Review concept of 'light duties' in MCs for injured workers
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As an occupational medicine specialist who sees workers with work-related injuries, I can relate to the views of doctors and non-governmental organisations in trying to help workers in such circumstances (Long medical leave not always necessary after surgery, Nov 3; and MCs for injured workers: Err on the side of caution, Nov 1).
Medical conundrum and ethical dilemma often arise when we encounter injured workers whose work is manual in nature, such as those from the construction, shipbuilding and cleaning sectors. While not exclusively so, many of them are foreign labourers who may not be familiar with their medical entitlements and health protection privileges.
Doctors must, therefore, not be unduly influenced by employers in determining what constitutes "the number of days of MC commensurate with the severity of injury".
In addition to medical leave, another option commonly prescribed by doctors and recognised by the Ministry of Manpower is "light duties". While this may be applicable in administrative jobs or even some light industries, it is difficult to find suitable job roles of this description for manual workers.
The concept of light duties must be reviewed. If doctors continue to issue light duties which cannot be implemented at the workplace, injured workers and employers alike will be placed in a bind. To get employers to interpret what constitutes light duties may not be fair, given that there is a clear conflict of interest as employers will want to get their workers back on the job as soon as possible. This is compounded by an authority gradient between the employer and the worker.
Instead of light duties, a fit note can be prescribed. This specifies medical advice on work based on the functional effects of the worker's condition. For example, a worker with good recovery progress from shoulder surgery can return to work, but should avoid carrying loads heavier than 5kg.
Actionable advice enables employers to adjust work requirements for workers and reduces ambiguity. The system of fit note has been adopted in the United Kingdom, generally with good outcomes in empowering an early and safe return to work. With training, UK general practitioners can and are expected to prescribe fit notes.
Doctors are the primary source of medical recommendations that directly impact a worker's ability to return safely to work. This responsibility cannot be delegated, and neither can we expect employers to undertake this role.
Gan Wee Hoe (Dr)
