Functional neurological disorder, or FND, can affect movement, sensation, speech, thinking or episodes such as functional seizures. The pattern and impact vary between people and can vary for the same person over time. An employer does not need to become a medical expert. It does need a reliable way to understand how the work affects the individual, make fair employment decisions and control any foreseeable safety risk without turning a diagnosis into a blanket restriction.
Understand FND without trying to diagnose it
FND is a neurological condition involving a problem with how the nervous system functions. NHS information describes symptoms including weakness, movement difficulties, sensory changes, cognitive problems and functional seizures. The symptoms are real; they are not something a manager should dismiss as imagined, exaggeration or poor attitude.
The diagnosis also does not tell you what a person can safely do. One employee may have predictable fatigue and occasional weakness; another may have variable speech, concentration or episodes of altered awareness. Ask about the effect on work, what the employee already knows helps, and whether occupational-health or treating-clinician advice is needed. Do not ask a manager to decide whether an event was epileptic, functional, a faint or something else.
Keep language neutral. Record observed facts and the employee's own account rather than labelling behaviour. This helps protect dignity and produces better information for any occupational-health referral or safety review.
NHS Inform: functional neurological disorder ↗ · Related guide: occupational health referrals →
Hold a private, work-focused conversation
Start with the employee's role and experience: which tasks are reliable, which are difficult, whether symptoms fluctuate, what warning signs they recognise and what support would make work more manageable. Ask only for health information that is relevant to the decision. A diagnosis rarely justifies circulating a detailed medical history to supervisors or colleagues.
Agree who needs to know what. A line manager may need an instruction such as allowing an unscheduled break, using a buddy for a particular task or following an emergency plan. They will not usually need the full clinical background. Record the arrangement, the purpose, who owns each action and when it will be reviewed.
If the employee is absent or returning after a change in symptoms, use occupational health to clarify functional capacity, likely duration, adjustments and review points. The referral should ask practical questions rather than requesting a judgement about whether the condition is genuine.
Review risk around the actual job
HSE says there is no automatic legal requirement for a separate disability-specific risk assessment, but an employer that becomes aware of a disability should review its existing assessment to make sure relevant risks are covered. Where the general assessment does not resolve an individual's needs, a concise person-specific assessment is a sensible way to record the additional controls. Involve the employee and keep the focus on work, not diagnosis.
Consider the consequences if weakness, reduced awareness, sensory change, fatigue or concentration difficulty occurred during each material task. Relevant questions may include lone work, driving, work at height, open water, hot surfaces, moving machinery, sharp tools, stairs, manual handling and the ability to raise an alarm or evacuate. A Newcastle office role and a Teesside production role will produce different decisions even where the health condition is the same.
Controls should be proportionate: changing the sequence or timing of work, planned recovery breaks, limiting a defined high-consequence task, improving access or seating, providing a buddy for particular activities, or temporarily reallocating part of the role. Avoid a vague conclusion such as 'not fit for safety-critical work'. Name the task, hazard, evidence, control and review date.
HSE: reviewing risk assessments for disabled workers ↗ · Related guide: getting risk assessments into the workplace →
Turn functional effects into a proportionate workplace plan.
HR + SAFETY can help coordinate an individual risk assessment, practical controls and occupational-health questions without making assumptions about the diagnosis.
Discuss an FND workplace assessmentCreate an agreed episode and emergency plan
Where episodes can affect movement, responsiveness or awareness, agree a short plan before one happens. It should set out the person's usual presentation, how colleagues should protect them from immediate harm, what helps or should be avoided, who to contact, what recovery support is useful and when the situation moves beyond the usual plan into a medical emergency.
Do not invent an FND-specific time rule or assume every event is covered by the known condition. Clinical advice should inform the personal plan. Call 999 for a life-threatening emergency and follow NHS advice where an episode is new, atypical, involves serious injury or breathing difficulty, or the person does not recover as expected. First aiders should work within their training and protect the person from hazards rather than restraining them or forcing anything into their mouth.
Keep the plan accessible only to people who need it and rehearse the operational parts discreetly. If the workplace, symptoms or advice changes, update the assessment, first-aid arrangements and emergency instructions together.
NHS: when to call 999 ↗ · Related guide: workplace first-aid needs assessment →
Make adjustments and equality decisions individually
FND is not automatically a disability in every case. Under section 6 of the Equality Act 2010, the question is whether a physical or mental impairment has a substantial and long-term adverse effect on normal day-to-day activities. Effects that fluctuate or recur can still be relevant. When the test is met, the employer has a duty to make reasonable adjustments; Acas also recommends considering support early instead of waiting for a legal dispute about the label.
Possible adjustments include flexible start times, extra breaks, home or hybrid work where suitable, reduced travel, a quieter work area, written instructions, adapted productivity measures, temporary changes to duties and a phased return. The right combination depends on the person's symptoms, the role and the employer's circumstances. Review whether the measure works rather than treating agreement as the end of the process.
Apply absence, capability and performance procedures with context. Establish the facts, consider medical advice and adjustments, and give the employee a fair opportunity to respond before making decisions. A safety restriction should not quietly become a permanent capability conclusion without proper review.
Equality Act 2010: disability definition ↗ · Equality Act 2010: reasonable adjustments ↗ · Acas: reasonable adjustments ↗
Respond properly after a workplace episode
First check welfare and follow the agreed plan. Then record the event factually: time, location, task, conditions, observed sequence, immediate action and outcome. Keep opinions about cause out of the initial record. If the episode exposed a control gap or someone was harmed, carry out a proportionate safety investigation and review the relevant risk assessment.
Separate safety learning from confidential medical detail. The team may need to know that a walkway, lone-working arrangement or emergency response is changing; they do not need the employee's diagnosis or clinical history. Health information is special-category personal data, so document the lawful basis and condition for processing, restrict access and retain only what is necessary.
ICO: data protection and workers' health information ↗ · Related guide: workplace accident-book records →
FND at work checklist
- Use the employee's account and appropriate clinical or occupational-health advice; do not ask managers to diagnose episodes.
- Identify the functional effect on each material task, including foreseeable high-consequence situations.
- Review the general risk assessment and record person-specific controls where needed.
- Agree an episode and emergency plan with clear escalation points and trained responders.
- Consider reasonable adjustments individually and review whether they work.
- Record incidents as facts, then investigate any control failure separately.
- Limit health information to people with a genuine need to know.
- Review after a change in symptoms, job, workplace, advice, episode or incident.
A sound FND response joins up HR, occupational health and safety without allowing one process to dominate. Listen to the individual, translate functional effects into task-specific decisions, agree what colleagues should do and review the plan when the evidence changes.
This guide provides general information for UK employers. It is not legal advice and should not replace advice based on the facts of a specific matter.