What is there as a general introduction to sickness absenteeism

This section should remain in the "Medical Adjudication" group, as this is where Sickness Absence belongs. The medical role is one of facilitation and adjudication. I believe it is important to place Sickness Absence in the same territory as "Incapacity" (rather than misconduct), as it gives the problem the correct "flavour". Addressing misconduct is simply the first step in the sequence. If found to be present, misconduct takes the problem to the Human Resources department, and tends to obviate the medical contribution.

1 STEP-WISE APPROACH TO HEALTH-RELATED POOR PERFORMANCE / EXCESSIVE ABSENTEEISM ARE THESE TWO THE SAME THING? Yes, see below...

The terms "health-related poor performance" and "excessive absenteeism" are placed together in this section, as they are regarded as synonymous. This is an important feature of the management of absenteeism. The component of the title, "health-related", indicates that the underlying reason for the "absenteeism" is a medical one. The term excessive absence has different implications for the various role-players in this issue.

Management should be encouraged to remain focussed on the employee's work performance, and to avoid entering into a debate regarding the legitimacy of the sickness absence, unless misconduct is suspected.
The employee should make every effort to seek (and comply with) appropriate medical advice, and apply any relevant principles of healthy living, in order to be restored to optimal health (and a satisfactory work record).
The medical team should be available to assist the employee in these endeavours, and to advise management regarding suitability to return to work.

Thes roles are explored in greater depth in another section ("Ohmlaw2").

The underlying reasons for poor work performance may be quite diverse. For example, they could relate to psychosocial problems at home, genuine ill health, logistic problems such as transport, and a long list of others. Ultimately, the final common pathway of all these “problems” is a poor work record or inadequate work performance. In other words the employee is either simply not at work, or when he/she is at work, the performance is below the required standard. Sometimes this under-performance may be that the employee is no longer able to perform some of the required tasks for that particular occupation. When this is the case the following approach is recommended.

1.1 Step 1: Exclude misconduct

Consider all given facts – is poor work performance (including sickness absence) justified?

Gather available medical evidence and evaluate. Have a look at the pattern of absence (frequency, weekend illness), validity of medical certificates, etc.

If the medical reports clearly show signs of not being valid (as defined by the Basic Conditions of Employment Act), or if no medical reports are given and it can be concluded that the employee is absent for other reasons than that of illness, the disciplinary code of conduct may be used.

Determine how regularly and what periods the person is absent, e.g. weekend absence without a medical certificate. Certain trends in sickness absence are a sign of fraudulent use of the entitlement, and can be regarded as misconduct. Medical certificates should be scrutinised carefully when they are provided from a wide variety of doctors.

If there is suspicion that the absence is not justified, try to obtain evidence for the suspicions, e.g. through unexpected visits to the employee’s home and/or evidence (preferably verified) from people who have first-hand knowledge of the person’s whereabouts.

Often unsatisfactory information is given in a medical certificate or it merely states that a person was absent. In such cases the company may request the employee to provide more information regarding the nature of the illness, should this be relevant. This option is rarely necessary. Note that the requirements for medical certification include a protection of the privacy of the employee, hence the doctor may not reveal the nature of the disease without the consent of the employee. The employer may not insist on private or confidential information. It could be considered reasonable, though, for the employer to seek reassurance that the extent of the absence is justified, given the nature of the condition, and for clarity regarding the likely return to work, and the returning person’s health status at the time of returning to work (does he/she still meet the requirements of the occupation?).

Where misconduct is established, the appropriate steps are taken, in accordance with the company’s disciplinary code.

1.2 Step 2: Regular communication (counselling)

Where no misconduct is established, the employee should be informed that the excessive sickness absence (or poor performance) has negative operational implications. It should be pointed out that the employee might ultimately be dismissed, unless there is an improvement in his/her attendance.

The counselling session should focus on:

The negative operational consequences for the employer, of the poor performance
Sickness does not provide an indemnity from performance appraisal
Action should be taken to rectify the absence profile (poor performance), with an agreed schedule (time-span) for improvement
The consequences if the situation does not improve.

The exact requirements in terms of how many informal discussions, formal counselling sessions, warnings (verbal and written), varies according to circumstance. Legal opinion indicates that this is determined by permutations such as:

How critical is the attendance (and optimal function) of the appropriate employee, on the operation? The more critical, the greater the demand to return to effective work, with commensurately reduced tolerance on the part of the employer.
How easily can an alternate person be found to replace the employee, temporarily? For employees that are easily replaced temporarily, there should be greater tolerance for the absence or incapacity.

1.3 Step 3: Establish a Plan, and follow through

The employee and employer should work together to establish an agreed pathway to recovery (meeting the needs of the employee, and the needs of the operation). This requires a step-wise approach, exactly as is described in the section, “Step-wise approach to handling the unfit employee”.

Point to Ponder:

Referral mechanisms and poor work performance

When an employee is referred for a medical opinion for reasons of poor work performance, extensive periods of sickness absence, ill health etc, the referral mechanism is important. All too often, medical professionals are frustratingly confronted by an employee who is referred by company management for a medical opinion for an obscure reason. This unmasks inadequate management policies or a need for training. Furthermore, it fuels an underlying implication that management is suspicious that the referred party is guilty of sick leave abuse or even misconduct, and that the occupational health unit is an expedient instrument for management action against this “culprit”, with negative industrial relations consequences. The medical practitioner is placed in the invidious position of the wise, all-knowing arbitrator, although the employer’s subtle underlying expectation may be that the practitioner act in support of the employer. This kind of practice should be avoided. Instead, a structured approach should be established, and procedurally followed.

Synergee has developed a referral form, which should be used by company management whenever a referral for medical evaluation is contemplated.

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