Medical Examinations

You cannot judge a book by its’ cover

Getting the facts on the physical and mental health of your working force will prove to be indispensable when designing a plan of approach for creating a healthy and safe workplace.

It is no secret that many diseases and illnesses will remain asymptomatic for prolonged periods of time. Once first symptoms emerge, the disaese unfortunately has often already evolved into more a more serious condition. Conditions such as; high bloodpressure, raised levels of Cholesterol or Bloodsugar are a real-life threat to a person’s health and ability to perform at work and for example his or her ability to drive a car or operate machinery.

Early detection of asymptomatic diseases and determining a person’s physical and mental abilities and/or disabilities is cornerstone in the great variety of medical examinations Medwork has to offer.

Pre-employment examination (AK)

The goal of a Pre-employment Examination is to determine whether an individual is fit to perform his or her job without risk to himself or others.

What is a Pre-employment Examination?

Pre-employment examinations are most commonly used as a useful component of the selection process for jobs that require certain physical or mental attributes. The goal is to determine whether the job applicant is expected to be able to perform his or her duties in a safe and healthy way.

Not only the physical health of an applicant should be considered. Candidates should also be evaluated for their ability to deal with the pressures or load factors associated with the position the candidate is applying for.

Although sometimes required by law, participation in this medical examination is normally on a voluntary basis, and a Pre-employment Examination is primarily focused on the risks associated with certain professions.

When is a Pre-employment Examination necessary?

This type of examination can only be requested if a certain job entails risks for the health or safety of the employee and/or third parties. Stringent guidelines apply as to when this examination is to be performed. Only after you have selected a suitable candidate for the vacant position you can request for the applicant to undergo a Pre-employment Examination. It goes without saying that you must inform the applicant that a medical examination is part of the hiring process.

Disabillity assessment

A Disability Assessment is performed to determine whether an employee that has been absent due to illness for a prolonged period of time can still be expected to be able to perform adapted duties within his or her own company, or could perform duties in another job, working for a different company (outplacement).

The disability assessment

On Aruba absence due to illness is usually referred to as ’AO’. ’AO’ is commonly used in cases of short-term disability, and if all goes well the employee returns back to work after a few days. The disability assessment discussed in this topic does not refer to this type of short-term disability. 

Disability asssessment for the purpose of determining loss of earnings

In this case disability is defined as the difference between what an employee would have earned if he or she did not have to stop working due to health problems and what his or her earning capacity is now due to limitations. By performing a disability assessment the loss of income can be determined.

In addition the disability assessment is also a good method for determining the extent to which an employee with long-term disability is fit for his or her own work or perhaps for a different function. For an employer considering the deployment of an employee this will prove to be a valuable tool. When submitting the resignation for an employee, the Labor Department will almost always ask for this assessment.

Who performs a disability assessment? 

A disability assessment is performed by a registered Occupational Health Expert. A dissability assessment can only be performed after a prior, extensive examination by an Insurance Medicine Physician, during which the permanent limitations due to illness or accident for an employee are determined. 

Only in cases where the Insurance Medicine Physician has declared an employee totally unfit for work (there are no sustainable opportunities) an assessment by the Occupational Health Expert is not necessary.

The term disability can only be used in cases where an employee, due to objective medical reasons, is unfit to do his or her job.

How does it work?

After the Insurance Medicine Physician has determined the limitations and has concluded there are sustainable possibilities, the Occupational Health Expert will take over. After reviewing the report drafted by the physician and interviewing the employee, the expert will try to identify a suitable position for this person by establishing the professional skills that can still be performed by him or her. In identifying a suitable position the following will be taken into account:

  • Training and employment so far
  • Hobbies
  • Interest in re-training
  • Future vision
  • Other professional activities.

A suitable position or job is determined by the posibilities for employment the employee has on the labor market, preferably with the current employer. To determine wheter an employee can still be given a position within his or her current organization the Occupational Health Expert will examine the possibilities by engaging in conversations with the department for human resources, management and/or supervisor.

A suitable job means that:

  • It is in accordance with the limitations stipulated for the employee
  • It is age-appropriate, but may be below the original level of the employee
  • It must be clearly present on the labor market
  • It type of work should be generally accepted
  • This job must be available on Aruba and at least 3 jobs, each with 5 working positions, can be found.

To go short: the job may not be unique.

Loss of income

Loss of income can be defined as the difference between the ’comparator wage’ and that what a person can earn with a suitable position or job (the remaining earning capacity).

The ’comparator wage’ (the salary the employee would have earned if he or she did not get disabled) is based on information given by employee or employer (usually the last pay slip).


Findings of the Occupational Health Expert along with the determination of the loss of income will be documented in a report. The employee should receive a copy of this report or a copy of the report should be made available for evaluation.

When is a disability assessment required?

There are certain situations in which and individual or organization will ask to have a disability assessment performed:

  • When organizations such as SVb, insurance company, Court and lawfirm wish to establish the amount of benefit due to a claim following an accident
  • When an employer wants to clarify whether an employee is fit for work or wants to consider opportunities for a suitable function.
  • When an employer wants to consider the re-integrations efforts undertaken so far.

In case of dismissal or deployment it is important for a company or employer to be able to show re-integration attempts to the Labor Department.

Function ability evaluation

Is an employee who has been away for prolonged period of time and wants to return to work still able to perform all of his or her original duties?

What to do if an employee wants to return to work after having been away for an extended period of time due to illness and you are wondering if the employee is still able to perform his or her original duties? What if an employee was involved in an accident that has left him or her with permanent physical damage most likely imparing him or her from performing at the same level as before the accident? 

Upon your request your company doctor will examine the employee and evaluate possible permanent impairments or disabilities. This will lead to a list of functional capacities remaining for the employee. In other words, this list will contain the details of what from a medical point of view still be expected from the employee.

Our registered Occupational Health expert will then invite the employee for an interview and based on data from the list mentioned above, it will be determined what possibilities there are for the employee’s professional duties. Evaluation will be perormed as to whether the employee can fully return to the original function with the original duties, or if adaptation to duties or workload need to be made. In collaboration between employer and employee decisions will be made with regards to necessary adaptations and job description.

Outcome of a Function Ability Evaluation will be documented in an extensive report.

Preventive medical examination (PMO/PAGO)

Mapping out the lifestyle of your employees and health risks they are facing. Predicting possible consequences for the health and safety of the workplace and productivity of your working force.

PAGO versus PMO

Until recent years the most common periodical medical check-up an employer would offer his employees was a so called Periodical Occupational Health Examination (PAGO in Dutch) during which a person’s health would be directly related to his or her job or duties.

Nowadays also more general health issues are included; issues that could have an indirect effect on a person’s ability to perform at work and the health and safety in the workplace in general.

This is called a Preventative Medical Examination (PMO in Dutch)

The Preventative Medical Examination

The Preventative Medical Examination focuses on the health-risks that employees within your organization are facing. The examination further maps out their lifestyle and working capacity. This examination includes evaluation of:

  • Occupational health risks
  • Personal health factors
  • Function-suitability.

Interpreting the results

Results of individual examinations are of course confidential, but the overall health status and risks of the entire group of employees participating in the Preventative Medical Examination will be found in the analysis drawn up in a final report. This analysis will help you set up a plan of action to help reduce health and safety risks uncovered by the examinations.

Medwork will help you set up a plan of action and provide you with effective tools to start reducing the health risks to which your employees are exposed, and together with you Medwork will start working on improving their fitness, health and productivity.

Where individual employees receive their personal results and advice, you as an employer will receive the overall results and advice that are organization and work related and will guarantee results. 

Any Preventative Medical Examination program is tailored to the nature of your business, the structure of your organization, your workplace and its’ employees.


When you are in need of expert advice Insurance Medicine is directed to problems relating to permanent invalidity, long-term or permanent disability, and loss of wages. What are the consequences for your company in the event of (permanent) disability? What about the social insurance contributions? Our expert advice and guidance include re-examinations, reintegration trajectory advice, and claim assessments.

Personal Injury

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Function Ability Evaluation

Function Ability Evaluation Still able to perform? Is an employee who has been away for prolonged period of time and wants to return to work still able to perform all of his or her original duties? What to do if an employee wants to return to work after having been away for an extended period of time due to illness and you are wondering if the employee is still able to perform his or her original duties? What if an employee was involved in an accident that has left him or her with permanent phys...

Claim Assessment

Permanent impairment? Evaluation of Permanent Impairment according to the standard of the American Medical Association (AMA). Injury damage assessments, calculations invalidity percentage, compensation assessment. Calculation of damage arising from a work accident or occupational disease Every year work accidents happen in Aruba. Such accidents can result in permanent injury, and in some cases, victims die. In addition, people could die every year as a result of occupational diseases. It goes wi...

Life Insurance and Mortgage Examinations

Making sure risks are covered Examinations performed for insurance companies regarding mortgage, life insurance and/or pension applications. Insurance-related examinations It is often necessary to undergo an insurance-related examination for the purpose of closing a life insurance or disability insurance policy. In the case of insurance-related examinations the examining doctor will evaluate potential risk factors, which are then reported to the relevant insurance company. 

Certified Professionals

Licenced to Examine, Evaluate and Conclude In situations where legal and financial consequences are lurking it is important to have the right experts by your side. Experts that have been trained and licensed by acknowledged Universities and Colleges and that are registered with reputable organizations. Medwork physicians are registered with the Dutch register for Individual Healthcare Professionals (Beroepen in de Individuele Gezondheidszorg) known as B.I.G. Our physicians are licensed in Occupa...

Re-Examination / Herkeuring (VA/AD)

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Capacity Assessment

Capacity Assessment Determining the permanent limitations First step in a re-examination process is the determination of remaining capacities or permanent disability by a licensed Physician in Occupational Health or Insurance Medicine. Getting the advice from an expert It is important to realize that these kind of evaluations can only be performed by a licensed Physician in Occupational Health or Insurance Medicine. How does it work? In preparation for the actual re-examination all necessary dat...