Guidelines for Pre-Employment Medical Exams

The Order is issued to implement functions of BHFS under Executive Order 102, s. 1999.
The Order is issued in relation to a Memorandum of Agreement among the Department of Health, Department of Labor and Employment, and the Maritime Industry Authority.
The stated objective is to establish, regulate, and upgrade standards of medical services and examination for overseas workers and seafarers.
The Order requires that only occupationally qualified and physically and medically fit workers/seafarers participate in inter-island/overseas employment programs.
The Order mandates updated rules to reflect advances in medical diagnostic procedures.

An Accredited medical facility is a clinic that passed Department of Health accreditation requirements to conduct Pre-Employment Medical Examination (PEME) for land-based overseas workers and seafarers on inter-island and overseas employment.
An Agency is a private recruitment entity, employment agency, or manning agency duly authorized/licensed by the Philippine Overseas Employment Administration and the Department of Labor and Employment to recruit and deploy workers overseas.
BHFS is the Bureau of Health Facilities and Services, a regulatory body under the Department of Health exercising regulatory functions under these rules.
PEME is the complete medical examination conducted as a requirement for screening to determine whether an applicant is physically and mentally fit to work abroad.
Seafarers include:
- Inter-island seafarers who sail/work within the Philippine sea, and
- Overseas seafarers who sail/work outside the country.
A Secondary category laboratory provides specified laboratory examinations, including routine hematology (CBC), routine urinalysis, routine fecalysis, blood typing (hospital based), quantitative platelet determination (hospital based), routine clinical chemistry (including specified analytes), and cross matching (hospital based).
A Shipping company is any Philippine registered shipping company engaged in local and foreign trade.

PEME for land-based overseas workers and seafarers for inter-island and overseas employment must be conducted only by medical facilities duly accredited for the purpose.
The PEME of overseas workers and seafarers must be conducted only after the agency (or its principal/shipping company) has:
- interviewed,
- trade tested, and
- finally decided to accept the applicant for employment.
The acceptance must be stated in a referral slip for pre-employment medical examination, duly accomplished stating the name of the worker, and addressed to the accredited medical facility where the PEME is conducted.
Any violation by the agency must be reported to the Philippine Overseas Employment Administration.

If the employer rejects the applicant or terminates the employment of the worker within three (3) months from the date of examination due to medical reasons, the cost of repatriation must be shouldered by the medical facility.
The medical-rejection/termination cases include major cardiac cases, pulmonary tumor, tuberculosis, bronhiectasis, and other illnesses whose condition could have been detected during the PEME.
When repatriation liability arises, the medical facility must file with the applicant’s agency or company and the DOH an affidavit of undertaking covering the repatriation obligation.
The repatriation cost must be taken from the cash bond posted at the DOH by the accredited facility.
If there is no deployment within ninety (90) days from the date of PEME, the applicant must undergo another PEME to ensure no infections or illnesses prevailing in the land were acquired since the last PEME.

Unless otherwise stated in the PEME referral slip, PEME for land-based overseas workers and seafarers includes:
- complete history taking and physical examination,
- chest x-ray using plates not smaller than 11" x 14",
- complete blood count including hemoglobin determination, hematocrit, WBC, RBC and differential count and platelet determination (qualitative and quantitive),
- blood typing,
- routine urinalysis,
- routine fecalysis,
- dental examination,
- psychometric evaluation, and
- electrocardiograph examination if the applicant is forty years old and above.
Seafarers must undergo all examinations above plus:
- visual acuity and color perception test using the Ishihara Test, and
- hearing and audiometric testing for all seamen regardless of position.
Tests for HIV antibodies or hepatitis B antigen or VDRL must be conducted:
- as required by the country of destination, or
- per the principal’s request.
Medical examinations not included in the PEME scope may be conducted on land-based workers and seafarers upon request by the agency (or its principal/shipping company).

The medical facility must submit PEME results to the referring agency or principal/shipping company within seventy-two (72) hours after completion of the required PEME tests.
If medical findings indicate the need for certain minor ailments to be treated, the clinic must advise the agency/company of the estimated period/time for treatment so the same may be referred to the agency/company for acquiescence.
The medical facility must guarantee the integrity of its examination results.
The clinic must use the prescribed medical rating system to standardize PEME:
- Administrative Order No. 176, s. 2001 for seafarers, and
- Bureau Circular No. 5, s. 1990 for overseas land-based workers.
The medical facility must use the prescribed Medical Examination Record Form.

Psychological screening and evaluation are handled by a full time psychologist registered with BHFS, who takes full responsibility for the work.
The psychological screening includes a battery of psychological tests consisting of:
- Draw a Person Test/or House Tree Person Test,
- Sack Sentence Completion Test,
- Bender Gestalt Motor Visual Test,
- Ravenas Progressive Matrices or Purdue Non-Language Test.
The psychological screening also includes:
- an autobiography, and
- a comprehensive interview.

PEME results for land-based workers are valid up to the end of the contract.
Following International Labor Organization guidelines, PEME results for sea-based workers have a validity period of two years for the PEME Certificate during continuous sea-based service on board.
If a contract is extended based on the decision of the hiring vessel, a medical examination must be conducted in the nearest port health examination center.
All agencies must consider the effectivity of PEME results in cases of transfer to another agency as long as the results remain within the prescribed validity period.
The medical facility must have a Master Logbook, duly registered and stamped by BHFS.

All previous orders that are inconsistent in part or in whole with the Administrative Order are rescinded or amended accordingly.
The Order takes effect immediately.