Preventive medical examinations

General rules for occupational medical examinations

You cannot permit workers to work without valid medical certificates stating that there are no contraindications to working in a specific position.

Workers must undergo medical examinations. Refusal to comply with employers’ instructions to do so is regarded as failure to comply with work-related instructions and may constitute the basis for the termination of employment contracts by employers without notice due to a serious breach of workers’ basic obligations.

Please note! During employment relationships, workers must undergo periodic medical examinations and check-ups (after at least 30 days of absence due to illness). If workers do not undergo medical examinations through their own fault and certificates are not issued, they will not receive remuneration for the time not worked for this reason.

Pre-employment examinations and then periodic examinations and check-ups, as well as other health services are performed by health care establishments (occupational health care services) under written contracts concluded by employers.

As a rule, periodic medical examinations and check-ups are performed during working hours. Workers retain the right to remuneration for the time not worked in connection with examinations, and if they need to travel to another location for these examinations, they are entitled to reimbursement of the travel costs in accordance with rules applicable to business travels.

Examinations are performed:

• at the expense of employers
• where possible, during working hours
• with remuneration for absence from work due to the examinations being retained (unless workers did not undergo the examinations through their own fault)
• with travel costs necessary to perform the examinations being reimbursed
• on the basis of referrals from employers (three copies: for a worker, for a health care establishment and to personal file).

Referral for examinations

You must issue three copies of a referral for examinations – the first copy for a health care establishment and the second copy for the future worker, while the third copy must be included in the personal file, when:

• a worker is employed
• an adolescent worker is transferred to another workstation
• another worker is transferred to a workstation at which factors harmful to health or arduous conditions are present.

The referral should:

• specify the type of preventive examination to be performed
• specify the workstation at which that person is to be employed – you may indicate two or more workstations in the referral, ranked according to your establishment’s needs
• contain a description of working conditions – the description should include information on the presence of hazardous factors, factors harmful to health or nuisance factors and other factors resulting from the way in which work is performed at the workstation or workstations. Exposure levels and current results of tests on and measurements of the factors harmful to health carried out at these workstations must also be provided.

See a model referral for examinations.

Pre-employment examinations

The following persons are subject to pre-employment medical examinations:

• newly employed persons
• adolescent workers transferred to other workstations
• other workers transferred to workstations at which factors harmful to health or arduous conditions are present
• persons employed to perform particularly hazardous work (regardless of the examinations they have undergone).

The following persons are not subject to pre-employment examinations:

• persons re-employed by the same employer in the same position or in a position with identical working conditions within 30 days after the previous employment relationship is terminated or expires
• persons newly employed by another employer within 30 days after the previous employment relationship is terminated or expires if a valid medical certificate states that there are no contraindications to working under the conditions described in a referral for medical examinations and the employer regards these conditions as comparable to the proposed position
• persons who are newly employed but remain in an employment relationship with another employer. The employer requires that such a person submit a valid medical certificate stating that there are no contraindications to working in the position concerned and a referral for examinations on the basis of which the certificate was issued.

This rule applies accordingly to persons who are newly employed but remain in an employment relationship with another employer.

The employer requires that such a person submit a valid medical certificate stating that there are no contraindications to working in the position concerned and a referral for examinations on the basis of which that certificate was issued.

Periodic examinations and check-ups

The following persons are subject to periodic examinations:

• periodically, all employed workers, within deadlines specified by occupational health physicians in certificates stating that there are no contraindications to work
• workers exposed to carcinogenic substances and agents or fibrosis-causing dust, also after they stop performing work as part of which they came into contact with these substances, agents or dust and after the employment relationship is terminated, if they request such examinations.

The following persons are subject to check-ups:

• workers who are unable to work as a result of an illness lasting longer than 30 days.

Please note! If symptoms of an emerging occupational disease are found in a worker, the employer should, on the basis of a medical certificate, assign the worker to another job where that person is not exposed to the agent that has caused these symptoms (within the time and for the period specified in that certificate). The worker is entitled to a compensatory allowance for a period not exceeding 6 months if the transfer to another job results in a reduction in remuneration.

Sanitary and epidemiological examinations

Persons who take up or perform work involving a risk of transmission of an infection or an infectious disease to other persons (for example, work in the catering industry or work with food products) must, on the basis of a referral from the employer and at the employer’s expense, undergo compulsory sanitary and epidemiological examinations.

Sanitary and epidemiological examinations are performed by accredited laboratories:

• of the State Sanitary Inspectorate or the Military Sanitary Inspectorate and other laboratories, under contracts concluded with these authorities
• units responsible for treating lung diseases and tuberculosis – in the case of examinations for tuberculosis, under contracts concluded with the competent authorities.

The results of examinations are submitted to the examined person and the employer (or the contracting authority) in the form of a medical certificate.

The medical certificate states:

• that the person is able to perform work involving a risk of transmission of an infection or an infectious disease to other persons
• that there are temporary or permanent contraindications to performing work involving a risk of transmission of an infection or an infectious disease to other persons.

Persons for whom temporary or permanent contraindications to performing work involving a risk of transmission of an infection or an infectious disease to other persons exist cannot perform this work. As an employer, you cannot assign such work to them, while maintaining confidentiality.

Medical certificate

A medical certificate is issued at the end of examinations. It states:

• that there are no contraindications to working in a specific position, or
• that there are health contraindications to working in a specific position – under the working conditions described in the referral for the medical examinations.

The physician issues two copies of the certificate: for the examined person and for the employer, who includes the certificate in the worker’s personal file.

An employee whom you have referred for a pre-employment, periodic medical examination or for a check-up may be referred by a physician, with the employee’s consent, to participate in a health program or health policy program. However, in the medical certificate the physician will not take into account the results of examinations or check-ups carried out under health programs if they do not overlap with the mandatory examinations and check-ups carried out under your referral.

The physician may also issue a referral for other examinations for the purpose of issuing a medical certificate regarding contraindications to working in a specific position under the working conditions described in the referral.