Shrnutí: Occupational health examinations are compulsory, especially for hazardous work and certain professions defined by law. It will not be compulsory for non-hazardous category 1 work from 2025. However, the doctor does not communicate your diagnoses to the employer – he or she only assesses whether you are medically fit for a particular job. We explain what rules apply to occupational health checks.
If you are dealing with a dispute with your employer over an occupational health examination, a refusal of an assessment or a question of fitness for work, you can consult an attorney online. We can help employees and employers assess whether the procedure was in accordance with the law.
The purpose of any medical examination is, of course, to determine the health of the client or patient. In this case, however, the aim is not so much to detect and cure a disease, but rather to rule out diseases or conditions that limit or prevent the applicant’s or employee’s fitness for a particular job. The employer is supposed to assign employees only to work that corresponds to their state of health.
However, each job involves different requirements for the employee’s medical condition. We can certainly imagine different criteria, for example, for the job of a police officer, a miner, an airman, a professional driver, or even an office clerk or telephone operator. While some require physical fitness, excellent eyesight and good health, others do not mind a few diopters, colour blindness or being significantly overweight.
Risk factors and a list of diseases that limit or exclude fitness for work are laid down in legislation.
You may now be asking yourself a worrying question: will my new employer now know all my current diagnoses? This is not a pleasant thought. You may have a history of illness that carries a certain stigma in society that you do not want to expose yourself to. And it doesn’t even have to be about diagnoses as serious as HIV or mental health problems – honestly, who wants to discuss, say, their skin problems, acid reflux or undergoing liposuction with colleagues at work? But you don’t have to worry about any of that.
As part of an occupational health examination, the doctor sticks to the framework of the job category your occupation falls into (there are 4 such categories in total). He or she will only assess whether you are fit to perform the job. He or she does not write the reason for your unfitness or any health problems that are not related to the job in the report. Even though he is an occupational physician who works closely with the employer, he must respect medical confidentiality.
In practice, we often see situations where employees are concerned that the employer will see their complete medical records or specific diagnoses. However, this is not standard in an occupational health report. Rather, the most common conflicts arise around the question of whether an employee is fit to perform a particular job and whether the employer has correctly assessed the job category.
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The general framework is mentioned in the Labour Code and the Specific Health Services Act. Specific legislation is mainly based on the Occupational Health Services Ordinance. The latter mainly lists the necessary medical examinations in connection with employment. These are the initial, periodic and emergency medical examinations, which are intended to assess health in relation to work as a precautionary measure, and the exit examination and the medical examination after the end of hazardous work, which are carried out to assess the state of health in order to determine whether, for example, the hazardous work has had a negative impact on it.
Tip: We have covered the Labour Code and its five most useful parts in our separate article. It includes a decree on medical records, which sets out all the information you are entitled to and how it is handled.
The range of people covered by each examination is determined primarily by the type of examination:
| Tour type | When it takes place | Is it compulsory? |
|---|---|---|
| Input | Before starting work | For hazardous occupations as defined by law |
| Periodic | During the employment relationship | For some occupations only |
| Extraordinary | When there is doubt about medical fitness | Yes |
| Exit | After completion of hazardous work | For selected occupations |
Employees must undergo an initial medical examination before starting work only in cases provided for by law, especially for hazardous work or occupations with special health requirements.
If the law or the employer requires an initial medical examination, the employee must undergo it. Therefore, you cannot refuse it, or theoretically you can, but the employer will probably not employ you because he/she may be penalised. However, if the employer requires specialist examinations, but these are not indicated by the assessing doctor, you are not obliged to undergo such examinations.
The purpose of the medical examination is primarily to determine whether the employee can perform the job, and there are several categories of jobs that have different requirements.
The employer is required to provide an initial medical examination:
A common mistake is that the employer requires further specialist examinations without the assessing doctor actually indicating them. The employee is not obliged to undergo examinations that are not related to the performance of the work or are not medically justified.
Tip: We have discussed agreements on work performed outside the employment relationship, i.e. the agreement on work activity and the agreement on the performance of work, in detail in our texts on the blog.
Your employer may have a relationship with a specific doctor to provide preventive health care or may refer you to your GP. Employees may be referred to a registering GP, particularly for Category 1 work or in other situations specified by law.
Your employer will usually provide you with a form requesting an initial medical examination, samples of which are available to download online.
The cost of an initial medical examination is usually around 500 crowns, but the employer should cover the entire cost of the examination. The applicant pays for the initial medical examination at the start of the employment relationship and the employer reimburses it after the employment relationship has started (but they can agree that it will be reimbursed even if the employment relationship has not started). If the check-up is arranged by your GP, he or she will usually provide you with a receipt which you will then have your employer reimburse.
If an employer fails to provide compulsory occupational health examinations where required by law, they may be guilty of an offence.
These examinations are not mandatory from 2023, but employers and employees can still insist on them. An exception is made for hazardous work, for which periodic examinations are still compulsory. Periodic medical examinations are intended to check whether the employee is still fit to perform the work in question.
However, the legislation quite logically sets different time periods for different positions. For example, while for a professional firefighter the period is 12 months, for a regular civil servant it would be 6 years. Whether the worker is under 50 or over 50 also plays a role. As the age increases, the interval shortens.
In some cases, it is also necessary to carry out an emergency medical examination if there are concerns that there has been a loss or change in fitness for work. This may be the case where the employee has not worked for more than 8 weeks after an accident at work with severe consequences or for other reasons.
The employer also has the right to order an extraordinary occupational examination if it has doubts about the employee’s medical fitness.
Has your employer questioned your medical fitness or forced you to undergo an examination you do not agree with? An attorney can help you assess whether your employer is following the Labour Code and the Specific Health Services Act.
Tip: If you fall ill during your employment, you are entitled to sick pay. We’ve explained the rules for taking it in a separate article.
An exit medical examination is carried out after the end of the work. This is legally obligatory, for example, if the employee has performed work classified under the Public Health Protection Act in the second, third or fourth risk category, or if an occupational disease or threat of occupational disease, if any, was recognised at the time of employment with the current employer.
If the doctor’s office hours and the employee’s working hours permit, the employee should be examined during his/her working hours (this does not apply to the initial examination, which takes place before the start of the employment relationship).
A work-related medical examination is considered to be an ‘other important personal obstacle to work’, where the employee is granted leave of absence for the necessary period of time.
As the above lines indicate, employers have two types of obligations. First, they must have a written contract for the provision of occupational health services and classify each of the jobs performed into one of four categories. Failure to do so exposes them to a fine of up to CZK 1 million.
In addition, employers must provide an initial medical examination and, where applicable, periodic, emergency, exit and follow-up medical examinations. If an employer fails to provide an initial medical check-up, he/she commits an offence for which a fine of up to CZK 2 million may be imposed.
Legal advice is particularly worthwhile if you:
Occupational health screening is an important part of the employer-employee relationship because it helps to protect the health of workers while helping employers meet their legal obligations. Initial, periodic and exit examinations have clearly defined conditions and rules based on the Specific Health Services Act. Whether it is for starting work, long-term health monitoring or termination of employment, it is always important to comply with the applicable legislation and to have everything properly documented.
No. The employer only receives information about whether you are medically fit to do the job.
The cost is usually borne by the employer. In the case of an initial examination, the applicant sometimes pays for it first and the employer then reimburses it.
Your employer is unlikely to be able to hire you because it would be in breach of its legal obligations.
It depends on the type of work and the risk category. For some professions it is renewed regularly.
Yes, if he has reasonable doubt about the employee’s medical fitness.
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Ondřej is the attorney who came up with the idea of providing legal services online. He's been earning his living through legal services for more than 15 years. He especially likes to help clients who may have given up hope in solving their legal issues at work, for example with real estate transfers or copyright licenses.
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