Return to Work Assessment – Case Study
Return to Work Case Study: Supporting a Safe Return to Work Following Above-Knee Amputation | Bespoke Wellbeing
Case Study — Occupational Health Assessment: Supporting an Employee Return to Work after an Above-Knee Amputation
At Bespoke Wellbeing, our purpose is simple: to make a positive difference to people’s lives through practical occupational health physiotherapy.
This case study shows how a return-to-work occupational health assessment helped a manufacturing employee safely return to work following an above-knee amputation. It demonstrates how clinical reasoning, clear workplace recommendations, and a structured phased return plan supported both the employee’s recovery and the employer’s duty of care.
Referral
A manufacturing company referred a Spray Booth Operator to Bespoke Wellbeing for a return to work occupational health assessment following an above-knee amputation related to a circulation condition.
The employee had been absent from work for several months and was progressing through rehabilitation with NHS prosthetic services. Their employer wanted clear guidance on whether a return to work was possible, what workplace adjustments might be required, and how to reduce the risk of injury during recovery.
The referral asked us to assess:
- current fitness for work
- functional limitations
- manual handling capacity
- safe workplace adjustments
- recommendations for a phased return to work
A virtual assessment was arranged with one of our Specialist Occupational Health Physiotherapists.
The Assessment Findings
During the occupational health assessment, we reviewed the employee’s current mobility, rehabilitation progress, and the physical demands of their role in the workshop environment.
At the time of the assessment the employee was primarily using a wheelchair while continuing prosthetic rehabilitation.
One important clinical observation was the employee’s strong upper-body strength and independence with transfers, which meant they could safely perform seated work tasks and move between workstations if the environment allowed sufficient space. This type of functional observation is important in return-to-work assessments, as it shows what someone can do rather than focusing only on limitations.
However, the assessment also identified several challenges that needed to be addressed before returning to work:
- limited tolerance for prolonged standing
- reduced ability to carry out manual handling tasks
- difficulty kneeling or working at floor level
- fatigue linked to ongoing rehabilitation
The employee also described periods of low mood during recovery, although they were already receiving appropriate support through NHS services.
Taken together, the findings suggested that a return to work was possible, but only with clear adjustments and a gradual increase in duties.
Return to Work Recommendations
Following the assessment, we advised that the employee was fit for work with adjustments.
The priority was to allow the employee to return to work in a way that supported rehabilitation while protecting them from unnecessary strain or fatigue.
We recommended:
- predominantly seated, bench-based duties initially
- avoiding heavy manual handling tasks
- temporarily removing kneeling and floor-level work
- regular rest breaks during shifts
- adapting the workstation to ensure wheelchair accessibility
- reduced working hours at the start of the return
A six-week phased return to work plan was proposed.
The first stage involved short shifts and seated workshop tasks only. As confidence and stamina improved, working hours and activity levels could gradually increase. The final phase focused on reviewing the long-term suitability of the role once prosthetic rehabilitation progressed.
We also advised the employer to complete:
- a workplace ergonomic assessment
- a manual handling risk assessment
- a Personal Emergency Evacuation Plan (PEEP)
- an accessibility review of the workshop environment
These steps helped ensure the return to work process remained safe and aligned with occupational health and Equality Act responsibilities.
Occupational Health Outcomes
THE EMPLOYEE — The employee was able to plan a realistic return to work rather than feeling uncertain about whether work would still be possible. Having a phased approach meant they could rebuild stamina while continuing rehabilitation and remain connected to their workplace.
THE REFERRER — The referrer received a detailed report explaining both the employee’s limitations and their remaining capabilities. The recommendations translated clinical findings into clear workplace actions, which made the return-to-work plan easier to implement. This gave management confidence that they were meeting their duty of care while keeping a skilled and experienced worker in the organisation
THE CLINICIAN — The physiotherapist’s role was to look beyond the diagnosis and focus on functional ability. By analysing how the employee could move, transfer, and work from a seated position, the assessment identified practical options that a standard tick-box review might have missed.
Why This Case Matters
Serious health changes can create uncertainty for both employees and employers.
This case shows how a structured assessment can bridge that gap. By focusing on functional ability and realistic workplace adjustments, it allowed the employee to remain in work while continuing recovery.
As one of our clinicians reflected afterwards: “The goal is always to help someone see what is still possible and build a safe path back to work.”
Need support with a complex return to work assessment?
If you have an employee who needs a specialist return to work – occupational health assessment – contact us to discuss your requirements – appointments@bespokewellbeing.co.uk.