What to do if someone doesn’t engage in the sickness absence process?

Jan 9, 2023 | Time Off Work

Managing employees who are on long-term sickness absence is often challenging, with adjustments to be considered, medical reports to review and the right level of support and contact needing to be maintained.

But what do you do if someone refuses to engage with the process? You don’t want the situation to result in stalemate, with a frustrated manager, colleagues bearing the brunt of the extra work, and the lack of certainty making planning impossible. Usually engagement is most needed when it comes to getting an Occupational Health report but it could also be about refusing contact or not attending meetings to discuss support/adjustments.

1. Understand why

As with any problem, understanding the root causes is key to resolving it, so if you can get to the bottom of what the reluctance is, you’ll be that much closer to getting things moving again, either with information, reassurance, adjustments, sanctions or a combination.

2. Make adjustments

Someone may have health-related reasons they feel they cannot engage, so adjustments might be needed.

For example, conducting meetings virtually rather than in the office, or offering an OH consultation over the phone rather than in person. You could alter the contact method you have with the employee if that makes it easier, or could liaise with a family member if they give consent and would prefer you to do that. The appropriate adjustments would depend on the individual and the circumstances, but being flexible where possible rather than sticking rigidly to normal process can help enormously.

Ask the employee what you can do to adjust things so that they feel able to engage. This makes it not seem optional to engage, but reassures them that changes to how the process works might be possible if they ask.

3. Offer reassurance

Some employees may be physically/mentally perfectly capable of participating but may be reluctant for other reasons. They may be nervous about seeing Occupational Health, having only ever seen their own doctors before. They may assume any process is designed to get rid of them or penalise them in some way, and don’t want to bring that decision closer or make it any easier.

Explain the purpose of the process and of the Occupational Health input – to explore how best the employer can support them, find out how their condition interacts with their work, and establish whether there are any reasonable adjustments that can be made to enable them to return to work.

Occupational Health advice is really positive for both parties, as it is specifically tailored to the workplace and is given by someone who has a good understanding of the employee’s role and tasks (assuming they are well-briefed), and plenty of experience in advising on supporting employees with health conditions. Employees who understand that the advice is designed to help them return to work if at all possible may feel slightly more positive about engaging.

Employees may also have concerns about things like confidentiality, about access to medical reports or similar, so you can offer reassurance about those things.

4. Sanctions and possible outcomes

Sometimes people still refuse to participate, or simply disappear off the radar, despite offers of reassurance or adjustments. You are not expected to therefore give up and do nothing, and it may be necessary to become a little firmer. If you have medical referrals in your contracts, as many employers do, you can refer to participation as being a contractual requirement.

You should also point out (along with emphasising the positive nature of Occupational Health/the absence process) that, if the individual doesn’t cooperate, the employer will need to make decisions without the useful input an Occupational Health practitioner will be able to provide, or will need to make decisions without the employee’s own input if they are refusing to attend meetings.

Another option is to make any enhanced contractual sick pay you offer conditional upon participation in the process. Obviously you can’t do this during the process itself, it would need to be within the contract or appropriate policy, but it’s an option to consider.


Following these steps should mean you can ‘unstick’ a process that has ground to a halt through non-cooperation, and make progress with dealing with the situation in a fair, supportive manner.


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