Presenteeism case study

Peter was 32 and a software designer. Over the course of a few months, his line manager, Sam, noticed he was making frequent mistakes with his work and looked very tired. Sam and his HR consultant agreed to put in place a performance improvement plan to help Peter.

His company didn’t offer any occupational health services, so the HR consultant called Zurich, to see if there was anything else that could be done to better support Peter. As our team - including claims managers, rehabilitation consultants and company Chief Medical Officers - work collaboratively, it was agreed Peter may benefit from some rehabilitation intervention and support. Initially, we called Sam, to make sure we fully understood the situation from all perspectives.

Sam explained that Peter had worked for the company for eight years and been great at his job, but in the last six months or so he was making out of character mistakes and seemed very sleepy at work. Peter said he couldn’t account for why this was the case and so was trying to compensate by staying late to try and finish work. Sam noted that Peter also seemed very low and was not socialising or engaging with his colleagues as he previously had. He had used all of his holidays less than halfway through the holiday year and had 12 days sickness absence spread over several episodes to date.

How Zurich was able to help

Peter agreed to speak to one of our rehabilitation consultants and so we arranged to call him the next morning. We reassured Peter about confidentiality and confirmed that any report would require his explicit consent to share. Peter informed the rehabilitation consultant that after nearly a year of investigations he was diagnosed with Multiple Sclerosis (MS). He suspected he had had this for some years but had ignored the symptoms. He felt that no-one could help him and so he hadn't bothered having any NHS follow-up.

Peter said that he loved his job and explained that he worked in a competitive environment. He thought that if his employer knew of his condition he would lose his job. He went on to explain that his marriage had also broken down and his wife had left him.

Peter said that he was struggling with his diagnosis, and he had visual issues as well as numbness of his hands and feet. He was not sleeping as he was preoccupied with anxieties about his job, finances and his impending divorce. He felt he had a “brain fog” and struggled to concentrate in work. Due to the paraesthesia (numbness) in his hands, Peter said he struggled with keyboard work. He also reported that he struggled with his commute to and from the railway station to work.

Our rehabilitation consultant discussed Peter’s situation with him and he eventually agreed that he needed to share this information with his employer and to seek medical review and support. We arranged a conference call with Peter and his employer and during the call we identified and agreed short-term adaptations to reduce his workload and arranged for him to work on tasks that were not business critical. We also agreed that he could sometimes work from home, which was balanced to complement his office work.

We advised Peter to seek a workplace ergonomic assessment, and via his employers his workstation was assessed and adaptations made. We also suggested that he made a referral to the Department for Work and Pensions’ Access to Work programme, which helped him with the costs of travelling to the railway station by taxi. This made his commute less fatiguing on the days he was working in the office. Access to Work also arranged two large visual display units and installed voice-activated software.

Since Peter’s wife had left him, he had largely ignored any bills and was facing a county court judgement. We arranged a telephone advice call with his local Citizens Advice Bureau to help him focus on his finances and understand what legal advice he required.

With Peter’s consent, we spoke to his GP regarding a referral back to the NHS neurology team and MS nurse. Peter met with his nurse within three weeks. We were also able to fund short-term psychological assessments and give him access to ‘talking therapy’ to help him address his emotional concerns.

He started receiving the right medical support, including reviews with consultants, who arranged disease-modifying medication. His ongoing visits to the MS nurse meant she could also begin proving regular support and advice to Peter.

Developing a longer-term work plan

It became apparent that Peter could not manage his full-time hours, but could still contribute meaningfully to the business on part-time hours, so we suggested a longer-term work plan. After reviewing Peter’s medical evidence and the feedback from colleagues in the rehabilitation team, our claims team was able to provide Peter with a proportionate payment for the hours he could not work. We review Peter’s case regularly to make sure he is still receiving the support he needs.

Peter is getting his life back on track. His anxieties are being replaced with hope, and he is becoming positive about the future.