Brief doctor’s notes not enough to prove disability

Vague notes left employer with insufficient information

An Alberta arbitration panel has upheld the dismissal of a stressed health care worker for not providing sufficient medical information supporting her absence from work.

Beverly Rose was a nursing attendant for the Alberta Health Service (AHS). Her employment began in 1998 and she worked at a hospital in Calgary before transferring in August 2013 to the South Health Campus at the Inpatient Women’s Health Unit.

In the fall and winter of 2013, AHS identified some problems with Rose’s job performance and began an evaluation. AHS assigned a nurse preceptor to work with Rose, but her performance still didn’t improve and AHS recognized that Rose was finding it stressful to work in the unit.

One day, Rose was late for work due to bad weather and she was suspended because of it. She started feeling micromanaged and bullied by her manager, which added to stress she was experiencing due to financial difficulties in her personal life.

On Jan. 7, 2014, Rose attended a performance review to discuss AHS’s concerns over the job she was doing. She was then off sick the next day and didn’t return.

Rose supplied a medical note on Jan. 13, which explained she was “absent due to medical reasons” from Jan. 13 to Jan. 21. The note was from a doctor who wasn’t Rose’s regular family physician, who was away. AHS didn’t feel the note provided an adequate explanation for Rose’s absence and informed her on Jan. 21 that further medical information was needed to support an application for benefits. Rose was on unpaid sick leave because she had used up her existing paid sick leave.

Rose provided another note, this one from her regular physician, saying she was “unfit for work due to medical reasons until 1 March 2014.” AHS sent her paperwork for a short-term disability application, which was sent to the benefits provider on Feb. 7. The medical information in the application indicated a diagnosis of depression caused by difficulty in the workplace with symptoms that appeared on Jan. 20, and an expected return-to-work date of March 1.

The benefits provider rejected the benefits claim on the grounds that Rose’s alleged cause of her condition wasn’t evidence of a medical disability, which was required by the benefits plan. Rose informed AHS she would appeal the decision, but AHS indicated there was no medical evidence to support her absence so she was expected to return to work. When asked if she was planning on returning March 1, Rose responded that she was unsure. AHS placed her on an unpaid leave of absence.

AHS didn’t hear from Rose after that, so on March 11 the AHS abilities advisor left her a message about providing updated medical information. Rose confirmed she had been told in her appeal that she needed to provide more medical information to the benefits provider to provide “a clear understanding of what was restricting (her) from performing the duties of (her) own occupation.”

On March 12, Rose provided a medical note to both AHS and the benefits provider stating she was suffering from “a significant episode of depression” caused by “financial and familial stress and workplace stress.” The note indicated it might take two or three months for recovery. Rose had also began counselling through the AHS employee assistance program (EAP) and, after AHS followed up, Rose provided another medical note saying “consultation remains pending. Unfit for work until 1 May.”

Rose’s appeal for benefits was denied by the provider due to insufficient medical evidence. The next day, March 26, she told the abilities advisor that she had given new medical information to the benefits provider and she expected to return to work on May 1. Rose was told to provide the medical information supporting her absence by 4 p.m. that day or she would be deemed to have abandoned her position, leading to termination of employment.

The benefits provider reviewed the additional medical information and approved short-term disability benefits on April 2, with the expectation of a return to work on May 1. This information was passed on to AHS, who changed Rose’s status from an unpaid leave of absence to short-term disability leave.

AHS heard nothing from Rose for the rest of April and she didn’t show up for her scheduled shifts on May 3 and 4. This created difficulties for the unit, which had tight staffing and resources available. AHS sent a letter to her saying she needed to return to work or provide medical information supporting an extension of her medical leave. In addition, Rose was told if she didn’t contact AHS before May 7, she would be considered absent without leave and her employment would be terminated. Under the collective agreement, if an employee missed three consecutive shifts without supporting medical evidence or notification, she could be terminated.

On May 6, AHS received two medical notes from Rose dated May 1 stating that she was still unfit for work but would likely be able to return on June 1. It also stated “work placement be found at a hospital or AHS facility closer to her residence.”

AHS didn’t accept the medical notes as sufficient to support Rose’s continued absence or transfer to another location. Rose was advised on May 13 that she had missed five shifts and if she didn’t return to work or provide supporting medical information, she would be terminated.

Rose didn’t show up at work over the next couple of days and AHS terminated her employment on May 16. Rose filed grievances claiming a failure to accommodate and wrongful dismissal. On June 19, she provided a medical note stating she was fit to return to work with no restrictions as of June 1.

The arbitration panel found AHS maintained sufficient contact with Rose throughout the process and Rose was well aware of what was required of her. Given she didn’t contact AHS for a month leading up to her initial expected return date and AHS didn’t have information supporting her inability to return, AHS was entitled to conclude Rose wasn’t absent for “good and proper reasons,” said the panel.

The panel also found AHS had reason to be suspicious, as Rose went on medical leave right after a poor evaluation meeting and part of the reasons given for her condition was work stress. In addition, Rose made no effort to determine what was a sufficient note and usually provided very short ones with little real information, and was difficult for AHS to contact during business hours.

“The panel therefore concludes that the mere existence of the medical notes in this case is insufficient to establish that (Rose) had good and proper reason to be away from work,” said the panel. “Further (she) could have been under no misapprehension when she failed to attend her shifts on May 13, 14, and 15, 2014 that those notes were sufficient proof of her inability to attend work.”

The panel upheld the dismissal, finding AHS had the right to dismiss Rose under the collective agreement. It also found Rose didn’t provide sufficient medical evidence to show she had a disability requiring accommodation. See Alberta Health Services and AUPE, Re, 2016 CarswellAlta 243 (Alta. Arb.).

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