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.
The Occupational Health and Safety Act puts a general duty on every employer to provide a working environment that is safe and without risk to health. The regulations made under it then name specific hazards and say what medical surveillance each one requires. If an employee is exposed to one of those hazards, the medical stops being a policy choice.
That is why the honest first step is a hazard map — which jobs, which exposures — not a quote for "medicals for everyone".
Where no regulation requires it, an employer may still test if it is justifiable — the Employment Equity Act names the inherent requirements of a job among the grounds. A driver's vision, or the fitness of someone in a safety-critical role, are the usual examples. The test has to fit the requirement: checking vision for a driving post is justifiable; a full medical for an office post usually is not.
Medical testing with no legal requirement and no job-related justification is prohibited by section 7 of the Employment Equity Act, and that applies to applicants as well as employees. HIV testing is prohibited unless the Labour Court has declared it justifiable. Using a medical to screen out people who are unwell but able to do the job is the kind of testing the Act exists to stop.
Where a hazard requires surveillance, all three usually do, and they only make sense together:
An inspector from the Department of Employment and Labour can issue a contravention or prohibition notice, and on a construction site a worker without a valid certificate cannot lawfully be there. The quieter cost is under the COID Act: without a baseline and periodic records, an employer has nothing to measure an occupational disease claim against — neither to support a legitimate one nor to answer one that is not.
They are compulsory where the job exposes the new employee to a hazard a regulation names — construction work, noise above the limit, hazardous chemicals and similar. Elsewhere they are allowed only if justifiable by the inherent requirements of the job.
Usually not by law, because an office job rarely carries a listed exposure. Some employers run voluntary wellness screening, which is a different thing from a medical certificate of fitness and must be voluntary.
Where an employee was under medical surveillance for a hazard, the exit assessment is what documents their status at separation — standard practice, and the record that matters most if a claim follows.