Occupational Health Care

Employers are legally obligated to provide occupational health care for their employees. The purpose of occupational health care is to prevent work-related illnesses and accidents and to promote the health and safety of work and the work environment. It is not the same as general health care. In addition to the statutory services, employers may choose to offer general or specialist medical care, but they are not legally required to do so.

Employer responsibilities

Employers must arrange occupational health care at their own expense to the extent necessary based on the work, working arrangements, staff, and workplace conditions. "Working arrangements" also include health risks and hazards related to temporary agency work, part-time work, and fixed-term employment. This includes, for example, the organization of working and rest times due to night shifts or overtime. Failure to comply with occupational health care obligations can result in a fine.

Employers and occupational health care service providers must enter into a written agreement detailing general arrangements, the scope, and the content of services.

If the employer organizes occupational health services internally, these arrangements must be described in a separate report or as part of the occupational health care action plan or the occupational safety program.

When making decisions related to occupational health care, the employer must cooperate with employees or their representatives. This is a legally sanctioned obligation. Cooperation means that employees have the opportunity to propose improvements and receive timely information about matters affecting occupational health, such as workload or similar factors.

Before making any essential decisions about organizing occupational health care, the matter must be discussed in the occupational safety committee or equivalent cooperation procedure, or with the occupational safety representative. In workplaces with fewer than 10 employees, where a safety representative is not legally required, employees must still be given a genuine opportunity to participate in the discussion.

Implementation of occupational health care

Employers must have a written occupational health care action plan. This can be part of the occupational safety program or another development plan. The action plan must include general goals, workplace-specific needs, and actions based on those needs.

If drug testing is planned for job applicants or employees, the employer must have a written substance abuse policy. The policy must describe the procedures for prevention and guidance for treatment. Positions requiring drug testing must be discussed in a cooperation procedure before implementing the policy. 

Occupational health care is based on a workplace survey identifying physical, chemical, and biological exposures; physical and mental workload; functionality of the work community; risks of accidents and violence; working arrangements; and specific disease risks due to the work environment or employee characteristics. Based on this, further occupational health care measures are determined.

The employer’s occupational health care includes:

• Evaluation of the healthiness of work and working conditions through regular workplace visits and other occupational health care methods
• Health assessments and evaluation of work ability, e.g., through health check-ups. Employees must not refuse these without justified reason
• Proposals for measures and follow-up, e.g., to improve safety, adapt work to the employee’s capacity, and promote work ability
• Providing information and guidance. For example, employees have the right to an explanation of their workload
• Monitoring the work ability of partially disabled employees and referring them for rehabilitation
• Participating in organizing first aid as required by occupational safety law
• Planning and implementing actions that support and promote work ability
• Evaluation and monitoring of occupational health care itself

In addition to statutory services, employers may offer general and/or specialist medical services. All employees must be treated equally regardless of whether they are permanent, fixed-term, or part-time.

Data processing

Employers are required to provide occupational health care providers with information about work, work arrangements, occupational diseases, work-related accidents, staff, workplace conditions, and any changes thereto.

Employees must, upon request, provide information about health hazards present in the workplace.

Occupational health care providers must inform both employees and employers about work-related health risks and how to prevent them. Employees must be informed about their health examinations and the results.

The employer, occupational safety committee, and occupational safety representative are entitled to receive information from occupational health care providers that is relevant to employee health and improving workplace conditions.

The general rule under the Occupational Health Care Act is that confidential information must not be disclosed without the written consent of the individual concerned.

Exceptions to confidentiality apply in cases involving particularly hazardous work. In such cases, the occupational health physician may provide the employer and occupational safety authorities with a written statement summarizing the results of health assessments. The physician evaluates the employee’s medical fitness for specific duties. In recruitment situations, the job applicant must be informed of the results first.