One of the basic obligations of every employer is to ensure that the assigned work is performed exclusively by employees who are medically fit to perform it. More precisely, employers are obliged not to allow employees who are unfit for the work to perform such work.
One way to fulfill this obligation is to subject employees to initial, periodic (regular), or extraordinary medical examinations. Whether employment has had a negative impact on an employee’s health is determined by a possible exit medical examination or a medical examination after the end of hazardous work (follow-up).
A recent amendment to Act No. 373/2011 Coll., on specific health services, as amended (hereinafter the “SHSA”), has brought about fundamental changes and administrative relief for employers of employees performing work that does not involve occupational hazard for the health of the employee and which falls within the first category according to Act No. 258/2000 Coll., on the protection of public health and on amendments to certain related acts, as amended (hereinafter the “PPHA”).
In this article, we present an overview of employers’ obligations in this area.
Categorization of work
The decisive factors for assessing whether an employer is obliged to send employees for occupational health examinations are based on the categorization of work according to Section 37 of the PPHA, which distinguishes four basic categories according to the incidence of factors that may affect the health of employees and their risk to health at work. Every employer is obliged to proactively seek out risks associated with the performance of work.
- The first category of work includes work which, according to current knowledge, does not have an adverse effect on the health of employees, i.e., it is not risky or hazardous to health. The employer decides on the classification of work in this category based on the absence of risk factors that would place the work in a higher category.
- The second category of work includes work which, according to current knowledge, may exceptionally have an adverse effect on the health of susceptible individuals, but does not exceed hygiene limits. The classification of work into this category is decided mainly by the employer, who notifies the relevant regional health authority of the classification of work into this category within 30 calendar days of the start of its performance or a change in the conditions for its performance.
- The third category of work includes work in which hygiene limits are exceeded and occupational diseases occur repeatedly. The classification of work into this category is decided by the relevant regional public health authority based on a proposal from the employer.
- The fourth category of work includes work involving a high risk to health that cannot be eliminated even with the use of available and applicable protective measures. The classification of work into this category is decided by the relevant regional public health authority based on a proposal from the employer.
According to Section 39 of the PPHA, work falling within categories three and four, or work in category two, where so decided by the competent public health authority or specified by a special legal regulation, is always considered hazardous work.
Initial medical examinations
An initial medical examination is performed to ensure that job applicants whose health does not meet the requirements for the anticipated work are not assigned to perform work in conditions that are expected to be physically demanding. In addition, an entry examination is also performed before a change in the type of work or before transferring an employee to another job, if the work is performed under conditions different from those for which the employee’s health suitability was assessed.
It is necessary to reject the frequent and inaccurate simplification that there has been a blanket abolition of initial medical examinations for employees who are to perform work in the first category.
Namely, following the amendment to the SHSA, employers are only relieved of the obligation to provide initial medical examinations for work falling within the first category, which does not involve occupational hazard. On the contrary, even in the case of work classified in the first category that involves occupational hazard, or if the work includes activities for which health requirements are stipulated by law, the employer is still obliged to provide an initial medical examination.
It should be added that the employer is also obliged to arrange an initial medical examination if the employee himself insists on it. It should also be noted that, even though it is not a legal obligation, the employer may require the job applicant to undergo an initial medical examination.
In such cases, if the employer does not require the job applicant to undergo an initial medical examination, the applicant is considered medically fit to perform the work for which they are to be assigned, until an examination proves otherwise.
For the remaining categories of work, i.e., categories two, three, and four, the employer is always required to arrange for an initial medical examination by their company doctor. If a job applicant refuses to undergo an initial medical examination even though they have been referred for one, they are deemed to be medically unfit.
Periodic (regular) medical examinations
Periodic examinations are performed to detect early changes in the employee’s health that may have arisen in connection with the physical demands of the work performed or the aging of the body, where continued performance of the work could lead to damage to the health of the employee in question or to the health of other persons.
The obligation to provide periodic examinations and their frequency are always assessed with regard to the categorization of the work performed by the employee, the presence of occupational hazard, and if so stipulated by special regulations.
For employees performing work in the first category, which does not involve occupational hazard, the employer is obliged to ensure periodic examinations only if the employer insists on it or the employee requests it. In such a case, periodic examinations are always performed every 6 years, and for employees over 50 years of age, once every 4 years.
For employees performing work in the first category, which involves occupational hazard, the employer is obliged to provide more frequent periodic examinations, always after 4 years, or 2 years for employees over 50 years of age, unless the frequency is specified otherwise by law.
For employees performing work in the second category, which does not involve occupational hazard, the employer is obliged to ensure periodic examinations only if the employer insists on it or the employee requests it. In such a case, the periodic examination takes place every 4 years, and for employees over 50 years of age, once every 2 years.
For employees performing work in the second category, which is associated with occupational hazard, and the third category, the employer is also obliged to ensure periodic examinations every 2 years.
In the case of work in the fourth category, periodic examinations are mandatory every year.
Extraordinary medical examinations
Extraordinary medical examinations are performed to determine the health status of the employee in question if there is reasonable suspicion that their fitness for work has been lost or changed, or if there is an increase in the risk level of a previously identified risk factor in working conditions, either:
- based on a request submitted by the employer on its own initiative or at the initiative of the employee;
- based on information provided by the attending physician about a reasonable suspicion that a change in the employee’s health has led to a change in their medical fitness;
- if ordered by a public health authority under the PHPA or as stipulated by the act regulating the use of nuclear energy and ionizing radiation;
- if required by the health demands of specific working conditions during a given period;
- there has been a deterioration in working conditions in the sense of an increase in the level of risk for a risk factor for which the employee’s medical fitness has already been assessed;
- the limit value of the biological exposure test indicators has been exceeded at least twice, or on the basis of the conclusions of other examinations or measurements carried out for the purpose of monitoring the burden on the organism caused by risk factors in working conditions;
- a change in the employee’s health status has been detected during an occupational medical examination, which suggests a change in medical fitness for work in less than the period for a periodic examination; or
- work performance was interrupted:
i. due to illness for a period longer than 8 weeks, with the exception of work in category 1 according to the PHPA, and unless it is work or an activity that involves occupational hazard or unless otherwise specified by other legal regulations,
ii. as a result of an accident with serious consequences, illness associated with unconsciousness or other serious damage to health, or
iii. for other reasons for a period longer than 6 months, unless the interruption of work is due to maternity or parental leave.
Exit medical examinations
An exit medical examination is performed to determine the employee’s state of health at the time of termination of employment, with an emphasis on identifying any changes in health that can be assumed to be related to the physical demands of the work performed. The employer is also obliged to arrange an exit medical examination before transferring an employee to another job or before changing the type of work, if it involves the termination of hazardous work, or if this obligation is stipulated by another legal regulation.
Exit medical examinations are always performed if the employee performed work classified in category two (hazardous), three, or four. In other cases, only if the employee was diagnosed with an occupational disease or was at risk of an occupational disease while working for the current employer, if these conditions persist, or if the employee suffered an accident at work while working for the current employer and was diagnosed with at least two periods of temporary incapacity for work causally related to the accident, or a new point assessment of pain or social impairment was performed.
An exit medical examination shall also be performed if requested by the employer or, through the employer, by the employee.
Follow-up medical examination
A follow-up medical examination is performed exceptionally for the purpose of timely detection of changes in health status arising in connection with work under such working conditions, the consequences of which may manifest themselves even after the termination of work, for the purpose of timely provision of necessary health services or compensation, but only when required by law.
Conclusion
The basic obligation of the employer is to ensure that employees are medically fit to perform the assigned work in order to prevent the occurrence of health problems among employees. The employer can fulfill this obligation through initial, periodic, or extraordinary medical examinations, which serve to determine the employee’s ability to perform or continue to perform the assigned work.
If you have any questions on this topic or other labor law issues, please do not hesitate to contact us.
Mgr. Jakub Málek, managing partner – malek@plegal.cz
Mgr. Kateřina Vyšínová, junior lawyer – vysinova@plegal.cz
23. 10. 2025