Key takeaways

Annual/periodic exams and any medical surveillance required by safety and health rules must be employer-paid. Employers cannot pass these costs to workers, directly or indirectly.
Pre-employment medical exams (PEMEs): If the employer requires the exam as a condition for hiring, the consistent compliance practice is that the employer should shoulder the cost (or directly arrange and pay the clinic). This is firmly required in several regulated sectors (e.g., seafaring/overseas employment) and expected in local employment as part of fair recruitment.
No salary deductions, reimbursements, or charge-backs to employees for legally required medical exams, PPE, and OSH compliance.
Sector-specific rules (construction, manufacturing with hazardous work, food handling, transport, maritime/overseas) may mandate specific exams; when mandated, the employer pays.
Data privacy, informed consent, and anti-discrimination laws govern how exams are conducted and how results are handled.

The legal framework (big picture)

Labor Code & OSH regime Philippine law requires employers to furnish a workplace free from hazardous conditions and to implement an Occupational Safety and Health (OSH) program. Under the OSH Law and its implementing rules, medical services, surveillance, and examinations that are required by law or by the nature of the work are an employer obligation. As a corollary, costs of OSH compliance may not be transferred to workers (whether by payroll deduction, forced “reimbursement,” or making employment conditional on paying those costs out of pocket).
Implementing rules & the OSH Standards The OSH Standards require on-site or accessible medical and dental services, and for certain headcounts and risk profiles, a company nurse, physician, clinic space, and equipment. The Standards also contemplate baseline, periodic/annual, and exit medical exams for workers with exposure to specific hazards (noise, chemicals, dusts, biological agents, etc.). When an exam is required by OSH rules or the employer’s risk assessment, the employer shoulders it.
Recruitment and fair hiring principles In Philippine practice, if the employer requires a pre-employment medical exam (PEME), the employer should pay. This aligns with DOLE’s compliance posture against charging applicants or employees for costs that are for the employer’s benefit or for legal compliance.
- For local direct hires, many employers either (a) give a referral to an accredited clinic and pay the clinic directly, or (b) reimburse any out-of-pocket amount upon hiring.
- For agency or contractor-deployed workers, DOLE rules restrict passing hiring-related costs to workers; reputable contractors pay for PEMEs they require.
- For overseas employment, the rule is explicit in standard terms: the principal/agency shoulders required PEMEs and fit-to-work clearances.
Special sectors
- Construction and projects with declared hazards: Medical surveillance (including baseline and periodic exams) flows from the Construction Safety and Health Program (CSHP). Employer pays.
- Seafarers and OFWs: The PEME and scheduled medical checks specified in standard employment contracts are principal/agency-paid.
- Food handlers / hospitality: Local ordinances and DOH issuances often require health certificates; in practice employers arrange and pay for required examinations and certifications for their staff.
- Transportation / driving roles: Vision and fitness checks required by the job are employer-paid if required for employment or continued assignment.
No wage deductions / no charge-backs Even where the law doesn’t spell out “the employer pays for X,” DOLE inspection practice treats any deduction from wages for legally mandated tests, PPE, or OSH compliance as unlawful. The safer practice is simple: if you require it, you pay for it.

Pre-employment medical exams (PEME)

When is a PEME allowed or required?

Employers may require a PEME to assess fitness for a particular job, subject to:
- Job-relatedness and necessity (i.e., the exam screens for conditions relevant to the job’s bona fide physical/health requirements).
- Proportionality (limited to tests that make sense for the role and identified hazards).
- Non-discrimination (no screening out on protected grounds like sex, age, disability, pregnancy status, etc., except where a genuine occupational qualification exists and is allowed by law).

Who pays?

Best practice / compliance norm: The employer.
If the applicant is not hired: Many employers still shoulder (or do not bill) the PEME because it was for the employer’s purpose. Others reimburse only if hired; this is riskier from a fair recruitment standpoint. The safest approach is never to make applicants pay.

Tests that must not be required or misused

HIV testing cannot be mandatory for employment; where offered for health reasons, it must be voluntary, with counseling and informed consent.
Pregnancy tests must not be used to deny hiring or employment benefits; discriminatory use violates the Magna Carta of Women and anti-discrimination protections.
Genetic information and other intrusive data are heavily regulated under the Data Privacy Act and general anti-discrimination principles.

Annual and periodic (in-service) medical exams

When are they required?

Hazard-exposed workers: If your risk assessment or the OSH Standards identify exposure (e.g., lead, benzene, noise, silica, isocyanates, biological agents), you must run a medical surveillance program, including baseline and periodic/annual exams, and sometimes exit exams.
All employees (general health monitoring): Many employers conduct Annual Physical Exams (APE) as part of wellness and early detection. While an APE for all employees isn’t always strictly mandated, if your OSH program makes it a requirement or your workplace presents general health risks, the employer pays.

Who pays?

Employer, always, where the exam is:
- Legally required (OSH Standards/IRR/sector rules); or
- Required by company policy for continued assignment or access to the workplace; or
- Required by a client site (e.g., vendor access to petrochemical plants or data centers with stricter clearance protocols).
What about HMOs? Health maintenance plans are not legally required, but widely provided. If the employer uses the HMO to deliver mandated exams, the employer still cannot shift any uncovered cost to employees.

Scope and frequency

Determined by the company physician and OSH Committee based on the risk assessment: which tests (e.g., chest radiography, spirometry, audiometry, biological monitoring), how often, and for which groups.

May an employer require an exam after a medical leave or incident?

Yes. Fit-to-work or return-to-work evaluations after illness, injury, or prolonged leave are permissible and often required by OSH protocols. As these are employer-required for safe reintegration, the employer pays.

Handling results: privacy, consent, and access

Informed consent & minimality. Examinees must know what will be tested and why; collect only what is necessary for the job or legal compliance.
Confidentiality. Individual results are medical records. Supervisors should receive fitness-for-duty assessments (e.g., “fit with restrictions”), not raw clinical data, unless the worker consents or a clear legal basis exists.
Retention. Keep medical records separate from personnel files, secured per the Data Privacy Act and OSH guidance.
Worker access. Employees should be able to access their own results upon request.

Common compliance pitfalls (and how to avoid them)

Charging the worker/applicant: Requiring candidates or employees to pay for PEME/APE, then promising reimbursement later, or deducting from wages if they leave early—avoid. Pay clinics directly or reimburse promptly without conditions.
Over-testing: Ordering broad panels unrelated to the job or hazards (e.g., routine chest X-ray for low-risk desk roles) can raise privacy and proportionality issues.
Discriminatory use of results: Rejecting or terminating on protected grounds instead of making reasonable accommodation where feasible.
Silence on client-mandated tests: If a client site mandates additional checks, the employer still bears the cost for its deployed workers.
Data sprawl: Emailing lab reports broadly, or storing them without access controls—tighten privacy governance.

Practical templates you can adopt

A. Policy clause (pre-employment)

Medical Examination Costs. Where the Company requires a pre-employment medical examination to assess fitness for a particular role, the Company shall arrange the examination with an accredited provider and shoulder the full cost. No applicant shall be required to pay for or be reimbursed for such examination as a condition of hiring. Exam scope shall be limited to tests necessary for the job and identified risks.

B. Policy clause (annual/periodic)

Annual and Periodic Medical Examinations. As part of our OSH Program, the Company shall provide employer-paid baseline, periodic/annual, and exit medical examinations for employees as determined by the OSH risk assessment and applicable standards. The Company shall not deduct or recover any part of these costs from employees.

C. Data privacy clause

Medical Data Privacy. Individual medical results are confidential. The Occupational Health personnel shall maintain records separately from personnel files, disclose only fitness-for-duty conclusions to management, and process data consistent with the Data Privacy Act and applicable health regulations.

D. Vendor/client sites

Client-Mandated Medical Clearances. Where a client site requires additional medical examinations or vaccinations for site access, the Company shall bear the costs and ensure such requirements are job-related and compliant with law.

FAQs

Can we ask applicants to pay first, then reimburse if hired? You shouldn’t. It risks being treated as unfair recruitment and, if any part hits payroll, an unlawful deduction. Pay clinics directly or reimburse regardless of hiring outcome if you required the exam.

What if an employee wants optional tests beyond the required scope? Optional, employee-requested tests (not required by law, risk, or policy) may be for the employee’s own account—but keep the boundary clear and never bundle optional items as if they were required.

Do we have to provide an HMO? No. But mandated OSH medical services/exams are separate from HMO benefits and remain employer-paid.

Are drug tests allowed? Only where lawful, job-related, and policy-based (e.g., roles implicating public safety). If required, the employer pays and must observe due process, confidentiality, and confirmatory testing protocols.

What about pregnancy tests? Don’t require them as a screening tool or use them to deny employment; that is discriminatory. If pregnancy presents a specific, documented hazard, manage via risk controls and accommodation, not exclusion.

Compliance checklist (quick use)

Written OSH Program and risk assessment identifying who requires baseline/periodic exams
Accredited clinic panel with direct-billing to the employer
Narrow, job-related PEME/APE test menus
No applicant/employee out-of-pocket for required exams (no deductions, no charge-backs)
Confidential handling of medical data; fitness-for-duty only to line managers
Clear policy language and worker notices
Tracking of due/overdue periodic exams for hazard-exposed workers

Bottom line

In the Philippines, if the exam is required by law, by the nature of the work, by your OSH program, or simply because the employer wants it, the employer pays. Keeping costs off workers, limiting tests to what’s necessary and lawful, and safeguarding medical data are the pillars of a compliant and fair program.