Tuesday, 13 October 2026
Medical Termination Is Not About Illness. It Is About Capacity.
Most termination situations involve something the employee did, or failed to do.
Medical termination is different.
There is no misconduct. No poor performance. No deliberate breach of trust. The employee may have spent years giving the role everything they had. And yet the employment relationship may still have to end. Not because of anything that went wrong, but because of something that changed.
Understanding this properly is the first step to handling it correctly.
What medical termination actually involves
Medical termination arises when an employee is unable to perform the essential functions of their role due to a medical condition. It is not disciplinary termination, business restructuring, or contractual expiry. It sits in its own category, governed by its own logic.
The central question is not: what is the employee’s diagnosis?
It is: can this employment relationship realistically continue, given what the employee’s medical condition means for their capacity to work?
That distinction matters in practice. Illness alone does not justify termination. What matters is functional impact – what the employee can and cannot actually do in the role. And that conclusion must be supported by objective evidence.
The role of medical evidence
Medical certification from a registered practitioner is the evidentiary gateway to medical termination.
This has a practical implication most employers miss. A diagnosis, on its own, is not enough. What the employer needs to demonstrate is not that the employee has a particular condition, but that the condition prevents them from performing the essential functions of their role.
Equally, assertions of incapacity without medical support are rarely defensible. Courts and tribunals expect a grounded evidentiary basis, not management impressions of what the employee seems capable of.
Medical label is not the same as medical evidence. The evidence has to translate the diagnosis into functional impact.
The spectrum from temporary to permanent
Medical incapacity is not binary.
At one end, an employee is unwell but expected to recover within a defined and reasonable period. The employment relationship is intact. Temporary leave, managed carefully, is the appropriate response.
At the other end, incapacity is permanent or effectively irreversible. The employment relationship has reached its natural limit.
Most difficult cases fall somewhere between these two extremes.
The law does not require proof of permanent incapacity before medical termination can be justified. It requires a reasoned assessment of whether continued employment is realistic, taking into account how long the incapacity has already lasted, what the medical prognosis says, and what the operational reality of the role demands.
What the law expects is not certainty. It is judgment that is grounded in evidence, applied with fairness, and documented.
Why it is difficult
Medical termination is among the most difficult decisions an employer can face, precisely because no one has done anything wrong.
The employer is not asserting misconduct. The employee is not at fault. And yet the situation may have reached a point where continuation is not possible. It is not because anyone failed, but because capacity has been lost.
Employers who approach this well do so by keeping the question factual: not what happened to this person, but what is now possible. Not character. Capacity.
In the next article, I look at how employers navigate medical termination in practice: prolonged illness policies, the hidden risks of light duties, and why the language in a termination letter can be the most legally consequential thing an employer writes.