Pre-employment medical examination

Large businesses

Self-employed

SMEs

When an employer wishes to recruit a new employee, he must send him for a medical check with the occupational health practitioner of the occupational health service to which the employer is affiliated.

The practitioner will determine whether the employee's health allows him to fill the position in question. This medical check is compulsory, regardless of the nature of the work (i.e. office work, industrial or construction work, etc.).

After recruiting an employee, the employer must also organise regular medical examinations (only applicable in certain cases).

Who is concerned

Any employer who has concluded or is in the process of concluding an employment contract with a new employee must have him pass a medical examination.

Pupils and students with employment contracts and trainees in training must also undergo a medical check before employment if they are to fill a hazardous position.

Prerequisites

The employer must be affiliated to an occupational health service or have his own internal service which will carry out the medical checks.

The main occupational health services are:

the Multi-sector Occupational Health Service (Service de santé au travail multisectoriel - STM);
the Occupational Health Association for the Tertiary and the Financial Sector (Association pour la santé au travail des secteurs tertiaire et financier - ASTF);
the Industrial Occupational Health Service (Service de santé au travail de l'industrie - STI).

Deadlines

The employee must undergo the medical check at the latest 2 months after starting work.

In the case of persons hired for a hazardous position, the pre-employment medical check must take place before the date of entry into service and must later be completed by regular medical checks.

When the medical examination is scheduled to take place after the recruitment process, the conclusion of the employment contract is subject to the outcome of the check-up. If the employee is deemed unfit for the position considered, the contract is cancelled as of right.

Besides the pre-employment medical check, regular examinations may be requested by the employer, the occupational health practitioner, the employee or the joint works committee.

Costs

The costs for the medical checks when recruiting an employee are included in the contributions paid by the employer to the occupational health service.

The time needed to complete the compulsory medical checks is considered as effective working time.

If the medical examination takes place outside of working hours, the employee is entitled to payment or compensation.

How to proceed

Employer application for a medical check

In order to organise a medical check, the employer must send an application for a medical check to his occupational health service.

After accepting the application, the occupational health service schedules an appointment and informs the employer. The employer informs the employee of the date and time of the medical check.

If an employee who has already undergone a pre-employment medical check for a position is later transferred to a new position that exposes him to new health risks, the employer must inform the occupational health practitioner, who will decide whether it is necessary to carry out a new medical examination.

Businesses that are members of the STI or the ASTF may apply for a medical check online, by using their authentication on their occupational health service website.

Medical check

Medical checks with an occupational health practitioner generally take place at the relevant occupational health service.

In some cases, the occupational health practitioner may come to the employer's premises to carry out the examination.

The documents to be presented by the employee vary depending on the occupational health service. In general, the employee must present:

his identity card or residence permit;
his Luxembourg social security card;
his health record or vaccination card;
the glasses he wears for his working and recreational activities, where applicable.

The medical check comprises several parts, depending on the risks the employee will be exposed to, as well as on his medical history. The basic examination includes:

an eye test, adapted to the type of activity (work on a screen, truck driver, etc.);
a physical examination carried out by the occupational health practitioner (blood pressure, spinal examination, heart and lung auscultation, etc.);
urine tests;
a hearing test in the event of exposure to noise or if the practitioner deems it necessary.

No AIDS/HIV test may be done under any circumstances.

Results of the medical check

Fit for work

At the end of the medical check, the occupational health practitioner declares whether or not the employee is fit for the job.

The practitioner will issue, where necessary, restrictions and comments on the job. However, no diagnosis will be shared with the employer (medical confidentiality).

If the employee is deemed fit for work, the practitioner establishes a medical examination report in 3 copies:

1 copy for the employee;
1 copy for the employer;
1 copy which is kept in the employee's medical records at the occupational health service.

For businesses affiliated to the STM, the examination report indicates the validity period of the fitness for work plus the date and time of the medical examination. The STM sends the concerned business a list of employees who are likely to undergo regular medical checks and is also responsible for inviting employees to regular medical checks before their examination report expires.

The examination reports issued by the ASTF and STI do not mention any validity period.

Regular medical checks are only compulsory for certain employees, namely:

young workers;
workers in hazardous jobs.

The periodicity of these exams varies from every 6 months to every 5 years.

Besides the pre-employment medical check, regular examinations may be requested by:

the employer; or
the occupational health practitioner;
the employee;
the joint works committee;
the staff delegation, depending on the situation.

Moreover, after an employee's uninterrupted absence of more than 6 weeks, the employer must inform the occupational health practitioner of the employee's return to work. The employee may have to undergo a new examination if the occupational health practitioner deems it necessary.

In the case of a change of employer, the previous employer may, with the employee's consent, send the report on the last medical examination to the new occupational health service taking over the employee's affiliation.

Unfit for work

If the employee is unfit for work, the medical practitioner sends the examination report stating the unfitness by registered letters to the employee and the employer, stating:

the procedures and deadlines for appeal;
proposals to adapt the job to the employee.

Where possible, the employer must take these proposals into consideration.

Except in the event of immediate danger for the employee, the practitioner will examine the work conditions in detail and, where applicable, examine the employee one more time before making a final decision on the employee's unfitness.

In any case, the employer cannot appoint the employee to a position for which the health practitioner has deemed him unfit.

Means of appeal

Employers and employees can file an appeal against the unfit for work decision by the occupational health practitioner, and also against the result of the periodic medical examination.

The appeal takes the form of a request for a new medical examination with the Chief Medical Officer of the occupational health division within 40 days after the notification of the results of the first medical examination.

It is possible to lodge an appeal against the Chief Medical Officer's decision with the Council of Arbitration of Social Security (Conseil arbitral de la sécurité sociale - CASS). An appeal may be lodged against the ruling of CASS with the High Council of Social Security (Conseil supérieur de la sécurité sociale - CSSS).

The appeals are to be sent to the competent authority, by simple letter on plain paper in as many copies as there are parties involved, within 40 days from the notification of the decision or the ruling. After this deadline, appeals are not admissible and the decision is final.

Criminal penalties

The provisions relating to the pre-employment medical check are imperative. In the event of a violation of these provisions, the employer may be sentenced to imprisonment between 8 days and 6 months and/or a fine between EUR 251 and EUR 25,000.