Occupational health care – Workflow

Workflow for organizing occupational health services in accordance with ArbMedVV

Occupational health services are based on the Occupational Health Services Regulation (ArbMedVV). These services are intended solely to protect employees from health impairments resulting from their professional activities. They generally include:

• Advice for employees
• Occupational medical history and findings
• Assessment of individual stress factors in the workplace
• Information on protective measures and behavior

Important: This does not involve general medical diagnosis or treatment as usually provided by statutory or private health insurance companies. Occupational health care is always limited to work-related stress.

Step 1 – Determining the types of provision required

In any case, the risk assessment forms the basis.

• Identification of all activities and workplace conditions  

• Classification of relevant occupational health events according to ArbMedVV (German Occupational Health and Safety Regulation)  

The following reasons for taking precautions are particularly common:

• G37 – Computer workstations (ergonomics, visual requirements)
• G26 – Respiratory protection (e.g., ozone, hazardous substances)
• G20 – Noise (> 80 / > 85 dB(A))
• G24 – Skin protection (wet work, chemical substances)
• Precautionary measures in accordance with BioStoffV (health services, cleaning, wastewater)
• G41 – Risk of falling (roof work, scaffolding, aerial work platforms)
• Precautionary measures for heavy physical work (load handling, forced postures)
• G40 – Carcinogenic substances

The types of pension plans are usually determined as follows:

• during the **ASA meeting**,  

• during **site inspections**,  

• by consulting the **occupational safety specialist**,  

• through feedback from the **company doctor**.

The result of this step is a (short) list of all relevant activities with associated precautionary measures.

Step 2 – Assigning the affected employees

In a further coordination step, employers, company doctors, and occupational safety specialists jointly determine which employees are assigned to which preventive measures based on their activities. A distinction is made between:

a) Provision for offers

• Employers must offer pension plans in writing.
• Employees are free to decide ("Yes, I will participate." / "No, I decline.").
• The declaration must be reported back to the employer.

b) Mandatory pension provision

• Employers must encourage employees to participate in pension plans.
• Employees must participate (legal obligation).
• Precautionary measures are a prerequisite for being allowed to carry out the activity.

The result is a complete list of employees with the corresponding types of pension plans (including designation as voluntary/mandatory).

Step 3 – Written assignment of the company doctor

The employer is responsible for the organization and appoints the company doctor in writing.

The order must include:

1. List of employees by name

    • Name of the person  

    • Job description  

    • Type of provision (voluntary or mandatory)

2. Date details

    • Date  

    • Time / Time slot  

    • Optional: Block appointments for multiple people

3. General conditions 

    • Where does preventive care take place?  

    • What equipment is available?

This gives the company doctor a clearly defined task, comparable to a written order slip in the skilled trades.

Step 4 – Provision of premises (if carried out on site)

If the preventive care takes place at the workplace, the employer shall provide a suitable room:

• Lockable room, undisturbed, no public access  

• Peaceful and confidential atmosphere  

• Lying down option (examination couch)  

• Table and two chairs  

• Power connection  

• Shading / privacy screen → no visibility from outside  

• Cleanliness and hygienic conditions  

Alternative:

The employer may agree that employees visit the company doctor's office. In this case, the order shall include the information that no company premises are required.

Conclusion

Occupational health care is a structured administrative process that only works if:

1. the employer correctly derives the types of precautions from the risk assessment,
2. clearly assigned to the relevant employees,
3. the company doctor receives a precise written request,
4. suitable premises or practice visits are ensured.

The company doctor can only perform his duties properly if the employer provides him with the necessary information, appointments, and organizational requirements.