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Work fitness assessment and occ health, income protection

katwater51 Scope Member Posts: 41 Connected
Hi if anyone has any knowledge or experience that could help me I’d be really grateful. I’m in a complicated and difficult situation with my health and work and recent things have happened and I have no clue how to deal with them or what any processes involve. 

So brief background; I’ve been signed off sick for 4-5 years, with chronic pain, chronic spine injuries. Like many people on here probably I’ve seen a lot of specialists and medical professionals with no joy. 

With work I went off sick, managed to do a phased return, hung on for about 6 months and then had to go off again. (The pain has been so bad I’ve had 3 acute mental health crises over the past 4 years.)

The job is computer-based, and I have upper back pain and pain down both arms. It makes sitting upright painful and using a keyboard extremely painful. As an adjustment we tried voice recognition software but it wasn’t compatible with our file management system so I still had to type for that. It was excruciating a lot of the time. I tried to keep going for a long time and got extremely depressed. 

So in the end I’ve been on long term sick leave for 3 years and my firm has an income protection benefit scheme. This pays me a proportion of my old salary. Roughly 3 years ago the insurer assessed me and found me incapable of work. And I kept seeing Doctors, having treatment, looking for a cure and so on. But my symptoms have got worse, I have struggled to deal with it but I’m trying to do my best. 

Over the course of last year and early this year I got really unwell, so I could no longer manage living on my own and have had to ask a friend to stay with her. I’ve ended up imposing on her for about 5 months! My thinking was that maybe the next step had to be staying with family for a bit but they’re abroad so it’s a massive decision. And my friend has been amazing and says she will help me with looking into a powered wheelchair or a mobility scooter. 

The recent development with work that has really confused and scared me is that the work insurer has made me do another assessment and decided that I am now capable of work.(Just in case you’re wondering, because it was so hard and stressful I did ask them to get an up-to-date medical report instead. But they refused and said they needed an assessment.)

So now they have suspended my benefit payment, and I hve financial problems and uncertainty. 

Also work has emailed me to say:
a) I can appeal and
b) they’ll get occ health to contact me to see if they can provide any further adjustments.

My questions would be does anyone have any knowledge or experience of these situations? For example has anyone had to carry out an appeal against a group income protection policy decision before?
(The really strange thing is that the insurance company refuses to give me any information directly because I am not legally the policy holder. My employer is. So I don’t know anything about what gaps they have in their evidence or why they wouldn’t get a medical report or the reasons given in the assessment. This makes me think it’ll be quite hard to appeal. So if anyone has any knowledge about being in that situation or the process I’d be really grateful.)

Secondly does anyone have any experience of being assessed by occupational health? Particularly after a long absence? I’m confused - what if they say I’m unfit for work while the insurance company continues to say that I’m capable. 

I’ve seen on another post that @janer1967 you gave some impressive information so I hope its okay to tag you here. If you have the chance maybe you could let me know if you have any thoughts/advice. 

Thanks I’d be really grateful of anyone has any experience they can share. 


  • janer1967
    janer1967 Community member Posts: 21,964 Disability Gamechanger
    Hi there Thanks for the tag 

    Unfortunately I don't have any knowledge of group insurance protection 

    I can't understand if they said you were unfit for work for such a long period that your employer did not proceed to medical dismissal 

    I do know about oh process but I'm not sure how this would help as it is the insurance company paying you I would think their assessment would over ride oh assessment 

    Though oh referral could help in the appeal if they find you unfit 

    I'm sure under data protection you have the right to see any report they have made about you and suggest you submit a freedom of information request to ask for this 

    Sorry can't help further maybe cab can help or a financial adviser 
  • katwater51
    katwater51 Scope Member Posts: 41 Connected
    Hi J, thanks for your answer. My employer has never mentioned medical dismissal. I’m not familiar with it - is that the same as what you’ve mentioned in other posts; medical retirement? Again this is something I’ve never heard of and my employer’s never mentioned it. Is it where a person accesses support from their pension early due to their inability to work? 

    Do you recommend any website that could shed light on medical dismissal and/or retirement that I could check out. 

    I’m mystified by the whole situation. I suppose I will end up having to do a data request. But why they won’t just give me the information is just as bizarre. 
    Thanks again. 
  • janer1967
    janer1967 Community member Posts: 21,964 Disability Gamechanger
    Hi again 

    Medical dismissal is when your emploent is terminated on grounds of medical reasons and most companies consider this after company sick pay ends 

    Ill health retirement is where you take a pension early because you are no longer fit to work in any capacity at all before normal retirement age . You will get your pension early this is hard to get authorised znd pension providers all have different criteria 

    Acas website is the place to look for medical dismissal 

    Your pension  provider for pension details or pension wise 

    It maybe because of this insurance protection they don't do medical dismissal as there is no legal obligation to compensate for medical dismissal so you are probably financially better off but nos this is ending it may be discussed 

    Have a look at your company policy 
  • katwater51
    katwater51 Scope Member Posts: 41 Connected
    Hi J, thanks so much for clarifying that. 

    You mentioned you have experience of OH. Do you have any idea of next steps? 
    I’ve replied to HR and said I’m happy to speak to OH. It seems like we already tried several adjustments though. I reduced my working week, fist to 4 days and then to 3.5, had voice recognition software and a sit & stand desk. The voice recognition software didn’t work very well on our system. The role requires being in the office so I was only able to work from home one day a week. 

    Do you have any idea of any further adjustments I could suggest. 
    Thanks again. 
  • L_Volunteer
    L_Volunteer Community Volunteer Adviser, Scope Member Posts: 7,983 Disability Gamechanger
    @katwater51 How have things been for you more recently? I appreciate it has been a little while since you last posted on this thread now.

    I want to make sure you have access to the support you need and deserve but I am also aware that things might have changed since.

    Please don't hesitate to let us know if we can do anything to help. We are all here for you  :)
    Community Volunteer Adviser with professional knowledge of education, special educational needs and disabilities and EHCP's. Pronouns: She/her. 

    Please note: if I use the online community outside of its hours of administration, I am doing so in a personal capacity only.
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