Transcript Sick certification + Benefits

SICK CERTIFICATION +
BENEFITS
Jo Swallow
T/F Quiz!
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A med 3 can only be issued by the GP
A med 3 can be based on a phone conversation
A med 3 can usually be backdated
A med 3 can not be issued by a nurse
A patient who is appealing their ESA allowance
must be issued a Med 3
A patient needs to be signed back fit to work after
a certification expires
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A patient can have 2 med 3s issued if they have 2
jobs.
SMP is paid for how many weeks?
ESA pays more than job seekers allowance?
When would you sign a Form DS1500?
The Employment and Support
Allowance
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The limited capability for work test
The limited capability for work-related activity test
The work-focused health related assessment
The work-focused interview
Case 1 –Mr palmer
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Mr palmer attends your surgery with pain in his
lower back.
He works as a builder and this pain is preventing
him from being able to work. He has already been
off for 6 days and comes asking for help.
In pairsWhat issues might you consider? What action would
you take?
Writing a sick certificate:
Liaising with employers
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Consider issuing a Med 3:
“You need NOT refrain from work” with specific advice to
employers about adjustments to duties or hours in the remarks
section.
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Example of specific advice to employers:
" This woman is fit to return to work but is not fit to carry out
manual handling tasks for the next two weeks”.
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Consider returning the individual to work in the middle
of the week rather than a Monday
Paying for treatment / investigations
Mr Palmer 2,
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Mr palmer reattends 2 weeks later stating that his
pain is still present and requesting a further month
off work,
Thoughts, issues,
Plan?
Length of absence is a risk
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Window of opportunity (1- 6 months)
Worker off for 4 – 12 weeks: 10-40%
chance of being off work at one year
Worker off 6 - 12 months: 90% chance
of never returning to any form of work in
the foreseeable future
Waddell and Burton
Risks and harm of being
out of work
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Loss of fitness
Physical and mental deterioration
Increased risk of poor health x 2-3
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Social exclusion
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Poverty
Waddell and Burton, 2006
Risk and harm – mental health risks
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Psychological distress and depression
Increased x 2-3
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Increased suicide and mortality
20% exIcess deaths
Families and work
Children in workless households:
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have a higher prevalence of recurrent health
conditions and lower well-being
suffer higher rates of psychiatric disorders
are more likely to experience worklessness
themselves during adult life
Is Work good for your health and wellbeing?
Strong evidence exists that unemployment is harmful to
health. The unemployed have higher mortality, poorer
general health, poorer mental health and higher
medical consultation, medication consumption, and
hospital admission rates.
(Waddell & Burton)
Case 3
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56yr old michael thomas attends 7 days after
undergoing a TURP for benign prostatic disease.
He works as a painter and decorator,
How long until he can commence work?
Any guides?
Other thoughts?
Fitness for work: prognosis
Source: www.workingfit.com
( see also OUP Handbook of General Practice)
Other resources…
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http://www.rcseng.ac.uk/patient_information/getwell-soon/welcomepage?searchterm=get+well+soon
Driving and regulations