Occupational medicine

Occupational medicine is designated as a specialty of medicine aimed at addressing well-being needs. Another role of occupational medicine is to look after workers by highlighting their physical, mental, and social needs, regardless of their profession.

According to the World Health Organization (WHO), occupational medicine prevents various diseases and potential health problems. Among them are, for example, health impairments, protection against workplace accidents, and the establishment of a protocol ensuring the maintenance of employees’ physiological and psychological integrity.

France has a specific organization of occupational medicine governed by labor legislation. Consequently, medicine must benefit every worker, regardless of the company’s size. Occupational medicine is supervised by the staff union, the service in charge of the ministry, and social assistance.

Occupational Medical Examination

A medical examination at work is not complicated; its procedure is the same as with your doctor. However, do not forget to bring your health record book, documents related to your medical history, and your glasses. A medical assistant will take your medical file to consult and record information to create an official medical record.

A medical examination will take place upon your hiring. This term is governed by Article R4624-10 of the labor code. This legislation confirms the necessity of a medical examination for each employee at the time of hiring, either a little before or a little later, before the end of the probation period.

During the medical examination, the occupational physician identifies potential health problems of workers. At the same time, they ensure to prevent any deterioration of employees’ health. To do this, the physician monitors working conditions (hygiene, PPE, congenital diseases, communicable diseases) and the general health status. However, they do not perform regular medicine for clients.

An occupational medical examination takes place within 3 months following hiring. It is conducted by a nurse or a physician. However, minors and night workers must undergo a preventive medical examination before starting their position. At the end of the interview, a physician establishes a health assessment for an official medical record.

When to Consult Occupational Medicine

Don’t know when to consult occupational medicine? It is now possible to meet with occupational medicine at any time. However, we advise you to go only during opening hours. Note that the occupational physician should not be contacted in case of emergency care or medical problems and will not issue you a sick leave prescription.

According to the labor code, the information visit and the prevention visit must be spaced at least 5 years apart. However, for employees in fragile health or advanced age or working in hazardous conditions, the interval is reduced to 3 years.

Occupational Medicine: Is It Mandatory?

The question is as follows: does the law require the employer and the employee to undergo a medical examination at work? The answer is yes because the law is very explicit on the subject. Moreover, the visits confirm whether the employee is able or not to work in their physical condition and health status.

Here are the mandatory visits in occupational medicine:

Note however that an employer must guarantee the safety of their employees in their work environment.

Pre-employment medical examination

According to article R4624-10, the employee must undergo medical monitoring from the time of hiring. This action is called a “pre-employment medical examination.” It involves providing each employee with a medical examination before the hiring date or shortly after, that is, before the end of the probationary period.

Pregnant women, disabled persons, elderly people, and workers under 18 years old should be subjected to a more thorough medical check-up. Indeed, they are required to undergo a medical examination before starting their duties. This option also applies to employees on fixed-term contracts (CDD). These employees must, before the end of their probationary period, undergo a medical examination. This will also be the case for temporary workers or replacement workers.

Periodic medical examination: According to article R4624-16, the employer must offer their employee regular medical visits. These visits are generally spaced 2 years (24 months) apart and are conducted by an occupational physician. The goal is to maintain the employee’s medical fitness while they hold their position. The date of the first visit coincides with the 24-month period following the pre-employment medical examination.

Follow-up medical examination: This is a medical examination conducted for an employee who has been absent from their position to recover from a health problem. It is a mandatory check to determine if the employee is ready to return to work. The purpose of a follow-up medical examination is also to determine if the employee’s absence could potentially have a negative impact on the work.

Return-to-work medical examination: It is governed by article R4621-22 which obliges the employer to provide the employee with a return-to-work examination. The doctor then conducts the visits in the following cases: maternity leave, sick leave, work accident, non-work-related accident. This law stipulates that the convalescence medical examination must take place no later than 8 days after convalescence and the initiative belongs to the employer.

The pre-employment medical examination is mandatory but is there a way to be exempted?

According to article R4624-12, the labor code confirms the non-obligation of a pre-employment medical examination in the following 3 cases:

• The employee occupies the same position or the same job, which will also be the case for those who will hold a job in the same company or in the same company but relocated.
• In the case where the company’s occupational physician has a fitness certificate in accordance with law D4624-47.
• In the case where the last medical examination revealed no unfitness for work. Furthermore, the employee has been rehired for the same position and by the same employer for one year.

How to request occupational health services?

You can request occupational health services at any time. Therefore, the occupational physician must conduct a thorough medical examination. The employee can also decide to call upon an occupational physician when they feel unfit to continue their work.

He can then take legal action to both keep his job and receive personalized medical assistance. To consult an occupational physician, you will make an appointment by contacting the health service. In each company, you will see contact details displayed on your follow-up certificate or on your health record.

In the event that the employee has an emergency or an immediate health problem, he can call the doctor directly by phone. This action will not result in any sanction against the employee, but he must provide additional information to his employer about appointments taken during or outside working hours.

Occupational medicine employer obligation

An employer must offer each of their employees a chance to enjoy appropriate medical care allowing the continuity of work. For this, the employer is required to provide a periodic medical examination every 24 months for those who still hold their position.

Of course, this includes those who have high-risk jobs. The employer then covers the medical examination of all employees, until work stoppage or retirement. Regardless of the sector: private or public, an employer is obliged to set up an intra- or extra-company health service exclusively for employees.

This will allow employees to benefit from adequate medical monitoring. Thus, all employees, whether holders of permanent or fixed-term contracts, apprentices, or temporary workers will have access to a periodic medical examination. The issue is that occupational medicine has nothing to do with interns.

Some visits are mandatory such as the preventive visit or the informative visit. In these two cases, it is the employer who must obligatorily direct it. The employer and the doctor have the right to request additional medical visits in exceptional cases.

Who pays for the occupational medicine consultation?

The consultation, medical fees, medications, and the salary of the doctor or nurse are paid by the employer. The company then pays the medical expenses and the consumables of the infirmary. Sometimes, the employee travels to an inter-company health service; the travel, or rather the costs, will also be borne by the company.

However, know that a medical examination is an integral part of an employee’s working time. This means that it is considered a loss in added value for the company. Nevertheless, the employer cannot require the employee to make up for the time absent during their medical examination.

What you will need to know:

If the company has a number of employees between 413 and 2,220, the examinations carried out must be between 400 and 2,134 each year depending on an internal or external occupational health service. Of course, all this remains the employer’s responsibility, although they must take into account the opinions of a doctor.

What is the power of the occupational physician?

The occupational physician monitors the health of each employee; indeed, he oversees their physical condition, their psychological and physiological integrity, and identifies risks of contamination or transmission of diseases. Note, however, that an occupational physician does not work in routine medicine. In some cases, the occupational physician is simultaneously a psychologist, staff representative, health union spokesperson, social services manager, etc.

The occupational physician has the right to request a medical examination in order to detect a possible spread of viruses or contagious diseases. He can also determine if the position and the employee’s health condition coincide. There may also be other reasons for which the occupational physician may conduct a medical examination according to his judgment.

Here are the main powers of the occupational physician:

• Improve the working conditions of each employee by providing the best possible care.
• Adapt working hours, positions, and work rhythms according to the integrity and physical capacities of each employee. This will help maintain a good work pace and respect employees’ rights.
• Protect the employee against potential workplace accidents and prevent risks related to handling chemical agents or dangerous practices that could lead to workplace accidents.
• Ensure GHP (Good Hygiene Practices) in various premises (cafeteria, canteen services, toilets, etc.)
• Raise employees’ awareness about respecting hygiene rules within the establishment for all types of work (manual, industrial, machinery, etc.)
• Advise on the infirmary facilities, various premises, ensure the progression rule …
• Control the equipment and products used by employees to ensure they do not pose a health risk.

According to article L4624-1 and the labor code: occupational medicine can carry out or propose reassignment changes based on age, physical capacity, and mental health status. The occupational physician also provides the employer with the means to assess health risks related to work. Consequently, he creates a company file and coordinates medical visits. There are also options for product traceability and epidemiology. The employer will therefore be required to take these suggestions into account and, in case of non-compliance, to provide additional information.