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What outcomes can we expect?

Each case is different, so what happens after the employee's health assessment will depend on the reasons for the health assessment, the findings of the assessment and your agency's policy. For the employee, this might include:

  • confirmation of employment (in cases where an employee has undergone a health assessment as a condition of engagement)
  • clearance to travel overseas for the purposes of employment
  • staying at work, with or without reasonable adjustments
  • returning to work, with or without reasonable adjustments, or
  • incapacity for continued work.

There is a general misconception that health assessments are used to push people with ill health out of the workplace. This is not the case. On average, terminations due to physical or mental incapacity represent less than three per cent of all APS separations

Once the agency has the health assessment report and you have discussed the findings with your human resources team (or the case manager), you should revisit your reasons for undertaking the health assessment .

  • Have the original objectives of the health assessment been met?
  • Have all your questions been sufficiently answered? Is there anything you are unclear on?
  • Do you have all the information you need to proceed?
  • Have you identified the next steps?

Once this is clear, have a conversation about the findings and the next steps with the employee, so that they are kept in the loop and continue to be part of the process. Your human resources team or the employee's case manager should also participate in this conversation.

Regardless of the outcome of the health assessment, this will likely be a difficult conversation.

  • Give the employee the opportunity to bring a support person with them.
  • Show your usual concern and empathy—be open, honest and sensitive and address all of the relevant issues.
  • Make sure to provide the employee with a clear understanding of what will happen next.
  • Give the employee sufficient opportunity to talk through any concerns and ask questions.
  • Be mindful that the report may raise issues that the employee was not aware of or result in an outcome the employee did not expect—the employee's GP or specialist will be a valuable support person for the employee if this occurs.

Staying at work or returning to work

More often than not, employees are able to stay at or return to work. Being at work is generally an important part of an employee's recovery or rehabilitation process—it is more than just an 'end point'.

If an employee is able to stay at work, it may be appropriate to introduce a condition management plan for the workplace.

A template for a condition management plan is included under 'Useful Tools' in this guidance.

Research shows that the longer ill or injured employees are off work, the less likely they are to return to work. The statistics are staggering—if an employee is off work for:

  • 20 days, the chance of ever getting back to work is 70 per cent
  • 45 days, the chance of ever getting back to work is 50 per cent
  • 70 days, the chance of ever getting back to work is 35 per cent

Sometimes, returning to work might take a period of time or happen in a graduated way (this is usually called a graduated return to work). An employee may also require work-related reasonable adjustments to support them to stay at or return to work. These adjustments might be necessary for a short period, or for the longer term.

Performance management

In some cases, when an employee is suffering from ill health, their work performance can suffer as a result.

Generally, if an employee is able to work, they should be participating in normal work practices (such as performance management processes). However, these practices can be modified to accommodate an individual's specific condition and needs, including to:

  • occur at an appropriate time or be delivered in an appropriate format
  • take into account any mitigating circumstances (including the impact of health on an employee's performance).

Factsheet 11 'Role clarity for good mental health' from the Australian Public Service Commission's publication Working Together: Promoting mental health and wellbeing at work provides useful tips on setting and communicating expectations, roles and responsibilities to your employees. Knowing how to set and communicate expectations is particularly important for effective performance management.

If an employee's health condition is preventing or restricting them from participating in performance management or other normal work practices, it may be appropriate for your agency to seek specific medical advice, through a health assessment, on the employee's capacity to participate in these practices. It may be that the employee needs particular adjustments to support them to perform effectively.

Reasonable adjustments

Reasonable adjustments enable people with injury or ill health to participate in the workplace to their full capacity. They can help people to stay at work or can form part of return to work arrangements. Under the Disability Discrimination Act 1992, employers are required to make reasonable adjustments so that employees with disability are able to perform the inherent requirements of their job, unless this would cause 'unjustifiable hardship' to the employer.

The employee's health assessment report should identify any reasonable adjustments the employee may need. Reasonable adjustments are many and varied, but might include:

  • changes to:
    • working hours
    • days
    • duties
    • work practices, or
    • management styles
  • adjustments, such as new or modified:
    • equipment
    • furniture, or
    • software.

Most reasonable adjustments are inexpensive and easy for an agency to accommodate. Ask yourself 'how can I make this adjustment?' rather than 'why should I?'.

There are a range of resources available on reasonable adjustments in the workplace.

  • Comcare's factsheet on reasonable adjustments includes information on 'What are reasonable adjustments', 'What is considered in making reasonable adjustments' and 'What is reasonable when making adjustments'.
  • The Australian Public Service Commission's video 'Leading the Way: Reasonable adjustments in the workplace' provides personal accounts from APS employees on the importance of reasonable adjustment in the workplace.
  • The Australian Human Rights Commission's information on employment includes an explanation of reasonable adjustments, unjustifiable hardship and inherent requirements of a job in the context of the Disability Discrimination Act 1992.

JobAccess Employment Assistance Fund

The Australian Government's JobAccess Employment Assistance Fund helps people with disability or mental health conditions by providing financial assistance to purchase a range of work related modifications and services. Assistance is available for people who are about to start a job or who are currently working, as well as those who require assistance to find and prepare for work.

The Employment Assistance Fund may reimburse the cost of work-related modifications and services including:

  • the cost of modifications to the physical work environment
  • modifications to work vehicles
  • adaptive equipment for the workplace
  • information and communication devices
  • Auslan interpreting
  • specialist services for employees with specific learning disorders and mental health conditions
  • disability awareness training
  • deafness awareness training, and
  • mental health awareness training.

The Employment Assistance Fund is available to Commonwealth government employees.

Return to work plan

If an employee is off work and the health assessment finds that they are able to return to work, you should work with the employee and your human resources team to develop a return to work plan in advance of the employee's return. The plan should incorporate the relevant medical advice from the health assessment and any other related information the employee has provided.

A return to work plan will help you, the employee and your human resources team (or case manager) work together to make the employee's return to work as successful as possible, without exacerbating the health condition or giving rise to any new conditions. It will also help you to identify and provide suitable (and meaningful) work for the employee upon their return.

'Employees who have a successful return to work have supportive management. Management makes it known to the employee that they care what is happening to them. It's human nature that we want acknowledgement, that we're part of a team, and that our efforts at work are appreciated. Something simple such as a phone call from someone inquiring on how they are and if there is anything the workplace can do…'

Dr Brenda Tait, Advisory Group for Comcare's Centre of Excellence in Mental Health and Wellbeing at Work

A template for a return to work plan is included under 'Useful Tools' in this guidance.

As the employee's manager, you are integral in supporting the employee to return to work. If an employee is off work, stay in contact with them. This will help the employee to feel connected to the workplace and feel like they are a valued team member.

Barriers to returning to work

There are many factors which make it difficult for an employee to return to work, including:

  • stigma or perceived stigma associated with ill health, particularly mental ill health
  • suspicion about the severity of the employee's health condition
  • perceived or actual lack of return to work planning or support from the employer
  • fear that colleagues may find out about the diagnosis
  • reduced self-confidence
  • uncertainty about the type of assistance that will be provided
  • fear of discrimination and the impact on future career prospects
  • concerns that work related contributors or causes of stress have not been addressed.

Many of these barriers can be alleviated through a manager's genuine, open and honest communication with the employee.

Working Together: Promoting Mental Health and Wellbeing at Work, Australian Public Service Commission

Incapacity for continued work

In a very small number of cases, an employee's health condition may permanently prevent them from being able to work. Section 29(3)(d) of the Public Service Act 1999 allows an agency head to terminate employment where an employee is unable to perform their duties because of mental or physical incapacity. This ground is rarely used to terminate employees.

There are restrictions on the termination of employment on the basis of medical or physical incapacity in the Fair Work Act 2009, the Disability Discrimination Act 1992 and the Commonwealth superannuation legislation.

Fair Work Act 2009

Under the General Protections provisions in the Fair Work Act 2009:

  • an employer is prohibited from dismissing an employee because the employee is temporarily absent from work because of illness or injury of a kind prescribed by the Fair Work Regulations (section 352), and
  • an employer is prohibited from taking adverse action against an employee because of their race, colour, sex, sexual preference, age, physical or mental disability, marital status, family or carer's responsibilities, pregnancy, religion, political opinion, national extraction or social origin (section 351).

In addition, an employer is also prohibited from taking a range of other adverse actions against an employee or a prospective employee on discriminatory grounds.

Disability Discrimination Act 1992

Paragraph 15(2)(c) of the Disability Discrimination Act 1992 provides that it is unlawful for an employer to discriminate against an employee on the ground of the employee's disability by dismissing the employee. As with the Fair Work Act 2009, the prohibition on disability discrimination does not apply where, because of a disability, the employee would be unable to carry out the inherent requirements of the particular employment. But unlike the Fair Work Act 2009, the Disability Discrimination Act 1992 expressly incorporates the concept of 'reasonable adjustment' in relation to indirect disability discrimination, and agency heads need to be aware of this.

Terminating APS Employment: The Legislative Framework, Australian Public Service Commission

If the employee is a member of a Commonwealth superannuation scheme (the Commonwealth Superannuation Scheme (CSS), the Public Sector Superannuation Scheme (PSS) or the Public Sector Superannuation accumulation plan (PSSap)), there are particular requirements relating to termination on medical grounds as it relates to the employee's entitlement to receive invalidity retirement benefits.

If the employee is a member of these schemes and it is unlikely that they will be able to work again, your human resources team will consult with the relevant scheme authority to find out what the process and options are.

If the employee is not a member of a Commonwealth superannuation scheme, the same requirements do not apply. However, your agency must be satisfied that the employee's physical or mental incapacity is sufficiently serious to prevent them from performing their duties and must comply with the relevant provisions in the Fair Work Act 2009 and the Disability Discrimination Act 1992 before considering terminating employment on medical grounds.

Depending on the circumstances, other grounds for termination may be applicable. However, agencies must take care to avoid claims of discrimination on the basis of disability.

Other outcomes

Condition of engagement

Similar to health assessments for other purposes, health assessments as a condition of engagement can be used to evaluate:

  • the individual's practical, physical or psychological capacity to undertake the job
  • work health and safety considerations, and/or
  • issues relating to your agency's duty of care.

If a health clearance is imposed as a condition of engagement, failure to obtain the necessary clearance can result in termination of employment under section 29(3)(f) of the Public Service Act 1999.

Overseas travel or assignment of duties

Again, as with other health assessment processes, health assessments that occur where an employee is to travel overseas as part of their employment or where they are to be assigned new duties, provide your agency with assurance that:

  • the employee is physically and psychologically able to undertake the job
  • work health and safety considerations have been taken into account, and
  • issues relating to your agency's duty of care have been considered.

In this case, failure to meet the health clearance requirements determined by your agency head would mean that the employee would not be cleared to work overseas or would not be assigned the new duties.

[25] Australian Public Service Commission, Statistical Bulletin 2013–14

[26] Comcare, Health Benefits of Work

[27] Australian Public Service Commission, 2013, Working Together: Promoting Mental Health and Wellbeing at Work

[28] Australian Public Service Commission, Terminating APS Employment: The Legislative Framework