Long-term sickness absence is one of the most legally and operationally demanding situations an employer faces. It sits at the intersection of employment law, occupational health, disability discrimination, contractual obligations, and straightforward human complexity. Handled well, it protects both the employee and the business. Handled badly, it creates tribunal claims, reputational damage, and — often — the same outcome you were trying to avoid, but at far greater cost.
Defining long-term absence
There is no statutory definition of "long-term" sickness absence. Most HR practitioners and employment tribunals treat four weeks as a working threshold — at that point, the nature of the management task changes materially and different processes apply.
Practical definition: Treat any absence that has lasted, or is likely to last, four or more consecutive weeks as long-term for process purposes. This triggers the steps in this guide.
The first four weeks — what you should be doing
Many employers make the mistake of leaving the employee alone in an attempt to be considerate — and then finding, weeks later, that there has been no meaningful communication, no understanding of the prognosis, and no process in place. Welfare contact is not harassment. It is good management.
- Make welfare contact within the first week — a phone call or message, not a formal letter. The tone should be genuinely supportive, not administrative.
- Continue regular contact throughout the absence — typically fortnightly, depending on the condition and the employee's wishes.
- Keep brief, factual records of every contact: date, medium, what was discussed, what was agreed.
- Ask whether there is anything the business can do to support an earlier or phased return — but do not pressure the employee towards a date.
- Ensure the employee knows what their contractual and statutory sick pay entitlement is, and when it will expire.
Getting medical evidence
Fit notes tell you that an employee is unfit for their current role. They do not tell you what the prognosis is, whether adjustments could enable a return, or how long the absence is likely to continue. For managing long-term absence, you need more.
- Occupational Health (OH) referral. An OH assessment considers the employee's condition in the context of their job and working environment. OH can advise on return timescales, reasonable adjustments, and fitness for specific duties. If you do not have in-house OH, use an external provider — this is not optional for long-term absences.
- GP or specialist report. You can request a report under the Access to Medical Reports Act 1988. The employee has the right to see the report before it is sent and can refuse permission. If they refuse, you manage on the information available — but document that a request was made and declined.
Do not manage long-term absence without medical evidence. Dismissing an employee without obtaining medical advice is one of the most reliable ways to lose an unfair dismissal or disability discrimination claim.