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:
- is residing at a post listed in Appendix A of this directive; or
- 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:
- payment of actual and reasonable medical expenses; and
- 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:
- 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
- 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:
- the immunization is recommended by Health Canada; and
- 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:
- the domestic help is one who is in regular contact with the employee or a dependant; and
- 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.