How to convince my GP to write me a note excusing me to work shiftwork

I am close to my early 50's. I have never worked shift work a day in my life. It's always been a desk type job. I have sleep apnea that isn't controlled very well by cpap therapy...that's been going on for almost a decade. My sleep is typically very fragmented. I am predisposed to depression but not depressed or taking any meds. I have off and on bouts of inflammatory bowel disease. My blood pressure is mildly high and I am somewhat overweight due to a recent issue with my back. We presently live in a hi-rise apartment where often maintenance is done during the day. Sleeping during the day is usually not feasible, especially since I am light sleeper.

There have been major cuts at my job. The HR department asked me to consider a shift work position where they have been trying to fill permanently for the last two years. The job is very stressful and has high demands. I told them that if they chose me, that it would be detrimental to my health. They then told me to get a doctor's note to support that. With their logic and mindset, I don't think they care if I fail at that job because they can turn around and lay me off due to incompetence. Or if my medical condition worsens, then I'd have to leave any ways. It's a win-win situation for them because they will have someone in the position (temporarily) and then they'll do the same to the next person.

Does anyone have an compelling arguments that I could use to persuade my GP to write me a note? A colleague of mine asked her GP and she was denied because she currently has no health issues.

I find being straightforward

I find being straightforward with doctors the best approach when you need a note. If your GP is already familiar with your medical issues, and you don't come in every month asking for notes, I would think that getting a note wouldn't be a problem.

Good luck!

Dear Lpevo, You already

Dear Lpevo,

You already presented valid compelling arguments I am only articulating them aloud for you :

A. From what you said , one of the main treatment means as well as treatment outcomes for OSA (sleep apnea) would be to increase the amount and quality of one's sleep.
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A1 Quote : ".My sleep is typically very fragmented. We presently live in a hi-rise apartment where often maintenance is done during the day. Sleeping during the day is usually not feasible, especially since I am light sleeper."
-- Firstly You could say to GP that nightshift would lead to further disruption in your sleep patterns for several reasons ://noisy environment maintenance work etc , //your biorythm is already less than ideal (v light sleep etc) imagine adding circadian sleep disturbance to the mix. //Also does your wife help you usually with the CPAP machine during the night but she works dayshifts ? noone to help you monitor it?
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A2. Quote :".I have sleep apnea that isn't controlled very well by cpap therapy"...
--Add to your partially (poorly treated) OSA the new sleep difficulties created by night shift your OSA woukd get even worse
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B. OSA. Is a serious illness. If treated inadequately this could lead to serious complications
B1 ."I am predisposed to depression(aka low mood, stress).My blood pressure is mildly high "
--If your OSA. gets worse this would translate into an increase in the severity of the OSA complications that you've already developed.
--"I have on and off bouts of inflammatory bowel disease: This sounds as disabling as your OSA ?And aren't stress and insomnia well-known triggers for flare-ups ?
---I found this interesting quote online unfortunately the article was about 7 years old : "Significantly higher severity of OSAS during daytime sleep after night shift may intensify unfavorable health effects of OSAS. Patients with OSAS if not effectively treated should avoid nighttime work."

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B2. "With their logic and mindset, I don't think they care if I fail at that job - because of worsening OSA- because they can turn around and lay me off due to incompetence. Or if my medical condition worsens, then I'd have to leave any ways. "
-- Just tell this to your GP . Worries about decreased work performance etc due to a worsening medical condition(with the associated tiredness, decreased concentration etc) are entirely legitimate.

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C.Miscellaneous
C1. "The HR department asked me to consider a shift work position .The job is very stressful and has high demands. "
- I think the first phrase stands for a good argument .
- The second phrase stands for a trickier argument. Your main worry about night shift is the biological dysfunction that it might create (ie Change in the night-day biorythm,hormonal changes melatonin etc) . The type of work ( more stressful or demanding) would be problematic only because you would be doing it at your worst (at night) ; you could handle it well if you would be doing it at your best(during daytime) . If you'd want to bring this up be careful how you phrase it so that ppl understand what you actually mean by it versus a misinterpretation like " he wants to avoid hard work"
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C2.At the same time you wouldn't want for your GP. to overzealous and write something like " He is Overall impaired by his illness" instead of. smthg like "He would be able to perform at an adequate or good level provided that he receives adequate treatment and the reasonable ADA's accomodations -ie no night shift- "
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C3This is unrelated to your question but you mentioned " I have sleep apnea that isn't controlled very well by cpap therapy..." You might want to flag it with your GP(perhap he needs to optimise your treatment)?

- This may add another layer ie your employer has the duty to provide reasonable accomodations for your illness versus the employee has the duty to take steps towards adequate treatment of his condition or something like that.__

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Please take my personsl suggestions with a grain of salt draw your own conclusions hope that someone with more expertise would be able to advise you

1. The bottomline is that you

1. The bottomline is that you are mainly worried about your job security/ your livelihood . Therefore , you can't afford taking any risks with regards to your health(ie ill-effects of night shift/ or of irregular schedule that add to your pre-existing disability 2ry to OSA) . Poor health inevitably leads to poorjob performance this would affect your employment status. Your doctor and any reasonable person should agree with your viewpoint.

2. In the unlikely event that your dr. would hesitate to issue a certificate I'd confront him with a more recent articlethat supports your view. For example http://www.sleepeducation.com/news/2011/03/22/shift-work-may-cause-swell-in-sleep-apnea-symptoms or an article of your choice
(This article would apply to you as well because at the moment your OSA is only partially(or poorly) treated
3. If you are in one of those unfortunate positions bad GP , callous employers… … hope not..
I. was reading that OSA can cause significant disability / complications but thatsome employers are poorly educated in this regard hence the potential for discrimination .
I found some interesting links hope others ie MicOnTHeNorthShore might be able to provide you with more pertinent advice:
- http://www.apneasupport.org/worried-about-my-job-t31182-15.html. If you look at the 3rd post the mod gives some good advice
- http://www.discriminationattorney.com/lawyer-attorney-1289001.html
- http://askjan.org/media/sleep.html

Ipevo, I think jaja gave you

Ipevo, I think jaja gave you some good ideas on working with what you already know.

One of them included researching a website wherein rights pursuant to the Americans with Disabilities Act was cited. Thus, my question, which side of the border are you on?

I did a little searching to see what medical problems were typically associated with shift work, particularly the night shift. It seems that the disorientation in one's lifestyle and circadian rhythms creates a good deal of cardiac stress, placing some patients at increased risk.

How is your heart? Do you have a personal or familial history of increased risk? This is something you may wish to explore with your physician, along with the health costs associated with possible increased sleep apnea. Sleep apnea can be quite serious.

Your physician should be able to calculate your cardiac risk, depending on your current health, lifestyle, and family history, and compare that to estimated risk associated with working nights. An increased risk of sleep apnea or cardiac stress (or both) might warrant avoiding changes leading to that stress, with a physician's note to your employer in support of such.

Thank you for advising her ,

Thank you for advising her , and after reading your suggestions I realised that I was a bit superficial also unclear.
- Indeed the GP and the client would be able to arrive to a joint impression re suitability for shift work, as there are # degrees of severity according to cardiac risk etc.
- In the case of family practitioners , I think that the main problem arises from the fact that they have busy schedules and only 15 minutes or so allowed per consultation . Cases from both ends of the spectrum (v unwell or doing well) are easier to decide upon whereas the in-between ones would be more time-consuming.
- The client could help her case & help the GP in the process as well by researching the topic " OSA+shift work" & presenting all her relevant clinical information in a succint and clear manner

WOW!! Good Luck, JsJs.

WOW!! Good Luck, JsJs.

Thank you everyone! You're a

Thank you everyone! You're a very very smart and helpful bunch of people!!!

So I finally got to see my GP and he was wonderful. Unfortunately, my HR department adviser is a real d ouche bag and is looking for a way to terminate my employment. I really think she's out to get me for bringing up several improprieties of the department to the the manager who of course, made excuses and made no changes.

The latest gong show event is HR is refusing to accept my MD's note. Instead, she insists on HR (herself)creating forms for me to have my doctor complete (at my expense) to show what my limitations are to "reaffirm what he wrote" and some other legalize wording.

It's like, hello!?? I have no limitations. I have a restriction that I can't work shift work. Even the hiring manager who I spoke to said that HR adviser simply doesn't "get it" that there are health risks associated with shift work. Both I and my GP agree that I have no limitations now but once I start working shift work, I will. And based on current literature the damage might be irreversible should I be forced to work shift work. I see no logic in that women. How is forcing someone who has medical restriction from working shift work beneficial to the unit, and organization? Never mind myself...HR looks out for the best interest of the employer, not employee.

Unless I am mistaken though, there IS a difference between limitations and restrictions? Also, I am trying to arrange a one-on-one meeting with upper management and bring them up to speed about all this. I was thinking of using an analogy should he (very likely) choose to defend HR's actions like someone who has a lung problem or COPD being forced to work in an asbestos mine when they never worked in a mine before. However, I don't like that example. Any better ones and suggestions you have?

I'm glad your doctor was

I'm glad your doctor was helpful.

I have had to talk to the "supreme" boss several times about my health concerns. Again, I have found being forthright has been the best approach. Don't go with the analogy if you're not comfortable with it. Don't attack the HR woman, simply say, IF asked, that she seemed to have a lot of questions. Concentrate on your relationship with the employer--you recognize that he may have questions and you wanted to speak to him directly.

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