Medical Documents – Prognosis vs Diagnosis

As I wrote in January, short term illnesses such as flu or strep throat do not trigger the Sick Leave provision in the Collective Agreement; they are considered incidental illnesses. Sick Leave in the CA is an employer-paid short term disability (STD) leave that could lead to long term disability (LTD).

Academic staff, especially faculty members, have great flexibility in how they allocate their time and where they do their work. This allows most to work to full capacity over the course of the year without having to officially take time off for health reasons, incidental or Sick Leave. It also means that many with physical or mental disabilities do not need workplace accommodation (modifications required by law) because they have developed work strategies that obviate the need.

If you need Sick Leave or workplace accommodation, the employer continues to pay you your full salary and has the right to ask for medical documentation from your health care professional(s) regarding your absence or your restrictions and limitations. If you have been on Sick Leave, it is normal for the employer to request medical clearance saying you are able to return to work. This protects you from an over-eager employer, and it protects the employer from potential liability should you return too soon and re-injure or become sick again.

In helping QUFA Members who find themselves in these situations, I have encountered two main challenges with the medical documentation. First, Members do not understand what the medical documents should explain. Second, it can be difficult to figure out appropriate descriptions and recommendations for restrictions and limitations impinging on intellectual work.

The medical information should give a prognosis rather than a diagnosis. A diagnosis is considered private health care information and is also not necessarily useful in figuring out whether or not you can work, nor whether you require workplace modifications. While most people believe it is useful to state that they have depression or MS or a broken arm, the diagnosis does not describe how this affects the individual in accomplishing her or his work. The information sought by the employer is practical to aid in current and future work assignment, a prognosis outlining function and timelines. Do you have physical or mental restrictions and limitations that would hinder you from doing any part of your job? Can it be estimated how long these will exist in part or in whole? When is it likely you would be able to return to work, part time or full time? Will you require any modifications in your work environment to enable you to do your job and, if yes, for how long?

Both symptoms and work vary from person to person. Whether returning from Sick Leave or figuring out a workplace accommodation, your symptoms, not your diagnosis, dictate what sorts of restrictions or limitations you have. These must be taken into account when determining workplace modifications that will allow you to do your job with dignity. Symptoms can change over time, meaning that the type or degree of restriction or limitation may also have to be changed, so follow-up is necessary to ensure appropriate workplace accommodation.

Queen’s Human Resources’ regular follow-up for QUFA Members takes place annually during the winter term to catch the window before teaching and service is assigned for the following academic year so that restrictions and limitations can be taken into account. The medical feedback could be anything from ‘no change’ to a need for major revamp. Regular follow-up is considered a best practice: the employer keeps on top of the needs of its workforce, and the employee does not have to ask to be heard.

In spite of my explanations, I find Members still have trouble with all this and I wonder whether it is because I am so deeply engrossed in it that I miss giving important details. I invite you to contact me with your questions and comments so that I may attempt better explanations.

The other challenge I identified, difficulty figuring out appropriate descriptions and recommendations for restrictions and limitations impinging on intellectual work, is worthy of its own Corner.