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Occupational Health Services

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Medireco Clinic s.r.o. – Occupational Health Services, is a private healthcare provider specialising in the delivery of occupational health services throughout the Czech Republic. We offer occupational health services tailored to the needs of clients from the private (business), public (government-run), and non-profit sectors.
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Information about a medical records summary

  1. A Medical Records Summary (hereinafter “MRS”) must form part of every pre-employment, special or periodic occupational health assessment. This LEGISLATIVE REQUIREMENT is set out in Act No. 373/2011 Sb., on Specific Health Services, as amended, namely in Section 42(1)(b). The Medical Records Summary is the MOST UP-TO-DATE SOURCE OF HEALTH INFORMATION about the person being assessed and constitutes a key document for the physician to issue a medical opinion.
  2. Information on the obligation to provide a Medical Records Summary is also set out in the AGREEMENT FOR THE PROVISION OF OCCUPATIONAL HEALTH SERVICES (in the article Employer’s Obligations). The agreement is based on the above-mentioned Act and on Decree No 79/2013 Sb., as amended, in which this obligation is set out, namely Section 6(2)(d).
  3. A Medical Records Summary may be replaced by a confirmation that there has been no change in health status since the last MRS was issued “CONFIRMATION OF UNCHANGED HEALTH STATUS”, provided that
    • the request is made to the same provider (assessing physician) who previously issued the medical opinion
    • and that no change in the assessed person’s health status has occurred since the previous MRS (Act No. 373/2011 Sb., Section 42a(1)).
  4. If a job applicant or employee DOES NOT HAVE A REGISTERED GENERAL PRACTITIONER, the assessing physician shall record this fact in the medical records (in the form of a statutory declaration) and have the assessed person sign the record. For such a job applicant (employee), the assessing physician shall usually carry out a more extensive examination to compensate for the missing information from the Medical Records Summary of the registered general practitioner. The costs of the indicated specialist examinations are included in the occupational health assessment and are paid by the employer.
  5. If an employee has a registered general practitioner but does not provide the Medical Records Summary, the physician may decide (at their own discretion) not to conclude the assessment. Until then, the applicant/employee will not receive a medical opinion and will be considered MEDICALLY UNFIT.
  6. IF THE PERSON IN QUESTION IS A FOREIGN NATIONAL, whose medical records are held in another country, the assessing physician will accept a Medical Records Summary only if it has been TRANSLATED INTO CZECH AND OFFICIALLY CERTIFIED. An officially certified translation is not required where the Medical Records Summary is in the Slovak language (Act No. 373/2011 Sb., Section 42(1)(b)).
  7. The registered general practitioner shall issue the MRS, or, as applicable, a confirmation of unchanged health status, NO LATER THAN WITHIN 10 WORKING DAYS from the date of receipt of the application; the application must be supported by a referral from the occupational health service provider (Act No. 373/2011 Sb., Section 42a(2)). Where no referral is provided, the general statutory time limit for issuing a Medical Records Summary applies, namely 30 working days from the date of receipt of the request (Section 65(1)(a) of Act No. 372/2011 Sb., on Health Services).
  8. A medical records summary or confirmation may be used to assess medical fitness for work FOR A PERIOD OF NO MORE THAN 90 DAYS from the date of its issue by the registered general practitioner (Act No. 373/2011 Sb., Section 42a(2)).
  9. For occupational health assessments, a Medical Records Summary must be provided, RATHER THAN COMPLETE MEDICAL RECORD (the wording of Act No. 373/2011 Sb. itself uses the term “medical records summary”, not merely “medical records”). There are several reasons:
    • a time-consuming process for the assessing physician when reviewing complete, often very extensive medical records; while a Medical Records Summary is concise and clear
    • the Medical Records Summary must remain with the provider as part of the occupational health assessment documentation (this is not possible with the full medical record)
    • preventing the applicant/employee from removing “unfavourable” medical reports from the medical records prior to their submission to the assessing physician
  10. Assessments for which a MEDICAL RECORDS SUMMARY IS NOT REQUIRED are precisely defined by law (Act No. 373/2011 Sb., Section 42a(3), and implementing Decree No. 79/2013 Sb.)
    • A Medical Records Summary is not required in the case of an exit occupational health assessment (Section 13 of the Decree)
    • for a special occupational health assessment, provided that less than six months have passed since the last medical opinion was issued, or where the occupational health services provider does not require it (Section 12(4) of the Decree)
  11. If an applicant/employee has not visited their registered general practitioner for several years, the general practitioner is entitled to make the issue of a Medical Records Summary CONDITIONAL ON THE COMPLETION OF A PREVENTIVE HEALTH CHECK-UP.
  12. Only the assessing physician is authorised to access the Medical Records Summary for the purposes of carrying out the occupational health assessment. After carrying out the assessment, the physician shall issue a medical opinion for the employer, which contains only the conclusion as to whether the applicant/employee is medically fit for the work activity or not. All specific information relating to an employee’s health constitutes SENSITIVE PERSONAL DATA within the meaning of personal data protection act No. 101/2000 Sb. As a rule, the employer cannot request such information from the employee.
  13. Occupational health assessments, including the supporting documentation required for them (Medical Records Summary, specialist examinations), ARE PAID FOR BY THE EMPLOYER (Act No. 373/2011 Sb., Section 58). An exception applies to the PAYMENT OF THE PRE-EMPLOYMENT MEDICAL ASSESSMENT prior to the establishment of the employment relationship. This assessment and additional costs related thereto (the fee for the Medical Records Summary, specialist examinations) are paid by the job applicant. Once the employment relationship has been established, these costs are covered by the employer. In the case of assessing medical fitness for night work, the employer always covers the cost of the pre-employment medical assessment, including all related expenses.
  14. To avoid unnecessary delays in the issuance of a medical opinion, it is necessary for EMPLOYERS to INFORM APPLICANTS/EMPLOYEES well in advance of the requirement to provide a Medical Records Summary for each occupational health assessment.
  15. If there is a REVIEW of the correctness of an issued MEDICAL OPINION, the Medical Records Summary shall constitute one of the key elements focused on by the administrative authority. If the Medical Records Summary is not included as a part of the submitted file, the file is returned to the assessing physician and the process of issuing the medical opinion is substantially delayed.

We often encounter A LACK OF UNDERSTANDING OF THE IMPORTANCE OF THE MEDICAL RECORDS SUMMARY on the part of employers (due to administrative and financial burden). Employers should be aware that the assessing physician often obtains information from the Medical Records Summary that an applicant/employee may withhold during the assessment. This helps prevent medically unfit workers from being assigned to positions where their health could deteriorate, or where there is a risk of a work-related injury or the development of an occupational disease.