Finding a Company Doctor: Obligations, Search Strategies and Legally Compliant Appointment

§ 3(1) of the Occupational Safety and Health Act (ASiG) obliges every employer to appoint a company doctor (Betriebsarzt). DGUV Regulation 2 specifies how many deployment hours per year the doctor must provide — depending on industry, activities and number of employees. This obligation exists regardless of company size: even companies with ten employees must have occupational medical cover, although the volume of hours will then be comparatively modest.

In practice, many managing directors face the question of how to find a suitable company doctor, what that doctor may cost, what qualifications they are required to hold, and how the formal appointment process works. This article answers these questions step by step — with specific statutory sources and tried and tested selection criteria.

The Occupational Safety and Health Act (ASiG) of 1973 is the central statutory basis for the company doctor obligation. § 2 ASiG defines the tasks of the company doctor: advising the employer on occupational safety, accident prevention, humane work design, and health protection. § 3 ASiG establishes the appointment obligation; § 4 ASiG governs the qualification requirements.

DGUV Regulation 2 specifies the volume of hours. It distinguishes between basic care and occasion-related care. Basic care is determined by the care model (entrepreneur model for very small businesses, standard care for all others) and a sector-specific classification into business type groups (BTGs). A manufacturing company with 100 employees requires significantly more company doctor hours per year than an office-based service provider with an identical headcount.

In addition, occasion-related care tasks arise under Annex 4 DGUV V2: new equipment, hazardous substances, operational changes, and accident clusters. Additional deployment times apply for these occasions and are not counted against the basic care volume.

The role of the company doctor cannot be delegated: neither a general practitioner nor an employee of a company health fund can assume the statutory function of company doctor if they do not hold the specialist or additional occupational medicine qualification.

§ 4 ASiG sets out the qualification exhaustively: the company doctor must be a licensed physician and must hold either the specialist title in occupational medicine or the additional designation of occupational medicine (Betriebsmedizin). Both qualifications require specific postgraduate training completed with the relevant state medical association (Landesärztekammer).

In practice, the distinction between specialist physician in occupational medicine and physician with additional occupational medicine designation is relevant: the specialist physician has completed a five-year postgraduate training programme; the physician with the additional designation requires a shorter supplementary training. Both are authorised to act as company doctor; the duties are identical.

Physicians in other specialisms — general practitioners, orthopaedists, internists — are not authorised to act as company doctor without the stated additional designation. An appointment without this qualification does not fulfil the requirements of the ASiG and may result in fines under § 25 ASiG.

When appointing an external company doctor, it is therefore advisable to require a current certificate of qualification from the relevant medical association. This certificate forms part of the appointment documentation and should be immediately producible in the event of a DGUV inspection. The auditor calls; the evidence is ready.

The volume of deployment hours is the primary determinant of the cost of occupational medical care. DGUV Regulation 2 provides, for standard care, a table specifying the minimum deployment time in hours per year by business type group (BTG) and number of employees.

Practical examples:

• Office/administrative businesses (BTG 1), 100 employees: approx. 20 company doctor hours per year under basic care
• Retail (BTG 2), 200 employees: approx. 50 hours per year
• Manufacturing/processing industry (BTG 3), 100 employees: approx. 50 hours per year
• Construction/logistics (BTG 4), 50 employees: approx. 38 hours per year

These figures are minimum volumes; occasion-related care is additional. Companies with elevated hazard potential — chemical industry, healthcare, radiation protection — typically have significantly higher deployment times.

The precise calculation of the deployment volume is the starting point for every request for proposals from external company doctors. Without a correct calculation, there is a risk of entering into a contract with an insufficient hours contingent that does not meet DGUV requirements. A health and safety officer can assist with the calculation.

The search for a suitable company doctor typically follows one of three routes:

1. Supra-company occupational medical service (ÜÄMD): These bodies provide occupational medical care for several companies simultaneously and specialise in external care for mid-sized businesses. In Germany they are usually organised through employers' liability insurance associations (Berufsgenossenschaften) or sector-specific associations. They cover the full range of services required under DGUV Regulation 2 and ensure deputisation arrangements.
2. Practising occupational physician with company doctor practice: Some physicians holding a specialist title in occupational medicine or additional occupational medicine designation offer external care directly. The advantage lies in the personal relationship; the disadvantage is the cover risk during holiday or illness.
3. Compliance platforms with an officer network: Providers such as CIVAC enable the appointment of an external company doctor from a vetted network of certified partners. Letter of appointment — signed, filed, demonstrable — without months of independent research.

Searching via the German Medical Association (Bundesärztekammer doctor search with occupational medicine filter) or via the relevant employers' liability insurance association is a further starting point. DGUV and many Berufsgenossenschaften also publish lists of approved supra-company services.

The appointment of a company doctor must be made in writing. An oral instruction does not satisfy the requirements of the ASiG and cannot be evidenced in an inspection. The appointment contract should contain the following minimum provisions:

• Name and qualification of the appointed physician (specialist title or additional occupational medicine designation, with evidence)
• Scope of activity in hours per year, broken down between basic care and occasion-related care
• Responsible operational area and premises
• Deputy arrangements in the event of absence
• Freedom from instruction of the company doctor in professional matters (§ 8 ASiG)
• Duty of confidentiality and data protection provisions under § 8(1) ASiG
• Remuneration arrangements and notice periods

The freedom from instruction clause deserves particular attention: under § 8 ASiG, the company doctor is free from instruction in the exercise of their professional expertise. The employer may not give professional directions — but may set organisational parameters. A contract that restricts freedom from instruction is void under § 138 BGB to the extent that it infringes the protective purpose of the ASiG.

§ 9 ASiG protects the company doctor from disadvantage on account of their activities. Nevertheless, the appointment relationship can be terminated by ordinary or extraordinary notice, provided this is done for objective reasons and not on account of professional recommendations. A termination causally linked to an unwelcome recommendation by the company doctor is an abuse of rights and may give rise to claims for compensation.

When changing the company doctor, the following aspects must be observed: continuity of occupational medical care must be ensured; a gap in the care relationship is not permissible. The new company doctor should be briefed on ongoing occupational health and safety measures, identified hazards, and forthcoming occupational health surveillance examinations under the Occupational Health Care Ordinance (ArbMedVV).

Occupational health surveillance examinations under the Occupational Health Care Ordinance (ArbMedVV) constitute a separate but closely related regulatory framework: the employer is obliged to offer and document mandatory occupational health surveillance for certain hazardous activities. This obligation does not end with a change of company doctor; the new physician must seamlessly continue the ongoing surveillance measures.

A complete handover documentation — risk assessment, list of mandatory surveillance examinations, outstanding recommendations — is indispensable when changing company doctors and should be structured as a project handover in the CIVAC workspace.

The Occupational Health Care Ordinance (ArbMedVV) distinguishes three categories of surveillance that the company doctor carries out or coordinates on behalf of the employer:

1. Mandatory surveillance (Pflichtvorsorge): The employer must offer this for certain activities and the employee must participate. Examples: activities involving carcinogenic substances (Annex Part 1 ArbMedVV), noise above the trigger value (Annex Part 3 ArbMedVV), activities involving biological agents of risk group 3 or 4.
2. Offer-based surveillance (Angebotsvorsorge): The employer must offer this; the employee may decline. Examples: screen-based work (Annex Part 4 ArbMedVV), night work under the Working Time Act (ArbZG).
3. Requested surveillance (Wunschvorsorge): The employee may request this; the employer must facilitate it, provided a connection between the activity and a health concern is credibly established.

Documentation of the surveillance examinations carried out and offered is a component of occupational health and safety management and is systematically reviewed in DGUV inspections and official workplace inspections. Missing evidence of mandatory surveillance is a frequent point of criticism in operational audits. Audit-ready, documented, ArbMedVV-compliant: evidence of offered and attended surveillance must be available at all times.

The costs of occupational medical care are borne entirely by the employer; § 8(2) ASiG expressly prohibits any cost-sharing by employees. Prices for external company doctors vary considerably by region, business type group and provider structure. A detailed article on hourly costs can be found at external company doctor: cost per hour.

As a general guide: for purely office-based businesses with low hazard potential (BTG 1), annual company doctor costs for small companies (up to 50 employees) are often below €1,000 per year; for manufacturing businesses or businesses with chemical hazards, costs can be well into five figures for 200 to 500 employees.

Supra-company services frequently offer lump-sum contracts covering a defined annual hours volume at a fixed price. These contracts are price-transparent but sometimes contain additional costs for occasion-related deployments not included in the basic volume. During contract negotiations, it is advisable to explicitly clarify which services are included in the basic price and which are charged separately.

For tax purposes, the costs of occupational medical care are deductible as business expenses; documents relating to the appointment and service delivery should be retained for ten years (§ 147 AO).

CIVAC offers companies the option of appointing a certified external company doctor directly through the platform. The model: licence the workspace for your internal company doctor, or have our partners take over the occupational medical care as an Officer-as-a-Service. Both routes use the same workspace, the same documentation standard, and the same reporting line to management.

The CIVAC workflow for company doctor appointment includes: qualification verification prior to appointment, calculation of the correct deployment hours volume under DGUV Regulation 2, preparation of the letter of appointment containing all particulars required under the ASiG, mapping of surveillance deadlines in the task module of the workspace, and exportable documentation for DGUV inspections and workplace visits.

The CIVAC SLA: letter of appointment — signed, filed, demonstrable — within two business days rather than the usual research time of two to six weeks. All 490 audit templates in the workspace are also available for occupational medical documentation tasks.

If you wish to fulfil the company doctor obligation in a structured manner and without the burden of searching, please speak with us. Turn reading into a mandate: info@civac.de.