DID YOU KNOW THAT… an employee may be dismissed for medical inability to work if no reasonable accommodations are possible?

With Order No. 24994 of September 11, 2025, the Italian Supreme Court – labor division – clarified that although the employer has a duty to actively seek solutions to preserve the job of a worker who has become medically unfit, this obligation does not extend to imposing unreasonable organizational changes or creating positions that are not genuinely useful to the business.

In the case at hand, a female worker employed as a bartender, following a road accident, had been declared by the occupational physician fit to work but with significant restrictions: “total exclusion from manual handling of loads, exclusion from prolonged standing, cannot provide table service, should preferably be assigned to a seated position”. The employer, a company managing a hotel with bar and restaurant service, dismissed her for supervening medical inability to work, claiming it was impossible to reassign her to other compatible tasks.

The Court of Appeal, confirming the first-instance ruling, rejected the challenge to the dismissal. It held that the worker lacked the skills required for alternative roles (cook, receptionist, administrative staff) and that the other tasks available were incompatible with her health conditions, also ruling out the possibility of adopting reasonable accommodations.

The Supreme Court likewise dismissed the employee’s appeal, confirming the legitimacy of the dismissal. The Supreme Court reiterated the established principle that, in cases of dismissal for supervening medical inability to work, the employer must prove not only the impossibility of assigning the worker to compatible tasks (i.e. the so-called repêchage obligation, meaning the duty to attempt reassignment), but also the impossibility of adopting “reasonable organizational accommodations”, pursuant to Article 3, paragraph 3-bis, of Legislative Decree no. 216/2003. The burden of proof regarding the existence of a justified reason for dismissal lies entirely with the employer, who must demonstrate having made a diligent and reasonable effort to identify an appropriate organizational solution.

The Supreme Court further clarified that the assessment of the “reasonableness” of accommodations is a matter of fact, which can only be challenged before the Supreme Court for defects in reasoning. In this case, the Court of Appeal had carried out a detailed review of possible alternatives: assigning the worker to bar service, even with scheduled breaks, would still have required periods of standing incompatible with medical restrictions; assigning her to cashier duties, although theoretically a seated role, would have required administrative tasks beyond her professional expertise, resulting in an unreasonable alteration of the company’s organizational structure. Such options, imposing a disproportionate burden on the business, cannot be considered reasonable accommodations.

In conclusion, the ruling reaffirms that the duty of social solidarity and the protection of workers in cases of supervening medical inability to work require the employer to take an active role in seeking solutions to preserve employment. However, this obligation is not unlimited. Where the employer proves, as in this case, that any possible adaptation would entail a disproportionate burden or an unreasonable alteration of the company’s organization, dismissal for justified objective reason (i.e. giustificato motivo oggettivo) must be deemed lawful.