FSD 38 - Preventive Medical Services Expenses

Scope

Introduction

The employer wishes to ensure through preventive medical services that the general good health of employees and their dependants at posts outside Canada is maintained and that a tour of duty abroad will not have to be terminated because of the foreseeable or avoidable illness of an employee or dependant. Health Canada has been delegated authority to amend Appendix A – Schedule of Unhealthy Posts of this directive as and when required.

Directive

38.1 Application

38.1.1 An employee and each dependant shall have the right, or may be required by the employer, to undergo chest x-ray examination, physical examination and laboratory or special examination or immunization as may be required, at the nearest place where suitable facilities exist as determined by the medical service provider as defined in FSD 2 - Definitions, and the results of such examinations shall be forwarded to the medical service provider if, the employee and/or dependant:

1. is residing at a post listed in Appendix A of this directive; or
2. is in full-time attendance at an educational institution away from the post and expenses are being paid pursuant to FSD 51 - Family Reunion.

38.2 Medical Examinations

38.2.1 The medical examinations referred to in section 38.1 and related hospitalization, if applicable, shall be administered in the manner prescribed by Health Canada, without charge to the employee, by a Canadian government facility, or by a private medical facility where the deputy head has authorized its use due to special circumstances or the absence of a Canadian government facility.

38.2.2 Where medical examinations are administered pursuant to sections 38.1 and 38.3, the deputy head shall authorize:

1. payment of actual and reasonable medical expenses; and
2. payment of travelling expenses, where applicable.

38.2.3 An assessment as to fitness for duty prepared by the medical service provider shall be submitted to the deputy head in respect of any medical examination administered pursuant to section 38.1. At the employee's request, the employer shall provide the employee with access to this assessment.

38.3 Independent Medical Opinion

38.3.1 Whenever a medical matter is at issue, the employee shall have the right to have a personal physician submit a written medical opinion to the medical service provider. Another assessment as to fitness for duty shall be submitted to the deputy head, taking into consideration the medical opinion of the employee's physician.

38.3.2 On behalf of the employer, an independent written medical opinion which shall be taken into consideration in the assessment as to fitness for duty may be requested:

1. by the deputy head when the deputy head is not satisfied with the fitness for duty assessment provided in subsection 38.2.3 and a second written medical opinion has not been provided under subsection 38.3.1; or
2. by the medical service provider when it determines there is a significant variance between the written medical opinions provided in subsections 38.2.3 and 38.3.1.

38.3.3 In making the decision concerning the assignment of an employee, the deputy head shall give consideration to the assessments as to fitness for duty submitted pursuant to subsections 38.2.3, 38.3.1 and 38.3.2.

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

38.4 Medical Expenses

38.4.1 The deputy head may approve payment of the necessary expenses of immunizing an employee and dependant(s) against communicable disease, provided:

1. the immunization is recommended by Health Canada; and
2. such costs are not covered by local law.

38.4.2 The deputy head may approve payment of the expenses incurred by an employee in securing preventive medicines, provided they have been prescribed by competent medical authority which is acceptable to the medical service provider.

38.4.3 Where the deputy head determines that domestic help is required for security reasons, the deputy head may approve payment of the expenses of a medical examination, laboratory tests, chest x-rays and expenses of immunizing against communicable disease of the domestic help prior to employment and annually thereafter, provided:

1. the domestic help is one who is in regular contact with the employee or a dependant; and
2. such costs are not covered by local law.

38.5 Paid Leave and Overtime

38.5.1 Where it is necessary for a medical 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.

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

38.6 Insurance Plan

38.6.1 Expenses incurred by the employee pursuant to section 38.1 and subsections 38.3.1, 38.3.2, 38.4.1 and 38.4.2 shall not be a charge against the employee's health and hospitalization insurance plan.

38.7 Unhealthy Posts

38.7.1 For the purposes of this directive, the posts listed in Appendix A are classed as unhealthy on the advice of Health Canada.

38.7.2 An unhealthy post is one where personnel are exposed to and may develop illnesses or diseases of a nature they would not develop or would be unlikely to develop in Canada.

Effective October 1, 2022

Abidjan, Ivory Coast
Abuja, Nigeria
Accra, Ghana
Addis Ababa, Ethiopia
Algiers, Algeria
Amman, Jordan
Ankara, Turkey
Baghdad, Iraq
Bamako, Mali
Bandar Seri Begawan, Brunei Darussalam
Bangalore, India
Bangkok, Thailand
Beijing, China
Beirut, Lebanon
Belgrade, Serbia
Bogotá, Colombia
Brasilia, Brazil
Bridgetown, Barbados
Bucharest, Romania
Buenos Aires, Argentina
Cairo, Egypt
Caracas, Venezuela
Chandigarh, India
Chennai, India
Chongqing, China
Colombo, Sri Lanka
Cotonou, Benin
Dakar, Senegal
Damascus, Syria
Dar es Salaam, Tanzania
Dhaka, Bangladesh
Doha, Qatar
Erbil, Iraq
Georgetown, Guyana
Guadalajara, Mexico
Guangzhou, China
Guatemala, Guatemala
Hanoi, Vietnam
Harare, Zimbabwe
Havana, Cuba
Ho Chi Minh City, Vietnam
Hong Kong, China
Islamabad, Pakistan
Istanbul, Turkey
Jakarta, Indonesia
Johannesburg, South Africa
Juba, Sudan
Kabul, Afghanistan
Kampala, Uganda
Kandahar, Afghanistan
Kathmandu, Nepal
Khartoum, Sudan
Kigali, Rwanda
Kingston, Jamaica
Kinshasa, Democratic Republic of Congo
Kuala Lumpur, Malaysia
Kuwait City, Kuwait
Kyiv, Ukraine
La Paz, Bolivia
Lagos, Nigeria
Lima, Peru
Lusaka, Zambia
Managua, Nicaragua
Manila, Philippines
Maputo, Mozambique
Mexico City, Mexico
Monterrey, Mexico
Moscow, Russia
Mumbai, India
Nairobi, Kenya
New Delhi, India
Niamey, Niger
Nur-Sultan, Kazakhstan (formerly Astana)
Ouagadougou, Burkina Faso
Phnom Penh, Cambodia
Port-au-Prince, Haiti
Port of Spain, Trinidad and Tobago
Pretoria, South Africa
Quetta, Pakistan
Quito, Ecuador
Rabat, Morocco
Ramallah, West Bank
Recife, Brazil
Rio de Janeiro, Brazil
Riyadh, Saudi Arabia
San José, Costa Rica
San Salvador, El Salvador
Santiago, Chile
Santo Domingo, Dominican Republic
São Paulo, Brazil
Seoul, South Korea
Shanghai, China
Taipei, Taiwan
Tartu, Estonia
Tegucigalpa, Honduras
Tehran, Iran
Tel Aviv, Israel
Tripoli, Libya
Tunis, Tunisia
Ulaanbaatar, Mongolia
Vientiane, Laos
Wellington, India
Yangon, Myanmar
Yaoundé, Cameroon

Notes:

1. Notwithstanding the provisions of section 107 of the Federal Public Sector Labour Relations Act, revisions to this Schedule shall not constitute a change in terms and conditions of employment for employees subject to the Foreign Service Directives.
2. Health Canada has the delegated authority to amend this Appendix as and when required.