Absence notes - Determining justifiable absence

When an employee is off sick and claiming to be 'incapable of work' then it is necessary, for the administration of statutory sick pay, that they provide medical evidence that enables the employer to certify incapacity for periods of absence; self-certification can be accepted normally for up to six days of absence, while a doctor's note is likely to be needed for seven days or more. Commonly, someone who has been a hospital in-patient will be certified by the ward sister.

Whether or not you accept that the employee is incapable of work based on the evidence presented is your own decision as an employer. In the majority of cases, the evidence will come in the form of a sick note signed by the employee's general practitioner. However, in other cases, it may not be a GP that has immediate control over the employee's treatment and they may not be in a position to make the decision on whether or not the employee needs time off work.

In these cases, the information that you receive in relation to your employee's incapacity may come in the form of a recommendation from the healthcare practitioner acting as the employee's immediate treatment provider. This will not look like the usual GP's note, nevertheless you should give it due consideration because it may contain valid grounds for your employee's incapacity. Paying attention to the content of the recommendation, not only its source, is vital.

You mention that your particular employee is absent from work due to dental pain after visiting a dentist. Tooth or gum problems are prime examples of situations that are potentially incapacitating but for which, quite understandably, an individual would not visit the doctor. The dentist will be in a position to quantify any post-procedure time off that your employee might need. It would be inappropriate for the employee's GP to make a decision in the case of treatment with which they have not been involved. You will need to consider all of the relevant, available information to assess whether or not the employee is incapable of work; in the case that you have mentioned, this should include the recommendation from the dentist because of its value as an opinion from a qualified practitioner.

It is important to remember that a healthcare practitioner's recommendation is not a doctor's sick note and, although not of equal status, its intention is clear: it recommends that your employee will benefit from time off work. While this form of medical evidence will not play an authoritative role in your decision, it does hold persuasive force in establishing your employee's incapacity and you should assess it on its merits.

The dentist's points out that, in the practitioner's experience of the condition that your employee is suffering from, time off work is beneficial. Ask yourself whether you would accept the evidence or not if it appeared verbatim on a typical doctor's sick note. Evidence of incapacity should not be dismissed purely on the basis of where it has come from.

You should take subtle measures to ensure that the healthcare practitioner is genuine - the recommendation should include the name, address and specialism of the practitioner.

Other healthcare practitioners from whom you might receive recommendations as a way of certifying an employee's absence include osteopaths and herbalists. There are also certain NHS schemes for which referral from a physiotherapist or psychologist is possible where there has been very little input from a registered medical practitioner, so certification of absence from work would, again, be appropriate from such.

In any case, an employer should consider the recommendation in the same way as a doctor's sick note but, ultimately, it is for you to decide whether or not you accept the evidence.