In the Philippines, an employer may require a worker to undergo a medical examination when it is genuinely connected to the job, workplace safety, fitness to work, drug-free workplace rules, or occupational health requirements. But when the test is mandatory because the employer requires it, the general rule is simple: the employer should shoulder the cost, not the worker. This is especially true for pre-employment medical examinations, annual physical examinations, job-related fit-to-work tests, random workplace drug testing, and medical surveillance required under occupational safety and health rules.

This issue usually comes up when an applicant is told, “Magpa-medical ka muna at your own expense,” or when an employee sees a payroll deduction for an annual physical exam, drug test, X-ray, laboratory test, or return-to-work clearance. The answer depends on the purpose of the test, who required it, and whether the cost was shifted through an unlawful deduction, reimbursement demand, or hiring condition.

The short answer: mandatory employer-required medical tests should not be charged to workers

If the medical test is required by the employer for hiring, deployment, continued employment, return to work, assignment to a hazardous job, or compliance with the company’s occupational safety and health program, the cost should generally be treated as an employer expense.

This is supported by three main Philippine labor principles:

Employers must maintain a safe and healthful workplace.
Medical examinations required under occupational safety and health rules are part of workplace health compliance.
Employers cannot make wage deductions unless allowed by law.

Republic Act No. 11058, the Occupational Safety and Health Standards Law, requires employers to comply with occupational safety and health standards, including medical examinations where required, and treats the cost of implementing an approved safety and health program as part of business operations. The law also gives DOLE authority to enforce these standards in workplaces. (Lawphil)

Legal basis: why the employer usually pays

1. The Labor Code and Omnibus Rules require free medical examinations in the workplace context

The clearest rule comes from the Omnibus Rules Implementing the Labor Code, Book IV, Rule I, Section 9. The company physician engaged by the employer must:

conduct pre-employment medical examinations free of charge for proper selection and placement of workers; and
conduct annual physical examinations free of charge for workers.

This is why an employer-required pre-employment medical exam or annual physical exam should not be treated as a personal expense of the applicant or employee. The rule exists because the exam is not just for the employee’s private benefit. It helps the employer decide proper job placement, identify workplace risks, and comply with safety and health obligations. (Labor Law PH Library)

2. RA 11058 makes occupational safety and health an employer compliance duty

Under Republic Act No. 11058, employers, contractors, and subcontractors must provide a workplace free from hazardous conditions, inform workers of hazards, and comply with OSH standards including training, medical examination, and where necessary, protective and safety devices. (Lawphil)

The same law states that the cost of implementing a duly approved safety and health program is an integral part of operations cost. In construction and contracting or subcontracting arrangements, it must be a separate pay item. This is important because an employer should not treat OSH compliance as something workers have to finance out of their own wages. (Lawphil)

DOLE’s current OSH framework was updated through Department Order No. 252-25, Series of 2025, the Revised Implementing Rules and Regulations of RA 11058, which took effect in May 2025 and replaced the earlier DOLE Department Order No. 198-18 as the main revised IRR. (BWC Dole)

3. Wage deductions are strictly limited under Article 113 of the Labor Code

Even if the employee already paid or the employer wants to deduct the amount from salary, the employer still has to comply with wage deduction rules.

Article 113 of the Labor Code says that an employer may not deduct from wages except in limited cases, such as insurance premiums with the worker’s consent, union dues, or deductions authorized by law or DOLE regulations. The Supreme Court has recognized that deductions outside the legal exceptions are prohibited under Article 113. In Lusabia v. Super K Drug Corporation, the Court discussed illegal deductions and reproduced Article 113’s limited exceptions. (Supreme Court E-Library)

A medical exam fee does not automatically become deductible just because the employee signed a form. Consent must be real and lawful. A deduction is especially questionable when the worker had no practical choice because the test was required for hiring, retention, deployment, or continued work.

4. Deductions to secure employment or retention are prohibited

Article 117 of the Labor Code also prohibits deductions made for the benefit of the employer or its representative as consideration for a promise of employment or retention in employment.

In practical terms, this matters when an employer says:

“Pay for this medical test or we will not hire you.”
“Your deployment will not proceed unless you pay the clinic.”
“We will deduct the annual physical exam fee from your salary.”
“You must reimburse the company for the drug test to keep working.”

If the test is a company requirement for the employer’s hiring, placement, safety, or compliance purposes, making the worker pay can look like shifting a business compliance cost to the employee.

When an employer may require medical tests

Employers are not prohibited from requiring all medical tests. Some tests are lawful and even necessary. The problem is usually who pays and whether the test is lawful, relevant, confidential, and non-discriminatory.

Common lawful examples include:

Type of test	When it may be required	Who should generally pay
Pre-employment medical exam	To determine fitness and proper job placement after an applicant is being processed for employment	Employer
Annual physical examination	As part of the company health program or OSH compliance	Employer
Fit-to-work exam	After illness, injury, accident, prolonged absence, or before assignment to safety-sensitive work	Employer, if required by the employer
Hazard-specific medical surveillance	For workers exposed to chemicals, noise, dust, radiation, biological risks, heat, or other occupational hazards	Employer
Random drug test	Under a written drug-free workplace policy and applicable law	Employer
Chest X-ray, CBC, urinalysis, stool exam, ECG, or other lab tests	If required as part of employer’s medical screening, annual exam, or occupational health monitoring	Employer
Personal medical certificate	If voluntarily obtained by the worker for personal reasons, not required by the employer	Worker, unless company policy or benefit says otherwise

Special issue: pre-employment medical exams

Pre-employment medical exams are one of the most common problem areas in the Philippines.

Many applicants are told to go to a company-accredited clinic and pay first. Sometimes the applicant is promised reimbursement only after hiring. Sometimes there is no reimbursement at all.

Under the Omnibus Rules, the employer’s physician must conduct the pre-employment medical examination free of charge for proper selection and placement of workers. This means that when the medical exam is a company-required step for hiring or assignment, the safer and legally sound practice is for the employer to pay directly or reimburse the applicant promptly. (Labor Law PH Library)

Practical distinction: applicant expense vs. employer-required exam

Not every medical document is automatically an employer expense. The distinction usually looks like this:

Situation	Likely treatment
Applicant voluntarily gets a general medical certificate before applying anywhere	Usually personal expense
Employer requires a specific clinic, test package, or fit-to-work clearance as a condition for hiring	Generally employer expense
Job offer is conditional on passing the company medical exam	Generally employer expense
Applicant pays first because the clinic requires payment, then submits receipt for reimbursement	Acceptable only if reimbursement is clear, prompt, and not used to avoid the employer’s obligation
Employer deducts the test cost from the first salary	Legally risky and likely improper unless clearly authorized by law

A good rule of thumb: if the employer controls the requirement, chooses the test, chooses the clinic, or uses the result to decide whether the person may work, the employer should not pass the cost to the worker.

Annual physical exams and periodic medical surveillance

Annual physical examinations are usually part of the employer’s health program. They are meant to monitor worker fitness, detect occupational illness early, and support safe placement.

The rule on annual physical exams is explicit: they should be conducted free of charge to workers. (Labor Law PH Library)

For high-risk workplaces, annual exams may not be enough. Workers exposed to particular hazards may need specialized tests. Examples include:

audiometry for workers exposed to high noise;
spirometry or chest imaging for workers exposed to dust or fumes;
blood or liver function tests for chemical exposure;
vision tests for drivers, crane operators, or equipment operators;
heat-stress monitoring for outdoor or high-temperature work;
infectious disease screening in healthcare or laboratory settings, where allowed by law and DOH/DOLE rules.

If the test is part of occupational medical surveillance, it is not a private errand. It is part of the employer’s safety and health compliance system.

Drug testing: random workplace drug tests are borne by the employer

Drug testing has its own legal framework.

Under Republic Act No. 9165, the Comprehensive Dangerous Drugs Act of 2002, officers and employees of public and private offices may be subjected to random drug testing under the company’s work rules and regulations, and the law states that this is borne by the employer for purposes of reducing workplace risk. (Philippine Presidential Office)

DOLE Department Order No. 53-03 also requires private establishments, especially those with 10 or more workers, to implement drug-free workplace policies and programs. Random drug testing must be done under company rules, with strict confidentiality of screening and results. (Supreme Court E-Library)

This means a company should not randomly select employees for drug testing and then deduct the fee from their wages.

Tests employers should handle carefully: HIV, pregnancy, and sensitive health information

Some medical tests raise discrimination and privacy issues.

HIV testing

HIV testing is heavily protected under Republic Act No. 11166, the Philippine HIV and AIDS Policy Act. No HIV testing should be conducted without informed consent, and discrimination in employment based on actual, perceived, or suspected HIV status is prohibited. (Lawphil)

The Supreme Court applied this protection in Bison Management Corporation v. AAA and Pernito, G.R. No. 256540, February 14, 2024. The Court held that termination due to HIV status was illegal, and that RA 11166 prevails even where a foreign employment setting allegedly treats an HIV-positive worker as unfit. (Supreme Court of the Philippines)

Pregnancy testing

A pregnancy test should not be used to deny employment, remove a worker, or penalize a woman for being pregnant. Employers must be careful because pregnancy-related discrimination can violate labor standards, gender equality principles, and maternity protection laws.

Medical data privacy

Medical records are not ordinary HR documents. Health information is sensitive personal information under the Data Privacy Act of 2012, Republic Act No. 10173. Employers and clinics must limit access, keep results confidential, and use the information only for legitimate employment and safety purposes. (Lawphil)

In practice, HR usually does not need the worker’s full diagnosis. Often, HR only needs a fitness conclusion such as:

fit to work;
fit with restrictions;
temporarily unfit;
for further evaluation;
recommended reassignment or accommodation.

The detailed diagnosis should be handled only by authorized medical personnel, unless disclosure is legally required or properly consented to.

What workers can do if they were charged for a mandatory medical test

If you were required to pay for a company medical test, avoid relying only on verbal discussions. Build a clear paper trail.

Keep proof of payment. Save the official receipt, clinic invoice, online payment confirmation, or payroll deduction record.
Identify who required the test. Keep the job offer, HR message, text, email, memo, checklist, onboarding requirement, return-to-work instruction, or clinic referral form.
Check whether the test was company-specific. Note whether the employer chose the clinic, specified the tests, required submission of results, or made the test a condition for hiring or continued work.
Ask HR for reimbursement in writing. A short written request is better than a verbal argument. State the date, test, amount, and reason it should be reimbursed.
Check the company policy, CBA, employment contract, or onboarding documents. Some companies have reimbursement procedures, but employees miss the deadline because the process is not explained clearly.
If there is no reimbursement or there was a salary deduction, raise the issue through DOLE. For many employment disputes, the usual first step is the Single Entry Approach (SEnA), a 30-day conciliation-mediation process for labor and employment issues. Requests may be filed at DOLE offices or through online filing channels. (senawebbapp.azurewebsites.net)
For broader OSH violations, request DOLE inspection or assistance. DOLE has visitorial and enforcement authority under Article 128 of the Labor Code and RA 11058 to inspect workplaces, examine records, and determine compliance with labor and OSH standards. (Lawphil)

Documents to prepare before asking for reimbursement or filing with DOLE

Document	Why it matters
Official receipt or clinic invoice	Proves the amount paid
Payslip showing deduction	Proves the employer deducted from wages
HR email, chat, memo, or onboarding checklist	Proves the employer required the test
Referral slip to a company clinic	Shows the test was company-directed
Employment contract or job offer	Shows the hiring or deployment condition
Company policy or handbook	Shows whether the employer promised free medical exams or reimbursement
Medical clearance or fit-to-work certificate	Shows the test was used for employment purposes
Written reimbursement request	Shows you tried to resolve the issue internally

Do not post medical results publicly on social media. If you need to show proof, redact sensitive details and keep the discussion limited to the payment issue unless the medical details are truly necessary.

Common scenarios

“The company said I must pay for my pre-employment medical exam before I can start.”

If the exam is required by the company for hiring, placement, or fitness to work, the employer should generally pay or reimburse it. The pre-employment medical exam required for proper selection and placement is specifically described in the rules as free of charge.

“The employer deducted the annual physical exam fee from my salary.”

That is legally questionable. Annual physical examinations under the employer’s health program should be free of charge. A payroll deduction also has to pass the strict rules on wage deductions under Article 113 of the Labor Code.

“I paid for the drug test because HR said everyone must undergo random testing.”

Random workplace drug testing under RA 9165 is borne by the employer. If the test was part of the company’s drug-free workplace program, the worker should not shoulder the cost.

“The company requires a fit-to-work clearance after sick leave. Who pays?”

If the fit-to-work clearance is required by the employer before allowing you to return, it should generally be shouldered by the employer, especially if it is part of workplace safety, return-to-work, or occupational health procedure. If you voluntarily went to your own doctor for personal treatment, that personal consultation may be different, but a company-required clearance or test should not be shifted to the worker.

“The employer requires extra tests because I will work abroad.”

For overseas employment, separate rules may apply through the Department of Migrant Workers, licensed recruitment agencies, and destination-country requirements. However, Philippine law still protects workers from illegal deductions, discriminatory testing, and unlawful cost-shifting. If the test is required by the recruitment agency or employer for deployment, the documents should clearly state who pays and whether reimbursement is due.

Frequently Asked Questions

Can an employer require a pre-employment medical exam in the Philippines?

Yes, if the exam is job-related, reasonable, and used for proper selection or placement. But under the Omnibus Rules implementing the Labor Code, pre-employment medical examinations required for proper selection and placement should be free of charge to the worker.

Can a company deduct the cost of an annual physical exam from salary?

Generally, no. Annual physical examinations required under the employer’s health program should be free of charge. Payroll deductions are also strictly limited by Article 113 of the Labor Code.

Who pays for mandatory drug testing at work?

For random drug testing of officers and employees under RA 9165 and company drug-free workplace rules, the cost is borne by the employer.

What if I signed an authorization allowing the deduction?

A signed authorization does not automatically make the deduction valid. If the deduction is not authorized by law, or if the employee had no real choice because the test was required for employment or retention, the deduction may still be questioned.

Can the employer require me to use a company-accredited clinic?

Yes, employers often use accredited clinics for consistency, occupational health reporting, and record control. But if the employer requires a specific clinic or test package for employment purposes, that supports the argument that the employer should shoulder the cost.

Can an employer refuse to hire me because I failed the medical exam?

It depends. The employer may consider genuine fitness-to-work issues if they are job-related and supported by medical findings. But the employer should not use medical exams as a cover for discrimination. HIV status, pregnancy, disability, age, or other protected conditions must be handled under applicable labor, health, anti-discrimination, and privacy rules.

Is HIV testing allowed as a job requirement?

Compulsory HIV testing as an employment condition is generally unlawful. HIV testing requires informed consent, confidentiality, and non-discrimination under RA 11166.

Can I ask for reimbursement even if I already paid the clinic?

Yes. Keep your receipt and the employer’s written instruction requiring the test. Ask HR for reimbursement in writing. If the employer refuses, you may raise the issue through DOLE’s SEnA process or the appropriate DOLE office.

How long does a DOLE SEnA process take?

SEnA is designed as a 30-day mandatory conciliation-mediation process for many labor and employment issues. The actual timeline may vary depending on notice, attendance, settlement discussions, and whether the issue is referred to another DOLE office or the NLRC.

What if I am still applying and not yet an employee?

The rule on free pre-employment medical examination is tied to proper selection and placement of workers. If the employer requires the medical exam as part of its hiring process, especially after shortlisting or a conditional offer, the employer should not use the applicant’s non-employee status to shift a company hiring requirement to the applicant.

Key Takeaways

Employers may require lawful, job-related medical tests, but mandatory employer-required tests should generally be paid by the employer.
Pre-employment medical exams and annual physical exams required for workplace health purposes should be free of charge to workers.
RA 11058 treats occupational safety and health compliance, including required medical examinations, as an employer duty and business operations cost.
Payroll deductions for medical tests are risky because Article 113 of the Labor Code strictly limits wage deductions.
Random workplace drug testing under RA 9165 is borne by the employer.
HIV testing, pregnancy-related testing, and other sensitive medical issues must be handled with strict confidentiality and without discrimination.
Workers should keep receipts, HR instructions, payslips, and messages before requesting reimbursement or filing with DOLE.