This post focuses on the unconscious biases which can interfere with an employee’s return to work after a serious health issue. This is the fourth post in a series for line managers who are supporting such employees, and are wondering how they can best do that. 

Rather than focus on HR policies and employment law, what I share here are the subtle and often unseen aspects which can help the employee’s return to work or derail it. Knowing about them will enhance your ability to relate empathically with your employee and support them, which is a key ingredient for a working relationship built on trust. This in turn can enhance employee engagement and loyalty. The earlier posts are here, here and here

Our biases can impact how we treat employees

As part of supporting an employee returning to work after a serious health issue, one of the topics I’ve written about has been how not to say the wrong thing. I’m continuing this theme but from the perspective of how unconscious biases and assumptions we hold around health, illness and disability can impact what we say.

My starting point is to look at some of the most common unconscious biases we hold as a society. These messages surround us and can sometimes impact what we believe, think and say. The aim is to deepen our awareness to enable us to make mindful choices about what we say and do when supporting a colleague who is returning to work after a serious health issue.

This week I am sharing two prevalent biases. In two weeks, I’ll share three more and offer questions you can ask yourself to uncover the unconscious biases around health, illness and disability you may hold.

avoiding acting on unconscious biases

Don’t think I will put my foot in it today.

Unconscious Bias 1 – Having had a serious illness or acquired a disability means you can no longer work

Consider a man in his mid 40’s who works in a large organisation in a senior position and the organisation’s culture has a reputation for being demanding and stressful. He looks in good physical shape but unexpectedly has a serious heart attack.

Or a person has a car accident and is paralysed as a result.

A common assumption I’ve come across in this instance is the person needs to change their life completely including giving up work. This reminds me of the statistic that ‘42% of disabled people seeking work found the biggest barrier were misconceptions about what they can do’ (ACAS, 2016).

That is a key point.

What do we assume of people’s abilities after they have experienced a serious health issue?

unconscious biases about disability in the workplace

Picture obtained from ACAS Twitter feed @acasorguk (14-Mar-2017). Myth statistics come from the report ‘Disability Discrimination: Key points for the Workplace’ published September 2016.

Although significant changes to one’s life may be needed, returning to work can be possible. With many health issues, people’s physical capabilities are affected temporarily (sometimes for several years) or permanently, but their cognitive capabilities are not. With other health issues, a person’s cognitive capabilities are impacted, but they can employ strategies to manage them so they can continue to work.

The return to work may take time. I’ve seen a gradual return take a year. Adaptations may be needed to physically change the workplace so it is accessible. To alter how things are done (adjusting hours, working from home, adjusting existing role, moving to a new role). Or equipment may be needed to help the person do their job (e.g. voice to text software, standing desk).

Biases can relate to specific illnesses and injuries

There can also be assumptions related to specific illnesses, for example heart attacks which happen at an age you don’t expect it to.

  • Young people don’t get heart attacks. – They do. Strokes too. Many illnesses do not practice age discrimination.
  • The stress of the job caused the heart attack. – Not always. It might be a contributing factor, particularly if it has led to unhealthy eating and drinking habits and little or no exercise. The person’s medical history, family history, and any current medical issues which may have gone undiagnosed could also be contributing factors. But sometimes illnesses can unexpectedly happen and there is no known cause.

Unconscious Bias 2 – For an illness/symptom to be valid, it must be visible

This is a pervasive bias in our society. The impact of illnesses like Chronic Fatigue Syndrome, Myalgic Encephalomyelitis (M.E.), Transverse Myelitis, and Multiple Sclerosis for some people can be invisible. Sometimes you may hear people say, ‘Well, s/he looks well,’ in a quizzical tone of voice and look in the eye. I’ve had many people tell me the response to them saying they have chronic fatigue is, ‘You never look tired,’ or ‘We are all fatigued.’

Imagine hearing that over and over again. You start to feel as if you have to prove that yes, you do have a health issue. It can over time lead to a deterioration in working relationships.

One reason for unpleasant responses could be people experience anxiety (sometimes unknowingly) over not knowing how to respond

When you can see something, like a person on crutches, you have some ideas on how to respond, you open the door for them.

When you cannot see something, you can feel less clear on what is real or not, what is happening and what you could do in response. Many people like to know and feel certain because it gives them a sense of control, it is reassuring.

Educating colleagues so they understand the impact of the condition and that the person can look well on the outside, but inside feel very unwell, and how they can support the person and each other can help. This can enable the team to continue focusing on what they can all do and performing as a team. Rather than only focusing on what one person cannot do.

However, some people will not want to disclose information about their health issue and how they are affected.

There can be many reasons for this, some which are a desire for privacy, to be seen as normal and just like everyone else, not wanting to respond to questions which may be felt to be too personal, not wanting to talk about it because it makes the health issue that much more real, or the person is tired of talking about it. Whatever is said, it must be agreed with the employee. And as the line manager, you can still promote the two-way street of support among all team members.

Team work sharing the workload

The ideal – supporting each other. Drawn by B Babcock 2017

This invisibility bias points to related assumptions in our society. But I will address them in two weeks. In the meantime, consider what can happen if someone acted on these assumptions when supporting an employee returning to work after a serious health issue.

What’s it like for you?

Have you seen these two unconscious biases in action in the workplace? Or others? What was the result? Feel free to share here. Just make sure examples cannot name companies or people.

If you have an employee returning to work after long-term sick leave and want some support to ensure a smooth transition, have a look at how we can work together and get in touch for a free no obligation consultation.

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© Copyright Barbara Babcock 2017


Disability discrimination: Key points for the workplace, ACAS, September 2016 (Downloaded 14 March 2017 from

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