Fit for Work Assessment

Occupational health professionals can conduct fit for work assessments to evaluate employees’ capacity to perform their job role safely and effectively.

  • Assessments determine if health conditions or disabilities impact the ability to work.
  • They identify any adjustments or restrictions needed to enable the employee to work.
  • Assessments are carried out by occupational health doctors or nurses.
  • Information is provided to the employer on capability for work and recommendations.
  • The employee’s medical details remain confidential – only fitness for work advice is shared.

“Fitness to work refers to an assessment of whether someone is fit to undertake their work activities without risk to their own or others’ health and safety”. ¹

  • Regular health surveillance and reviews may be recommended for chronic or fluctuating conditions.
  • Reassessment can be done if circumstances change, e.g. after treatment or recovery period.
  • Input on the appropriateness of phased returns to work or modified duties is given.

Occupational Health Fitness for Work Assessment

Key elements of a fit to work assessment include:

  • Review of job duties and physical/mental demands.
  • Medical history and examination if required.
  • Assessment of current symptoms and treatment.
  • Impact of condition on functional capacity for role.
  • Discussion of possible adjustments to enable work.
  • Timeframes for recovery or review.

The Faculty of Occupational Health Nursing has guidelines on conducting fit for work assessments:

Competently assess a worker holistically, including any health-related impairment and disabilities in relation to their individual work tasks and environment.²

Formulate evidence-based and timely advice on fitness, adjustments and rehabilitation to assist the worker in maintaining or returning to work.²

Examples of Fitness to Work Recommendations

  • Phased return – building up from reduced hours to full duties.
  • Modified duties – avoiding certain tasks temporarily.
  • Ergonomic equipment – chairs, height adjustable desks.
  • Regular breaks to rest or exercise.
  • Restricted hours – avoiding night shifts.
  • Working from home options.
  • Redeployment to a different role if incapable of current work.

Case Study 1 – Return to Work With Adjustments

Sarah has chronic back pain and was off sick from her job in a warehouse. Her GP referred her for an occupational health assessment before returning to work.  

The occupational health physiotherapist reviewed her job demands, such as manual handling, and examined her back function. Sarah’s pain limited her ability to lift heavy weights.

The physiotherapist recommended a phased return starting with amended duties. Sarah would avoid heavy lifting initially and instead carry out packing tasks. Regular breaks and a special chair were also advised.

These adjustments enabled Sarah to return to work while managing her back pain. Her condition improved, and she later made a full return to her normal role.

Fit to Work Assessment – In Detail

The fit to work assessment takes an in-depth look at an employee’s health in relation to their specific job role.

It combines medical and occupational health insights to reach an evidence-based conclusion on whether the employee is fit to carry out their work duties safely and effectively.

Some key elements of the fit to work evaluation include:

  • Physical Assessment – The occupational health clinician will assess any physical limitations or health conditions that could restrict job capability. They may conduct activities like range of motion tests or muscle strength assessments relevant to the role.
  • Mental Health Check – The assessment will consider any mental health problems that may impact on work performance, such as anxiety, depression or stress. Questionnaires may be used to evaluate mental health symptoms.
  • Job-Centric Examination – There will be an in-depth review of the employee’s particular job demands and their work environment. The clinician will determine if they can meet the required duties with or without reasonable adjustments.
  • Guidance – The occupational health report will outline specific advice ranging from recommended workplace adaptations, treatment options that could improve capability, revised hours or duties that may aid a phased return, and, in severe cases, whether redeployment to an alternative role is necessary.

The aim is to reach an evidence-based decision on work fitness that protects employees’ health while allowing them to remain in appropriate employment wherever possible. Regular reviews will be advised where appropriate.

Case Study 2 – Assessed As Unfit for Work Role 

Tom works as a roofer but has developed severe osteoarthritis in his hips, making climbing ladders and physical labour extremely difficult.

His occupational health assessment concluded he was no longer fit to carry out the core duties of his roofer job. Even with adjustments, it would be unsafe and cause further joint damage.

The occupational health physician recommended redeployment to a ground-level role that does not involve heavy lifting, prolonged standing or climbing. Otherwise, medical retirement on health grounds may be necessary if no suitable alternative roles exist.

Tom’s employer was able to find him an administrator job. He could still work with adjustments, just not in his previous roofer role.

Final Thoughts on Fit for Work Assessments

Overall, occupational health-led fit for work assessments are crucial in matching an employee’s health capabilities to the requirements of their job role.

They bridge the gap between general health guidance from GPs and the specific demands of the individual’s profession.

The key aim is to ensure workplaces are adapted to support their workforce’s physical and mental health needs. This promotes well-being at work, staff retention and organisational productivity.

Fit for work evaluations enable occupational health experts to provide tailored, evidence-based advice on any adjustments or restrictions needed to facilitate an employee safely remaining in or returning to appropriate work.

By considering the holistic health of workers and the nuances of their jobs, fit to work assessments promote healthy, inclusive and productive work environments.

Key Takeaways

Occupational Health Fitness for Work Assessment: This is the gold standard in merging health with work needs.

Harmonising Health with Job Responsibilities: Ensuring job demands don’t compromise health.

Health-Centric Workplace Tweaks: Alterations that factor in health for a safe and productive work setting.

By incorporating these evaluations, businesses can stay ahead, comply with regulations and actively champion the health and wellness of their workforce.

  1. 2021. Evaluation of the Statement of Fitness for Work: qualitative research with employers and employees. DWP 2012 [online] Available at: [Accessed 11 September 2023].
  2. 2021. Fitness for Work. [online] Available at: [Accessed 11 September 2023].

Article fact-checked and approved by Dr Deryk Waller

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