Ethics Guidance for Occupational Health Practice 9th Edition - Book - Page 87
4.80. When requesting reports from others it should be made clear that advice
is sought only on the medical condition, functional abilities and prognosis, not
on the possible effects on their employment or their entitlement to a pension.
4.81. OH Professionals should be aware of the complaints procedure and appeals
mechanism. As for initial assessments, assessments for appeals may be
undertaken through either physical consultation or as a ‘paper review’ exercise.
Neither is inherently superior from an ethical standpoint. A physical
consultation may convey the perception of a more comprehensive
representation for the worker, but it also has a greater risk of partiality arising
from an emotional response by the occupational health professional to the
applicant’s situation. Pension decisions and appeal assessments are likely to
be conducted on 'paper review’ to try to ensure consistency; further
examination would rarely provide new objective evidence.
4.82. Advice on eligibility for ill health retirement should only be given by
occupational health professionals who have suitable and sufficient knowledge
of the role and working environment, because it is usually necessary to assess
whether the worker is unfit to perform their normal work as well as whether
they are incapable of all work. Many pension schemes require their medical
advisors to have a qualification in occupational medicine and some larger
schemes ensure quality assurance of their guidelines, application of the criteria
and audit of decisions made. This represents good practice.
International consultations
4.83. When conducting consultations with workers who are overseas, occupational
health clinicians must recognise that regulatory obligations may arise in both
jurisdictions. Although occupational health work may not involve prescribing,
regulators and licensing authorities may still consider activities such as medical
assessment, interpretation of clinical information, or the formulation of advice,
to constitute the provision of a ‘medical service’. Where an activity is defined as
a 'medical service', this may trigger licensing, registration, or other legal
requirements in the jurisdiction presiding over the consultation.
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