Occupational Physician: Requirements & Costs
When Is an Occupational Physician Required by Law — and What Does Occupational Health Care Cost?
Under German law, an occupational physician or occupational health care is required starting with the first employee (ASiG Section 2). Costs vary by care model and company size, ranging from about €600 to €10,000 per year; basic SME care is typically around €1,500/year.
Occupational Health Care by Company Size
| Company Size | Care Model | Typical Annual Cost |
|---|---|---|
| 1–10 employees | Needs-based care or external service | €600–1,500 |
| 11–50 employees | Regular external care | €1,500–4,000 |
| 50–250 employees | Regular external care or in-house physician cooperation | €4,000–10,000 |
| >250 employees | In-house occupational physician or fixed contract hours | Individual, often >€10,000 |
Why Occupational Health Care Is Legally Required
Under Section 2 of the German Occupational Safety Act (ASiG), every employer in Germany must appoint occupational physicians to support them on all matters of workplace health protection. This obligation applies regardless of company size — even the first employee establishes the right to occupational health care.
The specific details are governed by DGUV Regulation 2 together with the relevant trade association (Berufsgenossenschaft): it defines how many care hours per year are required depending on industry and hazard class (basic care plus company-specific care).
What the Occupational Physician Actually Does
- Occupational health check-ups (mandatory and offered check-ups depending on the hazard)
- Support with risk assessments, particularly for physical workload
- Expert support for company reintegration management (BEM)
- Advice on ergonomic workplace design and working-time models
Care Models — Which Model Fits Which Company Size
Small businesses with up to 50 employees can use the alternative needs-based care model: instead of fixed annual care hours, support is provided on an as-needed basis, supplemented by mandatory basic training for the business owner (the entrepreneur model, or Unternehmermodell). Larger companies require regular care with fixed annual hours, and beyond a certain employee count an in-house or fixed-contract occupational physician is often worthwhile.
Key takeaways
- Under German law, occupational health care is required starting with the 1st employee (ASiG Section 2)
- Costs: approx. €600–10,000/year; basic SME care is typically ~€1,500/year
- Small businesses with up to 50 employees can use the entrepreneur model (Unternehmermodell)
- The occupational physician also supports BEM and risk assessments
- Fine risk for missing care: €5,000–10,000
Frequently asked questions
As a small business owner, can I take on the occupational physician's tasks myself?+
Under the entrepreneur model (Unternehmermodell), available to businesses with up to 50 employees depending on hazard class, the owner can take on many tasks themselves after completing basic training — but this does not replace occupational health check-ups, which must still be carried out by a physician.
Does every employee have to attend a health check-up?+
No. German law distinguishes between mandatory check-ups (required before starting certain hazardous work, e.g., screen-based work with particular strain), offered check-ups (the employer must offer them, but the employee can decline), and check-ups on request (initiated by the employee).
What does it cost if we don't have an occupational physician at all?+
Violating ASiG Section 2 can result in a fine of €5,000–10,000 under German law. In addition, occupational health documentation will be missing in the event of a workplace accident, which increases liability risk.
Keep Occupational Health Care Properly Documented
EasyBGM keeps track of check-up appointments, care hours, and BEM deadlines — all in one place.
Sources
- Section 2 ASiG — Appointment of Occupational Physicians ↗
- DGUV Regulation 2 — Occupational Physicians and Safety Specialists ↗
Last updated: 2026-07-06. Not legal or tax advice — have your specific case reviewed by a professional.