be unusual for the employer to require a specific risk assessment.
      The Fit for Work Team.

  91. Ollie Hall

    Hi, I’ve recently returned to work following a hernia operation. During a meeting prior to my return with the Companies occupational health representative it was suggested that a phased return with adjustments would be appropriate as some of my duties consist of heavy repetitive lifting . I was told that I would be paid for my full shift regardless of how many hours my phased plan was (I am a full time contracted employee ).i have just discovered that they are only paying me for the hours that I actually worked. When I queried this they said it was because I didn’t have a fit note that specified a phased return or the medical limitations. My GP had previously advised me there was no requirement for a fit note as he was not fully familiar with my company or my duties and that it was my companies responsibility to asses the risks to me. Also if I do eventually get paid for the remainder of my contracted hours during my phased return should it be wages or SSP/CSP as I am actually at work. Thanks

    • Fit for Work team

      Dear Ollie,
      Thank you for your enquiry. You would not need to have a fit note in order to return to work. Regarding you contracted hours and SSP you would need to contact your HR department as each business will have their own policy for payment of contracted hours. However, SSP is only payable for days where you have not worked at all, so if you have attended work on any day, then SSP is not payable. Please read the following guidance and information that may be helpful around understanding sick pay:
      And more information here about the phased return
      If you require further assistance with your enquiry please contact our advice line by visiting the Fit for Work website at
      The Fit for Work Team.

  92. Sharon Louise

    Hi, we have an employee who has become disabled and is due to return to work. He has asked for a meeting in order to discuss his return. What should I expect from the meeting and how should I prepare for the meeting?

  93. lolita boiko

    after carpal tunnel release and left shoulder tendonitis i ask occupation doctor change 1 task because cant gripping and wrapping big flowers bouqets,and want 8h shift,but doctor no support and i work in busy 12 h and do all tasks,but when start pain my hand more i ask GP doctor 1week with light duties ,but company no support my recquest and no give me job from 12.03.2015 i work for company 8year,occupation doctor in my face tell she work for company ,but no for workers,very please help me return to work i want independant occupation health assesment,GP doctor tell all my problem need sort with companys health occupation doctor,but i no agree because cant believe this doctor,i have stress all period ,cry every day because i feel discrimination,last week i no get sick pay,when finish my sick pay from 12.03.2015,please help

    • Fit for Work team

      Dear Lolita,
      Thank you for your enquiry. Having a company occupational health assessment is much more valuable than sourcing outside occupational health as they are aware of the duties involved in your job role. This does not mean that you are unable to seek an independent occupational health assessment, but you would have to pay for this. Ultimately your employer does not have to undertake these recommendations if they are not seen as reasonable, necessary, or within the business scope of the company. Here is some further information about occupational health
      If there is an aspect of your job that you are struggling with I would encourage you to speak with your employer so they are aware of what support you might need. Discuss any issues around increased pain and how you are looking to work shorter hours with lighter duties for a short period of time. However you should be aware that any adjustments will be at the discretion of your manager.
      It is also unclear as to why you feel you have been discriminated against, but here is a link about discrimination that you may feel is helpful: You can also contact ACAS who deal with aspects of employment law if you feel that you need further assistance.
      Please also see this link regarding guidelines for sick pay
      The Fit for Work Team.

  94. Emma Joseph

    I had 2 weeks off for having horrific pain caused by gall stones. I need to have my gallbladder removed.
    I have returned to work asking for less hours as I am still in pain. My employer agreed these terms and wrote them on my back to work form.
    Now she has just gone from the back to work form and given me a lot more hours.
    I don’t know what to do as I am not sure if sheis breaking terms of return to work or if she can just do it. Or whether i can go to doctors and get a note stating I can only do so many hours.
    Just confused and feel like leaving my job.

    • Fit for Work team

      Dear Emma,
      Thank you for your enquiry, adjustments to working hours or work are at the discretion of the employer. If your employer agreed to adjust your work or hours for a period to assist you, I would suggest you discuss this with your manager, and explain that you are still in pain and struggling with your normal work. It may be that he/she has simply not realised that you continue to require assistance. You can go to your GP and request a fit note stating adjustments, but again your employer is under no legal obligation to provide this. It would be for the business to decide if this is a reasonable and manageable adjustment.
      The Fit for Work Team.

  95. Jan Howe

    I have been off work 4 months due to hip replacement, G.P put phased return on my fit note, company say it’s their policy to only pay what I work. I was previously advised that pay is topped up with ssp how does this work ? I am now on greatly reduced wages,I wouldn’t have done a phased return Please could you advise me. Thank you

  96. Pamela Richards

    I am a teacher who is currently of work as a result of a severe flare up of rheumatoid arthritis brought on by a withdrawal of medication due to a bout of pneumonia. I am aiming to return to work in the autumn term but am concerned about future flare ups. I received 28 weeks of SSP which finished in May. If I have to take more time off sick when I return, will I be entitled to claim further SSP?

  97. Mr P

    Hi I’ve just returned to work on a phased return requested by my GP after a heart op and four months off with pay. This will mean working two days the first week, three days second week and so on up to a month before returning to full time. all this info was sent to HR with the relevant paper work. I have been told by HR for me to be paid for the full week whilst on this phased approach I will have to use my holiday time to cover the days that I’m off, is this correct?

    • Fit for Work team

      Dear Mr P,
      All companies vary in how they manage a phased return, but there may also be the option of you being paid your salary for the days that you work, and statutory sick pay (SSP) for any full days you do not work during your phased return.
      The Fit for Work Team.

  98. jayne

    I am currently signed off work -now into my 6th week off due to the sudden death of my mother and two weeks later my father.i am off with acute stress.i feel as though i can go back to work but perhaps on reduced hours for a few weeks rather than full i discuss this with my GP or my manager

    • Fit for Work team

      Dear Jayne,
      I’m very sorry to hear you have experienced these bereavements so close together but pleased to hear that you feel ready to make a return to work. You do not need to see your GP before you return and can discuss this with your line manager if they can accommodate a phased return for you. If you were to see your GP, you may be given a ‘fit with restricted duties’ that may advise that you would be fit for reduced hours for an agreed period – this does often make return easier. Policies and what each business can accommodate can differ, so it would be worth first checking with your line manager and discussing your return.
      The Fit for Work Team.

    • Fit for Work team

      No – this would only be provided after your surgery as planned surgery can be cancelled or postponed from time to time and the absence may not be required.

  99. H Meyers

    Hi there.

    Are employers allowed to schedule you without telling you and without your doctors Fit to Work form that they requested?

  100. Mrs R

    I’m 32+3 weeks pregnant and suffering with back pain at work. My doctor has given a fit for work note recommending reduced hours. My employer would normally pay full pay for sick pay but has said that if I reduce my hours for the three weeks indicated, they will reduce my salary. Is this allowed?

    • Fit for Work team

      Although there are set criteria for payment of statutory sick pay (SSP), companies can outline their own criteria for payment of company sick pay. If you work for a larger company that has a Human Resources department, they should be able to advise you further. Employers would not usually be obliged to pay for hours not worked, and the decision whether or not to provide a period of amended duties including restricted hours on full pay, would be entirely at their discretion.

  101. Steve

    Hi, my wife and I were involved in a serious car accident last year. As a result my wife, who works in Care, has been off work since August 2014 with a prolapsed disc. In April 2015 she received a phased back to work from her doctor, providing her employer made necessary adaptations for her to come back to work. Since then her employer have not facilitated any adaptations, and although my wife received full pay for her first month of ‘phase back to work’, she has not received any further payments, and doesn’t have any income whatsoever. Would she be eligible for any benefits from the state, and is there a limit of how long a ‘phase back to work’ should take?

    • Fit for Work team

      Dear Steve,
      Thank you for your enquiry. Unfortunately because state benefits are dependent upon personal circumstances, we are not able offer specific advice in this regard, but would advise that your wife contact either her local job centre or Citizens Advice Bureau who will be able to advise more accurately. With regard to the Phased Return to Work these tend to be arranged around a relatively short period of time, for example 4 – 6 weeks, which gives the individual time to rehabilitate themselves back into the workplace. However, it is possible that some longer term adjustments to the persons duties at work could be required. Any adjustments would need to be agreed with the employer, and there is no obligation on the employer to agree to them if they do not consider them to be reasonable and manageable. Our Web Site does offer guidance on workplace adjustment, phased return to work and adjustments for employees with back pain which you may find helpful. I hope you have found this information to be useful, please do not hesitate to contact us further if we can be of further assistance.
      The Fit for Work Team.

  102. Lee

    I’ve had carpal tunnel surgery and my doctor has given me 6 weeks off sick note. The occuptional therapist at work recommends I go back on phased returned to work and is giving recommendations of jobs I could perform not using my affected hand. I have 3 more weeks to go before my sick note is finished. I do not want to go back to work before then. Can my employer force me to go on this phased return to work? Can I tell them that without the risk of losing my job?

    • Fit for Work team

      Hi Lee,
      For your own enquiry – if your company have sought the opinion of their Occupational Health provider, and they have assessed you as fit for work with adjustments, then your company can choose to accept the opinion of the Occupational Health provider and expect a return to work. If you do not feel able to return because your recovery has not gone as expected, we would suggest you discuss this with your manager, and request a further appointment with Occupational Health.
      The Fit for Work Team.

  103. Sarah

    Hello my husband was off work for nearly two years after an accident at work he has gone back on reduced hours work has been a pain in the back side trying to get him on a personal improvement plan , he is still on reduced hours but has got to have a different op on his foot and will be off for a period of 6-12 weeks but is now classed as disabled for his foot should he get full sick pay or only sick pay for the 3 days that he’s been working for the last nearly 8 months

    • Fit for Work team

      Hi Sarah,
      With regard to your husband’s sick pay, SSP (Statutory Sick Pay) is payable for 28 weeks, and if he has been paid SSP for the days he did not work during the phased return period, it is possible that he has exhausted his entitlement. If his company operate a company sick pay scheme it is likely they will have a policy which covers what they will pay and when. I would advise that he contacts the payroll department to ask if he is still entitled to SSP – his manager should be able to advise on the company sick pay policy. If your husband is still entitled to statutory sick pay, then this should be paid at his contracted hours, however, company sick pay will be at the discretion of the company, and dependent on their policy. If all sick pay has been exhausted he should receive a form from his employer which he can use to apply for alternative benefits as appropriate.
      The Fit for Work Team.

  104. Henry Bennett

    My brother returned to work after having a heart attack; this was a role which was 50:50 manual and admin. His HR discovered that he had the HA several months later and sent him home for three months and are now saying that he has to return to work in a role which is predominantly manual or they will let him go. There are roles which are more admin based and it had been inferred that he would be offered one with the training required; this option has now disappeared as they are not hiring for those type of roles.
    What can he do? Have his employers followed the law? Have they followed the general approach that should be taken?
    Any thoughts would be appreciated.

    • Fit for Work team

      Hi Henry,
      You indicate that your brother’s employer does not currently have a vacancy in an administrative role, and they are under no legal obligations to create one, so in this respect they have not broken any law. A return to a role with some element of physically demanding work is possible after a heart attack and in many cases, an increase in physical activity is helpful rather than harmful. It may be appropriate in some instances to offer adjusted duties but it is for the employer to decide if adjustments are reasonable, taking into account any considerations of the Equality Act 2010, should it apply. With regard to what your brother can do, could he consider asking his employer to refer him for an Occupational Health assessment in order to determine his fitness to undertake the role as it currently stands? If the Fit for Work referral service has begun in his area (see the roll out map), he could ask his GP for a free referral in order to discuss his return to work. This would also determine if he could meet the requirements of the Equality Act 2010, which may require some adjustments to his role, and although this would guide his employer it still remains their responsibility to determine if adjustments are reasonable.
      The Fit for Work Team.

  105. Linda Walker

    I have just had a ocpational assessment and they said I need a phase to work but I have just got a sick note for three week what shall I do

    • Fit for Work team

      Hi Linda,
      You can return to work on a phased return despite your fit note recommendation and do not need to wait for the 3 week period to elapse. You should agree a phased return with your manager along with any other recommendations from occupational health. You do not require a further note from your doctor with an amended date or fitness statement.
      The Fit for Work Team.

  106. Shimon Forman

    my wife returned to work after a heart attack. Her line manager had made adjustments to the work plan to compensate for her absence. He has not reverted to the previous plan now that she has returned, leaving her with very little to do. She raised the matter with him but he prefers the new arrangement. Does she have any redress?

    • Fit for Work team

      Hi Shimon,
      Thank you for your query – it is generally for an employer to make decisions about the distribution of work, it may be that in re-allocating some of your wife’s work her manager is trying to protect her and avoid overloading her during the initial phases of her return to work. I would advise that she approaches her manager again and explain that she is finding the lack of work quite stressful, and feels that she is ready to take on more responsibility. Even if her manager prefers the current work plan it maybe that they can discuss other activities which she can become involved in. A good way of identifying limitations and needs is to look at the six principles within a stress risk assessment as these can help both employee and manager to agree suitable duties The following link lists these principles and might provide some guidance: Additionally ACAS may also be able to offer additional advice on employment rights.
      The Fit for Work Team

  107. Maria

    I had a gynaecology operation in March and I’m due to return to work in 2 days time. Despite chasing occupational health for a return to work appointment, they have not yet organised the appt. Should I return to work without having occupational health appt?

    Maria S

    • Fit for Work team

      Hi Maria,
      Thank you for your enquiry. If you feel able to return to your normal work, then it would be quite acceptable to return to work without undergoing an occupational health assessment. One alternative might be for you to speak with your manager about any adjustments you feel you might require in order to ease you back into the workplace. If for some reason you feel that you need the input of occupational health I would advise you contact your manager and explain your situation, it may be that they can speed up the referral on your behalf or amend some of your duties pending the assessment. If the Fit for Work referral service has begun in your area (see the roll out map), you could ask your GP for a free referral in order to discuss your return to work.
      The Fit for Work Team

  108. Layla Hammond

    Im returning to work after 4 months off work my return date is 1/06/2015 my doctor has said i need a phase return to work and said i need to discuss the hours with my employer but my manger is saying that if the doctor doesn’t specify the hours i need to do they won’t accepted my phase return and they need my doctor to write down the hours. I told my doctor this and he said it is usually something that i discuss with my HR dept not with my doctor. Who is right in this situation? I would be grateful of any help thank you.

    Layla Hammond.

    • Fit for Work team

      Hi Layla,

      There is no legislation which would cover this. While a GP can indicate on the Fit Note the hours to be worked, this would be unusual. A GP would usually only indicate the period the adjustment is required. This is because the GP would not have a working knowledge of every organisation and its needs. Therefore, it is a matter best discussed with your employer, if possible. That way, you and your employer can identify the specific needs of the organisation, and work out hours that suit both you and the organisation you work for. The Fit for Work website offers a selection of resources, which might help you and your employer reach a mutually beneficial agreement (e.g. this guidance sheet on the phased return to work: If the Fit for Work referral service has begun in your area (see the roll out map), you could ask your GP for a free referral in order to discuss your return to work.
      The Fit for Work Team

  109. shannon

    hi I have just had 10 weeks off due to an injuered hip that will need a major operation early next year I have this week been cleared by my doctor to return to full work as being a full time employee who only took 2 weeks non paid leave in that ten weeks does my employer have to return me to full time hours or do they have the right to only roster me on 3 x 6 hour shifts.

    • Fit for Work team

      Hi Shannon,

      This will be entirely dependent upon the terms and conditions of your employment. If you are a full time employee with a permanent contract, then usually your employer would allow you to return to your full time contract. However, if you are contracted on differing hours or, for example, zero hours contract, then your employer is able to adjust your hours to suit business needs.

      I would advise that you contact your employer to discuss this further and establish the reasons for the change in hours, it may be that they are simply trying to ease you back into the workplace gently.

      The Fit for Work Team.

  110. John

    I’m a teacher. I’ve been on a phased return now since early March this year after a period of illness of more than 12 months. Our “sick year” runs from the start of April to the end of March. My employer is telling me that as I have not yet started teaching full time yet I am considered to have not resumed my duties and consequently am effectively still sick. As a result, should I go sick again this year I will not be paid sick pay because I exhausted my entitlement over the last year. Is this possible?

    • Fit for Work team

      Hi John,

      If you are referring to sick pay in accordance with your employers organisational sick pay scheme then you would need to make enquiries about their specific rules – payroll departments are generally very knowledgeable and should be able to provide accurate advice. Employers/organisations are responsible for their own policies on organisational sick pay, and will have differing rules. There is no legislation which determines what can or cannot be paid by an employer in relation to company sick pay.

      With regard to Statutory Sick Pay, if a period of absence starts within eight weeks of the end of a previous period of absence, the periods are linked and count as one period of sickness. SSP is only payable for 28 weeks in any one period of absence (including linked periods). If you are off sick more than once with more than eight weeks in between, the periods you were off sick are not added together and the 28 weeks starts being counted again each time. Citizens Advice provide some useful information on their website

      The Fit for Work Team.

  111. Anna


    My mom has returned to work after 4 months absence – after her operation. Her colleague had advised that she is entitle to work for 50% of her normal time instead her full hours for some time at the beginning of her return to work. Could someone please advise how true it is ?

    I would appreciate any advice.

    Kind regards,

    • Fit for Work team

      Hi Anna,
      What you are describing is a phased return to work, whereby an individual can return to work on reduced hours which would increase gradually over what is usually a short period. This is not an entitlement, but is something that some employers may consider in order to help an employee back to work following a long absence. Perhaps your mum should discuss this with her manager, who could advise on the position of her particular company.
      The Fit for Work Team.

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