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Occupational health/29 July 2026/3 min read

What happens in a pre-employment medical.

Hearing, vision, lung function, blood pressure and a physical assessment against the demands of the job. What the employer sees, what stays with you, and how long to allow.

Written for patients of Muswellbrook Doctors, Muswellbrook Fair.

Around Muswellbrook, a pre-employment medical is often the last thing standing between a job offer and a start date, which makes people understandably nervous about it. Most of that nervousness comes from not knowing what is being assessed or what the employer will be told.

What it is for

A pre-employment medical is a job-matching exercise. The question being answered is narrow: can this person perform the inherent requirements of this particular role safely, and is there anything that needs adjusting or monitoring?

That is why the content varies so much. An assessment for a role involving heavy manual work, respirator use and night shift looks very different from one for an office-based role. The employer's own form drives what gets done.

What usually happens on the day

Allow a long appointment. This is not a ten-minute consultation, and rushing it helps nobody.

What your employer actually sees

This is the part people most want to know. The employer receives an opinion about fitness for the role — typically fit, fit with stated adjustments, or not fit for specified duties — along with anything they are legally required to be told.

They do not receive your medical history. Your consultation, your diagnoses and your medicines remain confidential in the ordinary way. If something is found that needs following up for your own health rather than for the job, that comes back to you and to your regular GP.

If you are working in the coal industry

Coal mine workers in New South Wales are covered by a separate scheme run by Coal Services, and it is not the same thing as a general pre-employment medical.

From 1 January 2026, Order 45 replaced Order 43. It moved to a single risk-based assessment model valid for up to three years, made chest imaging to ILO standards a mandatory requirement, and made medical review mandatory where a condition may affect safe work. Existing Order 43 assessments are only recognised if you have not changed employers — an Order 43 does not transfer to a new employer even if it is recent.

These assessments must be carried out by a provider approved under the Coal Services scheme. If your employer has asked for an Order 45 assessment, check with reception first about where to have it done.

How to prepare

What it costs

Pre-employment medicals are not a Medicare service. They attract a fee and are not bulk billed. In many cases the employer pays it directly — check with them first, and tell reception what the arrangement is when you book.

The short version
  • Allow a long appointment. These take considerably longer than a standard consultation.
  • Bring photo ID, glasses or contacts, and a list of your medicines.
  • The employer receives a fitness opinion against the job — not your medical history.
  • Coal industry assessments run under Coal Services Order 45, which replaced Order 43 on 1 January 2026, and must be done by an approved provider.
  • These assessments attract a fee and are not bulk billed. The fee is often paid by the employer.

The report answers one question: can this person do this job safely?

It is not a summary of your health, and your employer does not receive one.
If you need help now
  • In an emergency, or if someone's life is at risk, call 000.
  • Health advice around the clock — healthdirect on 1800 022 222.
  • Outside our hours — Muswellbrook Hospital, 36 Brentwood Street, (02) 6542 2000.

General information only. This article is general health information for anyone who finds it useful. It is not advice about your own situation and it does not replace a consultation with a doctor who knows you. If you are worried about a symptom, book an appointment or call us on (02) 6530 7404. Last reviewed 29 July 2026.

Booking a pre-employment medical?

Tell reception which employer and which form when you book — the assessment and the time needed vary a great deal between them. Bring photo ID, your glasses, and a list of your medicines.

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