Unpacking Return to Work After Sickness Absence

You manage a small team of three. One of your direct reports has just returned after two weeks off sick. Their fit note gave little detail, just “stress.” They’re back now and say they’re fine. So that’s the end of it… right?

Hopefully. But even from this brief summary, there are clear flags that merit a closer look.

• The individual was sufficiently unwell that they couldn’t function at work for two weeks.

• “Stress” is a broad label. It may refer to a one-off life event, but it can also signal an ongoing situation that hasn’t resolved.

Once you look beneath the surface, it becomes clear that there could be more going on with this individual’s health that could impact the relationship between work and health again. Here are three different scenarios, all plausible from the headline information you have to hand.

Three Very Different Scenarios

Scenario A:The employee is normally well, but was suddenly evicted from their home. The last two weeks were acutely stressful, but the issue is now resolved. They have moved into a new place and feel back to baseline.

Scenario B: The stressor is work-related. A recent team departure has increased everyone’s workload. This employee feels they can’t keep up and is becoming anxious about performance expectations.

Scenario C:The employee has a background of anxiety that has worsened with both the eviction and the increased workload. Disrupted sleep led to impaired concentration and time off. Worried about job security, they’ve started using alcohol to manage their sleep.

All three scenarios are equally plausible based on the limited information you have. And yet they lead to completely different implications when it comes to the individual's capacity, risks, and needs.

• Scenario A suggests a resolved one-off issue, with a likely smooth return to work.

• Scenarios B and C highlight deeper, ongoing concerns that could easily recur or escalate.

The only way to understand which situation you’re dealing with is to explore it, carefully and appropriately.

Why This Is Hard for Managers

Employees may be reluctant to share personal details about their health or circumstances.

As a manager, you may also feel constrained:

• What questions can you ask?

• How much should you know?

• What do you do with the information once you have it?

And without a clinical perspective, it can be difficult to translate health information or know when  health problems are developing and likely to be ongoing.

Where Occupational Health Helps

Occupational Health (OH) provides a safe, structured way to gather this information. Employees receive a confidential clinical assessment from someone who understands both health and the workplace. Occupational health can then use this information to produce recommendations that are shared with the workplace with the employee’s consent. This helps to support a safe and sustainable return.

Ideally, every employee returning from sickness absence would have a brief OH check-in. It creates a secure landing space and helps identify any ongoing issues early. But many workplaces don’t have routine access to OH. So, for those that don’t, here are some pointers to help managers gather appropriate information and identify when an OH referral is likely to be especially valuable.

Key Information to Consider on Return to Work

When an employee returns from sickness absence, look at the wider context:

1. Absence Pattern

• Duration of this absence

• Any previous absences

• Known health conditions or recent health changes

2. Information from the Fit Note

• Stated reason for absence

• Any suggested adjustments or comments (Even minimal information on a fit note is still a data point.)

3. Possible Work-Related Factors

• Is there any indication this or previous absences have been related to work factors?

4. Employee’s Own Perspective

• What are they willing to share about how they’re feeling now?

• Do they feel ready to return?

5. Non-health issues 

• Remember: non health issues can have a bearing on health and work, and should not be discounted as unrelated to the relationship between work and health 

Using This Information to Triage on Return to Work

By gathering data along these lines, managers can better distinguish between:

• A resolved one-off issue

• A potentially ongoing health or work-related concern, which may need additional support and benefit from an occupational health assessment.

Keeping the Conversation Open

A return to work isn’t a single moment, it’s a process. Staying open and revisiting support needs over the first few weeks can make a significant difference. This also gives you a clear sense of whether the employee is truly settling back in, or whether an OH assessment would help prevent further problems down the line.

Next Steps

If you’d like guidance on managing returns to work or need clinical support for your team, our occupational health clinicians are here to help. Get in touch with Insight Workplace Health for tailored advice and practical next steps.