FND and Work: Reasonable Adjustments, Sick Leave and Access to Work

Is FND a disability at work?

FND is not automatically treated the same way for every person. The legal question is impact. GOV.UK says a person is disabled under the Equality Act 2010 if they have a physical or mental impairment with a substantial and long-term negative effect on normal day-to-day activities. "Substantial" means more than minor or trivial, and "long-term" usually means 12 months or more. The Equality Act does not apply to Northern Ireland, so people in Northern Ireland should use NI-specific advice routes.

FND can affect work through weakness, tremor, gait problems, functional seizures, fatigue, pain, dizziness, speech symptoms, cognitive symptoms, sensory overload, dissociation, migraine, anxiety around episodes, or recovery time after activity. The diagnosis matters, but the adjustment conversation should focus on the barrier: what part of the job is unsafe, unreliable, slower, inaccessible or triggering?

Examples include getting to work, standing at a counter, using stairs, handling hot equipment, concentrating in long meetings, managing screen time, answering phones during speech symptoms, staying safe after functional seizures, working under intense sensory load, or returning after a flare.

Should you tell your employer?

You do not have to tell an employer everything about your health. Acas says nobody has to tell an employer or potential employer that they are disabled. But once you do tell them, the employer has a legal responsibility to support you. In practice, an employer can only make useful adjustments if they understand the work barriers.

You can keep the explanation short. You might say:

I have Functional Neurological Disorder, a condition that affects how my nervous system functions. My symptoms are real and can fluctuate. At work it affects [attendance/travel/mobility/speech/concentration/safety]. I am asking for adjustments so I can work as safely and reliably as possible.

You do not need to share every medical detail. Share what helps the employer act: the functional impact, risk, adjustments requested, whether the issue is temporary or long term, and when to review the plan.

Reasonable adjustments that may help with FND

GOV.UK gives examples of reasonable adjustments such as changing recruitment processes, doing things another way, physical workplace changes, working somewhere else, changing equipment, and phased return with flexible hours or part-time working. For FND, useful adjustments are often practical and specific.

Not every adjustment will be reasonable in every job. A hospital ward, school, warehouse, call centre, office and self-employed role all have different constraints. The strongest request explains the barrier and offers a realistic way to reduce it.

A simple adjustment request template

Put the request in writing where possible. This gives everyone a record and helps avoid vague promises. Acas says requests can be made in writing, in a meeting, or through a formal workplace process.

Ask for a review date. FND can change, and an adjustment that works during a flare may need to be adapted later.

Occupational health and evidence

An employer may suggest occupational health. That can be useful if the report focuses on functional barriers and practical adjustments. Before the referral, ask what questions the employer is sending. If the questions are vague, suggest clearer ones:

• What symptoms currently affect the employee's work tasks, attendance, travel, mobility, concentration or safety?
• What adjustments would reduce risk or make work more reliable?
• Would a phased return, altered hours, home working or adjusted duties be appropriate?
• How should disability-related absence or symptom flares be reviewed?
• When should the adjustments be reviewed?

Medical evidence can come from a GP, neurologist, physiotherapist, occupational therapist, psychologist, speech and language therapist, FND clinic or mental health professional. A useful letter does not only say "has FND"; it describes the work impact and support needed.

Sick leave, fit notes and phased return

Employees can take sick leave if they are ill. GOV.UK says employees need proof if they are ill for more than 7 days. For sickness lasting more than 7 days in a row, a fit note may say the person is either "not fit for work" or "may be fit for work". If it says "may be fit for work", the employer should discuss changes that might help the employee return, such as different hours or tasks.

Fit notes can come from a GP or hospital doctor, registered nurse, occupational therapist, pharmacist or physiotherapist. That is useful for FND because a physiotherapist or occupational therapist may understand the functional work barrier more clearly than a short GP appointment can capture.

Statutory Sick Pay is paid by the employer if you are eligible. GOV.UK currently lists SSP as up to £123.25 per week for up to 28 weeks, and your contract may provide occupational sick pay above the statutory minimum.

If absence is disability-related, Acas says reasonable adjustments might include changing absence trigger points, increasing the number of absences before a review, or recording disability-related sickness absence separately. This is not a free pass for unlimited absence, but it does mean the employer should consider whether the normal absence process puts you at a disadvantage because of disability.

Access to Work

Access to Work can help you get or stay in work if you have a physical or mental health condition or disability. GOV.UK says support can include a grant for practical support, help managing mental health at work, and communication support at job interviews.

For FND, Access to Work may be relevant if you need specialist equipment, assistive software, a support worker, a job coach, a travel buddy, help with travel to work if you cannot use public transport, vehicle adaptations, or changes related to a home workplace. It may also signpost mental health support for staying in work.

Access to Work is not a replacement for reasonable adjustments. GOV.UK says it will not pay for reasonable adjustments, because those are changes your employer must legally make. The two routes can sit alongside each other: the employer considers reasonable adjustments, and Access to Work may help where extra funded support is needed.

If you are in Northern Ireland, GOV.UK points to separate Northern Ireland employment and Access to Work routes, so use nidirect rather than assuming the Great Britain process applies.

If work is becoming a problem

If you are being pressured to return too quickly, criticised for disability-related absence, refused adjustments, or pushed toward resignation, slow the process down and get advice before making irreversible decisions.

• Keep a timeline of symptoms at work, adjustment requests, meetings, decisions, absence dates and emails.
• Ask for decisions in writing, especially if an adjustment is refused.
• If an adjustment is refused, ask what alternative would address the same barrier.
• Ask whether occupational health, a union representative, HR, a disability passport or a return-to-work plan can be involved.
• Contact Acas, Citizens Advice, a union or an employment adviser before resigning, signing an agreement or missing a deadline.

GOV.UK says it is against the law for employers to discriminate because of disability in areas including application forms, interviews, terms of employment, promotion, dismissal, redundancy, discipline and grievances. It also says an employer has to make reasonable adjustments to avoid you being put at a disadvantage compared with non-disabled people.

Benefits if work is limited or stops

If FND limits how much work you can do, check benefits early rather than waiting until savings or sick pay are gone. Universal Credit may include an extra amount if a health condition or disability limits capability for work. New Style Employment and Support Allowance may be possible depending on your National Insurance record, and GOV.UK says it can be claimed on its own or at the same time as Universal Credit, although Universal Credit is reduced by New Style ESA received.

You cannot get New Style ESA while receiving Statutory Sick Pay, but GOV.UK says you can apply up to 3 months before SSP ends. PIP is separate from capability-for-work benefits and can be paid whether or not you are working if you meet the PIP rules.

What to ask your clinician when work is affected

Bring work problems into appointments. Do not just say "work is hard". Ask specific questions:

• Which symptoms should make me stop work immediately or seek urgent help?
• Would neurophysiotherapy, occupational therapy, psychological therapy or speech and language therapy help with work goals?
• Can my fit note mention a phased return, altered hours, amended duties or workplace adaptations?
• Could you write a short letter explaining the functional work impact and adjustments that may help?
• Should driving, lone working, machinery, lifting, heat, stairs or travel be reviewed for safety?

Occupational therapists can be particularly useful for FND because they look at daily activities, work, fatigue, cognitive barriers, aids, adaptations and graded return. Neurosymptoms notes that occupational therapists can help identify work or study impact, integrate symptom management strategies into tasks, liaise with employers or education providers, advise on reasonable adjustments and consider Access to Work.

Frequently asked questions

Sources and further reading

• GOV.UK: Definition of disability under the Equality Act 2010
• GOV.UK: Disability rights at work
• GOV.UK: Reasonable adjustments for disabled workers
• Acas: Asking for reasonable adjustments
• Acas: Disability-related absence
• GOV.UK: Access to Work
• GOV.UK: Taking sick leave
• GOV.UK: Statutory Sick Pay
• GOV.UK: Health conditions, disability and Universal Credit
• GOV.UK: New Style Employment and Support Allowance
• Neurosymptoms: Occupational therapy and vocational roles in FND