When an Employee Says, “I Am Sick”: Should HR Grant Leave or Send the Employee to Hospital?

By Frank Ofili

One of the situations that can place a Human Resource practitioner in a difficult position is when an employee walks into his office and declares:

“I am not feeling well. I need to go home and treat myself.”

At first glance, it appears to be a simple request for leave.

But after years of working in HR, I have learnt that some of the seemingly simple situations that walk through the HR door are actually the ones that require the greatest judgement.

I have had occasions when an employee came to my office looking perfectly composed and asked for permission to go home because he was “not feeling fine.” To the employee, it was simply a request to be excused from work.

But a good HR practitioner has to think beyond the request.

What exactly is wrong with the employee?

Is the employee merely tired?

Is it a minor headache?

Is the employee genuinely ill?

Could the employee’s condition make it unsafe for him to continue working?

Does the employee need medical attention?

And, perhaps most importantly, what is the Company’s responsibility after the employee has told HR that he is unwell?

This becomes even more important where the organisation operates a subsidised medical scheme and has designated hospitals or healthcare providers for its employees.

In my view, where an employer has provided a medical scheme for its employees, the more responsible HR position is to facilitate medical assessment rather than simply grant casual leave to an employee who has reported being sick.

This is not because an employer should force an employee to receive medical treatment against his or her will.

Employees have personal autonomy over their healthcare.

Rather, it is because the employer has a legitimate responsibility to manage sickness absence properly, protect the health and safety of the employee and others, and ensure that an employee who claims to be medically unfit for work is appropriately assessed.

A responsible employer should not merely manage an employee’s absence from work; it should take reasonable steps to protect the employee’s health and wellbeing.

I once learnt that “I am sick” is not enough information

One thing I have learnt in HR is that you should never diagnose an employee from the HR desk.

An employee may tell you:

“It is malaria.”

Another may say:

“I think it is just typhoid.”

Another may say:

“I only need to go home and sleep.”

But HR is not a medical profession.

I have encountered situations where what initially sounded like a minor complaint turned out to require more attention than the employee had anticipated. That is why I have become increasingly cautious about the seemingly harmless instruction:

“Okay, go home and treat yourself.”

Sometimes, the most responsible thing HR can do is to stop the conversation there and say:

“Since you are unwell, let us arrange for you to see a doctor.”

That changes the entire nature of the situation.

Instead of HR merely authorising an absence, the organisation is responding to a health complaint.

There is also a legal basis for this approach in Nigeria

The Labour Act recognises sickness absence as a distinct form of leave. Section 16 provides for paid sick leave for temporary illness where the illness is certified by a registered medical practitioner. The law also provides that, where requested by the employer, a worker may be required to be examined by a qualified medical practitioner nominated by the employer.

This is significant for HR practice.

An employee’s statement that “I am sick” is not necessarily the same thing as a medically established inability to work.

A responsible employer is entitled to have appropriate procedures for determining whether an employee is genuinely ill, whether the employee is fit to work and whether medical rest is required.

Consequently, when an employee reports illness, HR should reasonably be able to say:

“We are concerned about your health. The Company has a medical scheme and an approved hospital. Let us arrange for you to see a doctor.”

That is very different from saying:

“You cannot be sick unless you go to our hospital.”

The first is an attempt to facilitate healthcare and properly manage absence.

The second could amount to an unreasonable interference with an employee’s personal healthcare choices.

That distinction is important.

The factory environment makes the issue even more serious

I have worked in manufacturing environments where an employee’s physical condition is not merely an individual welfare matter.

Imagine a production operator working around a high-speed machine.

Now imagine that operator telling the supervisor:

“I am dizzy.”

Should the response simply be:

“Okay, go home”?

What if the employee becomes dizzy while operating the machine?

What if he loses consciousness?

What if another employee is injured while trying to assist him?

What if the employee decides to drive himself home and has an accident on the way?

These are the questions HR and management should be thinking about.

A factory worker who is dizzy, severely weak, confused or otherwise medically impaired may not only be a danger to himself or herself. If the employee operates machinery, drives a forklift, works around moving equipment, handles hazardous substances or works in another safety-sensitive environment, allowing the employee to continue working could potentially expose other employees and the Company to serious risk.

The Labour Act recognises sickness absence as a distinct form of leave. Section 16 provides for paid sick leave for temporary illness where the illness is certified by a registered medical practitioner. The law also provides that, where requested by the employer, a worker may be required to be examined by a qualified medical practitioner nominated by the employer.

Therefore, medical fitness is not merely a welfare issue. It can also be a workplace safety issue.

I have always believed that in a manufacturing environment, when an employee says, “I am sick,” the first question should not necessarily be:

“How many days do you want?”

It should be:

“Are you fit and safe to be here?”

The “two days’ casual leave” trap

There is another issue that HR practitioners should consider.

When HR grants casual leave to an employee who says he or she is sick, the Company may have evidence only that the employee was permitted to be absent from work.

There may be no evidence that the employee actually obtained medical attention, what the medical condition was, whether the employee was fit to return to work, or whether further treatment was required.

I have seen how quickly a simple HR decision can become complicated when circumstances change afterwards.

Imagine an employee comes to HR and says:

“I have severe dizziness and I don’t think I can work today.”

HR responds:

“Okay, take two days casual leave.”

The employee goes home.

Instead of seeing a doctor, he self-medicates.

His condition deteriorates.

He is eventually admitted to hospital.

Suddenly, the question is no longer simply whether HR approved two days’ absence.

The question may become:

“What did the employer know, when did it know it, and what did it do after it knew?”

That is the question HR should be concerned about.

It would be wrong, however, to conclude that the Company automatically becomes legally liable whenever an employee reports illness and subsequently suffers an adverse medical outcome.

Liability does not arise simply because an unfortunate event occurred after the employee was granted leave. There would ordinarily need to be a proper legal basis for the claim, including evidence of the Company’s duty, a breach of that duty, causation and the resulting harm.

The circumstances therefore matter enormously.

Not every “I am sick” situation is the same

Consider two employees.

The first walks into HR and says:

“I have a mild headache and I would like to go home.”

The second says:

“I am having severe chest pain. I am extremely dizzy and I can barely stand.”

These are not the same situations.

In the first situation, the employer’s response may be relatively straightforward.

In the second, simply handing the employee a leave slip and saying “Go home and treat yourself” could be much more difficult to defend, particularly if the employee’s condition was obviously serious.

The more apparent the medical emergency, the greater the expectation that the employer will take reasonable steps to protect the employee.

I have also learnt that HR should resist the temptation to play doctor

Sometimes employees themselves invite HR into diagnosis.

“HR, please, what medicine should I take?”

My answer is usually simple:

“Please see a doctor.”

HR should never say:

“It is probably malaria.”

Or:

“Just take some painkillers.”

Or:

“It is only stress.”

That is not the function of HR.

The role of HR is to recognise that an employee has reported a health problem and facilitate appropriate professional medical assessment.

The doctor should determine the employee’s condition, treatment, fitness for work and whether medical leave is required.

This distinction is particularly important because an HR professional who casually recommends medication may inadvertently create a problem that he or she never intended to create.

What if the employee refuses the Company’s hospital?

This is where HR must strike a careful balance.

The Company should not physically force an employee to undergo treatment.

An employee who chooses to seek healthcare elsewhere should ordinarily be allowed to make that personal healthcare decision, subject to the Company’s lawful absence and medical-certification requirements.

However, HR should document the refusal.

For example, HR can record that:

• the employee reported being unwell;
• the employee was offered access to the Company’s approved medical facility;
• the employee declined the referral;
• the employee indicated an intention to seek treatment independently; and
• the employee was reminded of the Company’s sick-leave and medical-certification requirements.

The employee should also be informed that the Company does not recommend self-medication.

This is a much stronger HR position than simply saying:

“Okay, take casual leave.”

It demonstrates that the Company took the employee’s complaint seriously, offered access to professional medical care and did not knowingly encourage self-medication.

It also establishes an important principle:

The Company can provide and facilitate healthcare without taking responsibility for an employee’s personal decision to reject it.

I would rather have a documented refusal than an undocumented assumption

This is one of those HR lessons that becomes clearer with experience.

Documentation is not about trying to “catch” employees.

Good documentation protects everyone.

If an employee refuses a medical referral, I would rather have a simple record stating:

“Employee reported illness at 10:15 a.m. Employee was advised to attend the Company’s approved hospital for medical assessment. Employee declined and stated that he preferred to consult his personal doctor. Employee was informed that the Company’s sick-leave and medical-certification requirements would apply.”

That small record may become extremely important later.

It establishes that HR did not ignore the employee.

It establishes that medical assistance was offered.

It establishes that the employee made a choice.

And it establishes that the Company did not simply send an apparently ill employee away without taking the complaint seriously.

Sick leave is not the same thing as casual leave

There is another important distinction.

Not every absence arising from illness should necessarily be treated as “casual leave.”

Organisations should clearly distinguish between:

Casual or personal leave – absence for personal matters.

Sick leave – absence arising from illness and managed in accordance with the Company’s sick-leave policy and applicable law.

Medical referral – the process through which an employee who reports illness is directed to an appropriate healthcare provider.

Emergency medical treatment – immediate intervention where the employee appears to be suffering from a serious or potentially life-threatening condition.

When these categories are blurred, HR becomes vulnerable to inconsistency.

An employee should not have to “convert” a medical condition into casual leave simply because HR has no clear procedure for dealing with sickness.

Work-related illness or injury is a different matter

There is an even more important distinction where the illness or injury may be work-related.

If an employee suffers an injury at work, collapses at the workplace, is exposed to a hazardous substance, or develops symptoms that may reasonably be connected to workplace activities, HR should not simply classify the incident as a request for casual leave.

The situation may trigger the Company’s occupational health and safety procedures and potentially the provisions of Nigeria’s Employees’ Compensation Act.

Such an incident should be properly reported, investigated and, where appropriate, referred for medical treatment.

For example, if an employee sustains an injury while operating a production machine, the appropriate HR response should not be:

“Do you want one or two days casual leave?”

The questions should be:

What happened?

Was the employee injured?

Was the machine involved?

Was there a safety violation?

Was first aid provided?

Was the incident reported?

Does the employee require medical attention?

Could the incident happen again?

That is the difference between merely administering leave and actually managing workplace risk.

Compassion and procedure must go together

One mistake HR practitioners sometimes make is to believe that following procedure means becoming insensitive.

It does not.

If anything, the most compassionate response may be the most procedural one.

An employee who says, “I am sick,” should not be treated as though he or she is merely trying to escape work.

At the same time, HR should not automatically assume that every complaint is genuine without appropriate verification.

The answer lies somewhere between suspicion and naivety.

Compassion without procedure can create organisational risk.

Procedure without compassion can create organisational resentment.

Good HR requires both.

So, should HR grant leave or send the employee to hospital?

My answer is:

Where the employee has reported illness and the Company has a subsidised medical scheme or approved healthcare provider, HR should ordinarily facilitate medical assessment rather than simply grant casual leave.

But the employee should not be physically forced into treatment.

The better approach is:

“You have reported that you are unwell. The Company has a subsidised medical scheme specifically designed to provide you with access to medical care. We therefore recommend that you undergo medical assessment at our approved medical facility. If you choose to seek treatment elsewhere, you may do so, but you will be required to comply with the Company’s applicable sick-leave and medical-certification requirements.”

That approach protects the interests of both parties.

It protects the employee by ensuring that a genuine health problem is not casually dismissed.

It protects the Company by demonstrating that it took reasonable steps to address the employee’s complaint.

It protects HR by creating an appropriate documentary trail.

And it protects the organisation from inadvertently creating a culture in which employees simply report illness, obtain casual leave and resort to self-medication without any medical assessment.

The bigger lesson for HR

Over the years, I have come to appreciate that HR is often about what happens after the obvious answer.

An employee says, “I am sick.”

The obvious answer is:

“Okay, go home.”

The HR answer should be:

“Let’s first make sure you are okay.”

That does not mean HR should become a hospital.

It does not mean the Company should control an employee’s personal healthcare choices.

It does not mean every headache should trigger an ambulance.

It means HR should develop the judgement to distinguish between an ordinary request for time off and a situation that requires medical attention.

And where the organisation has already gone to the trouble and expense of providing a heavily subsidised medical scheme, the natural response to an employee who reports illness should not be:

“How many days of casual leave do you need?”

It should first be:

“How can we get you the medical attention you need?”

That is not HR being unnecessarily rigid.

That is responsible employment management.

And where an employee knowingly declines the medical assistance offered by the Company and chooses instead to self-medicate, the Company should ensure that the employee’s decision is properly documented.

If an unfortunate medical outcome subsequently occurs, that record may become extremely important in demonstrating that the Company did not ignore the employee’s illness and did not encourage or facilitate self-medication.

Ultimately, good HR is about balancing competing interests.

Compassion with procedure.

Employee autonomy with employer responsibility.

Flexibility with accountability.

Humanity with proper documentation.

The principle, therefore, should be simple:

When an employee reports illness, HR should manage the illness — not merely manage the absence.

That, in my view, is what responsible HR looks like.