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Occupational health care

Occupational physician duty from the first employee

The duty to have an occupational physician starts with the first employee. Employers must organise occupational health care and occupational safety support. Form and scope of care depend on the Occupational Safety Act (ASiG) and on DGUV Regulation 2 (DGUV Vorschrift 2) as issued by the responsible accident insurance institution.

Two employees, one in a high-visibility vest, walk through a bright production hall
Contents
  1. Legal basis
  2. Form of care and number of employees
  3. Content of care
  4. Occupational safety committee
  5. Typical gaps
  6. Start and change of care

Form of care and number of employees

Section 2 of the model text distinguishes by the number of employees: up to 20 employees, care follows Annex 1; above that, Annex 2. In addition, an entrepreneur who is actively involved in day-to-day operations can choose an alternative model under Annex 3 or Annex 4. The accident insurance institution sets the upper limit for this (at most 50 employees for Annex 3, 20 for Annex 4).

Employees (countable)Form of careContent Up to 20Standard care under Annex 1Support with preparing and updating the risk assessment; care on specific occasions; no fixed assignment hours More than 20Standard care under Annex 2Basic care with assignment time per employee per year by care group of the industry sector, plus company-specific care Up to the institution's upper limitAlternative care under Annex 3 or 4The entrepreneur carries out tasks personally after training; care on specific occasions by the occupational physician and the occupational safety specialist remains

For this assignment, the number of employees is calculated as an annual average under Section 2 (5) of the model text. Part-time employees working no more than 20 hours a week count as 0.5, those working more than 20 up to 30 hours as 0.75, and those working more than 30 hours as 1.0. The calculator on the quick-check page gives a first indication.

Content of care

In standard care under Annex 1, the occupational physician supports the entrepreneur with the risk assessment and acts on specific occasions. The model text names the following occasions, among others: planning and changing of operating facilities, new work equipment or substances with increased hazard potential, new work processes, work by pregnant women, young people or severely disabled people, accidents and occupational diseases, emergency and hygiene plans, changes to shift systems, the need for occupational health check-ups, reintegration after illness and clusters of health problems.

Basic care under Annex 2 includes workplace inspections, contributing to the risk assessment including psychosocial stress, organising occupational health check-ups, advice on workplace design and protective equipment, taking part in the occupational safety committee, and documentation. Company-specific care is added when occasions go beyond this. Occupational health check-ups under the Ordinance on Occupational Health Care (ArbMedVV) continue in every form of care, regardless of the form chosen.

Occupational safety committee

Under Section 11 ASiG, an occupational safety committee must be set up in companies with more than 20 employees. Here too, part-time staff working no more than 20 hours a week count as 0.5, and those working no more than 30 hours as 0.75. The committee meets at least once a quarter. The threshold in § 11 ASiG and the forms of care in DGUV Regulation 2 rest on different provisions and must each be checked separately. Details are in the article Occupational safety committee in the company.

Typical gaps

At the start of care, check the following points:

  • a written appointment with tasks and scope,
  • current workplace inspections and reports,
  • mandatory check-ups (Pflichtvorsorge) that were not arranged and offered check-ups (Angebotsvorsorge) that were not offered, plus the check-up register (Vorsorgekartei),
  • a risk assessment including the part on psychosocial stress,
  • an occupational safety committee that actually meets, where one has to be set up.

Each of these points can be put right. During an inspection by the accident insurance institution or the trade inspectorate (Gewerbeaufsicht), they are among the documents that must be produced.

Start and change of care

To start, the industry sector, accident insurance institution, number of employees and locations are enough. These determine the form and scope of care. The written appointment, the first workplace inspection and the planning of check-ups follow. The article Occupational health and safety when starting a company describes the order of the first steps after founding. When you change your occupational health care from your previous provider, we take over the existing documents and continue the check-up deadlines. Workplace inspections require presence on site. Under Section 6 of the model text, digital elements of care are allowed only under conditions, and check-up appointments follow the in-person cases in AMR 3.4 (occupational medicine rule). We arrange on-site appointments with companies in the Ingolstadt, Munich and Upper Bavaria area. Consultations and meetings are possible nationwide by video.

Questions on this article

Does a company with two employees need an occupational physician?

Yes. DGUV Regulation 2 covers every company with at least one employee. Under the model text, standard care under Annex 1 applies up to 20 countable employees, without fixed assignment hours.

Do employees in mini-jobs and part-time staff count?

Yes. For the obligation, every employed person counts. For the thresholds, Section 2 (5) of the model text weights by weekly working hours: 0.5 up to 20 hours, 0.75 up to 30 hours, 1.0 above that.

Can the entrepreneur take on care tasks personally?

Yes. In the alternative models under Annexes 3 and 4 of DGUV Regulation 2, the entrepreneur carries out tasks personally after training. Check-ups and advice on specific occasions remain the occupational physician's task. The accident insurance institution sets the upper limit.

What happens without an occupational physician?

Without an occupational physician, the employer breaches the duty to appoint under the Occupational Safety Act. Breaches can be punished as an administrative offence (Ordnungswidrigkeit). In addition, check-ups, risk assessment and advice are missing, and a company has to show these during an inspection or after an accident.

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Legal basis and sources

This article is based on the following statutory texts and publications of the competent bodies; each can be read in the original wording.

ASiG — Occupational Safety Act

Federal Ministry of Justice — appointment (§ 2), tasks of occupational physicians (§ 3), occupational safety committee (§ 11).

DGUV Regulation 2 — model text (as of December 2025)

German Social Accident Insurance — § 2 appointment and thresholds, § 5 report, § 6 digital technologies, Annexes 1 to 4.

DGUV Regulation 2 — overview and entry into force

German Social Accident Insurance — decision of 28 November 2024, institution-specific versions since 2025.

DGUV Rule 100-002

German Social Accident Insurance — explanation of Regulation 2 for practice, forms of care, documentation.

§ 11 ASiG — Occupational safety committee

Federal Ministry of Justice — duty for more than 20 employees, how part-time staff are counted, composition, quarterly meeting.

Links checked in October 2026. They lead to the publishers\' own pages.

Request occupational health care for your company

Tell us your industry sector, number of employees and accident insurance institution. You will receive an assessment of the form of care and a package quote.

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