How is the request for a second opinion arranged?
Only the primary company doctor can and may legally request a second opinion. An employer may request a second opinion. An employee may request a second opinion from their own company doctor. The primary company doctor may not refuse this request, as doing so is punishable by a fine and disciplinary action.
Why do we work with a quotation for the second opinion?
This is an assignment with a responsibility clause and a payment obligation, just like the Working Conditions Act and your work as a company doctor. If you are a self-employed company doctor, I assume that you do this on the basis of an agreement between you and your clients. If you are employed, there is a contract between your employer (health and safety service) and the client in addition to your own employment contract.
Providing a quotation/assignment confirmation is therefore normal practice when providing services.
Flow chart for invoicing second opinion company doctor
1. Second opinion company doctor provides second opinion
The second opinion company doctor provides a second opinion to the employee on behalf of the primary company doctor. The second opinion is initiated at the request of the employee with whom a treatment relationship is ongoing. The second opinion examination is based on the information provided by the employee to the company doctor, as well as on the information obtained by the second opinion company doctor from the occupational health and safety service provider.
2. Second opinion occupational physician invoices occupational health and safety service provider
The second opinion occupational physician invoices the occupational health and safety service provider for the work performed. The invoice is anonymous, so that the employee cannot be traced. It is recommended to state the agreed characteristics and/or cost items of the assignment, the name of the person performing the work and the name of the person requesting it.
3. Occupational health and safety service provider invoices employer
The occupational health and safety service provider invoices the employer for the work performed, including the costs of the second opinion.
Justification based on the Working Conditions Decree, GDPR, New Working Conditions Act and NVAB advice.
The invoice for the second opinion from the company doctor is anonymous, as this is mandatory under Article 2.25, paragraph 2 of the Working Conditions Decree. This article stipulates that the costs of a second opinion are borne by the employer. However, the employer has no right to know who provided the second opinion.
Privacy legislation
The anonymity of the invoice is also in line with privacy legislation. The General Data Protection Regulation (GDPR) stipulates that personal data may only be processed if there is a legitimate basis for doing so. In this case, the legitimate basis is the performance of the employment contract. However, the employer is not entitled to the personal data of the second opinion company doctor.
New Working Conditions Act
The new Working Conditions Act, which came into force in 2023, does not contain any changes with regard to the anonymity of the invoice from the second opinion company doctor.
NVAB
The Dutch Association for Occupational and Company Medicine (NVAB) advises occupational health services to charge the employer for the costs of a second opinion. The NVAB states that the employer is responsible for the reintegration of the employee. A second opinion can contribute to successful reintegration.
Conclusion
The invoice for the second opinion from the company doctor is anonymous, as this is mandatory under the Working Conditions Decree and in line with privacy legislation. The new Working Conditions Act does not contain any changes regarding the anonymity of the invoice. The NVAB advises occupational health and safety services to charge the employer for the costs of a second opinion.
The second opinion company doctor and Vrije Opdrachten will act in accordance with the above flow chart when invoicing. The Client is aware of this and will comply with it.