Phased return to work. Anyone done it? What does it entail?

[2kidsintow]

I've been off for 4 weeks (one of them half term) after developing and being diagnosed with trigeminal neuralgia.


I'm starting to reach a level of medication that is managing my pain. It has been very unpredictable, but I'm on day 3 of minimal pain now and am starting to feel that things are getting better. I have an MRI scan on Friday to see if they can find the common cause for most people's TN (a compression of the trigeminal nerve in the brain).

My headteacher has been wonderful and has offered to 'ease me back in gently'. I've never had a long term (ish) sick leave before - never even needed a sick note before in a 17 year career, so I'm not sure what that entails.

Do I need to have sick leave to cover the week(s) that the phased return would take place over.

Do I need to have a fit note that specifies phased return?

Do I need to accept phased return? Because my condition is purely a pain condition, I don't think that I'll be too wiped out by going back to work - no more than after the summer holidays, for example when life has been at a slower pace for a few weeks.

OR - Am I daft to turn down phased return? I could ask to be signed off the the next 4 weeks, which would take me up to the Easter hols. It would give me leeway to find out if my pain management is stable or adjust my dosage if it proves not to be, would mean I miss 2, 12 hour days when we have parents' evenings planned and would allow me to spend a few of those weeks returning on more hours per week. I could also get my scan without worrying about time off from work.

As well as the offer of phased return, the management at work have made me promise not to return until I am 100%, so I do need to make sure my pain is under control. It can be very unstable, I can think it's improving and then it dips.

Last weekend, I had upped my dose a couple of days before and had an amazing 2 days of minimum pain. Then I had a nightmare of a day on Monday this week with severe attacks (ear infection, toothache in every tooth, someone stabbing pins in my teeth and more!) every 45 minutes all day from the minute I woke to bedtime. I couldn't speak or concentrate and certainly couldn't cope with my class in that state.

What to do....

[gretagrape]

I had a phased return after a health condition and I felt it was definitely beneficial, for me and my company. I did a couple of weeks of 3 mornings, then 2 weeks of 5 mornings, then increased the hours gradually - I think all in all it took about 8 weeks to get back to full time and we adapted as we went by seeing what I could manage and going from there.
I had a fit to work note from the GP that specified I was only fit to work on part time hours, then it was up to me and occupational health to sort out the details.
You might not be physically tired out by going back full time straight away but if the pain is still a bit erratic then at least a phased return would allow you to see how you manage if you are at work with increased pain - it might be that you could actually cope with a half day, but if you just plough straight back in and you have a painful day then you might just think you can't cope with it at all.
I think your company is ridiculous to say you have to promise to be 100% better before coming back if it's something that might fluctuate (fair enough if it's a one-off flu or broken arm!) - that puts undue pressure on you and might make you feel vulnerable if you have to take time off later.

[2kidsintow]

Thanks for the advice.

To be fair to work, the 'come back when you are 100%' was voiced out of concern for me, not a worry about my reliability. I work in a small-ish school and we are all friends as well as colleagues.

It is in their interest to have me back when my pain is far more stable, teachers only get covered from the third day of absence. So that's why I was considering the 4 week request from the GP as it would give me plenty of time to finally get my dose right and check that I'm not getting breakthrough pain.

[Matildathecat]

If you are only on day three of reduced pain I would say it's too soon to be back at all. Pain conditions are notoriously difficult to predict or manage unfortunately. I'd be keeping a sharp eye and also eg increasing the amount of talking and moving you do to see if that makes a difference.

But overall, yes, phased return is a great option. I'm sure you will feel tireder that you think. Your colleagues sound nice .

Good luck.

[gretagrape]

Oh I got that context all wrong! You mean that they are nice enough not to put pressure on you to come back early - that's good then!

[2kidsintow]

It is good.
I've actually been signed off til the start of the Easter holidays by my GP to make sure I've given it plenty of time to get right. :)

The headteacher has again said that phased re-entry can be considered when I return. However, there are only 5 weeks of our next half term left - and one of them has a training day and one has a bank holiday... and I don't teach on a Friday either.
I shall mull on it over the next few weeks and see.

[legoplayingmumsunite]

I've not done it myself but have managed people who are having a phased return. I work for a large corporation so anyone who has had long term sick has to have an appointment with the occupational health department to plan their phased return to work, can you do something similar with the school nurse and head? Sometimes we do more than just phase the return, e.g. I had one employee who had someone else to work alongside them for the first few weeks. That gave them the freedom to work shorter days during the return period, knowing that the work would still be done when they weren't able to do it themselves.

I'd say don't rush back but whenever you go back have a phased return because working will tire you out and the pain will increase.