Occ health: Occupational Health “Operational fitness” versus “Fitness-for-work”


There is terminology used in occupational health that can be confusing to the uninitiated. Different industries use these occupational health terms differently.

Operational fitness assessments that are requested by employer
– after return-to-work RTW post-illness
– when the employee has developed suspected physical and mental impairment which is adversely influencing their ability to perform their duties
– the employee experiences difficulty in wearing personal protective (PPE) clothing
– when the employee develops problems with performing duties during night shift
– when the employee is under consideration by the employer for transferral or secondment to another department or position associated with risk
– the employee has labour relations problems and the employer wants to determine whether there is not an underlying medical problem for their behaviour
– in line with the requirements of the Occupational Health and Safety Act (OHSA), defined in the Act as medical surveillance examinations
– for expert opinion on the management of “outside” practitioners under Compensation for Occupational Diseases and Injuries Act (COIDA), especially in terms of the employees’ utilisation concerning their impairments. Are the employees receiving the correct treatment to be able to perform their duties in future
– in line with the Mine Health and Safety Act (MHSA) or other legislation regulating occupational health
– when the employee was exposed to substances (such as chemicals or asbestos) as listed reportable under COIDA or environmental stressor (chemical, physical, ergonomical, mental)
– in line with policies and procedures of the organisation as determined by the employer
– when the employee was injured and the First Medical Report (WCL4) and Progress and Final Reports (WCL5) must be sent to the Compensation Commissioner

Operational fitness assessment requested by the employee
– for the same reasons above
– due to conflict in the workplace; frequently labour relations problems end up on the Occupational Medical Practitioner (OMP) or the Occupational Health Practitioner’s (ONP) desk
– employees want to determine the merits of receiving compensation under the COIDA
– employees want to evaluate whether the employer is conforming with legislation


The difference between run-of-the-mill operational fitness examinations and FORMAL fitness-for-work examinations is that the latter has as outcome labour relations outcomes such as incapacity, transferral to another job, modification of job description and other “HR serious” outcomes. These are the outcomes that ultimately may be tested in the labour court.

Information crucial in fitness-for-work examinations

– Name and personnel number
– Demographic data
– Usual work that the employee performs (and since when?)
– Is the employee being accommodated currently? (since when and in which capacity)
– Is the employee coping currently?
– Is the employee temporarily or permanently placed in alternative work? (since when, in which capacity and is there an official change on the organogram)
– Is there an occupational risk profile (ORP) on the employee’s file describing the risks and hazards that the employee is exposed to?
– Are there any OHSA or legal requirements that the employee/ employer has to comply with?
– When was the employee’s last medical surveillance assessment done, if any?
– Who is the employee’s practitioner and where does he/she practice?
– What speciality is this practitioner in?
– Did the treating doctor supply any medical reports?
– What other diseases does the employee have?
– When was the employee admitted in hospital?
– Is there any new impairment that the employee has developed?
– Are there any PPE criteria that the employee has to comply with in order to perform their duties?
– Did the specialist comment on impairment? Does the employer and supervisor have any inputs on ability to work?

– The employee is “fit for usual work”
– The employee is “temporarily unfit for usual work but fit for alternative work”. Alternative work can indicate the level of physical strain placed on the employee (medium manual work or light manual work), it can indicate sedentary work or administrative work, or it can indicate restrictions. It can also report “fit for the work that the employee is currently performing”
– The employee is “permanently unfit for usual work, but fit for alternative work”
– The employee is “fit for usual work but with restrictions” e.g. not working at heights
– The employee is “permanently unfit for any work in the organisation”

Do not disclose medical confidential information