Module 6: Occupational Health Management - Section 5: The Medical Adjudication Process and Management of its Outcomes
OHM5.4: Managing the Employee Found to be Unfit by Medical Screening

THE EMPLOYEE FOUND TO BE "UNFIT" DURING MEDICAL SCREENING:

The status, unfit, can be considered in the same way as for disability, under two qualifiers, viz. extent and duration:

Extent: - the significance of the failure to meet the inherent requirements in the light of the possible consequences of the person continuing in that occupation. Many of the inherent job requirements, particularly the exclusions, are relative exclusions rather than absolute.

Hence, should hypertension be an exclusion for a particular occupation, it is reasonable to regard varying levels of raised blood pressure as linked with commensurate levels of exclusion from that work. For example, a blood pressure which is slightly over the normal limit requires a different reaction to a blood pressure which is life threatening. The employee with the slightly raised blood pressure could be allowed to return to work with the restriction that he is required to return for regular monitoring, that the blood pressure is seen to return to normal, with the passage of time.

By contrast, the employee with the critically raised blood pressure would be required to cease working in the relevant occupation immediately.

Duration: - the length of time that the person will remain or is likely to remain unable to meet the requirements of the occupation.

The permutations for action in the circumstances described above depend upon the interplay between the duration of the disability and its extent.

All reasonable attempts should be made to enable the employee to recover, and return to some form of work. The first objective is to apply whatever medical treatment options are available to restore normal (or optimal) function. Should this not be possible, it is incumbent upon the employer to attempt to find other suitable work for the affected employee in the company. This requirement applies to all affected employees - whether the underlying cause for the problem is work-related or not.

However, the Labour Relations Act makes special provision for those that have been injured on duty or have an occupational disease - there is a further requirement on the company to make every effort to find other suitable work for the affected employee. However, (work-related or not), should no suitable alternative work be available, the employee is regarded as incapacitated and the subsequent sequence of events for incapacitated employees is initiated.