Occupational Health Referral: Your UK Workplace Rights

An occupational health referral is a request to consider how your health and your job interact. It may follow a long absence, repeated short absences or a need for adjustments. Knowing the referral questions, the consent process and how recommendations will be used can make the assessment easier to prepare for.

Occupational health advice can inform a workplace decision, but neither an OH report nor a private sick note guarantees a particular outcome. This guide explains the roles of the employer, occupational-health clinician and treating team, and the questions to ask about reports and confidentiality.

What is an Occupational Health referral in the UK?

An Occupational Health referral is a formal process where an employer requests an independent clinical assessment of an employee's physical or mental health. The referral is typically triggered by prolonged sickness absence, frequent short-term sickness absences, or if the employer notices that a physical or mental impairment is severely impacting the employee's performance or safety.

An OH service may be an employer's in-house service or an external provider. Its clinicians should use professional judgement about health and work. Ask who is conducting the assessment, who commissioned it and what questions they have been asked to answer.

The central purpose of an OH referral is advisory. The practitioner's role is to answer specific operational and clinical questions posed by your employer's HR department, such as:

• Clinical status: What is the nature of the employee's medical condition and their active symptoms?
• Prognosis: When is the employee expected to be fit to resume their active job duties?
• Workplace adjustments: What specific physical or structural changes can the employer implement to support the employee's return?
• Disability status: Is the medical condition likely to meet the statutory definition of a disability under the Equality Act 2010?
• Relapse risk: What is the clinical likelihood of the employee suffering a relapse if they return to their original role?

Occupational health often focuses on work capability, adjustments and prevention. The exact service can vary, so ask what it includes. Do not assume that an OH assessment replaces your GP, specialist or usual treatment, or that every OH service has the same remit.

Consent, confidentiality and access to reports

Health information is sensitive personal data. Ask the service how the assessment will be conducted, what report it proposes to share, with whom and for what purpose. Clinical consent and the employer's data-protection obligations are related but separate; it is misleading to describe every use of health information as depending on one blanket consent rule.

The Access to Medical Reports Act can provide specific rights when an employer seeks a report from a doctor who is or has been responsible for your care. Those rights should not be assumed to apply identically to every OH assessment. Ask the clinician which process applies and request its explanation in writing.

• Ask what information the proposed report will include and whether you can see it before it is shared.
• For a treating-doctor report covered by the relevant Act, ask about access, correction and consent rights and the applicable time limits.
• Raise factual inaccuracies promptly. A clinician is not required to adopt a clinical opinion they do not hold.
• If you are considering withholding consent, ask about the consequences and alternatives before deciding.

An employer does not receive unrestricted access to your complete medical records merely by arranging an OH referral. Relevant information should be limited to what is needed for the stated purpose. For treating-doctor reports, Acas explains the permission and access process.

Can you refuse an Occupational Health referral?

You can raise concerns about attending an assessment or sharing a report and ask for adjustments to the process. Refusing may mean the employer has less information when making a decision. It does not automatically justify dismissal or remove duties around fairness, disability or confidentiality; get advice if the consequences are serious.

If you refuse to attend an OH assessment, your employer's HR department must still manage your sickness absence or capability issues. Without the benefit of independent clinical advice from an OH practitioner, your employer is legally permitted to make operational decisions based purely on the limited information available to them.

If information is missing, an employer may have to decide on the evidence available, but it should still investigate reasonably, consider your explanation and meet any applicable legal duties. An assumption about recovery is not a substitute for a fair process. Seek employment advice if capability action is proposed.

Therefore, employment advisors (such as Acas) generally recommend participating in the referral, but exercising your statutory rights to review the reports and ensure the adjustments proposed are realistic and safe.

Read the standard sickness-evidence rules and take any relevant documents you already have. A private certificate should be requested only if it serves a clearly agreed purpose; it is not a substitute for the occupational-health assessment.

The status of the Occupational Health report

A very common source of confusion is whether the recommendations made in an Occupational Health report are legally binding on your employer. The simple legal answer is: no, they are not.

An OH report is purely an advisory document. The practitioner provides clinical recommendations to the employer, but the operational decision on whether to implement those recommendations rests entirely with the company. For example, if the OH advisor recommends that you must work from home indefinitely, but your role is client-facing and cannot be done remotely, the employer is not legally forced to implement that adjustment.

In Great Britain, disability protections depend on the Equality Act definition, including the effect on everyday activities; a diagnosis or long absence alone is not the whole test. Northern Ireland has separate disability discrimination law. Ask for advice about your circumstances rather than assuming that one rule covers every workplace.

Ask the employer to explain its decision on proposed adjustments, including any alternative it has considered. OH advice is one part of the evidence. Whether a legal duty has been met depends on the circumstances, not simply on whether every recommendation was adopted.

To understand how these adjustments are managed, explore our comprehensive guide on a phased return to work UK guide to manage your gradual return to the workplace safely, or check our detailed analysis of a private medical certificate vs NHS fit note to see how different clinical documents support your case.

How robust medical evidence protects you during referrals

When you participate in an Occupational Health assessment, you are meeting with a clinician who does not know your medical history. They are performing a one-off evaluation, which can sometimes be brief or occur entirely over the phone.

Prepare the referral letter, a description of your duties and a concise timeline. Take relevant existing evidence if the service asks for it. You do not need to buy a new private certificate merely because an OH appointment has been arranged.

Explain which tasks are difficult, what changes have helped and any concerns about returning. Tell the clinician if there are gaps in the records or uncertainty about dates. A gap does not by itself prove that symptoms were minor or that support should be refused.

How a private certificate may help

Check the referral questions before deciding whether any additional evidence is needed. Your usual treating team may already hold relevant information. If a private document is requested, agree its purpose and acceptance first; an additional letter is not a guarantee that an OH recommendation will change.

DoctorCert offers an online request for a private medical certificate. Complete the booking questionnaire accurately; a GMC-registered doctor reviews the information and may decline the request or need further information. This is a documentation assessment, not a replacement for examination, tests, treatment or your usual care team. Check the service scope, price and refund policy before booking.

• Explain the symptoms, relevant dates and how they affect your work in the booking questionnaire.
• A GMC-registered doctor reviews the request. Issuance and the dates covered depend on that assessment.
• If approved, the private certificate is sent digitally. Confirm that the recipient accepts this evidence before requesting it.
• If the doctor cannot issue a certificate, the published refund policy applies. Seek appropriate medical care for symptoms.

Before payment, ask the recipient to confirm the document and dates it needs. If it wants a statutory or specialist form, check that the service can provide it rather than assuming that a general private letter is interchangeable.

Frequently Asked Questions

Can I refuse to attend an Occupational Health referral in the UK?

Raise concerns with the employer or OH provider and ask whether the assessment can be adapted. If you decline, the employer may need to decide on the information available. That does not make dismissal automatically fair or remove other legal duties. Seek advice before taking a step that could affect an active employment process.

Who pays for the Occupational Health referral?

An employer-arranged OH assessment is normally paid for by the employer. Ask in advance about any charge for further reports, travel or time away from work and check the relevant policy. Do not assume every possible expense is automatically reimbursed under one universal rule.

Do I have the right to see the Occupational Health report before my employer?

Ask for the OH service's report-review and consent procedure. Specific statutory rights can apply to a report from a doctor responsible for your care; they should not be described as applying identically to every OH report. Raise factual errors promptly and obtain advice if access is disputed.

Are the recommendations in an Occupational Health report legally binding?

No. The recommendations in an OH report are advisory, and the employer makes the final operational decision. However, under the Equality Act 2010, employers must implement "reasonable adjustments" for disabled employees. Ignoring an OH report's recommendations without a sound, documented business reason carries severe legal liability for discrimination.

Can my employer override my GP's sick note with an Occupational Health report?

While an Occupational Health practitioner's report does not automatically "cancel" your GP's sick note, employers and tribunals generally give significant weight to OH reports because they are written by specialists specifically focusing on your fitness for your specific job. If the two documents conflict, the employer should meet with you to discuss the discrepancies.

Need a medical certificate?

Use accurate dates and describe the symptoms and work effects in your own words. The booking questionnaire is an information-gathering step, not a promise that the reviewing doctor can issue the requested evidence.

Check the factual detail before a workplace decision

If you receive a report, check the job description, hours, dates and account of symptoms. Identify a factual error separately from a clinical opinion you disagree with, and ask the OH service how each can be addressed. Ask the employer how the report will inform the next meeting and what other information it intends to consider. Keep a copy of agreed actions and the review date so a recommendation does not become an unresolved instruction.

Preparing questions for the OH appointment

Read the referral questions before the appointment. If a question seems inaccurate or irrelevant, ask how to raise that concern with the provider. Write down the duties you are trying to manage, the changes already tried and what you hope the assessment will clarify.

Ask how you can check factual accuracy in the report and when a decision or review is expected. Keep your treating team's role separate from the employer's management decision.

• Who will receive the report, and for what stated purpose?
• Can the appointment format be adapted for an access or health need?
• What happens if a proposed adjustment cannot be implemented?

Editorial sources and scope

Sources checked on 16 October 2026: Acas guidance 1; Acas guidance 2.

This article provides general information. It is not an individual clinical assessment or employment-law decision. A private certificate is issued only where the reviewing doctor can support it, and the recipient decides whether it meets the required purpose.

Related guidance

Do I Need a Sick Note for Work?; Online sickness evidence; Request an assessment.