Plain answers for HR, SHEQ and operations managers: what the law requires, what a medical involves, and how to tell a good provider from a box-ticking one.
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What is a medical certificate of fitness? — A medical certificate of fitness is a signed statement from an occupational health practitioner that an employee is medically fit — or fit with stated restrictions — for a specific job and the hazards that job exposes them to. It certifies fitness for the work, not general health, and it is the document an inspector or a principal contractor asks to see.
Are workplace medicals compulsory? — For many employees, yes — but the duty comes from the hazard, not the job title. South African law makes medical surveillance compulsory where work exposes someone to a hazard a regulation names, such as construction work, excessive noise or hazardous chemicals, and the Employment Equity Act prohibits medical testing that has no legal or job-related basis.
Working at heights medical: what it checks — A working at heights medical is an assessment by an occupational health practitioner of whether an employee can work at an elevated position — scaffolding, ladders, roofs, platforms, structures — without a medical condition that could cause a fall. On a construction site the result is recorded on the employee's Annexure 3 certificate of fitness.
How to choose an occupational health provider — Check four things before you sign: that the person signing your certificates is a registered occupational health practitioner, that the medicals are matched to each job's hazards instead of one generic test, that clinical records stay confidential while you receive an audit-ready register, and that the price per employee is stated up front. Speed, on-site days and reporting all follow from those four.
Can you fail a pre-employment medical? — Not in the pass-or-fail sense most people worry about. A pre-employment medical checks whether you can safely do one specific job, and the certificate says fit, fit with restrictions, temporarily unfit or unfit for that job. A restriction or a temporary finding is far more common than a flat "unfit", and the medical can only test for what the job actually requires.