Separating illness from performance (Toughest HR question)

Independent medical evaluations can help HR determine if performance is being affected by an illness that needs accommodation

Question: One of our managers has approached the HR department for help with serious performance issues that may relate to an illness. “I have serious concerns regarding her performance. I’ve done everything I can to help her. I think something is wrong, she is not herself,” he said. How can we determine if it’s truly a performance issue or if there is an underlying illness?

Answer: The key to dealing with this issue is to separate illness from performance. You can use a few clues to help you with this:

Clue one: Is this an employee who has been functioning well since she started with the organization? If so, unless something has changed in the job, the issue is likely illness-related.

Clue two: Is there an issue in the employee’s personal life that may be causing her distress? While some employees are reluctant to share personal issues with their supervisor, most employees offer some clues as to what may be going on. It may be a personal issue that is causing stress and anxiety and, therefore, affecting her performance.

Clue three: Has the employee always struggled with performance? Do previous performance appraisals identify similar issues? If so, the issue is likely not due to illness and should be dealt with through performance counselling.

But you need to be sure your organization is protected from legal liability — the summary below will provide some assistance in dealing with this issue.

When it’s the Illness

When you suspect the performance issues are related to illness and the employee agrees (or tells you), recommending she see her doctor is a good first step. I strongly recommend a third-party adjudicator assess the employee’s medical information. As HR professionals, we often play the coach, psychologist or confidant. But playing doctor is not recommended — this is beyond our expertise.

Once the claim is adjudicated, the recommendation will signal your next move. The recommendation to approve the sick claim makes things easier, although more expensive. If you’re lucky, the employee will go on a short sick leave and when she returns, she will be ready to perform the full functions of the position.

When it’s performance

If the illness is not approved, then you are left to manage the performance issue. The good news is you can separate the illness from the performance and not risk legal liability for not accommodating the employee. You can now move forward through performance counselling, a coaching program or any performance improvement method you use within your organization.

Sometimes, it may not be this easy. You may encounter situations where the employee and her doctor insist illness is affecting performance. In other cases, the employee may refute an illness exists. In both these situations, an independent medical evaluation (IME) should be considered.

The independent medical evaluation

Most HR professionals will run into situations where an employee denies having any type of illness that is affecting her performance. Your gut tells you something is just not right. More often than not, there is usually an underlying condition — perhaps depression or alcoholism. Unfortunately, the employee will do her best to deny this to herself and especially her supervisor. This is when I recommend an IME. They are expensive but so is your underperformer, your supervisor’s time and your time spent managing the case.

Legally, employees must agree to undergo an IME. Approaching the conversation in a sensitive, respectful way, stating the benefits of the IME to the employee, may encourage her to agree to the request. Often the employee will secretly acknowledge to herself something is not right — she may welcome the opportunity to meet with a professional who will set her on the path to recovery. If she does agree, it’s critical to get her consent in writing.

The results of the IME

The IME will often provide good insight into the employee’s behavior, help you determine whether he is fit to return to work and recommend any accommodation. In some cases, the IME will state an employee is fine to return to work and no issues exist. In this case, you can focus on performance and accept you were wrong about an illness.

When an IME tells you an employee is not fit to perform the job, in most cases the employee will go on leave, but not before receiving good information forcing her to self-reflect. The information can be provided to the employee’s medical doctor, who can use this information in helping the employee get well. You have good information to provide to your adjudicator (with the employee’s consent, of course), that will assist your provider in assessing the case.

Situations can arise where an employee and her doctor strongly disagree with the outcome of the IME. Most doctors welcome IME results but if you are faced with this situation, I recommend you seek legal advice. One could argue the employee’s doctor knows her best to assess her health, not a doctor who meets the employee one time to perform an IME.

Of course, some employees will refuse to undergo an IME and refuse to acknowledge anything is wrong. In this case, after taking careful notes of discussions with the employee, you must focus on performance or lack thereof.

Managing illness can be an emotional, tricky matter. You need to be sensitive to the employee, respect the supervisor’s concerns and be conscious of legal obligations. Approaching the situation in a calm, focused manner will ensure respect and compassion for the employee and protection for your organization. When in doubt, seek legal advice.

Sandra Chiodo is director of human resources and organizational development at Peel Children’s Aid in Mississauga, Ont.

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