A new report by Britain’s national director of health and work recommends putting the “ability” back in “disability”.

“Are you suffocated by work? Do you need a break? Take a breather—you deserve one.”

That’s the advice you’ll find at www.bestfakedoctorsnotes.com, where they claim to offer “the Internet’s highest quality, most affordable fake doctors’ notes.” According to Dr. E.Z. Streat, whose photo adorns the site’s home page, these notes are “a must-have for anyone wanting to enjoy life.”

Aside from being an affront to people who are legitimately ill, the site illustrates the narrow perception of disability that has traditionally prevailed: that employees are incapable of doing any part of their job unless they are 100% fit.

Fake or not, sick notes would be a thing of the past if it were up to Dame Carol Black, Britain’s national director of health and work. In her groundbreaking report, Working for a Healthier Tomorrow, released earlier this year, Black recommends replacing the traditional paper-based sick note with an electronic “fit note,” focusing on what people can do rather than on what they can’t.

Many Canadian employers have already taken an ability-based approach to disability, allowing employees to return to their full duties gradually. But incorporating an ability-based approach right from the point of diagnosis is an important piece of the return-to-work puzzle.

As Black points out in her report, healthcare professionals are usually the first point of contact when someone falls ill, and their advice is often crucial in influencing a person’s belief about their ability to work. Yet many physicians are unaware of the evidence that returning to work—with appropriate adjustments—can be good for health and can even accelerate recovery.

While Black’s idea is a good one in theory, putting it into practice may prove difficult. As her own report notes, physicians don’t typically see providing advice on fitness for work as part of their role. As well, they may be concerned that giving the green light to an early return to work could damage the doctor-patient relationship.

Challenging or not, there is certainly good reason for the British government (or ours, for that matter) to proceed with Black’s recommendation. Her report puts the annual economic costs of health-related absence and disability at over £100 billion—more than the annual budget for the NHS, Britain’s public health system. And there’s nothing fake about that.

Don Bisch is the editor of BENEFITS CANADA. don.bisch@rci.rogers.com

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© Copyright 2008 Rogers Publishing Ltd. This article first appeared in the May 2008 edition of BENEFITS CANADA magazine.