Occupational Physician: Requirements & Costs
When Is an Occupational Physician Required by Law — and What Does Occupational Health Care Cost?
Under German law, an occupational physician or occupational health care is required starting with the first employee (ASiG Section 2). What it costs depends on the care model: for companies with more than ten employees, DGUV Regulation 2 sets basic-care hours of 0.5, 1.5 or 2.5 hours per employee per year, depending on the care group — for the occupational physician and the occupational safety specialist combined. These hours times the provider's hourly rate, plus the company-specific part, make up the annual cost.
Occupational Health Care by Company Size
| Company Size | Care Model | What drives the cost |
|---|---|---|
| 1–10 employees | Needs-based care or external service | Basic care without fixed hours per head, plus visits as needed × hourly rate |
| 11–50 employees | Regular external care | Basic-care hours (0.5 / 1.5 / 2.5 h per employee per year, depending on care group) × hourly rate |
| 51–250 employees | Regular external care or in-house physician cooperation | Basic care as above plus company-specific part × hourly rate |
| Over 250 employees | In-house occupational physician or fixed contract hours | Individual (contract hours or own position) |
Why is occupational health care legally required?
Under Section 2 of the German Occupational Safety Act (ASiG), every employer in Germany must appoint occupational physicians to support them on all matters of workplace health protection. This obligation applies regardless of company size — even the first employee establishes the right to occupational health care.
The specific details are governed by DGUV Regulation 2 together with the relevant trade association (Berufsgenossenschaft): it defines how many care hours per year are required depending on industry and hazard class (basic care plus company-specific care).
What does the occupational physician actually do?
- Occupational health check-ups (mandatory and offered check-ups depending on the hazard)
- Support with risk assessments, particularly for physical workload
- Expert support for company reintegration management (BEM)
- Advice on ergonomic workplace design and working-time models
Which care model fits which company size?
Small businesses with up to 50 employees can use the alternative needs-based care model: instead of fixed annual care hours, support is provided on an as-needed basis, supplemented by mandatory basic training for the business owner (the entrepreneur model, or Unternehmermodell). Larger companies require regular care with fixed annual hours; beyond a certain employee count an in-house or fixed-contract occupational physician is often worthwhile.
Key takeaways
- Under German law, occupational health care is required starting with the 1st employee (ASiG Section 2).
- Costs: service hours under DGUV Regulation 2 × the provider's hourly rate — compare offers from several providers.
- Small businesses with up to 50 employees can use the entrepreneur model (Unternehmermodell).
- The occupational physician also supports BEM and risk assessments.
- Fine of up to €25,000 (ASiG Section 20) if an enforceable order of the supervisory authority is not followed.
Frequently asked questions
As a small business owner, can I take on the occupational physician's tasks myself?+
Under the entrepreneur model (Unternehmermodell), available to businesses with up to 50 employees depending on hazard class, the owner can take on many tasks themselves after completing basic training. This does not replace occupational health check-ups, which must still be carried out by a physician.
Does every employee have to attend a health check-up?+
No. The German Ordinance on Occupational Medical Care (ArbMedVV) distinguishes mandatory check-ups (required before starting certain work, e.g., noise at or above the upper exposure action values or work with certain hazardous substances), offered check-ups (the employer must offer them, employees can decline — e.g., for work at display screens), and check-ups on request (initiated by the employee).
What does it cost if we don't have an occupational physician at all?+
If no physician has been appointed, the supervisory authority can order the appointment (ASiG Section 12). Anyone who does not comply with such an enforceable order risks a fine of up to €25,000 (ASiG Section 20, German law). In addition, occupational health documentation will be missing in the event of a workplace accident, which increases liability risk.
Keep Obligations in View
EasyWHP keeps track of BEM deadlines and the psychosocial risk assessment. The occupational health care itself is provided by your occupational physician.
Sources
- Section 2 ASiG — Appointment of Occupational Physicians ↗
- DGUV Regulation 2 — Occupational Physicians and Safety Specialists ↗
- ASiG Section 20 — Administrative offences (German law) ↗
- ArbMedVV — Ordinance on Occupational Medical Care (annex: mandatory and offered check-ups) ↗
Last updated: 2026-07-06. Not legal or tax advice — have your specific case reviewed by a professional.