Preamble: Dealing with sickness absence
There is considerable evidence from research in Europe and north America that work absence due to sickness is a major issue for management and that many companies have not yet introduced an effective policy to deal with it. It is apparent that few companies calculate the true cost of sickness absence and most document simply set out sickpay entitlements and procedures for medical authorization of absence.
Any strategy to minimise sickness absence should be firmly based on the pattern of incidence, the underlying causes, and a company’s overall HR policy framework. Recent studies have revealed that high levels of work absence are closely associated with:
Generous sick pay provision from the company and/or the state.
Increasing employee age and high levels of job security (or perceived security).
High levels of stress, job intensity, job repetitiveness and worker passivity.
Low levels of working-time flexibility, job responsibility and control.
Poor absence management and lack of accountability for the costs of sickness absence.
Lack of information about the normal duration of illnesses and recovery periods from operations.
High reliance on public health systems and their physicians to certify absence.
Failure to put in place a company wellness policy and rehabilitation programme.
Conflicts between sickness absence policy, health and safety policy and work-life balance policy.
Reluctance to raise absence as an issue for discussion with employee representatives.
It is also necessary to establish a clear distinction between:
1a] Normal sickness absence,
1b] absence for family reasons declared as sickness absence,
1c] repetitive absence by the same individuals (malingering) and
1d] long-term absence (in excess of four weeks). Management attention needs to focus on types 1b – 1d where significant cost savings may be achievable.
2a] General sickness absence and
2b] absence resulting from workplace incidents or environmental conditions. In the case of type 2b absence, a company will need to ensure that its actions do not aggravate any possible financial claims against it, or invite undue attention from health and safety officials.
Finally, a major problem with many sickness absence policies is that they focus almost wholly on the action to be taken when an employee becomes unwell, setting out bureaucratic procedures to record sickness absence. If companies have a HIV/AIDS policy, this is also often regarded as a separate initiative. It is rarely integrated into an overall strategy to promote and protect employee health and handle such issues in a humane and sensitive way.
An effective policy is one that addresses the wider and positive issue of employee wellness. It should aim to minimise sickness absence through a mix of health awareness, clearly defined entitlements and tight management controls – but with some scope for discretion in particular areas where employee welfare outweighs the risk of abuse.
Model company wellness policy (UK example)
The following text is generally suitable for UK operations, but will need to be modified to comply with statutory requirements and sectoral collective agreements in other countries.
This policy should be read in conjunction with the company’s sickpay guidance and its health and safety, maternity/parenting, uncertificated absence and equal opportunities policies.
Policy (published text)
The company values your contribution to its current and future success. For that reason, we need to ensure your continued well-being and to operate a consistent, fair, and effective approach to sickness absence.
Section 1: General provisions
1. Legal requirements: The company will comply with all legal obligations in each of the jurisdictions where it operates. This may give rise to local variations in corporate wellness provisions.
2. Working time and second jobs: In order to ensure that the company complies with statutory working time limits and to ensure the health and safety of staff, we must be informed of any time spent carrying out paid or voluntary employment for other employers, or work on a self-employed basis. If the combined work time for any employee in a given week exceeds the normal maximum weekly limit established by law, the company reserves the right to require the employee to curtail their outside work commitments. No work activities of any kind shall be carried out for third parties whilst an employee is on sickness absence.
3. Privacy: All employee medical data is considered as sensitive and handled in confidence on a strict ‘need to know’ basis. The only standard types of health data that the company retains on its general human resource records are as follows: a brief ‘fitness for work’ statement from a physician or other health professional, details of the number of days absent attributable to sickness, maternity or industrial injury, and any further details that may be required to comply with disability legislation. If the company wishes to obtain a medical report from your doctor, it will first seek your consent. You may ask to see the report and request amendments before it is supplied to the company.
4. Genetic tests: It is currently company policy not to make use of genetic testing during medical examinations, nor to retain any information arising from a genetic test on individual employee records. This policy will be reviewed from time to time in the light of developments in such testing procedures and medical advice received.
5. Violence and bullying: The company operates a policy of zero tolerance towards any form of physical or mental violence between co-workers. This includes abuse, intimidation, obscene gestures and bullying behaviour. You should report all such incidents to your line manager or the human resources department. If you make a complaint, it will be investigated and all reasonable steps will be taken to protect you whilst you are at work.
6. Disability: The company is an equal opportunities employer. If you have a disability, we will make whatever reasonable adjustments within the workplace and to employment arrangements that may be necessary for you to undertake your job. This includes the provision of appropriate special equipment and also facilitating access to your normal place of work.
Section 2: Avoiding absence
1. Proactive support: We encourage all staff to maximise their fitness, avoid common health risks and get back to work as quickly as possible after any period of sickness absence. To achieve this we’ll meet the reasonable costs of:
Regular health checks by a company-appointed physician (every two years).
Annual flu vaccinations and periodic Td-polio immunisation (where not available through the public health system).
Access to the company fitness centre (where available).
Private health care and permanent health insurance for senior management, key staff and their families.
Attendance at a physiotherapy clinic for those staff not covered by private health care insurance who are medically diagnosed as requiring such treatment, but who would have to wait over two weeks for an appointment under the public health system.
The company encourages employees to take regular exercise and maintain a healthy and well-balanced diet.
2. The sensible limits to privacy: To protect your own well-being, we request that you voluntarily inform your line manager if you suffer from diabetes, epilepsy, asthma or any other condition that may cause you to require assistance from co-workers. It is important that work colleagues are aware of any danger signs affecting your safety and that asthmatics carry their ventilators with them at all times.
3. A healthy working environment: The company does not permit smoking, the use of narcotic stimulants or the consumption of alcohol in any of its premises, or in public places near entrances to company premises. We reserve the right to search staff if we believe they are carrying alcohol or illegal substances into the workplace. Drug and alcohol testing is carried out on a random basis for all those required to drive on the company’s behalf, operate equipment for which there is significant health and safety risk, or act as a representative of the company to customers, suppliers, or the public. We also reserve the right to carry out testing if there is reasonable evidence that substance abuse may have occurred. Any proven instance of dealing in illegal substances by staff will be subject to instant dismissal for gross misconduct.
4. Ventilation and ambient temperature: Our principal buildings are fitted with ventilation systems and, where possible, full air conditioning. These systems are regularly checked for airborne contaminants such as legionella bacteria. Office environments will be kept within the temperature range of …… to …… degrees centigrade.
5. The nature of your job: We operate an ongoing job enrichment programme to enhance the quality of your working life, minimise stress and encourage you to take more responsibility for the end results of your work activity. Each year you will be asked to complete a short questionnaire about your job. This will then be used by you and your immediate supervisor to determine how your job could be enhanced. You may also contact the company’s human resources department at any time (on a confidential basis) to request a meeting with a stress counsellor.
6. Protecting yourself from injury and exposure to infection: You should wear any protective clothing supplied in connection with your job during all times that you are subject to the risks for which it was provided. If you are called upon to give assistance after an accident at work, or are otherwise involved in handling blood, you should always wear gloves (preferably the disposable rubber gloves contained in the company’s first-aid medical kits).
Section 3: Managing absence
1. Workplace injury or work-related illness: If you have experienced an injury at work you should seek assistance as quickly as possible from our nurse/qualified first aid assistant. They will determine what treatment may be necessary and notify all appropriate company personnel. If you experience any ill-health that may be attributable to your working environment, you should contact the human resources department as soon as possible and they will arrange for you to see the company’s occupational physician.
2: Medical appointments: Appointments for routine medical treatment should be arranged for times outside your normal working hours. When this is not possible, you must inform your immediate supervisor or the human resources department as soon as an appointment has been made. Cases of genuine emergency treatment, together with appointments made by those with a recognised disability or under the company’s HIV/AIDS policy will not be counted as sickness absence provided that they do not require more than four hours’ absence from work in each instance. Frequent absence for emergency treatment will be reviewed by the company and any abuse of this facility will be handled through the company’s disciplinary procedures.
3. Emergency dependant care: If you have young children, or dependants who are disabled or elderly, you will need to ensure that adequate provisions are made for them whilst you are at work. These should include fallback provisions in case your normal carers are unavailable at any time. If you are experiencing difficulties or anticipate any problems with your support network, please contact the human resources department. We shall always seek to be as understanding as we can about short-term difficulties. Occasional short periods of family-related absence will normally be covered by our emergency care policy and be subject to full pay. However, longer-term issues will need to be addressed by considering such measures as alternative working hours, part-time employment or joining the company’s temporary work register. At no time should you use sickness absence in order to deal with emergency dependant care. Such misreporting will be treated seriously as a disciplinary matter.
4. Protecting colleagues from exposure to infection: Should you contract influenza or any other readily contagious illness such as mumps, measles or chickenpox, you should remain at home and contact your immediate supervisor or human resources department as soon as possible on the first workday after it has become evident. This will help you and the company to determine how the impact of your absence can be minimised. Exceptions to this rule may occur in the case of hospitalisation, or continued attendance at work to meet an urgent commitment. In the latter case you should avoid unnecessary contact with others and return home at the earliest opportunity. Where circumstances allow, it may be possible to arrange for you to work at home, or to undertake an approved distance learning programme to enhance your skills. In such cases, an appropriate proportion of the time you are away from your normal work duties will not be recorded as sickness absence.
5. Paid time off (PTO): The company operates a paid time off (PTO) system. The holiday year runs from …… to …… , and your annual entitlement to paid time off consists of …… days of core holiday time, plus five conditional days.
A conditional day is one that will be paid in full, and may either be used for sickness absence or be carried forward to be taken as additional paid holiday in the following year. This means that if you do not take any time off for sickness during a holiday year (the qualifying year), you will be credited with an extra five days’ paid holiday in the following year. Each day that you take off for sickness, however, will reduce your entitlement to additional holiday days that may be carried forward. If you are absent due to sickness for more than five days in a holiday year, you will only be entitled to the core holiday time of …… days in the following year. Once the qualifying year has ended, any additional holiday days that have been accrued in that year cannot be reduced due to subsequent sickness absence.
6. Sick pay: Your ongoing sick pay entitlement outside the PTO system will be subject to minimum statutory requirements in the country where you are employed. However, we shall ensure that you continue to receive at least 75% of your normal pay for the first four weeks of sickness absence each year and 50% for a minimum period of …… weeks (or until our long-term disability plan becomes effective at …… weeks after commencement of absence). Once you qualify under the state disability scheme, your employment will normally be terminated on health grounds.
7. Confirmation by a medical practitioner: For all sickness absence outside the PTO system you must obtain written confirmation from your doctor that you need to be absent from work on medical grounds. This is required for every day that you are on sick leave in excess of the five ‘conditional days’ allowed each year and the written confirmation must be renewed at least every ten working days. Each doctor’s note must be forwarded to the company’s human resources department within a week of it being issued. The company will not provide sick pay for any day not authorised by your doctor.
8. Workloads due to absence: Your absence will inevitably place greater workloads on colleagues. In order to minimise this burden and protect the interests of the company you should, where possible, inform your immediate supervisor of any work priorities and provide any information and guidance that will assist others to complete outstanding tasks.
9. Review of absence: If you are absent for more than five days, you will normally receive a telephone call, letter or email from the human resources department to check on your situation and determine when you expect to return to work. If you are absent from work for over two weeks, you will be contacted to arrange a home visit by your line manager or a human resources officer. All those absent for more than four weeks will be subject to a review by the company’s occupational health physician. This may also require a home visit or, where appropriate, a visit to their surgery.
10. Hospitalisation: If your sickness absence involves a period of hospitalisation, please ensure that your line manager and/or human resources department are informed about the hospital where you have been admitted. If your period in hospital is for more than one week, the company will normally arrange for a work colleague to visit you.
Section 4: The consequences of absence
1. Fitness for work: The company will generally accept the recommendation of your medical practitioner that you are fit to return to work. If, however, you are willing to work but the company nevertheless requests that you undergo further medical checks, we shall pay you in full until the checks are carried out.
2. Return to work interview: If you are absent from work for longer than five working days in any three-month period, you will be required to attend an interview. Those returning from a long absence will normally be requested to attend an interview with the human resources department on their first day back at work.
3. Rehabilitation: If your period of sickness absence is longer than six weeks, your return to work will be subject to a rehabilitation plan. This may require your initial return to work to be on a part-time basis or your attendance at a specialist work rehabilitation centre. However, in circumstances where you may remain unfit to resume your normal duties in the foreseeable future, a special review will be arranged to determine whether any special access, equipment, redeployment or job design provisions can be made in order to continue your employment with the company.
4. Female returners: Before you return to work after maternity leave, you should arrange for a meeting with the human resources department to discuss any initial modifications that may be necessary to your working hours and job tasks. Where the nature of your job may be potentially hazardous to your health immediately after pregnancy, we shall seek to redeploy you on a temporary basis to a more suitable position.
5. Claims: If you have suffered from a workplace injury (or a work-related illness), injury compensation claims will not normally be affected by working from home, taking part in an approved distance learning course at the company’s expense whilst on sick leave, or participation in a rehabilitation programme. If you are uncertain about this issue, please contact your employee representative or the human resources department.
6. Care of dependants whilst you are sick: This should normally be arranged privately. However, if you are a single parent, disabled or suffering from a workplace injury, you may be given special financial assistance at the discretion of your line manager and the human resources department.
7. Substance abuse: Where it can be established that your sickness absence has arisen from misuse of alcohol or illegal narcotics, the company will require you to receive specialised counselling and to undergo remedial treatment in line with appropriate medical advice.
8. Deteriorating health conditions: If an existing health condition should deteriorate to the point where you are unfit to work, even with the special provisions that have been made for your condition, the company will terminate your employment. In such circumstances you may qualify for benefits under the company’s long-term disability insurance plan. If you are over the age of ….., it may alternatively be possible to arrange for your early retirement under the company pension scheme. Should you not qualify for such benefits, we will assist you to gain full entitlements under available state benefit schemes.
Section 5: Employees and HIV/AIDS
1. Company awareness: We take a positive view towards all our employees and you will not be treated any differently if you suffer from any health condition. There is no evidence that HIV or AIDS can be transmitted between people through normal social contact. It is therefore the company’s policy not to seek to identify those with either condition unless someone is employed as a health care professional or has to handle human blood (or blood products) as part of their job function. In such cases an HIV test will be voluntary, confidential and will involve appropriate counselling.
2. Management training: The company includes HIV/AIDS awareness briefings within its ongoing training and induction programmes for all managers and supervisors. The purpose of these briefings is to ensure that senior company personnel do not hold any misconceptions about either of these conditions, are prepared to handle individual cases with sensitivity and compassion, and are equipped to identify any discriminatory actions by their staff against those suffering (or assumed to be suffering) from HIV/AIDS.
3. Prevention of harassment: Harassment of persons suffering (or assumed to be suffering) from HIV/AIDS or AIDS-related conditions will not be tolerated. This includes the refusal to work with anyone suffering from such conditions. Those found to have taken part in harassment or bullying on these grounds will be subject to disciplinary procedures and potential dismissal.
4. Confidentiality: If you voluntarily inform the company that you are suffering from HIV or AIDS, then that information will be treated sensitively and in the strictest confidence. It will not be revealed to anyone apart from company medical staff, the human resources department and your most senior line manager.
5. Equal treatment: You will not be treated less favourably by the company if you have HIVor AIDS. You will have the same rights as other employees, including equal access to jobs and training opportunities, consideration for promotion and a company pension.
6. Additional time off: Where you have voluntarily informed the company that you have HIV or AIDS, special arrangements will be made for you to take additional time off outside the PTO policy. This will be to enable you to attend a hospital or specialist clinic for outpatient treatment or counselling.
7. Changes in an employee’s health condition: The company recognises that HIV and AIDS are serious and potentially progressive conditions. If we are informed that you suffer from either condition, however, every reasonable effort will be made to enable you to work for as long as possible, either through increased flexibility in working hours, or special adjustments to your working environment.
8. Travelling abroad: If you have HIV, AIDS you should seek medical advice before travelling abroad on the company’s behalf. Some countries test visitors for HIV, or ask for evidence of HIV status before issuing a visa. You should therefore check with the country’s embassy before making any final arrangements. Should a test be required, it is important to make sure that you receive the necessary pre and post-test counselling.
9. Further information: The human resources department holds details about various organisations that may be of assistance to those with HIV/AIDS and their families. This information will be made available, in confidence, on request.
Section 6: Disciplinary and grievance procedures
1. Disciplinary action: Should you act in any way that infringes the terms of this policy, you may face disciplinary action. In cases of serious violations involving deception, this may lead to the matter being dealt with through the company’s formal grievance and disputes procedure.
2. Grievance: If you consider that this policy has not been applied fairly or correctly, you should raise the matter initially with your immediate supervisor. If you subsequently remain dissatisfied by any response you receive, you may take up this matter with your employee representative, the human resources department, or any member of senior management. Serious grievances may also ultimately be handled through the company’s formal grievance and disputes procedure.
Example of a draft memorandum
To: All departmental managers
From: ……………….. CEO
Attn: ………………… Human Resources Director
Subject: The company’s new wellness policy
I attach a copy of our new wellness policy that has recently been agreed with the employee council. The deadline for its introduction is …… Before this date, each employee must individually sign off on their new terms and conditions.
In order to achieve smooth uptake of the new policy, the HR department will be holding a briefing for all departmental managers on …… and …… Please inform …… if you cannot make either of these dates, and a one-to-one session will be arranged.
The plan is to announce the new policy in the next in-house magazine in …… [month] and for the HR department to circulate copies of the policy with a letter from me about ten days after publication of the announcement. It will then be incorporated into our employee handbook, replacing our former sickness absence policy.
As most employees will be receiving some additional holiday entitlement and other benefits under our proactive support programme, we do not anticipate very much opposition. However, it is important that you are prepared to ‘sell’ the merits of the new policy if you should be approached by any staff member with their concerns.
These changes also involve a number of adjustments to our current accounting and performance review procedures that will directly affect you. The principal one will be the fact that once the new policy is in place, all sickness absence costs in addition to the five days allowed under the paid time off system will be chargeable against the budgets of the departments for which the absentee works. This includes the costs of substituting other staff to cover for the absent employee.
With kindest regards,
This model policy is provided in good faith and is not intended as a prescriptive approach to health, work absence or related matters. It does not constitute any specific guidance and full consideration should be given to the individual circumstances of a potential user when considering its adoption in any form. In providing this material neither FedEE nor any third party authors accepts any liability whatsoever for any executive decisions or actions taken. Before taking any course of action, you are strongly recommended to seek appropriate professional advice.
Reproduction of part or all of the contents in any form is prohibited other than strictly for individual or corporate use. The material may not be recopied and/or shared with any third party. The permission to reproduce the material does not allow for incorporation of any part of it in any work or publication, whether in hard copy, electronic, or any other form.
We should like to thank Alison Wallace, Partner, Steptoe & Johnson, London for kindly reviewing a draft of this policy and making a number of suggested amendments and additions that have been incorporated into the final text.