Source: http://www.newmancraneins.com/2012/09/paid-sick-leave-fewer-workers-comp-injuries/
Absence from work is one of the main challenging issues in the workplace involving both the management and doctors in the occupational health service. On one hand, the management looks at absenteeism in all its forms as being a drain to its profitability, meanwhile the pressure is on the doctor to ‘certify’ the individual as ‘sick’. The question is, “Are all absences related to being ‘sick’?” The management in most instances would refer the absent individual to the medical practitioner to rule out a medical possibility.
This can often lead to misunderstanding between all parties. The management might look at the doctor as a collaborator with the worker for profit and the doctor as taking the easy way out from the management. This can lead the management to take measures to control unauthorized absence which later results in poor manager, workers and union relationship.
Sickness Absence – What is it?
The term sickness absence is also known as sick leave (SL), or medical chit (MC) as the one we are most familiar with. Absence can be categorized into five basic categories:
- Sickness absence, which is defined as the absence attributed to incapacity due to illness or injury that is NOT work-related.
- Personal leave, which is defined as the absence due to personal reasons and having nothing directly to do with incapacity.
- “Time-lost” occupational injuries or illnesses. These are reportable under the workers’ compensation and relevant laws, therefore, are closely monitored.
- Pregnancy and child care leave. This is planned and preauthorized under the existing laws and employer’s policy.
- Partial absence.
What would be an interest to all would be the sickness absence, which is the leave that is allowed up to the maximum period under the existing policy.
Sickness absence can be further categorized as:
- Certified by the doctor (most common)
- Uncertified or “self certified”, usually not practiced in this country
- Prior authorization (example: doctor’s appointment for an on-going problem)
Sickness Absence and Its Control
Traditionally, recording of days away from work or the incidents of absence and attendance at work are used to monitor the presence or absence of the worker. These two methods can apply to all categories of workers including the management. In most instances, it is impractical as this depends on the nature of the job and the position of the worker, where he/she could be holding the managerial role and therefore the task, as well as the responsibilities would be different. The problem from the point of view of the management is differentiating the sickness absence from the unauthorized personal leave. Here then, the role of the doctor and a ‘certification’ would be a source of friction as discussed.
Sickness absence and monitoring should be an administrative responsibility and complemented by the doctor or an occupational health service. A well run occupational health service can help reduce this problem by evaluating employees through a fitness-to-work concept. In this concept, the emphasis should not be on policing compliance with the management policy on sick leave. So, it would be in the best interest of the companies to have an occupational health doctor to assists in this difficult area.
Sound health promotion programs in the workplace are one of the ways to address non-occupational factors determining health. Participation by the workers in such programs may reduce workers’ absentees.
The Doctors’ Role in Sickness Absence
The primary role of a doctor is to determine ‘sickness’ or simply decide whether the worker is healthy enough to carry out his/her role in the organization. Therefore, the doctor has to answer the fundamental question of “is he/she fit to work ?” Therefore, the concern of the doctor is first to the worker and secondly to the employer.
Source: http://www.republicreport.org/2012/america-mandatory-sick-leave-lobbyists/
The difficulty in certifying cases as fit to work or not, is not well defined because of the lack of physical or laboratory findings. This makes the task of the doctor so much harder. On the other hand, if there were physical or laboratory findings, then it would facilitate the doctor in arriving to a diagnosis. Employers must understand this aspect of the attending doctor’s task. Ultimately, it is the worker who actually decides to work or not, as he/she feels fit, whether or not a leave is given.
The diagnosis of the workers is at all times confidential, unless stated in the policy of the company and understood by the worker, it should never be revealed to anyone without the consent of the worker/patient.
Conclusion
Sickness absence will continue to be a challenge to all doctors, employers and employees. The solution is through a collaborative approach with much involvement of all parties. It should begin even at the pre-employment stage and continues through the life of the worker or company. There should be an available comprehensive occupational health service either through an in-house or out sourcing of such services.
Investment in the well-being of the workers will ensure continuous profitability and productivity of the company. It will also encourage a harmonious relationship between the employee and employers, as well as, the compliance of workers to applicable laws and regulations. In short, this would result in a win-win situation.
Dr. Lim Jac Fang is an occupational health consultant from Sabah with an impressive list of accomplishments and achievements in his field. Find out more at The Team page.
Reference
- The Health of Your Business by David Koh et al.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]