Sickness, Disability and Reasonable Adjustments at Work

Long-term sickness, recurring absences and health conditions can create difficult questions at work. You may be worried about your job, facing an attendance review, waiting for occupational health advice or struggling to get adjustments your employer has promised.

The legal position depends on your circumstances. Not every illness amounts to a disability under the law, and not every absence-related decision is discriminatory. However, an employer should not treat disability-related absence as an ordinary attendance problem without considering whether disability protections and reasonable adjustments apply.

This guide focuses on employment law in Great Britain: England, Wales and Scotland. Northern Ireland has a separate legal framework, so different legislation and guidance may apply there.

For the broader legal framework, see the UK Employment Rights pillar page.

When does a health condition count as a disability at work?

Under the Equality Act 2010, a person generally has a disability if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.

In this context, “substantial” means more than minor or trivial. “Long-term” generally means the effect has lasted, or is likely to last, at least 12 months, or is likely to last for the rest of the person’s life. Specific statutory rules apply to recurring or fluctuating conditions and certain progressive conditions.

A disability does not have to be visible. Mental health conditions, chronic pain, neurological conditions and other impairments may qualify, depending on their effects and the applicable legal test.

You do not necessarily need to have a particular diagnosis for the legal definition to be met. The effects of the impairment, their duration and how they affect everyday activities are important.

An employer may ask for relevant medical or occupational health information to understand your needs. However, the absence of a formal diagnosis does not automatically mean that no disability protection can apply.

What are reasonable adjustments at work?

Reasonable adjustments are changes an employer makes to remove or reduce a disadvantage that a disabled person would otherwise experience at work. The duty arises under the Equality Act 2010 where its legal conditions are met.

An adjustment should respond to the individual’s needs. There is no single list of adjustments that will be appropriate for everyone, even where two workers have the same diagnosis.

Depending on the role and circumstances, adjustments may include:

• changing start and finish times or allowing more flexible working hours;
• allowing additional breaks or changing the distribution of tasks;
• providing adapted equipment, software or an accessible workstation;
• allowing home or hybrid working where suitable;
• adjusting performance targets or the way performance is assessed;
• providing a phased return after sickness absence;
• allowing time off for treatment or medical appointments where reasonable;
• changing a workplace absence trigger or recording disability-related absence separately; or
• considering suitable alternative duties or a different role where appropriate.

The employer should discuss the barriers you face, consider the adjustments that could help and assess whether they are reasonable in the circumstances. Relevant factors can include how effective an adjustment would be, practicality, cost, available resources and health and safety.

An employer is not required to implement every adjustment requested. However, rejecting one proposal should not automatically end the discussion if other reasonable ways of reducing the disadvantage may be available.

Can an employer count disability-related sickness absence against you?

Disability-related absence can raise issues under the Equality Act 2010. An employer may need to consider reasonable adjustments to its attendance policy or the way it manages absence.

For example, an employer might consider adjusting an absence trigger, excluding some disability-related absences from a trigger calculation, or recording those absences separately. Whether a particular adjustment is reasonable depends on the circumstances.

There is no universal rule that all disability-related absence must always be disregarded. Equally, an employer should not assume that its standard attendance policy can be applied without considering disability-related disadvantage.

Two legal protections may be particularly relevant:

• Reasonable adjustments: whether a change to the absence policy or process is needed to avoid a substantial disadvantage.
• Discrimination arising from disability: whether unfavourable treatment because of something arising in consequence of disability can be justified under the statutory test.

Knowledge of the disability can be important. For some claims, an employer may have a defence if it did not know and could not reasonably have been expected to know about the disability. The knowledge requirements differ depending on the legal duty and claim.

What if your employer refuses reasonable adjustments?

If your employer refuses a request, ask for the decision and reasons in writing. Try to establish whether the employer understood the disadvantage you explained and considered the practical options available.

A refusal may be legally problematic if a reasonable adjustment was required and the employer failed to make it. But an employer may be entitled to reject a particular proposal where it is not reasonable, provided the relevant legal duties are properly considered.

Useful questions to raise include:

• What specific difficulty or disadvantage is the proposed adjustment intended to address?
• Has the employer considered the adjustment individually rather than relying only on its standard policy?
• Would a different adjustment achieve a similar result?
• Has occupational health or other appropriate advice been considered where useful?
• Has the employer explained why the requested adjustment is considered impractical or unreasonable?
• Is there a review date to assess whether the current arrangement is working?

Acas recommends that employers discuss adjustments with the worker, explain decisions and explore other ways to provide support where a requested adjustment cannot be made.

Keep a record of the request, the response, any meetings and any alternative arrangements offered.

What if you are on long-term sick leave?

Long-term sickness absence does not automatically end your employment or mean that your employer must keep your role unchanged indefinitely. The employer should, however, consider the relevant legal duties and the individual situation before deciding what to do.

A sensible process may include:

1. Keeping in contact appropriately. Agree how and when the employer will contact you during your absence, taking account of your health and circumstances.
2. Understanding the likely position. Consider available medical or occupational health information about your ability to work and any support that may help.
3. Discussing adjustments. Explore changes to duties, hours, location, equipment or the return-to-work process.
4. Considering a phased return. Where suitable, a gradual return may help you resume work safely and sustainably.
5. Reviewing the options. If returning to the existing role may not be possible, consider other reasonable adjustments or suitable alternative work where appropriate.

The process should be based on current information rather than assumptions about your condition or future ability to work. A condition may fluctuate or change, so the arrangements may need to be reviewed.

Can an employer dismiss you because of sickness or disability?

An employer may sometimes lawfully dismiss an employee following a genuine capability process involving prolonged ill health, but dismissal must comply with the relevant legal requirements. Disability discrimination protections may apply even where the employer has a legitimate concern about attendance or the ability to perform the role.

Before deciding on dismissal, an employer should consider relevant medical evidence, the likely duration of absence, the effect on the business, possible reasonable adjustments and whether alternative work is available. What is required depends on the circumstances.

Where disability is involved, an employer should also consider whether dismissal would amount to unfavourable treatment arising from disability or whether a failure to make reasonable adjustments has occurred. A potentially legitimate business aim does not, by itself, resolve every discrimination issue.

Employees may also have separate rights relating to unfair dismissal, contractual notice, sick pay or other employment terms. The eligibility rules and legal tests for these rights are not identical.

How to request reasonable adjustments

You can make a request in writing to your manager, HR department or another appropriate person. Explain the work-related difficulty and the change that may help. You do not have to disclose every detail of your medical history, although relevant information about the effect of your condition can help your employer assess the request.

A request can be simple. For example:

You can also use the Acas reasonable adjustment request template as a starting point.

What evidence should you keep?

Good records can help explain what support you requested, what your employer knew and how decisions were made.

• Copies of adjustment requests and employer responses.
• Relevant sickness absence records and attendance warnings.
• Occupational health recommendations or relevant medical information.
• Emails or notes of meetings about your health and working arrangements.
• Copies of applicable absence, capability and disability policies.
• Records of agreed adjustments and whether they were implemented.
• Performance reviews, disciplinary documents or dismissal correspondence.
• A dated chronology of significant events and conversations.

Keep records factual and preserve original documents where possible. Medical information is sensitive, so share only what is appropriate and use secure channels.

What should you do if the issue is not resolved?

If discussions have not resolved the problem, consider the following steps.

1. Raise the concern clearly. Explain what adjustment you requested, the disadvantage you face and the response you received.
2. Use the grievance procedure if appropriate. Set out the relevant events, documents and outcome you are seeking.
3. Seek support. You may be able to speak to a trade union representative, Acas or an employment law adviser.
4. Check tribunal time limits promptly. Do not assume that an internal grievance or ongoing discussion pauses the deadline.
5. Consider the available options. Depending on the facts, these may include further negotiation, resolving the issue at work or an employment tribunal claim.

Examples of workplace situations

Recurring absence linked to a long-term condition

A worker repeatedly needs time off because of a long-term health condition. Their employer’s attendance policy triggers a warning. The employer may need to consider whether adjusting the trigger or recording disability-related absence differently would be reasonable before deciding how to proceed.

A request for a phased return is refused

An employee returns after a lengthy absence and requests reduced hours for a limited period. The employer refuses without discussing the reasons or alternatives. Whether the refusal breaches a legal duty depends on the individual’s needs, the job, the proposed arrangement and what would be reasonable.

Performance concerns arise after a health condition changes

A worker’s condition begins affecting concentration and stamina. The employer notices a decline in performance. The appropriate response may include discussing the difficulties, exploring adjustments and following a fair process rather than assuming the worker is unwilling to perform.

An employee is dismissed following long-term absence

An employer considers ending employment because there is no clear return date. Relevant issues may include medical evidence, possible adjustments, alternative roles, the effect on the business and whether the process was fair and non-discriminatory. The outcome depends on the evidence and applicable law.

When a disability or sickness absence review can help

General guidance can explain the legal framework, but it cannot determine whether a particular refusal, warning or dismissal was lawful without examining the facts.

Common mistakes to avoid

• Assuming every health condition automatically qualifies as a disability. The statutory definition and its application to your circumstances matter.
• Assuming an employer must agree to every requested adjustment. The legal duty concerns reasonable steps, and alternatives may need to be considered.
• Assuming disability-related absence must always be ignored. The appropriate approach depends on the legal duties and individual facts.
• Relying only on verbal conversations. Keep a written record of important requests and decisions.
• Waiting until dismissal is imminent to seek advice. Earlier action may help clarify options and preserve evidence.
• Assuming a grievance pauses tribunal deadlines. Check the applicable time limit separately.
• Resigning without understanding the consequences. Resignation can have significant legal and financial effects, so obtain advice before taking that step if possible.

Frequently asked questions

Official guidance and legislation