Doctors’ notes, sick leave in spotlight as H1N1 hits

Employers take case-by-case approach: Survey
By Sarah Dobson
|Canadian HR Reporter|Last Updated: 11/30/2009

Ultra Electronics has seen its absenteeism rate rise to about 12 per cent during the H1N1 pandemic, compared to an average of three per cent. But it’s allowing people to work from home, if needed, and to take time to obtain the vaccination if desired, said Paul Reeves, head of HR at the Halifax-based company, which has 160 employees.

The biggest challenge has been presenteeism, he said.

“It’s actually saying to people, ‘Look, we’re really serious about this. If you have these symptoms, stay at home.’”

While some people might think this kind of approach presents an opportunity for abuse, the company has not seen that, with union or non-union workers, said Reeves, because people have targets to achieve and they support each other.

“It’s a relatively small organization so there’s a lot of interdependency here,” he said.

Ultra Electronics has also said workers can self-certify for five days and, if still ill after that, they should see a health professional. If the infection rate increases, the company may tell the adjudicator it needs to relax its requirements, he said.

“We’re kind of doing it on a case-by-case basis, we haven’t had to make a policy change at the moment and the response has really been great,” said Reeves.

With the pandemic hitting parts of Canada very hard, employers are faced with many questions when it comes to an appropriate response: Should H1N1 be treated as any other flu? Should a requirement for doctors’ notes be suspended? Should sick employees be made to stay home?

Judging by the results of a survey of 515 HR professionals conducted by Canadian HR Reporter earlier this month, responses have been mixed. More than one-half (58 per cent) said they have had employees suffering from H1N1 (and an additional 19 per cent are unsure) and, as a result, the impact has included higher absenteeism and staff shortages, overtime and delayed deadlines, fewer in-person interaction with clients, distracted or anxious employees and lost productivity.

With 40 employees, Davidson de Laplante Insurance Group has definitely felt the impact. Over a two-week period, at least three people were off sick each day. The company provides 10 days of sick time per year but its pandemic plan said if a worker is sick or has a sick loved one, benefits would be extended, on a case-by-case basis, said Jamie Roach, manager of HR and office operations at Davidson in Timmins, Ont.

“Nobody was going to go without pay because of H1N1.”

There has been no requirement for doctors’ notes and, realistically, if a worker has been off for three days, she’s probably feeling better, so if she goes to the doctor at that point, there’s not a lot of value to it, said Roach. This is especially true for a small company in a small community, with no workers on staff who abuse sick time.

“If people aren’t here, they’re sick,” he said.

The most common response to the pandemic in the Canadian HR Reporter survey was telling workers to stay home (94 per cent), followed by informing other workers of the illness (47 per cent) and return-to-work screening (22 per cent).

For companies that have not responded, the majority (63 per cent) are treating it like any other flu or are taking a wait-and-see approach (42 per cent). Some point to the reluctance of upper management (26 per cent), a lack of concern (19 per cent), time or resources (14 per cent) and accurate information (12 per cent).

Prior to the pandemic, the projections for absenteeism were as high as 35 per cent and actual levels are getting close, said Richard Alexander, executive director of the Newfoundland Employers’ Council in Mount Pearl, N.L., which held a workshop on employers’ rights and responsibilities in the face of H1N1.

“We’d like to talk about something else but that seems to be the only calls we’re getting,” he said. “I’m hesitant to use the word hysteria but there’s a heightened concern among employers.”

Doctors’ notes an issue

The council is recommending employers consider adjustments to sick leave policies, such as the suspension of a requirement for doctors’ notes.

“Yes, there’s concern people are going to abuse it but there’s not a whole lot that can be done around that,” said Alexander. “(The doctor’s note is) one tool of a bigger puzzle of tools. For some employers, that tends to work, for other employers, it doesn’t have a huge impact.”

More than one-third (38 per cent) of employers in the survey said they have suspended this requirement while 43 per cent have not (and 18 per cent said they don’t ask for such notes).

“Rightly or wrongly, at this time, our organization is relying on an honour system for any request for additional sick time by employees. So far, it seems to be working well,” said one organization.

Oceanwide, a Montreal-based firm with 110 employees, now requests a doctor’s note after a worker has been away 10 days instead of two. And those workers who have already used up their six paid sick days, but have H1N1, will be given credit for next year.

“We’re trying to say, ‘If you are in a bad situation, we’ll support you, but we can’t provide everything for free,’” said Anne-Marie Mallet, HR director at Oceanwide.

Abuse is a big management concern, she said.

“(A doctor’s note is) a painful tool for an employee, it’s not fun, but it’s the only way we can check,” she said. “Unfortunately, we have nothing better.”

Overall, 70 per cent of respondents felt doctors’ notes were valuable in stemming abuse of short-term sick leave (as with H1N1), though only six per cent of these found them “extremely valuable.”

“We have many employees that fake being off work. Getting the note validates that they saw a doctor and are legitimately sick,” said one respondent. “Just the trouble of going to the doctor for a note is sometimes enough of a deterrent, unless it is justified,” said another.

But respondents cited two major problems with the notes: Doctors provide them too easily and the notes are too generic.

“The explanations are so general, not explicit enough as to the nature of illness due to patient privacy,” said one.

“It overburdens the medical system, potentially could spread the virus… sometimes there is a cost to the employee and rarely will a physician deny the request from a patient. Perhaps it provides some accountability but, in my opinion, the benefit is negligible,” said another.

Some employers are moving to doctors’ notes that state the functional limitation of an employee, rather than certifying she is unable to work without knowing what she does, said Harold Smith, a partner in the St. John’s office of Stewart McKelvey. Only an employer knows a worker’s real duties, or whether these can be adjusted to meet that limitation.

“Functional assessment helps a lot because it weeds out the malingerers,” he said.

“Many (employers) are getting very, very tired of the system that constantly seems to ignore the fact employees do have an obligation to report to work, to do their job.”

Cindy Blair said she would prefer to have a doctor’s note though she knows it is hard to come by, especially now, and it doesn’t make sense if an employee is really sick.

“You have to have a little bit of faith,” said Blair, HR manager at Nutreco Canada in Winnipeg. “Sometimes, in some of the bigger companies, that’s more of a challenge. But because our company is a bit smaller, maybe it’s just a little easier. We tend to work quite closely as teams and knowing, if you’re not there, it’s causing additional burden to your teammates makes people not want to abuse the system.”

Absenteeism has been fairly low at the 200-employee company, which has “slightly” opened up its sick day policy, she said. As situations come forward, HR will make sure decisions are made fairly and consistently.

“You don’t want to make your rules around people who could potentially abuse the system but at the same time you don’t want to blow something wide open,” said Blair.

Sick leave policies

Employers are also divided when it comes to changes to sick day policies, as 47 per cent of those surveyed by Canadian HR Reporter have made alterations during the pandemic, while 50 per cent have not. The most common change is encouraging (88 per cent) or requiring (46 per cent) workers to stay home when sick, along with more sick days (29 per cent), return-to-work screening (22 per cent), warning others of an employee’s illness (22 per cent) and paid sick days (21 per cent).

Those employers that have not changed policies say the existing ones are fine (92 per cent) or have concerns about worker fraud and abuse (13 per cent).

“Our sick leave policy is generous in terms of paid time off and we always expect employees to stay home if they’re sick. Our education campaign about H1N1 is adequate to ensure employees will not return prematurely,” said one respondent.

Some employers have put in a separate sick leave around H1N1. However, this might not be necessary, said Alexander.

“Yes, it’s important to have those parameters and safeguards and tight policies around sick leave use and abuse, but it all stems back to those upstream factors — what kind of a work environment do you have? Is it supportive, is it human, is it good work-life balance, is it challenging for people?” he said. “Generally, the research around this stuff shows you get more of a decrease in sick leave if you can deal with some of those issues.”

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