Occupational health · social

Fitness for work

The assessment of whether a person's health permits them to work, with or without adjustments — formalised in the UK's fit-note system.

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Definition

Fitness for work is the occupational-health determination of whether an employee is able to perform their job safely and effectively given their health status. In the UK it is formalised through the fit note (Statement of Fitness for Work): after more than seven days of sickness absence, a healthcare professional — doctor, nurse, occupational therapist, pharmacist or physiotherapist — assesses the employee and certifies them either "not fit for work" or "may be fit for work", the latter prompting discussion of adjustments such as altered hours, duties or workplace adaptations; if no adjustment is agreed, the employee is treated as not fit. For absences of seven days or less, self-certification applies.

References

UK Government (GOV.UK)

fit-note regime, "not fit"/"may be fit for work" outcomes, assessing professionals, seven-day threshold, self-certification

Overview

What it means

The "may be fit" category shifted the system from a binary sick/well verdict to a graded capacity judgement, making return-to-work with reasonable adjustments the default expectation and keeping work itself within the scope of recovery.

How it is used

Used by employers managing sickness absence, occupational-health services, insurers and disability-employment policy; adjustments for disabled workers are a legal duty.

Why it matters

How fitness for work is judged determines whether ill health becomes job loss; well-designed assessment supports participation, rehabilitation and decent-work outcomes.

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