Understanding eligibility for Fit for Work referrals

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

understanding eligibiltyFit for Work’s free online resources (blogs, guides on the Advice Hub, ability to ask a question by email/web-chat etc.) and the free telephone advice line (0800 032 6235) can be accessed by anyone who needs help with work-related health matters. In order to ensure that the free Fit for Work referrals are available for those who need them, they are subject to a set of eligibility criteria.

What is a Fit for Work referral?

A Fit for Work referral is for employees who have been off sick from work for four weeks or more. The subsequent assessment aims to identify the obstacles delaying an employee’s return to work and provide recommendations about how those can be managed in order to help the employee return to work quickly and safely. Because Fit for Work understands that there are a whole host of reasons why a person might be off work sick over and above purely health reasons, the assessment is based on a holistic ‘biopsychosocial’ approach. This explores all health, non-health, work and non-work factors influencing a person’s ability to return to work – e.g. physical or mental issues, work-related factors, personal problems, etc.

In the majority of cases, the 45-minute in-depth assessments take place by phone between the employee and a Fit for Work case manager. Where a return to work is deemed appropriate, the assessment culminates in the production of a personalised Return to Work Plan. This plan provides a step-by-step approach to returning to work and can be helpful in discussions between the employer and employee. The Return to Work Plan can also be accepted by the employer as evidence for sick pay in a lieu of a Fit Note.

Who is eligible for a Fit for Work referral?

Eligibility for a Fit for Work assessment depends on five factors.

1. Location

Those living in England and Wales can be referred via fitforwork.org, while those in Scotland have a separate service, available via fitforworkscotland.scot.

2. Work status

Those who are in paid employment are eligible, those who are self-employed or unemployed are not.

3. Length of sickness absence 

GPs can refer patients who have been off sick or who in their view are likely to be off sick from work for four weeks or more.

Employers can refer employees who have reached four weeks of sickness absence and have not yet been referred by their GP.

Those who have been off work for reasons other than illness, or who have not been absent for the stipulated period of time, are not eligible for the service. Employees cannot self-refer but can ask their GP or employer to refer them.

4. Past referral

People who have been supported through a Fit for Work assessment in the last 12 months will not be eligible for a repeat referral.

5. Consent

GPs and employers must gain consent from patients/employees before they make a referral. Consent will also be sought from employees before their Return to Work Plan is shared with their GP and/or employer.

Employees: If you meet the eligibility criteria, ask your employer or GP to refer you to Fit for Work. To find out more about Fit for Work referrals, see this post.

Employers: Refer eligible employees by visiting fitforwork.org/employer and clicking on ‘refer an employee’.

GPs: Refer eligible patients by visiting fitforwork.org/general-practitioner and clicking on ‘refer a patient’.


  1. Jenny

    Can a fit for work assessment help if you are away from work for 4 weeks plus due to workplace bullying & harssment from your employer?

    • Fit for Work team

      We would aim to help anybody referred to us when absent to return to work. There are often issues at work that relate to disputes with employers or perceived bullying /harassment and it is important that your concerns are addressed. If you would prefer that your employer is not involved in the referral, you can ask your GP to refer you.

  2. Rebecca

    Hello, my husband has been off work for over a year as a result of an injury at work. This has left him with the worst form of debilitating chronic pain there is, in both of his hands and forearms. He also has over 70 blistering ulcerations across the affected areas that can bleed to the touch, contact with clothing, contact with water, change in air temperature…pretty much anything really. He is suffering with severe depression and anxiety on top of this. The amount of medication he is on is heartbreaking for me and the side effects are devastating to witness. His employers didn’t make any reasonable adjustments for him in the early part of his sickness and put this down to how quickly his illness developed. Would the opportunity of a fit for work referral be appropriate in this situation?

    • Fit for Work team

      Yes, if your husband is still absent from work, please do consider a Fit for Work referral. He can ask to be referred by either his employer or his GP.

  3. Cheryl

    What if we have an employee that has been off work for more than the four weeks and refuses to engage with the employer so we canot get their permission to refer them to Fit for work for an assessment. Their Doctor has not referred them either.

    • Fit for Work team

      Unfortunately, there does need to be consent to be referred to our service. Your employee is required to make ‘reasonable’ contact with you however during their absence. If you feel that this is not the case, you can receive more specific advice in relation to this at Acas (a government-funded free advice service about employment law). Their website is acas.org.uk.

  4. derek

    I’m off work as I cant stand for long and everyday I get symtoms of carcinoid cancer.this is not operable as its all over liver.monthly injections for life and I retire this year in December. Does this programme affect me.

    • Fit for Work team

      I’m sorry to hear about your illness. Fit for Work may be able to help you if there is any possibility of you returning to work before your retirement. We would look to see if there are any adjustments to your job that would enable you to make a return. If you would like to be referred, you can ask your GP to refer you, or your employer if you have already been absent for 4 weeks or more.

  5. Mart

    Assessment should be Face to face with mental health issues as over the phone can make things worst.

    • Fit for Work team

      I’m sorry to hear this and assuming this may relate to an experience you have had. There has been a great deal of research to assess the suitability of telephone based assessment for employees with mental and physical health issues which does support their use in most circumstances. A face to face assessment can be arranged at Fit for Work if communication is difficult or there is any other reason why a telephone based assessment is not suitable. If we can help you more directly, please do not hesitate to contact us

  6. Shayne

    Does it need to be 4 continuous weeks or can it be where an employee has had numerous odd days here and there amounting to 20 days off of work?

    • Fit for Work team

      Hi Shayne,
      Thank you for your enquiry. It needs to be four continuous weeks of absence.
      The Fit for Work team

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