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Introduction

The employer wishes to ensure through preventive services that employees and their dependants are medically fit for service abroad. Examinations for this purpose will normally be provided by Health Canada. Where Health Canada is not in a position to conduct the examinations or the deputy head authorizes use of a private facility, the employer will pay the costs of related expenses for examinations conducted at a private facility. Health Canada has been delegated authority to amend the appendix to this directive as and when required.

Directive 9

9.01 Prior to each posting an employee and each dependant who

(a) is to reside with the employee at a post, or

(b) is to be in full-time attendance at an educational institution outside of Canada,

shall have the right to a medical examination, or may as a condition of posting be required to undergo a dental and/or a medical examination which shall include specialist services, psychological assessments, x-rays and immunization against diseases as required. The posts for which pre-posting dental examinations are required are listed in the appendix to this directive, and published on the Department of Foreign Affairs and International Trade's website.

Where an employee is posted to a hardship post, as specified in FSD 58 - Appendix, the cost of a pre-posting eye examination will be reimbursed for employees and their dependant(s). Pre-posting eye examinations are not mandatory for the issuance of a Posting Confirmation Form (or equivalent).

Instruction

Where a dental examination is required, such dental examination shall include an assessment of any special dental treatment which may be required prior to or during the employee's assignment.

9.02 The dental examination, medical examination and related hospitalization and any special examination required shall be administered in the manner prescribed by Health Canada at a Canadian government facility. In special circumstances, the deputy head may authorize the use of a private facility.

Instruction

The employer shall pay the cost of the medical and dental examinations at a private facility only where:

(a) Health Canada is not in a position to conduct such examinations, or

(b) the deputy head considers a private facility to be more appropriate.

9.03

(a) An assessment as to fitness for duty prepared by Health Canada shall be submitted to the deputy head with respect to any medical examination administered pursuant to this directive.

(b) An assessment as to the requirement for dental treatment which is not available at the employee's post shall be submitted by Health Canada to the deputy head with respect to any dental examination administered pursuant to this directive.

Instruction

The assessment as to fitness for duty prepared by Health Canada does not contain confidential medical information. Confidential medical information is available to an employee under the Privacy Act, or may be obtained informally by an employee from Health Canada.

9.04 Whenever medical matters are at issue, employees shall have the right to have their personal physician submit a written medical opinion to Health Canada. That department shall review such opinion and submit another assessment as to fitness for duty to the deputy head, taking into consideration the medical opinion of the employee's physician.

9.05

(a) Where a variance in the written medical opinion submitted pursuant to Sections 9.03(a) and 9.04 is significant, Health Canada may request a third and independent written medical opinion which shall be taken into consideration in resubmitting an assessment as to fitness for duty to the deputy head.

(b) Where the deputy head is not satisfied with the assessment as to fitness for duty and a third and independent written medical opinion has not been obtained by Health Canada, the deputy head may request that a third and independent written medical opinion be submitted to Health Canada, which shall take such opinion into consideration in forming an assessment as to fitness for duty

9.06 In arriving at a decision concerning the assignment of an employee, the deputy head shall give consideration to the medical and dental assessments submitted pursuant to Sections 9.03, 9.04 and 9.05.

Instruction

Where, after taking into account any medical assessment as to fitness for duty provided, the deputy head determines that an employee cannot be posted for medical reasons, the employee shall be so informed.

9.07 The deputy head shall authorize:

(a) payment of actual and reasonable medical examination expenses, and/or

(b) payment of actual and reasonable dental examination expenses for examinations conducted as a condition of posting to those posts listed in the appendix to this directive,

and, where appropriate,

(c) payment of travelling expenses, as defined in FSD 2.01(cc), which means expenses for air transportation and local transportation to and from airports at the points of departure and destination and, when authorized in advance by the deputy head, for accommodation, meals and local transportation to and from the airport for a necessary stopover, where it is not possible or practicable to arrange an itinerary which will permit continuing travel to the approved destination.

9.08 Where the use of a private facility is authorized by the deputy head, the written opinion and professional account shall be submitted to Health Canada and the account shall be verified and recommended for payment when the quality of the written opinion is satisfactory to Health Canada.

9.09 Where it is necessary for a medical or dental examination authorized under this directive to be conducted during normal working hours, the employee shall be considered to be on duty for the period required for such examination.

9.10 Where an employee is required to undergo a medical or dental examination authorized under this directive and it is not possible to conduct such an examination during scheduled working hours, the deputy head may authorize overtime compensation as provided for in the applicable collective agreement for the period required for such examination.

9.11 Expenses incurred by the employee pursuant to Sections 9.02 and 9.04 shall not be a charge against the employee's health or hospitalization insurance plan.

Instruction

This directive also covers a cross-posting.

Guideline

Provisions for preventive medical services expenses other than pre-posting ones are covered in FSD 38 - Preventive medical services expenses.