Managing non-visible disabilities

Many people think of disabled people as being wheelchair users. However, the term ‘disabled people’ covers a wide range of different people with different impairments, which may or may not affect how they do their job. The legal definition of ‘disability’ is so wide that people you might not regard as disabled, or indeed do not think of themselves as disabled, are protected. That includes people whose disabilities are not obvious.

Many disabled people have conditions which are not immediately apparent, for example:

• Visual impairments.

• Hearing impairments.

• Speech impairments.

or are not apparent at all. For example:

• Diabetes.

• Dyslexia or dyspraxia.

• Epilepsy.

• Asthma or other respiratory diseases.

• Aspergers syndrome or autism spectrum disorders.

• Cognitive difficulties.

• HIV.

• Cancer.

• Heart disease.

• Gastric problems like irritable bowel syndrome or colitis.

• Mental health conditions like depression, anxiety, schizophrenia or bi-polar affective disorder.

Be aware too that people with visible disabilities may have additional non- visible disabilities, more than 6.9 million disabled people in Britain are of working age, which represents 19% of the working age population.

If the person with the disability is doing their job well and doesn’t need you to make any changes to their working environment or working practices, then there is no reason for you to know or for them to tell you about their disability.

There is no legal obligation for employees to tell their employers about a disability unless they need a reasonable adjustment or if their disability poses a health and safety risk either to themselves or others. As a manager you don’t need to know what disability or medical condition the person has had diagnosed. This may well be something that remains confidential between the employee and the occupational health adviser. 

You do, however, need to know the effect of the disability on the employee at work so reasonable adjustments can be identified and implemented if the person is having problems at work.

The law requires employers to make reasonable adjustments to remove barriers that place a disabled person at a substantial disadvantage in the workplace because of their disability. You must make reasonable adjustments when you know or could reasonably be expected to know that the person is at a substantial disadvantage. This means that employees do need to tell their employer they have a disability if it is having a substantial impact on the way they do their job and they need changes to the way they work or equipment to help them.

In addition, employers cannot overlook problems an employee might be having at work and should investigate further to see if these problems might be caused by a disability that the employee may or may not be aware of as yet and make reasonable adjustments to overcome them. In some cases the barriers will be physical such as doorways that aren’t wide enough for a wheelchair user but more often they will be the way in which the work is done, for example on a computer or within certain hours in the day for people who have non- visible disabilities.

How to make reasonable adjustments

You will have the skills, knowledge and authority to implement some adjustments yourself, for others you may need to call on your colleagues or external organisations for help. 

Always start with the person needing the adjustment. Talk to them to find out exactly what they are having problems doing so you have all the facts. Sometimes the person will be able to suggest a solution themselves, but don’t expect every disabled person to be an expert either on their own disability or on the adjustments that are possible or might work for them. Remember that employees might be unaware or unwilling to accept they have a disability or be learning to manage the effects of their disability, and neither you nor they may be aware of adjustments that are possible in your workplace.

Types of reasonable adjustments

Not everyone with a disability, visible or non-visible, will need a reasonable adjustment and even people with the same disability may not need the same adjustment. The following list illustrates the range of reasonable adjustments that some people with these non-visible disabilities have found helpful:

For people with concentration problems

• Providing quiet workspaces to reduce auditory and visual distractions.

• Allowing the person to work from home from time to time.

• Planning for uninterrupted work time, i.e. using ‘do not disturb’ signs.

• Dividing large pieces of work into smaller tasks and goals.

• Alarms and/or memory aids to remind them when to carry out tasks.

For people with depression and anxiety:

• Allowing telephone calls during work hours to a doctor, nurse, psychotherapist, counsellor, friend or family member for support and advice.

• Allowing breaks to let the person use stress management techniques.

• Monitoring workload and targets regularly.

• Allowing for periods of uninterrupted work, e.g. with a ‘do not disturb’ sign or from home.

• Training for managers and colleagues on how to respond when the person needs support or other adjustments

For people who experience fatigue, weakness or are in pain:

• An adjustable workstation which allows the person to stand or sit.

• More frequent rest breaks.

• Reducing or eliminating the need to lift or walk, e.g. by moving the workstation closer to meeting rooms or office equipment.

• Flexible working hours if the person finds it hard to stand on public transport during rush hour.

• Part-time working or job sharing or allowing the person to work from home from time to time.

• Providing parking close to the worksite. For people who have respiratory problems like asthma:

• Arranging for pre-notification of any planned construction, painting or pesticide applications.

• An air purifier near the workstation. Using non-toxic/low odour solvents, cleaners and other supplies.

• Allowing the person to control the temperature near their workstation with a heater or a fan.

For people with cognitive difficulties, e.g. dyslexia or following a stroke

• Providing written rather than verbal job instructions.

• Coloured paper and computer screen backgrounds.

• Helping the person to prioritise tasks.

• Voice activated software and grammar and spell-check applications.

• Additional training or coaching. For people who are sensitive to light or have seizures or blackouts, e.g. migraines or epilepsy:

• Lower wattage overhead lights, task lighting or natural daylight bulbs.

• Flicker-free lighting, i.e. replacing fluorescent lighting with full spectrum or natural lighting.

• Seating near a window for natural light but with blinds.

• More frequent rest breaks from computer work.

• Elimination of sharp objects in the vicinity of the person.

For people with personal interaction difficulties, e.g. Aspergers syndrome or autism spectrum disorders:

• Clear, unambiguous instructions about work tasks.

• Help prioritising tasks.

• Regular meetings with their manager.

• Pre-notification of any changes to routine, e.g. an away day.

• Providing awareness training for colleagues with the disabled person’s agreement.

• Allowing a support worker onsite to help the person manage any changes to their work routines

For people with gastric, bowel or bladder problems:

• Relocation to a workstation nearer to toilet facilities or exclusive access to a particular toilet.

• Relocation to a site nearer to the person’s home to reduce commute times.

• Allowing the person to work from home.

• The opportunity to make special dietary requests for work lunches, dinners etc.

• These are just examples of reasonable adjustments.

• This is not an exhaustive list.

Remember too that everyone is different. Different people need different types of reasonable adjustments, sometimes for similar impairments. In most cases they will be relatively simple, inexpensive or even free and easily implemented.In some cases, however, it will not be immediately apparent what needs to be done. You will need to speak to other people in your organisation and perhaps obtain reports from experts like workplace assessors, an Access to Work adviser, the employee’s doctor, specialist organisations and your organisation’s occupational health adviser.

The most important thing is to talk to the employee to find out what they are having difficulty doing. However, this is not always easy and there is more on having difficult conversations later. It is your job as a manager to ensure that reports are received and adjustments implemented within a reasonable time frame. This may mean chasing your colleagues in occupational health or IT for example, or external organisations who have conducted assessments. If getting expert reports and assessments organised is going to take time, make sure you tell the employee what is happening and how long things are likely to take – especially if they are not able to come into work during this time as otherwise they may feel very isolated and abandoned.

Confidentiality

Most importantly, do not tell anyone else about the employee’s disability or medical condition without their express and, preferably, written permission. Very few people need to know the details about an employee’s medical condition – perhaps only the medical adviser. What you and other people really do need to know is what the person is having difficulty doing at work and how their work can be changed with reasonable adjustments so they can realise their potential. Confidentiality is vital if you are to retain the trust of your staff.

Don’t I need to know about an employee’s disability for health and safety reasons?

It depends on the nature of the disability and the job the person does, in the majority of cases a person with a visible or non-visible disability poses no more of a health and safety risk either to themselves or others than employees without a disability in the workplace. However, risk assessments should be carried out for all employees who work in potentially dangerous environments, e.g. at heights or with heavy machinery or who must drive as part of their job. Disabled employees in these roles have an obligation to tell their employer if they have been diagnosed with a condition that might pose a risk to their own safety or the safety of others. These could be because of conditions like epilepsy or diabetes, or if they are taking medication which has side effects such as drowsiness.

Remember that the DVLA must also be notified about such disabilities that permits the person to hold a driving licence then it is safe for them to drive as part of their work. Your occupational health adviser should contact the person’s own medical adviser to confirm that the DVLA has been notified and that the person can continue to drive.

How will I know if someone needs a reasonable adjustment?

In some cases the employee will tell you they are having difficulty with some aspect of their work, e.g. getting in at 9am because they have a disability or medical condition. However as manager you should also be looking out for signs that someone might have a disability. Bear in mind that these signs might be linked to a disability the person may or may not know about as yet. 

Warning signs could be:

• Their attendance is poor or deteriorates.

• Their performance at work deteriorates.

• Their behaviour at work changes and they are tearful, aggressive, irritable or withdrawn and forgetful.

• They are persistently late or miss deadlines.

• They appear to be experiencing pain, discomfort or extreme fatigue.

• Noticeable weight loss or gain.

• They appear to be working excessive hours or taking on too many new projects.

Don’t waste time trying to work out if someone meets the legal definition of disability. If a member of your team is having problems at work, talk to them, try to find out what would help and make any changes you reasonably can to help them do their job.

As you can’t always be sure whether someone is disabled or not, it is best practice to make adjustments for anyone who is having problems at work. This way you will have done all you can to try to help someone work to the best of their ability, and means that you will recruit and keep the most talented people for your organisation.

Why won’t employees who know they have a disability tell me about it?

There are many reasons why a person with a non-visible disability won’t tell their employer about it, sometimes even when asked outright. 

For example:

• Fear of discrimination.

• Not believing it to be relevant to their ability to do the job.

• Not considering themselves to be disabled.

• The stigma associated with the disability.

• Fear of colleagues’ reaction to their disability.

Fear of discrimination

Many disabled people have had negative experiences in the past, often from a former employer, when they were diagnosed with or revealed a medical condition or disability.

This can lead to them concealing their disability from future employers. They fear they will not be offered the job or be treated differently if they tell potential employers about their disability. An applicant with a disability that can be concealed may do so if they believe they can do the job without having to tell anyone about it. In some cases the disability will have no impact on their ability to do the job and so they may never need to tell their employer about it. In other cases the employee may not have realised that their disability would affect their work until they start doing the job.

As a line manager, you should always consider the possibility that a new employee who seems to be struggling with a particular aspect of their job might have a disability. Look for warning signs like poor performance in a particular area, such as writing or comprehension skills, persistent lateness or days off sick here and there. Employees diagnosed with a disability while already working for you may fear they will lose their job if they tell you, particularly during a recession when unemployment is rising, you should be looking for warning signs that indicate you need to talk to the employee about the reasons for any poor or deteriorating performance and bear in mind this might be related to a disability.

Remember too that an employee with a newly diagnosed disability might be struggling to come to terms with its effects. This may mean they are either:

• Unwilling to accept that their disability or health condition is affecting their work performance and are therefore reluctant to talk about it; or

• They don’t as yet know what effect the disability will have on them and may be apprehensive or anxious about it.

In both cases the employee is unlikely to know what reasonable adjustments they need. They may not even realise they are entitled to reasonable adjustments at work but you as the employer have an obligation to make adjustments once you realise they have a condition that is having an impact on their work.

This means that if you notice an employee’s work or behaviour has changed and deteriorated, you need to talk to them to see if it might be disability related and start the process of making reasonable adjustments to remove any barriers they may be encountering.

Someone with a newly diagnosed disability may need to go through several stages.

First they must learn what effect the disability has on them in their day-to- day life, i.e. their symptoms and the effect of any treatment they might be receiving. Then they will need to assess how their disability affects them at work.

As an employer you have a vital role here, and your actions may determine whether they can continue to be a productive and effective member of your team or feel they need to leave. With help from experts, you can help the person identify the barriers they encounter at work because of their disability and ways in which they can be removed or reduced.

Experts that can help include:

• Occupational health advisers who are usually either doctors or nurses.

• Occupational therapists who

can provide practical advice on managing the effects of a disability at home and in the workplace.

• Disability employment advisers and Access to Work advisers who can arrange workplace assessments.

• IT specialists either within your organisations or specialists from organisations like the RNIB or AbilityNet.

• Your HR or diversity teams.

The most important thing you can do is to let people who work for you know they can talk to you and that you will help them to overcome barriers they may face at work.

Non-visible disabilities and recruitment

Employers often ask applicants and employees to ‘disclose’ their disability or to ‘declare’ whether or not they have a disability or serious health condition.

Such language is negative and unhelpful. It suggests that a disability or health condition is something someone might want to hide, and so should be encouraged to reveal or face penalties for not doing so. Such language might in fact have the opposite effect to that desired. Employees may feel intimidated by the language and believe it is a ‘big deal’ to tell their employer about a disability or health condition. Fear of what might happen if they do ‘disclose’ or ‘declare’ may well make them decide to conceal their disability for as long as possible – even if that means lying.

Try to avoid using words like ‘disclose’ or ‘declare’. Simply ask employees to tell you if they need changes to their working arrangements or environment because of a disability.

Neutral language is more likely to reassure job applicants and employees that telling you about a disability or health condition does not automatically mean they won’t get the job or be fired – especially if you also make it clear you will make reasonable adjustments for anyone who needs them.

Non-visible disabilities and recruitment

There are a number of stages in the recruitment process when employers commonly ask about the applicant’s health or any disabilities. Sometimes you do need this information but often it is irrelevant.

Application forms

Application forms should only ask if the person needs any adjustments for the interview. It is unlawful to ask on the form about any disabilities, past or present, or long-term or serious health conditions unless the questions relate directly to the job for which the person is applying. You can only ask questions about health or disability after a job offer has been made.

Monitoring forms

You can ask candidates if they have a disability on equal opportunity monitoring forms that accompany the application form or can easily be torn off the application form. Monitoring forms should say clearly that they are voluntary, not part of the application form and that they will not be seen by the short-listing and interviewing panel.

The purpose of the monitoring form is to ascertain how many candidates from different backgrounds or with particular characteristics have applied to your organisation for jobs of this nature or at this grade. Monitoring forms commonly also ask candidates about their race, gender, age, religion or belief, sexual orientation, as well as disability.

The forms should be clearly anonymous and the data collected used only for statistical purposes, i.e. if when analysing the statistics your organisation discovers that very few disabled people apply for jobs action can be taken to encourage applications from disabled people in the future.

The two ticks symbol

If your organisation is a two ticks symbol holder you can ask applicants if they have a disability and wish to be considered under the two ticks scheme. Candidates who indicate that they do wish to be considered under the scheme should then be guaranteed an interview if they meet the essential criteria for the job.

Adjustments for the interview

Ensure that candidates invited to an interview know in advance what this will entail. Tell them for example, if there will be a panel of three people asking questions or if they will be required to give a presentation or take a written test. Ask the candidate to let you know if they think they will have difficulty with any part of this process and so need adjustments.

You may well need to talk to the candidate to identify what barriers they are likely to face because of a disability, and to identify reasonable adjustments. Remember that it is unlawful to ask candidates questions related to health or a disability at the interview. If a candidate does tell you about a disability such as dyslexia but says they do not need any reasonable adjustments, you should ensure they fully understand the nature of the interview and the adjustments that are possible. For example, if they are going to be asked questions by a number of different people, suggest that they can ask for time to write down the question and think before replying. Or, you could offer more time for a presentation if that would be reasonable in the circumstances.

If you are on the interviewing panel you can ask candidates how they will do the tasks required in the job but make sure you ask this of all candidates and not just those who tell you they have a disability. Ensure that you use positive language and let the candidate tell you how they will do the job rather than asking negative questions about how their disability might limit their ability to carry out the necessary tasks. If the candidate will need adjustments to do the job, an offer can be subject to these being possible and reasonable.

Medical questionnaires

Many organisations ask candidates to complete medical questionnaires that ask detailed questions about the person’s medical history and sickness absence. These questionnaires are of limited value and are unlawful prior to offering the candidate the job. Using the information provided on the form to screen out candidate with health conditions or disabilities, past or present, is unlawful disability discrimination. In addition the medical information provided will be a very poor indicator of whether or not the person is able to do the job for which they have applied. Past sickness absence is rarely a good predictor of future absences.

In many cases you won’t get accurate information from the form for the reasons given earlier in this guide. Some candidates will not tell you about their disability because they fear that the job offer will be withdrawn if they are honest. Others may genuinely believe they have answered the questions accurately but will still not reveal non-visible disabilities.

This is because it is difficult to ask medical questions in an unambiguous way that non-medical or lay people will understand. Often people will genuinely believe that any medical condition they do have, or have had, isn’t relevant to the questions being asked.

If the job is potentially dangerous or needs certain levels of physical fitness you can ask all candidates to see your occupational health adviser to pass them as fit and able to do the job. But remember that all candidates, disabled and not, must be asked to see the occupational health adviser. Singling out disabled candidates is likely to be discriminatory.

Non-visible disabilities and retention

Many people with visible or non- visible disabilities have no problems at work, and are valuable and valued members of their team. Some people with non-visible disabilities will tell their employer about their condition and some will not for the reasons given above.

As long as they are able to perform their role satisfactorily they do not need to tell you about their disability. However, there may come a point with any employee, whether known to be disabled or not, when you need to have a difficult conversation.

Having difficult conversations

At some point in your career you are likely to have to talk to someone working for you about their poor performance. These are always difficult conversations. As said earlier, you should bear in mind that the person’s performance might be affected by a hidden disability. This could be a disability they are as yet unaware of or one that is newly diagnosed. It could also be a disability they have had for some time but is only now having an affect on their work, either because it or their medication has changed, or because their work has changed.

Your first meeting to discuss performance

You must ensure that the person doesn’t think they are being disciplined at this first meeting. Tell them you want to talk about their recent performance. Remember to give positive feedback on work that has been done well before moving onto how you would like to help improve performance in areas where they are not being as effective as you would like.

It is always better to ask ‘open’ questions rather than ones that allow for a ‘yes’ or ‘no’ answer. This will encourage the person to talk to you but you must remember to listen carefully to what they say. Ask the person how they think they are doing at work. They may well be aware of their shortcomings. If they are not then you need to ensure that they understand what they should have been doing and in what ways they have fallen short of the standards you expected of them. It is important to be specific about:

• The tasks or behaviour you want to talk about – give dates and examples.

• What you expected from the person.

• How their performance or behaviour fell short of what you were expecting.

• What you want to change.

Be clear about the minimum or mandatory aspects of the job, for example:

• A polite and professional manner with clients and colleagues.

• Accuracy of information provided to customers.

• Responding to queries within a specified time frame.

• Recording information accurately. 

• Following absence reporting or other internal procedures.

You then need to move onto ways in which you can help the person to meet these mandatory requirements. If you have noticed that the person appears to be in pain or distressed don’t be afraid to ask them about this by saying something like: “I’ve noticed you seem uncomfortable at your desk/have been taking painkillers quite a lot/been rather upset/angry recently. Can we talk about this? If it’s something to do with work, perhaps I can help?”

In many cases this will be enough for the person to reveal that for example, they have back pain or have been getting bad headaches. These could be caused by their workstation, or by overhead lights or noise in the workplace.

You should ask them what they think is causing the problem and then ask if they will see the occupational health adviser. Many employment contracts say that the employer can ask employees to see the occupational health adviser – check the contracts in your organisation.

Even if the contracts don’t say anything on this, the person is likely to consent to seeing the occupational adviser if they are reassured this is the first step in trying to make it easier for them to do their job and reduce their pain.

You should never ignore an employee who is distressed at work. If they have been crying or had an angry outburst, talk to them to try to discover the cause. Again, if you are reassuring and they don’t think they are at a disciplinary meeting they may be willing to tell you what has been happening. In some cases the causes for their behaviour will be outside work in which case all you can do is to offer understanding and support.

Reasonable adjustments that might help could include allowing them to:

• Take a break and a walk outside if they feel they need to cool down or be alone for a while.

• Take or make personal calls in private if they need to talk to a family member, their lawyer or a debt advice agency during working hours.

If the reason for their distress is work- related, for example, harassment or bullying by a colleague, or because of workloads and working hours you must take immediate action to address this. Refer to your organisation’s bullying and harassment policy and talk to your HR department on how such situations should be dealt with. Make sure the person who says they are being bullied or harassed knows you are acting on their allegations.

If workload or working hours are the problem, arrange a meeting to go through what they need to do and help them to prioritise their work or identify training they need. You may need to take some tasks away from the person if the workload is genuinely too much for them to cope with. Failure to do so when they have indicated they are not coping could lead to them developing mental health problems or other stress-related disabilities and possible claims for personal injury. Remember that you cannot know if the person meets the legal definition of disability as only a tribunal or court can decide this. Adopting the best practice approach of making reasonable adjustments in these situations might prevent someone from developing a disability in the future if they aren’t already disabled as well as improving their performance when at work.

In some cases, however, the person you are talking to may insist that nothing is wrong. If you point out behaviour or work that you have concerns about they may become defensive and find excuses or blame others. This is why it is important to ensure you have all the facts before you speak to an employee who is under-performing.

You need to be able to point to work that the individual has done or their behaviour you want to discuss. This will enable you to tell the person where exactly you are looking for improvement. In other cases the person may accept that their work or behaviour has been unacceptable and will promise to improve but they refuse any offers of help from you.

In both cases, if the person doesn’t want to talk about problems outside work or health problems, you cannot insist on doing so. Remember too that it is not your job to try to diagnose a disability. Any suggestion from you that the person might have a disability like dyslexia or a mental health problem is likely to go down badly. All you can do is to reassure them you are available to talk and that you will do all you can to help them improve their performance including referring them to your occupational health adviser who may recommend an assessment. You can also suggest reasonable adjustments that might help them to improve their performance, for example changing start times if they have been persistently late, or a workstation assessment, and ask them to think about these and talk to you again. Whether disabled or not, all employees need to understand what you require of them, and what is and what is not an acceptable standard of work and behaviour in the workplace. 

Employees need to understand that if they refuse your offers of help and reasonable adjustments and their performance continues to fall short of minimum standards, they do ultimately risk capability proceedings being taken against them.

Ongoing reasonable adjustments – ensuring continuity

Many employees with a non-visible disability do not tell their employer about it unless they are sure their employer, and in particular their manager, is going to be supportive and won’t discriminate against them. They often fear that telling their manager will mean they won’t be given good work anymore or their chances of promotion will be diminished. However, if you are seen to be an open and supportive manager, people who work for you are more likely to trust you enough to tell you about a disability or health condition or any other problems they might have that affects their ability to do their job. Once such trust has been established you can talk about any barriers the person faces at work and means of overcoming them, i.e. reasonable adjustments.

In many cases the only people who will know that the person has a disability is you, the HR department and the occupational health department, and only the medical adviser needs to know any actual diagnosis.

If you and your organisation are routinely flexible and make adjustments for all your employees, other members of staff may not even notice, let alone question, adjustments for someone with a non- visible disability. If they do notice the adjustments, they will be reassured that they can come to you if they too need a change in the way they work and that you will make reasonable adjustments for them.

New managers

Difficulties may arise when a disabled person moves to another department or when their manager moves on and they have someone new in charge. A new manager may not understand why a member of the team works differently to other members of the team and may try to standardise ways of working. Someone with a non-visible disability may be wary of discussing their disability with someone new with whom they have not as yet had time to develop a relationship. Removing reasonable adjustments may, however, lead to claims for disability discrimination.

If you are a new manager

If you are appointed as the manager of a team you don’t know, don’t try to change ways of working too quickly. Try to get to know each team member and build trust. Remember that members of your team may have agreed reasonable adjustments with your predecessor and that is why, for example, someone starts and finishes later than other team members or works from home from time to time, or asks for quiet uninterrupted work time when they won’t answer emails or telephone calls.

If you are moving on as a manager

If you are leaving your department or organisation, consider what your successor needs to know about your team. Remember, however, that even if you get the chance to handover in person to your successor, you must not pass on details of someone’s disability without their express consent. Information about health or a disability is regarded as sensitive personal data under the Data Protection Act, and as such can only be processed or passed onto someone else with the explicit and preferably written consent of the disabled person. You could talk to each member of your team and ask them what information they would like passed on to your successor. A better way, however, is to draw up a tailored adjustment agreement.

Tailored adjustment agreements

A tailored adjustment agreement is a living record of reasonable adjustments agreed between a disabled employee and their line manager.

The purpose of the agreement is to:

• Ensure that both parties – the individual and the employer – have an accurate record of what has been agreed.

• Minimise the need to renegotiate reasonable adjustments every time the employee changes jobs, is relocated or assigned a new manager within the organisation.

• Provide employees and their line managers with the basis for discussions about reasonable adjustments at future meetings.

It is a live document and should be reviewed regularly by both the employee and manager, and amended as appropriate. Remember, however, that expert advice from third parties, such as occupational health advisers, Access to Work or IT specialists may be needed before changes can be agreed and implemented. Tailored adjustment agreements are particularly useful where an employee’s disability isn’t visible. The agreement will give the employee more confidence when talking to a new manager about the effects of their disability because there is a document they can refer to as the basis for discussion at meetings.

New managers will also be reassured that the adjustments set out in the agreed by the organisation as reasonable and that they need do no more than review how they are working for the time being. Tailored adjustment agreements are also a good way of ensuring that an employee’s contact and emergency contact details are up to date, so as a manager you know who to contact if the need arises. Employees with fluctuating conditions or disabilities that might affect their behaviour can also specify in the agreement what they would like their manager to do in circumstances where their health or behaviour gives their manager or colleagues cause for concern. This can be especially useful for people who have bi-polar disorder or other mental health problems, and you as a manager can be confident you are doing what the person wants you to do if you follow the agreed procedures in the agreement, for example, contacting a named family member.

New managers of employees with such tailored adjustment agreements should accept the adjustments outlined in the agreement as reasonable and ensure that they continue to be implemented. The agreement may need to be reviewed and amended at a later date but this should not happen until both parties have worked together for a reasonable period of time.

Some people genuinely do not believe they have a disability. This might either be because they do not consider their particular health condition to be as serious as a disability, for example, diabetes, asthma or a back problem, or because they are unwilling to accept they are having any problems or that they need to seek help. People in both categories are unlikely to say they are disabled on monitoring forms and may well say there is nothing you need to know about in terms of their health and fitness to do the job. This may well be true if their condition has no impact on their work. However, it can cause problems when they are not performing to the standards required of them at work but are reluctant to accept this might be because of their health or a disability and some people don’t want the stigma often associated with the label of ‘disability’, or do not want to be defined by what might be regarded as a limiting health condition. This is particularly the case for disabilities which are often reported in negative terms in the media such as HIV or mental health conditions like schizophrenia, bi-polar affective disorder (manic depression), depression and anxiety conditions. Many people make assumptions about what people with such disabilities can and cannot do, their lifestyle or the way they might behave and as a result, employees fear that their colleagues might treat them differently if they knew about their disability so being a disability confident employer is a must for recruitment, retention and developing.

Phillip Waldman