2600 Employee Health Service
2635 (B) Occupational Health Physical Examinations
.110 General Information
.111 Physical examinations and testing are arranged for employees exposed to hazardous waste, arsenic, heavy metals, lead, PCBs, toluene, pesticides, hepatitis, hydrocarbons, asbestos, noise, etc. The range of services includes urine tests, blood tests, audiometry, spirometry, chest x-rays, and complete physical examinations conducted or overseen by an EHS physician.
.112 Location—Occupational health medical examinations are conducted at the EHS medical examination centers and at the offices of EHS consulting physicians in the following cities: Binghamton, Buffalo, Elmira, New York City, Plattsburgh, Poughkeepsie, Rochester, Stony Brook, Syracuse, Utica, Watertown, and White Plains. All agencies will be charged a fee for this service, based on exam type and location.
.411 A request for an occupational health physical examination and/or testing should be made on an EHS-699, Agency Request for Occupational Health Examination and mailed or faxed to EHS by the appropriate agency personnel, health and safety, or employee relations officer. A copy of an EHS-699 can be obtained at www.cs.state.ny.us/ehs. Facsimiles may be sent to (518) 233-3131. A separate request should be submitted for each group for whom occupational health physical examinations are required. The request should contain the following information:
- Name, title, address, telephone number, and fax number of person requesting the evaluation.
- Preferred service location where the agency would like to have the medical evaluation performed.
- Name and telephone number of the agency's contact person responsible for arranging the evaluation.
- Name, address, and telephone number of the individual approving payment of fees associated with the evaluation.
- The employee's agency code.
- Cost center code if the agency wishes this information to appear on the consulting physician's billing statement.
- Completion of the Exposures/Services and Respirator Type sections of the EHS-699, as appropriate.
- Completion of the Special Scheduling Requirements, as needed.
- A list of the names and social security or medical record numbers of each group of employees for whom the medical services are requested should be attached
.421 EHS will notify employees of all significant abnormal results and advise follow-up with their physicians as needed.
.422 EHS will complete an EHS-701.3, Employer Medical Examination Report as Required by OSHA and send it to the agency. This report outlines occupationally related findings.
TM-63; July 2008
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